Background:Central nervous system involvement is a serious complication of brucellosis with various incidence and various clinical presentations.Patients and Methods:Hospitalized patients in University Clinical Centre, Clinic for Infectious diseases in Prishtina, with laboratory-confirmed brucellosis, were analyzed, a brucellosis-endemic region. Among the 648 confirmed cases with brucellosis during the period 1991- 2013, 82 patients (12.65%) were diagnosed with neurobrucellosis. The clinical manifestations in patients with neurobrucellosis were evaluated and compared with brucellosis patients.Results:The major presentations among the brucellosis patients were headache, fever, sweating, nausea, weight loss and arthralgia, while from CNS predominant complains were: headache, vomiting, tremor, low back pain, hearing loss and visual disturbance. The mean age of 82 neurobrucellosis patients was 31.46 years with age distribution 12-71 years, from them 5 (6.1%), younger than 16 years, with a non-significant predominance of women (53.65%). The most common neurological findings were radiculopathies of legs (41.46%) neck rigidity (46.34%), agitation (25,6%), behavioral disorders (18.3%), disorientation (19.5%) and stroke (1.22%). Cranial nerves were involved in 20 of 82 patients (24.4%). Neurological consequences were evidenced in 5 (6.1%) patients. Three patients leave hospital with consequences of peripheral facial paresis, two with sensorineural hearing loss and one with left hemiparesis. Headache, nausea and vomiting and weight loss are significantly (p<0.001) more frequent complains in neurobrucellosis patients compare to patients with brucellosis. On the other hand, as regard to the physical findings and complications, meningeal signs and splenomegaly are significantly more frequent in neurobrucellosis (p<0.01) whereas the hepatomegaly and lymphadenopathy were more frequent (p<0.01) in brucellosis patients. Different significant correlations were observed among specific complains too.Conclusions:Our findings in regard to the specific associations of physical and clinical features in brucellosis patients in Kosovo, may serve as an indication for neurobrucellosis. In endemic areas for brucellosis patients complaining in radiculopathies, persistent headache, facial palsy, hearing loss or presenting stroke without risk factors, should be considered for screening for neurobrucellosis.

Based on our data, we can confirm an association between PTSD and migraine in a sample of patients from Kosovo.

Background Chemotherapy-induced peripheral neuropathy (CIPN) is most commonly associated with platinum-based drugs, taxanes, and vinca alkaloids. This prospective study from a single center in Kosovo aimed to evaluate CIPN in 120 patients receiving 4–6 cycles of platinum-based and taxane-based chemotherapy. Material/Methods One hundred twenty patients underwent neurological examination and nerve conduction studies (NCS) before chemotherapy, and after 4 to 6 cycles of treatment. Sixty patients were treated with platinum-based chemotherapy, 30 were treated with taxane-based chemotherapy, and 22 patients received a combination of platinum- and taxane-based chemotherapy. The most commonly used platinum-based compounds were oxaliplatin and carboplatin, whereas the most commonly used taxane medications were paclitaxel and docetaxel. Presence of neuropathy was confirmed with neurological examination of electrophysiological criteria applicable for polyneuropathies. Total Neuropathy Score (TNSr) was used to combine clinical and electrophysiological values. Results Around 90% of patients self-reported neuropathic symptoms, and in 60% of them polyneuropathy was present in NCS. All sensory and motor nerves had significantly lower amplitudes ( P <0.01). Platinum-based agents caused more pronounced decrease in ulnar nerve compound motor action potential (CMAP) ( P <0.05); when used solely or in combination with taxanes, they caused significant decrease in tibial nerve CMAP ( P <0.01). TNSr did not reach statistical significance between groups; only clinical muscle strength showed pronounced weakness in the combined protocol ( P <0.05). Conclusions These findings support previous studies and show that CIPN, including sensory and motor symptoms, is commonly associated with chemotherapy. Platinum-based chemotherapy agents were more commonly associated with ulnar and tibial nerve damage in this study population.

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Introduction: Purulent meningitis is a severe infection of the central nervous system caused by different bacteria and very often causes severe complications and high lethality. Since the disease still has unclear pathogenesis and high mortality, researchers and clinicians are focused on the influence of damage of the blood-brain barrier (BBB) and its subsequent impact on the outcome of purulent meningitis. The aim of this study was to investigate the albumin concentration and the albumin coefficient as the best parameters of BBB damage, and their influence on the outcome of patients with purulent meningitis. Material and methods: The study was carried out by examining the hospitalized patients in the Clinic of Infective Diseases in Prishtina, Kosovo. Blood-brain barrier damage is evaluated by analyzing the dynamics of values of proteins, glucose and albumins, as well as by determining the BBB coefficient of damage. Results: The data consistent with BBB damage in patients with purulent meningitis corresponded with disease outcome. Consequently, 56.97% of the patients who developed complications or died had very severe BBB damage. Patients with the mean value of albumin coefficient X = 46.5 ±27.23 g/l were at higher risk of developing complications (relative risk (RR) = 2.63; p < 0.0001) or having a lethal outcome (RR = 5.20; p < 0.0001). Patients with longer duration of pathological mean values of albumin coefficient were at higher risk of developing complications (RR = 3.11; p < 0.0001). Conclusions: Our data suggest that BBB damage in patients with purulent meningitis correspond with disease outcome. The best predictors for outcome were albumin coefficient and albumin concentration in cerebrospinal fluid.