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M. Dakkak [1] J.A. Kastelik [2] G.K. Buckton [1] C.M. Smith [1] A.H. Morice [2] (1.) Dept of Gastroenterology, Hull Royal Infirmary; (2.) Academic Dept of Medicine, University of Hull, [...]

Dept of Gastroenterology, Hull Royal Infirmary, Hull, UK In the East Yorkshire area, the Swallowing clinic is run as a Speciality referral clinic, with referrals from both General Practitioners and [...]

Forty one Shami cows available in Dier-Al-Hajar Station, having 1-5 lactations were used to monitor ovarian activity postpartum (pp), determine the times of the 1st ovulation and estrus, the diameters of dominant follicles and length of ovarian cycle till day 65 pp. Transrectal Ultrasound Echo System (7.5 MHz probe) was used to monitor the daily development and regression of ovarian follicles during the study. Results indicated that the frequency of the first ovulation pp was 19.5, 36.6, 24.4 and 7.3% for cows ovulating the 1st, 2nd, 3rd and 4th dominant follicles, respectively, and there is no ovulation in 12.2% during this study. The first ovulation was determined after 34.6±1.9 day pp, while estrus detected on day 49.1±2.3 pp. There were no effects of parities (primiparous and multiparous), season and suckling on the time of 1st ovulation pp. However, the 1st estrus occurred earlier in primiparous than in multiparous cows and in winter compared to other seasons. The frequency of short (8-13 days), intermediate (17-24 days) and long ovarian cycle (cycles without estrus detected) (25-31days) was 27.8, 58.3 and 13.9%, respectively, with an average length equals to 18.8±1.1 days. It was concluded that Shami cows resumed their ovarian activity quickly pp, this refers to the ability of insemination and fertilization within 2-3 months pp if there is the appropriate of environmental and management. [ABSTRACT FROM AUTHOR]

Background: Non-invasive biomarkers may reduce post-colonoscopy colorectal cancer (CRC) rates and colonoscopy overuse in Lynch syndrome. Unlike faecal immunochemical test (FIT), faecal volatile organic compounds (VOCs) may accurately detect both advanced and non-advanced colorectal neoplasia., Aim: The aim of this study was to evaluate the potential of faecal VOCs-separately and with FIT-to guide optimal colonoscopy intervals in Lynch syndrome., Methods: Prospective longitudinal multicentre study in which individuals with Lynch syndrome collected faeces before and after high-quality surveillance colonoscopy. VOC-patterns were analysed using field asymmetric ion mobility spectrometry (FAIMS) and gas chromatography-ion mobility spectrometry (GC-IMS) followed by machine learning pipelines, and combined with FIT at 2.55 μg Hb/g faeces. Gas chromatography time-of-flight mass spectrometry analysed individual VOC abundance., Results: Among 200 included individuals (57% female, median 51 years), 62 had relevant neoplasia at colonoscopy: 3 CRC, 6 advanced adenoma (AA), 3 advanced serrated lesion (ASL), and 50 non-advanced adenoma (NAA). Respective sensitivity and negative predictive value for CRC and AA (and also ASL in case of FAIMS) were 100% and 100% using FAIMS (54% specificity), and 89% and 99% using GC-IMS (58% specificity). Respective sensitivity and specificity for any relevant neoplasia were 88% and 44% (FAIMS) and 84% and 28% (GC-IMS); accuracy did not significantly improve upon VOC-FIT. VOC-patterns differed before and after polypectomy (AUC 0.70). NAA showed decreased faecal abundance of butanal, 2-oxohexane, dimethyldisulphide and dimethyltrisulphide., Conclusions: In Lynch syndrome, faecal VOCs may be a promising strategy for postponing colonoscopy and for follow-up after polypectomy. Our results serve as a stepping stone for large validation studies., Trial Registration: NL8749., (© 2024 The Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.)

More than 80 million people in the United States are affected by hair loss, also known as alopecia. Nonscarring alopecias are categorized as diffuse, patterned, or focal. Diffuse alopecias include telogen and anagen effluvium, are usually self-limited, and depend on stopping the underlying cause (e.g., stress). Patterned hair loss, specifically androgenetic alopecia, is the most common form of alopecia; it is typically genetic, and first-line treatment is minoxidil. Oral finasteride is another treatment available for male patients. Focal hair loss includes alopecia areata, which is typically self-limited and treated with intralesional corticosteroid or oral immunosuppressant therapy; tinea capitis, which is treated with oral antifungals; and traction alopecia, which is treated by decreasing tension on the hair. Hair loss can be caused by several systemic diseases. A comprehensive history and physical examination, with targeted laboratory testing, may elucidate malnutrition, autoimmune diseases, and endocrine disease. Patients with moderate to severe hair loss are more likely to have accompanying anxiety, depression, and lower work productivity and quality-of-life scores. Educating patients about expected hair changes, treatment options, and realistic outcomes can help patients feel that they are being listened to and that their hair loss is being taken seriously.

