Acinetobacter baumannii Early-Onset Sepsis After Home Delivery Into Toilet Water.

Early-onset sepsis (EOS) is an important cause of morbidity and mortality in newborns, usually caused by pathogens acquired intrapartum. We present the case of a term neonate born by home delivery in the toilet, after an unsupervised pregnancy. He developed a culture-proven early-onset sepsis caused by Acinetobacter baumannii. This was the first case of neonatal sepsis by this pathogen in our unit. The microorganism was susceptible to all antibiotics tested. The neonate was treated empirically with ampicillin and cefotaxime and completed 21 days of directed therapy with meropenem, as meningitis could not be excluded. During the clinical course, the newborn developed severe and persistent thrombocytopenia and neutropenia. In this report, we discuss the etiology behind this clinical presentation. We intend to raise awareness for the consideration of Acinetobacter baumannii as a potential pathogen in EOS, particularly in the presence of adverse birth circumstances.

Evaluation of the efficacy of deep brain stimulation / Evaluación de la eficacia de la estimulación cerebral profunda en el tratamiento quirúrgico de distonía cervical

OBJECTIVE: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a promising therapeutic option for patients with medically refractory dystonia. We present the results after 1 year of DBS of the GPi in 4 patients with cervical dystonia. MATERIALS AND METHODS: Four patients with medically refractory cervical dystonia who underwent stereotactic pallidal DBS surgery between June 2010 and November 2011 were included in this retrospective study. Preoperative and postoperative evaluations at 3, 6 and 12 months after surgery were performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). RESULTS: The 4 patients experienced a sustained improvement, with a mean TWSTRS reduction of 74.25%, at 12 months follow-up. Disability improved by 80.5% (mean) at 1 year follow-up. No stimulation-related side effects were reported. CONCLUSION: Pallidal DBS is a valid and effective second-line treatment for patients with cervical focal dystonia. Our results support its use in patients with an insufficient response to medical treatment

OBJETIVO: La estimulación cerebral profunda (ECP) del globo pálido interno (GPi) es una terapéutica eficaz para pacientes con distonía refractaria al tratamiento médico. Presentamos 4 pacientes con distonía cervical refractaria operados con ECP utilizando como diana el GPi y los resultados un año después de la cirugía. MATERIAL Y MÉTODOS: Fueron incluidos en este estudio retrospectivo 4 pacientes con distonía cervical refractaria al tratamiento médico que fueron sometidos a cirugía estereotáctica para ECP del GPi entre junio 2010 y noviembre 2011. Fueron realizadas evaluaciones pre y postoperatorias a los 3, 6 y 12 meses utilizando la escala Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). RESULTADOS: En los 4 pacientes se verificó un beneficio sustentado con una reducción media del 74,25% en las TWSTRS a los 12 meses de seguimiento. Un año después de la cirugía se obtuvo una mejoría media en la discapacidad del 80,5%. En ninguno de los pacientes de encontraron efectos secundarios relacionados con el procedimiento. CONCLUSIONES: ECP del GPi es un tratamiento quirúrgico válido y eficaz para la distonía cervical focal. Nuestros resultados apoyan su uso en aquellos pacientes con respuesta insuficiente al tratamiento médico

Evaluation of the efficacy of deep brain stimulation in the surgical treatment of cervical dystonia.

OBJECTIVE: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a promising therapeutic option for patients with medically refractory dystonia. We present the results after 1 year of DBS of the GPi in 4 patients with cervical dystonia. MATERIALS AND METHODS: Four patients with medically refractory cervical dystonia who underwent stereotactic pallidal DBS surgery between June 2010 and November 2011 were included in this retrospective study. Preoperative and postoperative evaluations at 3, 6 and 12 months after surgery were performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). RESULTS: The 4 patients experienced a sustained improvement, with a mean TWSTRS reduction of 74.25%, at 12 months follow-up. Disability improved by 80.5% (mean) at 1 year follow-up. No stimulation-related side effects were reported. CONCLUSION: Pallidal DBS is a valid and effective second-line treatment for patients with cervical focal dystonia. Our results support its use in patients with an insufficient response to medical treatment.