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Degenerative rotator cuff tears are the most common cause of shoulder pain and have a strong association with advanced aging. There is considerable variation in surgeons' perceptions regarding the recommended treatment for patients with painful rotator cuff tears. Natural history studies have better outlined the risks of tear enlargement, progression of muscle degeneration and decline in function over time. This information combined with known factors that potentially influence the rate of successful tendon healing such as age, tear size and severity of muscle degenerative changes can be used to better refine appropriate surgical indications. Although conservative treatment can be successful in the management of many of these tears, there are risks to nonoperative treatment as well. The application of natural history data can stratify atraumatic degenerative tears according to the risk of nonoperative treatment and better identify tears where early surgical intervention should be considered.

Background-Necrotizing enterocolitis (NEC) is the leading surgical cause of death in premature infants. We have accumulated evidence supporting a role for heparin-binding EGF-like growth factor (HB-EGF) in protection of the intestines from NEC. The aim of the current study was to evaluate the effect of loss-of-function of endogenous HB-EGF on susceptibility to NEC.