Vertebral osteomyelitis caused by Campylobacter jejuni in an immunocompetent patient

BACKGROUND: Campylobacter jejuni is the leading cause of human bacterial gastroenteritis worldwide. However, systemic infection with C. jejuni is uncommon, and osteomyelitis caused by C. jejuni is extremely rare. Cultivation from spinal bone biopsies has not previously been reported in the literature.CASE PRESENTATION: A 79-year-old immunocompetent male was admitted to the emergency department at Aalborg University Hospital in Denmark with lower back pain, fever and diarrhoea. A FecalSwab obtained upon admission was PCR-positive for Campylobacter spp, while an aerobic blood culture bottle was positive for C. jejuni (Time to detection: 70.4 h). A MRI of columna totalis showed osteomyelitis at L1/L2 with an epidural abscess from L1 to L2 with compression of the dura sack. The patient underwent spinal surgery with spondylodesis and decompression of L1/L2. The surgery was uncomplicated and the discus material was also culture positive for C. jejuni. The patient was treated with meropenem for a total duration of four weeks, followed by four weeks of oral treatment with clindamycin in tapered dosage. The patient recovered quickly following surgery and targeted antibiotic treatment with decreasing lumbar pain and biochemical response and was fully recovered at follow-up three months after end of treatment.CONCLUSIONS: While C. jejuni osteomyelitis is rare, it should still be suspected as a possible causative bacterial aetiology in patients with vertebral osteomyelitis, in particular when symptoms of diarrhoea is involved in the clinical presentation. Susceptibility testing is crucial due to emerging resistance, and targeted treatment strategies should rely upon such tests.</p

Evaluation of a phosphate kinetics model in hemodialysis therapy-Assessment of the temporal robustness of model predictions

In-depth understanding of intra- and postdialytic phosphate kinetics is important to adjust treatment regimens in hemodialysis. We aimed to modify and validate a three-compartment phosphate kinetic model to individual patient data and assess the temporal robustness. Intradialytic phosphate samples were collected from the plasma and dialysate of 12 patients during two treatments (HD1 and HD2). 2-h postdialytic plasma samples were collected in four of the patients. First, the model was fitted to HD1 samples from each patient to estimate the mass transfer coefficients. Second, the best fitted model in each patient case was validated on HD2 samples. The best model fits were determined from the coefficient of determination (R2 ) values. When fitted to intradialytic samples only, the median (interquartile range) R2 values were 0.985 (0.959-0.997) and 0.992 (0.984-0.994) for HD1 and HD2, respectively. When fitted to both intra- and postdialytic samples, the results were 0.882 (0.838-0.929) and 0.963 (0.951-0.976) for HD1 and HD2, respectively. Eight patients demonstrated a higher R2 value for HD2 than for HD1. The model seems promising to predict individual plasma phosphate in hemodialysis patients. The results also show good temporal robustness of the model. Further modifications and validation on a larger sample are needed.</p

Transmission loss patterns from acoustic harassment and deterrent devices do not always follow geometrical spreading predictions

Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of John Wiley & Sons for personal use, not for redistribution. The definitive version was published in Marine Mammal Science 25 (2009): 53-67, doi:10.1111/j.1748-7692.2008.00243.x.Acoustic harassment and deterrent devices have become increasingly popular mitigation tools for negotiating the impacts of marine mammals on fisheries. The rationale for their variable effectiveness remains unexplained but high variability in the surrounding acoustic field may be relevant. In the present study, the sound fields of one acoustic harassment device and three acoustic deterrent devices were measured at three study sites along the Scandinavian coast. Superimposed onto an overall trend of decreasing sound exposure levels with increasing range were large local variations in sound level for all sources in each of the environments. This variability was likely caused by source directionality, inter-ping source level variation and multi-path interference. Rapid and unpredictable variations in the sound level as a function of range deviated from expectations derived from spherical and cylindrical spreading models and conflicted with the classic concept of concentric zones of increasing disturbance with decreasing range. Under such conditions, animals may encounter difficulties when trying to determine the direction to and location of a sound source, which may complicate or jeopardize avoidance responses.The project was funded by the Swedish Fishermen Association, the Swedish Board of Fisheries, Aage V. Jensen Foundations, Danish Forest and Nature Agency, The Nordic Research Council and the Carlsberg Foundation. Additional logistical support was furnished by the Oticon Foundation and Reson A/S. A.D. Shapiro received financial support from the National Defense Science and Engineering Graduate Fellowship and the WHOI Academic Programs Office. 35