Vomiting and Abdominal Pain in a 5-Year-Old Male.

This case describes small bowel obstruction secondary to a Meckel's Diverticulum in a 5-year-old male patient with a chief complain of abdominal pain and vomiting. We review the pathophysiology, diagnosis, and management of Meckel's Diverticulum. This case report highlights the importance of considering a broad differential diagnosis during a clinical workup.

Arsenic exposure predicts bladder cancer survival in a US population.

PURPOSE: Chronic arsenic exposure at levels found in US drinking water has been associated with bladder cancer. While arsenic is a known carcinogen, recent studies suggest that it is useful as a therapeutic agent for leukemia. This study examined the relationship between arsenic exposure and bladder cancer mortality. METHODS: We studied 832 cases of bladder cancer diagnosed in New Hampshire from a population-based case-control study. Individual exposure to arsenic was determined in home drinking water using ICP-MS and in toenail samples by instrumental neutron activation analysis. RESULTS: Among the high arsenic exposure group, found using toenail arsenic level or arsenic consumption, cases experienced a de-escalated survival hazard ratio (HR) [high (> or =75 percent) versus low (<25th percentile) toenail arsenic overall survival HR 0.5 (95% CI 0.4-0.8)], controlled for tumor stage, grade, gender, age and treatment regimen. This association was found largely among invasive tumors, in smokers and was not modified by TP53 status. Bladder cancer cause-specific survival showed a similar trend, but did not reach statistical significance [HR 0.5 (95% CI 0.3-1.1)]. CONCLUSIONS: Arsenic exposure may be related to the survival of patients with bladder cancer.