Collagenous Colitis and Spondylarthropathy

Collagenous colitis is a recent cause of chronic diarrhea. Cooccurrence with spondylarthropathy is rare. We describe two cases: one man and one woman of 33 and 20 years old were suffering from spondylarthropathy. They then developed collagenous colitis, 4 and 14 years after the onset of spondylarthropathy. The diagnosis was based on histological features. A sicca syndrome and vitiligo were observed with the female case. The presence of colitis leads to therapeutic problems. This association suggests a systemic kind of rheumatic disease of collagenous colitis

UTILISATION D’INDICES POUR L’EVALUATION DE LA QUALITE DES SEDIMENTS : CAS DU BASSIN BOUMERZOUG (ALGERIE)

The objectives of this study are to use different indexes to assess the current pollution status in Boumerzoug basin. Indexes used in this study were Geo-accumulation Index (Igeo), Contamination Factor (CF), Contamination Degree (CD) and Sediment Pollution Index (SPI). Before, sediment trace metal concentrations (cadmium, chromium, copper, lead, nickel, zinc) have been investigated on surface sediments from permanent wadis of Boumerzoug basin in different seasons (winter, spring, summer and autumn). Trace metal concentrations followed the order: Zn>Pb>Cr>Cu>Ni>Cd. Indexes used give several status of sediment quality. Igeo, CF, CD and SPI reveal a polymetallic contamination dominated by two or more elements in which Cd, Cu and Pb are of greatest concern. Igeo gives more precision than CF, because it is classified into six classes. SPI has an advantage over the earlier indexes and viewed as a simple summary of the state of the sediment. However, the trace metal assessment indices are not to be used as the only indicator for sediment quality. More detailed analysis such as biological testing and analysis of existing benthic community related to sediment contamination should be performed for a better understanding about the nature, the fate and the toxic effects of contaminants in this ecosystem

Inocuité et efficacité de l’étanercept lors d’une polyarthrite rhumatoïde compliquée d’insuffisance rénale terminale à propos d’un cas

L’expérience clinique concernant l’utilisation de l’étanercept dans le traitement de la polyarthrite rhumatoïde chez des patients avec insuffisance rénale chronique terminale est limitée. Nous rapportons le cas d’une patiente âgée de 58 ans insuffisante rénale chronique au stade terminal qui avait reçu l’étanercept à la dose de 50 mg par semaine pour contrôler l’activité de sa polyarthrite rhumatoïde. Ce traitement avait permis de contrôler l’activité de la maladie. Aucun effet indésirable ni complication infectieuse grave n’avaient été notés. Le recul était de 18 mois

Dorsal costo-vertebral joint as a rare localization of Staphylococcus aureus sepsis

Background: Septic arthritis of the costovertebral thoracic joint is a rare site infection. We report an isolated case of septic arthritis of the 10th costo-vertebral right joint with osteitis due to Staphylococcus aureus. Case presentation: A 59 year old Tunisian man presented with a 2 months history of dorsal spinal pain with fever, associated with asthenia, anorexia and loss of weight. There was a raised C-reactive protein (176 mg/L) and erythrocyte sedimentation rate (100 mm/1st h). Tests for tuberculosis and brucellosis were negative. In the present patient, the clinical symptoms were unspecific with lack of obvious predisposing factors. He had neither history of taking immunosuppressors nor of any disease indicative of immunodeficiency. Thoraco-abdominal computed tomography (CT) showed a lytic lesion centered on the 10th costo-vertebral right joint and histo-pathologic exam of the costo-vertebral puncture confirmed chronic active osteitis and bacteriologic culture allowed identifying methicillin-sensitive Staphylococcus aureus. The patient was treated with ciprofloxacin 1500 mg/day, associated with daily rifampin (20 mg/kg) for total treatment duration of 12 weeks after consulting infectious disease specialists. After a follow-up of 6 months, the patient remained asymptomatic and the markers of inflammation negative. Conclusion: Septic arthritis of costovertebral joints should be considered when a patient presents with back pain, fever and elevated inflammatory markers. The diagnosis of septic arthritis of costovertebral joints remain a challenge to clinicians. CT is important to confirm a diagnosis and guide costovertebral biopsy and culture. Early and appropriate antibiotic therapy is important for a required outcome. Keywords: Costo-vertebral joint, Staphylococcus aureus, Septic arthritis, Dorsal spine, Computerized tomograph

The epidemiology of tuberculous dactylitis: A case report and review of literature

