Isolated tuberculous arthritis of the dorsal facet joint

AbstractIntroductionSeptic arthritis of the facet joint is a severe infection. The lumbar spine is frequently involved; the dorsal one is rarely affected.Case reportWe present a case of a patient with a history of right cervicobrachial neuralgia with anorexia and asthenia without fever. Performed investigations had concluded to tuberculous arthritis of the dorsal facet joint. The tuberculous etiology is an originality of our observation since it has been reported in only one case. In the absence of histological and bacteriological proof, the diagnosis was established according to clinical, epidemiological and biological data. Treatment was based on antitubercular antibiotics.ConclusionThe tuberculous origin of septic facet joint should be considered in front of trolling and unexplained back pain, especially in endemic countries

Population Structure of Pseudomonas aeruginosa from Five Mediterranean Countries: Evidence for Frequent Recombination and Epidemic Occurrence of CC235

Several studies in recent years have provided evidence that Pseudomonas aeruginosa has a non-clonal population structure punctuated by highly successful epidemic clones or clonal complexes. The role of recombination in the diversification of P. aeruginosa clones has been suggested, but not yet demonstrated using multi-locus sequence typing (MLST). Isolates of P. aeruginosa from five Mediterranean countries (n = 141) were subjected to pulsed-field gel electrophoresis (PFGE), serotyping and PCR targeting the virulence genes exoS and exoU. The occurrence of multi-resistance (≥3 antipseudomonal drugs) was analyzed with disk diffusion according to EUCAST. MLST was performed on a subset of strains (n = 110) most of them had a distinct PFGE variant. MLST data were analyzed with Bionumerics 6.0, using minimal spanning tree (MST) as well as eBURST. Measurement of clonality was assessed by the standardized index of association (IAS). Evidence of recombination was estimated by ClonalFrame as well as SplitsTree4.0. The MST analysis connected 70 sequence types, among which ST235 was by far the most common. ST235 was very frequently associated with the O11 serotype, and frequently displayed multi-resistance and the virulence genotype exoS−/exoU+. ClonalFrame linked several groups previously identified by eBURST and MST, and provided insight to the evolutionary events occurring in the population; the recombination/mutation ratio was found to be 8.4. A Neighbor-Net analysis based on the concatenated sequences revealed a complex network, providing evidence of frequent recombination. The index of association when all the strains were considered indicated a freely recombining population. P. aeruginosa isolates from the Mediterranean countries display an epidemic population structure, particularly dominated by ST235-O11, which has earlier also been coupled to the spread of ß-lactamases in many countries

Recursive wind speed forecasting based on Hammerstein Auto-Regressive model

A new Wind Speed Forecasting (WSF) model, suitable for a short term 1-24. h forecast horizon, is developed by adapting Hammerstein model to an Autoregressive approach. The model is applied to real data collected for a period of three years (2004-2006) from two different sites. The performance of HAR model is evaluated by comparing its prediction with the classical Autoregressive Integrated Moving Average (ARIMA) model and a multi-layer perceptron Artificial Neural Network (ANN). Results show that the HAR model outperforms both the ARIMA model and ANN model in terms of root mean square error (RMSE), mean absolute error (MAE), and Mean Absolute Percentage Error (MAPE). When compared to the conventional models, the new HAR model can better capture various wind speed characteristics, including asymmetric (non-gaussian) wind speed distribution, non-stationary time series profile, and the chaotic dynamics. The new model is beneficial for various applications in the renewable energy area, particularly for power scheduling

Diagnostic challenge in a Tunisian patient with Familial Mediterranean Fever, sacroiliitis and coxitis

AbstractIntroductionFamilial Mediterranean Fever (FMF) is a hereditary auto inflammatory disease. The most common joint attack is an acute large joint monoarthritis most often affecting the knee or hip and lasting for several days. Rarely, a more protracted arthritis may occur.Case reportHerein, we describe a 47-year-old man with FMF in whom a few years elapsed before a definitive diagnosis could be made. The patient presented, since the age of 25, with a history of recurrent episodes of fever, abdominal pain, bloody diarrhea and intermittent attacks of acute bi-arthritis of hips. At the age of 40, he was referred under the suspicion of Spondylarthritis (SpA); in view of an inflammatory back pain, talalgia and bilateral coxitis. The result of blood tests suggested the presence of a high level of inflammation without leukocytosis. Human leukocyte antigen (HLA-B27) was negative. X-ray and computerized tomography of the pelvis showed an overall bilateral joint space narrowing of the hips and grade 3 bilateral sacroiliitis. During the hospitalization, he developed an acute episode of fever, abdominal pain and muscle contracture, spontaneously resolved in 12h. We suspected FMF based on the clinical course and family history, as one of his brothers had suffered similar abdominal crises since childhood. Molecular analysis for FMF was done, and demonstrated a homozygote mutation of M649V. A definitive diagnosis of FMF was then made. Oral administration of colchicine was followed by a remission.ConclusionClinicians should consider FMF with sacroiliitis and coxitis in the differential diagnosis of spondyloarthritis