Archive for 2014

The great mimicker

Sunday, November 2, 2014 § 3

Burkholderia pseudomallei
Now, in a paper published in the Proceedings of the National Academies of Science, researchers from the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Programme in Bangkok, Thailand, and the University of Cambridge, in collaboration with Colorado State University and Genome Institute of Singapore, have identified how the bacteria develop this resistance.

By comparing the genetic make-up of isolates taken from six patients that had become resistant to ceftazidime against their original infecting ceftazidime-susceptible strain, the researchers found a common, large-scale genomic loss involving at least 49 genes that is thought to arise spontaneously as the bacteria replicate and mutate. The researchers were able to demonstrate that a specific gene within this region was the cause of the drug resistance. This gene provides the genetic ‘code’ to create a protein that is important to bacterial cell division and that is normally the target for ceftazidime.

The researchers , who were funded by the Wellcome Trust, also found that these mutated forms of B. pseudomallei would not grow in common laboratory cultures, including bottles that are normally used to culture blood from people with bacterial infections, as well as the routine culture media used in the diagnostic laboratory. This makes the detection of the drug-resistant forms very difficult. Consequently, patients carrying this strain could continue to be treated with drugs that have become ineffective.

An ankle injury in a middle-aged woman #CS1

Thursday, October 16, 2014 § 0


  • Data
  • Translation
A 44-year-old woman who worked as an emergency medical technician (EMT) presented to the ED with ankle pain after she twisted her ankle stepping out of the back of an ambulance. Her ankle radiographs are shown in Figure 1.
 • Is this a single malleolar fracture, a bimalleolar fracture, or a trimalleolar fracture?
 • In which way did the patient twist her ankle to cause this injury?

Một phụ nữ 44 tuổi là kỹ thuật viên cấp cứu y khoa nhập cấp cứu vì đau cổ chân sau khi cổ chân của cô bị vặn xoắn khi đang bước xuống từ phía sau xe cứu thương. Trên hình 1 là XQ được chụp sau đó.
 • Đây là một trường hợp gãy một mắt cá, hai mắt cá, hay 3 mắt cá?
 • Cơ chế chấn thương trong trường hợp này?