Measuring the strength of the horned passalus beetle, Odontotaenius disjunctus: revisiting an old topic with modern technology.

Over a century ago, a pioneering researcher cleverly devised a means to measure how much weight the horned passalus beetle, Odontotaenius disjunctus (Illiger) (Coleoptera: Passalidae), could pull using a series of springs, pulleys, and careful observation. The technology available in modern times now allows for more rigorous data collection on this topic, which could have a number of uses in scientific investigations. In this study, an apparatus was constructed using a dynamometer and a data logger in an effort to ascertain the pulling strength of this species. By allowing beetles to pull for 10 min, each beetle's mean and maximum pulling force (in Newtons) were obtained for analyses, and whether these measures are related was determined. Then, whether factors such as body length, thorax size, horn size, or gender affect either measure of strength was investigated. Basic body measurements, including horn size, of males versus females were compared. The measurements of 38 beetles (20 females, 18 males) showed there was no difference in overall body length between sexes, but females had greater girth (thorax width) than males, which could translate into larger muscle mass. A total of 21 beetles (10 females, 11 males) were tested for pulling strength. The grand mean pulling force was 0.14 N, and the grand mean maximum was 0.78 N. Despite the fact that beetles tended to pull at 20% of their maximum capacity most of the time, and that maximum force was over 5 times larger than the mean force, the 2 measures were highly correlated, suggesting they may be interchangeable for research purposes. Females had twice the pulling strength (both maximum and mean force) as males in this species overall, but when the larger thorax size of females was considered, the effect of gender was not significant. Beetle length was not a significant predictor of pulling force, but horn size was associated with maximum force. The best predictor of both measures of strength appeared to be thorax size. There are a multitude of interesting scientific questions that could be addressed using data on beetle pulling strength, and this project serves as a starting point for such work.

Metastatic Melanoma Invading the Minor Duodenal Papilla in a Patient With Pancreas Divisum Causing Acute Recurrent Pancreatitis: A Case Report.

Metastasis to the gastrointestinal (GI) tract should always be a consideration when melanoma, particularly metastatic disease, is diagnosed. While metastasis to the small intestine is common, given its rich blood supply, metastasis to the pancreatic ducts is extremely rare. In patients with pancreatic divisum, disease spread to the minor papilla can greatly increase the chance of developing pancreatitis due to the potential for increased pancreatic intraductal pressure. We present one unique case of metastatic melanoma to the minor duodenal papilla causing pancreatitis.

Unusual Instance of Primary Diffuse Large B-cell Lymphoma of the Colon.

Diffuse large B-cell lymphoma (DLBCL) commonly affects the gastrointestinal (GI) tract, although primary DLBCL rarely occurs in the colon. Primary colorectal lymphoma is a surprisingly rare diagnosis, accounting for a minute percentage of GI lymphomas and colorectal malignancies. We present an interesting case of an immunocompromised young adult female who was diagnosed with DLBCL confined to a cecum polyp after she underwent a colonoscopy for a GI bleed. The lymphoma presented endoscopically as a semi-sessile polyp in the cecum that was successfully removed. The patient was treated with appropriate therapy of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).

Massive Lower Gastrointestinal Hemorrhage as a Complication of Severe Campylobacter Enteritis.

Campylobacter enteritis is typically caused by Campylobacter jejuni or Campylobacter coli and is a major cause of diarrheal illness worldwide. Patients with Campylobacter gastroenteritis can be asymptomatic, but commonly present with a wide range of clinical symptoms including abdominal pain, diarrhea, vomiting, and occasionally self-resolving hematochezia. Although hematochezia can occur, acute massive lower gastrointestinal (GI) bleeding is a rare complication of Campylobacter gastroenteritis and should be considered as a possible differential diagnosis in the presentation of lower GI bleeds. We describe a unique case of a 48-year-old male who presented with massive lower GI bleeding requiring multiple transfusions and admission to the medical intensive unit; the patient was ultimately diagnosed with severe Campylobacter gastroenteritis.

Kaolin Clay Anemia.

Iron deficiency anemia is a common diagnosis encountered in the nutrition, primary care, and gastroenterology fields. Iron deficiency anemia most often leads to evaluation for various malabsorption disorders and colonoscopy to exclude colon cancer as an etiology. We present a case of iron deficiency anemia that was caused by geophagia. After the culprit dietary habit was stopped, the patient's iron deficiency anemia subsequently resolved.

A Prolonged Neurological Presentation of Legionnaire's Disease.

Legionnaire's disease is an uncommon pneumonic disease that can carry a mortality rate up to 20%. It commonly presents as an atypical lower respiratory illness. However, it is important to be mindful of the various extra-pulmonic presentations of the infection. Here, we present a case of a 51-year-old female who presented to the emergency department with lethargy, slurred speech, and confusion. Legionella has been reported to present with neurological symptoms but it is not a common occurrence in each hospitalization. These neurological symptoms often lead to an extensive workup and the complexity of the diagnostic workup can significantly influence patient outcome. However, it is crucial that physicians follow a systemic approach to establish a diagnosis in an expedited manner. This case emphasizes the importance of key objective evidence of legionella that can help guide a physician's diagnostic approach.

Purulent pericarditis, an unusual cause of cardiac arrest.

Purulent pericarditis is a rare infection of the pericardial space defined by the presence of gross pus or microscopic purulence. Here, we present a case of Streptococcus anginosus purulent pericarditis, leading to obstructive and septic shock. After prompt pericardial drainage, the patient experienced rapid improvement in symptoms. However, due to the presence of a loculated effusion and concern for development of constrictive pericarditis, a pericardial window was performed. Although purulent pericarditis is often fatal, this case illustrates the reduced morbidity following prompt recognition and drainage.

Upper Gastrointestinal Disorders in Adult Patients with Intellectual and Developmental Disabilities.

The purpose of this literature review is to address the diagnosis and treatment of upper gastrointestinal (GI) disorders in patients with intellectual and developmental disabilities (IDD). Manifestations of upper GI dysmotility and disorders include dysphagia, pulmonary aspiration, malnutrition, gastroesophageal reflux, and gastritis, all of which can impact a person's quality of life and lead to chronic, life-threatening conditions. This article will explore the existing diagnostic methods and treatments for gastrointestinal disorders as they relate to patients with IDD.

A Primary Care Approach to Constipation in Adults with Intellectual and Developmental Disabilities.

Constipation is a condition that is very prevalent and is reported in up to 40 percent of individuals with intellectual and developmental disabilities (IDD). Constipation in this patient population is most commonly secondary to neuromuscular abnormalities, immobility, suboptimal diet, and medication side effects. History taking is frequently limited in adults with IDD due to communication barriers, often leading to a missed diagnosis of constipation. Inadequately treated constipation may lead to adverse effects including behavioral disturbances, fecal impaction, intestinal obstruction, and even death from intestinal perforation and sepsis. As a result, a high index of suspicion must exist for this patient population. Treatment in these patients requires an individualized approach, to reduce the constipation and its associated health complications.