Background: Prior research has demonstrated that platelet-rich plasma (PRP) has shown promising results in the treatment of knee osteoarthritis, lateral epicondylitis, and rotator cuff disease. However, there is a lack of standardization with PRP regarding its use for partial thickness rotator cuff tears (PTRCTs). The primary objective of this review is to assess the location of PRP injections in the shoulder, and how it corresponds to shoulder functional outcomes in PTRCTs., Methods: Data sources included randomized controlled trials (RCTs) conducted between January 2010 and September 2021 with the terms PRP, partial thickness rotator cuff tears, intra-articular injections, subacromial injections, and intratendinous injections. Major inclusion criteria: partial thickness rotator cuff tears only, functional outcome scores pre-injection and post-injection, minimum 2-month follow-up time, and nonsurgical PRP injections only. Major exclusion criteria: PRP used as an adjunct therapy, full-thickness rotator cuff tears, and surgical intervention before treatment., Results: A total of 8 RCTs were included which utilized PRP injected into the shoulder for PTRCTs. Studies were grouped by the location of the injection with the following breakdown: 1 glenohumeral joint, 4 subacromial bursa, and 3 intratendinous as the site of injection of PRP. Intra-articular PRP showed a 46.2% improvement ( P  < .05) in the Disabilities of the Arm, Shoulder, and Hand score at 12-month follow-up, however PRP compared to physical therapy had no statistical difference. For subacromial injections, one study showed no statistical difference between hyaluronic acid and PRP vs PRP, but both groups showed improvement compared to normal saline at 3, 6, and 12 months ( P  < .05). For intratendinous injections, PRP was found to be superior in the Shoulder Pain and Disability Index scores at 66.1% improvement ( P  < .05) at 3 months and 71.6% at 6 months ( P  < .05) after two PRP injections when compared to dry needling. Another study showed a statistically significant difference in ASES score when combining LP-PRP injection intratendinous and subacromial bursa when compared to corticosteroid at 3 months. Furthermore, at 6-month follow-up, the PRP group showed significant improvement in the Oxford Shoulder Score compared to a subacromial bursa corticosteroid group 53.8% vs 31.7% ( P  < .01)., Conclusion: Based on our review of current literature, there is inconclusive evidence of the ideal location to inject PRP when partial rotator cuff tear is present. Despite PRP showing improved functional outcomes in patients diagnosed with PTRCT regardless of the injection site, more research is needed to figure out the optimal concentration of PRP, frequency of injection, and who are ideal candidates when utilizing PRP for PTRCTs.

Calcification of the medial collateral ligament is a rare cause of medial knee pain along with functional impairment. Most cases are asymptomatic but those that are symptomatic typically respond to conservative management. However, in those instances with persistent symptoms that desire further intervention but want to minimize the risks associated with surgery, we present a novel approach for calcium removal with an ultrasound-guided percutaneous needle tenotomy with TenJet™ as a reasonable treatment modality.

Background: Common extensor tendinopathy is a common cause of lateral elbow pain. Ultrasound-guided minimally invasive tenotomy (MIT) has been utilized successfully as a treatment for several years, but the use of TenJet device has not been well described., Purpose: To evaluate the effectiveness and safety of MIT with TenJet who failed nonsurgical management of common extensor tendinopathy in an outpatient setting., Methods: A total of 100 patients with common extensor tendinopathy who failed conservative treatment underwent ultrasound-guided MIT with TenJet device in the outpatient setting at a single institution. All 100 patients prior to MIT underwent diagnostic musculoskeletal ultrasound showing common extensor tendinosis. The findings were interpreted by a fellowship-trained and board-certified musculoskeletal radiologist. Patients were evaluated with the Oxford Elbow Score prior to the procedure and at 1-year follow-up. Exclusion criteria included prior corticosteroid injection within the past 6 weeks of the MIT intervention, active local or systemic infection, complete full thickness tear of the common extensor tendon, and pregnancy., Results: Oxford Elbow Score had a statistically significant difference in baseline to 1 year ( P  < .001). No complications were reported and zero patients went on to require open surgical intervention., Conclusion: MIT with TenJet is a safe, effective, and well-tolerated treatment for common extensor tendinopathy., (© 2023 The Author(s).)