The literature on tuberculous dactylitis is poor, and most literature consists of isolated case reports. The aim of this case series is to study the particularities and the epidemiological aspects of tuberculous dactylitis in Tunisian patients. Google and Medline search was done using key words “tuberculous dactylitis” and “spina ventosa.” Only Tunisian reports in adult patients were included. Eleven cases including this mentioned case were included in this review. There was a female predominance, high frequency of trauma before disease installation, rarity of predisposing factors, and less inflammation in blood tests when comparing with other cases in literature

Analysis of referral letters to rheumatology consultation in Tunisia

Aim of the work: Our objective was to analyze the content and quality of referral letters to rheumatology consultation. Patients and methods: This is a cross-sectional study conducted on the rheumatology consultations in a tertiary hospital over six months (April-October 2014). Patients were interviewed and their rheumatology consultation referral letters analyzed. The relevance of referent reasons, suggested diagnosis and additional tests requested prior to recruitment were studied. Results: We studied 302 referral letters for rheumatology consultation. The average age of patients was 55.34 ± 15 years (13–85). The sex ratio M/F was 0.3. All patients consulted for painful symptoms affecting mainly the lumbar spine (20%) and knees (20%). The current clinical problem was appropriately presented in 43% of the referral letters. Only 6 letters (2%) were illegible, 28 letters did not contain the consultation date (9%). General practitioners represented 59% of referring physicians. The age and patient history were more detailed in the letters written by physician specialists (p = 0.002 and p < 0.001 respectively). The complementary investigations were more requested by private sector physicians (p = 0.04) and physician specialists (p = 0.011). Of the 76 doctors who had proposed a diagnosis, 42 (55%) had proposed a correct one. The relevance of diagnoses showed no significant difference between GPs and specialists. Conclusion: Referral letters deserve more attention in order to improve communication between physicians and rheumatologists. Analysis of the quality of referral letters can be part of initial and continuing medical education. The referral letters have several shortcomings. A model referral letter has been proposed in this study

Inventory of land snails from the Kebir Rhumel basin, northeast of Algeria

This study constitutes a first attempt at a qualitative and quantitative inventory of land snails from the Kebir-Rhumel basin, in the northeast of Algeria. Sampling was carried out by hand from February to March in 2018 and 2019. Live snails and shells were collected from 30 stations along wadi banks. Identification followed the most recent specialized taxonomic literature and revisions. A total of 6531 specimens were collected, representing 25 species: Tudorella sulcata (Draparnaud, 1805), Rumina decollata (Linnaeus, 1758), Rumina saharica (Pallary, 1901), Ferussacia carnea (Risso, 1826), Ferussacia folliculum (Schröter, 1784), Mauronapaeus terverii (Dupotet in E. A. Forbes, 1838), Mastus pupa (Linnaeus, 1758), Cantareus cf. koraegaelius (Bourguignat in Locard, 1882), Cornu aspersum (O. F. Müller, 1774), Cornu sp., Eobania constantina (E. Forbes, 1838), Eobania vermiculata (O. F. Müller, 1774), Helix melanostoma (Draparnaud, 1801), Massylaea massylaea (Morelet, 1851), Cernuella cf. virgata (da Costa, 1778), Cochlicella acuta (O. F. Müller, 1774), Cochlicella barbara (Linnaeus, 1758), Trochoidea pyramidata (Draparnaud, 1805), Xerosecta cespitum (Draparnaud, 1801), Xerosecta sp., Ganula flava (Terver, 1839), Sphincterochila candidissima (Draparnaud, 1801), Sphincterochila otthiana (E. Forbes, 1838), Sphincterochila sp. and Caracollina lenticula (Michaud, 1831). Typical specimens are illustrated and described with a detailed report of their distribution along basin’s wadis

Inocuité et efficacité de l’étanercept lors d’une polyarthrite rhumatoïde compliquée d’insuffisance rénale terminale à propos d’un cas

L’expérience clinique concernant l’utilisation de l’étanercept dans le traitement de la polyarthrite rhumatoïde chez des patients avec insuffisance rénale chronique terminale est limitée. Nous rapportons le cas d’une patiente âgée de 58 ans insuffisante rénale chronique au stade terminal qui avait reçu l’étanercept à la dose de 50 mg par semaine pour contrôler l’activité de sa polyarthrite rhumatoïde. Ce traitement avait permis de contrôler l’activité de la maladie. Aucun effet indésirable ni complication infectieuse grave n’avaient été notés. Le recul était de 18 mois