Ulnar Neuropathy in Bicyclists

In brief: A common overuse injury associated with bicycling is ulnar neuropathy (handlebar palsy). The cyclist will notice the onset of numbness, weakness, and loss of coordination in one or both hands, usually after several days of cycling. Several corrective measures are suggested, including well-padded bicycling gloves, padded handlebars, correct frame size, correct distance from seat to stem, and frequent changing of hand position on the handlebars. If the pain cannot be alleviated by these measures, the cyclist should stop until improvement occurs.     

Adult presentation of ALCAPA: Echo and CT diagnosis

A healthy 20‐year‐old male presented with aborted sudden death. Both thoracic echocardiography and cardiac computed tomographic angiography demonstrated the characteristic findings of ALCAPA noting a dilated and tortuous right coronary artery, dilated coronary collateral arteries within the interventricular septum or along the surface of the heart, and visualization of the left coronary artery origin from the posterior aspect of the main pulmonary artery. Both imaging modalities demonstrated all three characteristic findings of this rare coronary anomaly and served as complementary imaging studies for surgical correction.     

Fractional flow reserve‐CT assessment of coronary stenosis

Coronary computed tomography angiography (CCTA) has been an established noninvasive method for detection of coronary artery disease (CAD). Although CCTA has had a high sensitivity and negative predictive value for CAD detection, specificity for obstructive CAD has been relatively low, partly due to coronary calcium, imaging artifacts, and other factors leading to an overestimation of stenosis severity. A relatively new noninvasive method of calculation of fractional flow reserve (FFR) using CCTA (FFR_CT) data has been developed. This noninvasive method yields similar results to invasive FFR measurement, improving specificity for noninvasively detecting lesion‐specific ischemia thus helping guide revascularization.     

Further Observations on Orbital

Vaginal epithelial cells mature from basal to intermediate to superficial cells. Estrogen causes more superficial cells to be shed, and the proportion of exfoliated cell types is called a Maturation Index. This index helps clinicians manage dysfunctional bleeding, evaluate hormone change at menopause or prepuberty, and predict ovulation.