The aluminum beverage tab and a soldier with chronic abdominal pain.

Since its introduction in the 1960s, the aluminum pull-tab has been an uncommon cause of aspiration and intestinal obstruction. In many cases, the inability to visualize aluminum on imaging studies delayed diagnosis and therapy or missed the foreign body altogether. Early reports of injury secondary to pull-tab ingestion or aspiration spurred the beverage industry to re-engineer the pop-tab in the 1980s. The new design meant to reduce injury by keeping the tab attached permanently to the can. Despite this innovation, the aluminum pop-tab continues to be a cause of injury. Here, we describe the inadvertent ingestion of an aluminum pop-tab by a 22-year-old patient that resulted in chronic intermittent abdominal distress due to recurrent bowel obstruction for 4 years. This case is unique in the length of delayed diagnosis and demonstrates the elusive nature of an aluminum foreign body.

Evaluation of Virulence Gene Expression Patterns in Acinetobacter baumannii Using Quantitative Real-Time Polymerase Chain Reaction Array.

According to the Centers for Disease Control's recently devised National Strategy for Combating Antibiotic-Resistant Bacteria, Acinetobacter baumannii is a "serious" threat level pathogen. A. baumannii's notoriety stems from the fact that a large number of modern strains are multidrug resistant and persist in the hospital setting, thus causing numerous deaths per year. It is imperative that research focus on a more fundamental understanding of the factors responsible for the success of A. baumannii. Toward this end, our group investigated virulence gene expression patterns in a recently characterized wound isolate, AB5075, using quantitative real-time polymerase chain reaction array. Notably, several genes showed statistically significant upregulation at 37°C compared to 25°C; MviM, Wbbj, CarO, and certain genes of the Bas, Bar, and Csu operons. Additionally, we found that in vitro biofilm formation by Csu transposon insertion mutant strains is attenuated. These findings validate previous reports that suggest a link between the Csu operon and biofilm formation. More importantly, our results demonstrate a successful method for evaluating the significance of previously identified virulence factors in a modern and clinically relevant strain of A. baumannii, thereby providing a path toward a more fundamental understanding of the pathogenicity of A. baumannii.