A union of two rare pathologies: small bowel diverticula perforation secondary to impacted gallstone ileus.

An 84-year-old lady presented with 1 day history of sudden onset generalized abdominal pain, fevers, and peritonism. Computed tomography was suggestive of a mid-small bowel perforation associated with a distal ovoid soft tissue density structure without pneumobilia. An urgent laparotomy demonstrated two areas of jejunal diverticula necrosis and perforation associated with a 3 cm luminal mass in the proximal ileum, and proximal small bowel dilatation.

Ontogeny of energy use in harvester ant colonies, and the metabolic expense of colony growth.

In animals, metabolic rates during ontogeny often scale differently from the way they do in cross-species or population comparisons, with near-isometric scaling patterns more often observed during juvenile growth. In multiple social insect taxa, colony metabolic rate scales hypometrically across species or populations at the same developmental stage, but metabolic patterns during ontogeny have not been examined for any social insect species. We performed the first ontogenetic study of social metabolic scaling in harvester ant colonies () over 3.

Benign Bone Tumors of the Hand: Beyond Enchondromas.

Beyond enchondromas, the most common bone tumors of the hand, there are numerous less common benign bone tumors and mimickers with which orthopaedic and hand surgeons should be familiar. These include other benign cartilage tumors, cystic lesions, osteogenic tumors, giant cell tumor, and fibrous dysplasia. Particularly unique lesions include bizarre parosteal osteochondromatous proliferation (Nora lesion), florid reactive periostitis, turret exostosis (acquired osteochondroma), giant cell reparative granuloma (solid aneurysmal bone cyst), and epidermoid cyst.

Breast Cancer Susceptibility Gene Sequence Variations and Development of Contralateral Breast Cancer.

Importance: Heterogeneity in development of estrogen receptor (ER)-specific first primary breast cancer exists due to deleterious germline variants in moderate- to high-penetrance breast cancer susceptibility genes, but it is unknown if these associations occur in ER-specific CBC.

Objective: To determine the association of deleterious germline variants in breast cancer susceptibility genes with ER-specific CBC development and whether ER status of the first primary breast cancer modifies these associations.

Design, Setting, And Participants: This case-control study included CBC cases and matched unilateral breast cancer controls from The Women's Environment, Cancer, and Radiation Epidemiology (WECARE) Study, a population-based case-control study.

Malaria elimination challenges in countries approaching the last mile: a discussion among regional stakeholders.

Background: The national malaria control programmes in Cambodia, Nepal, and Bhutan aim to achieve malaria elimination by 2025-2030. While the vivax malaria burden remains challenging, the consistent decline in falciparum malaria in these countries over the last five years suggests that the goal is achievable. However, unexpected cases in previously falciparum malaria-free districts continue to occur.