Inferior gluteal pain with sitting, unrelated to ischial bursitis

2021 ◽  
Vol 14 (11) ◽  
pp. e246294
Author(s):  
Chad Mears ◽  
Renuka Rudra ◽  
Alex John ◽  
Weibin Shi
Keyword(s):  
Hip Replacement ◽  
Botulinum Toxin Injection ◽  
Levator Ani ◽  
Ischial Tuberosity ◽  
Academic Medical Centre ◽  
Forward Flexion ◽  
Medial Thigh ◽  
Academic Medical ◽  
Gluteal Pain ◽  
Levator Ani Syndrome

A 64-year-old woman presented to an academic medical centre with postoperative left ischial pain following a left total hip replacement. Her pain was exacerbated by sitting down and with forward flexion of the spine, and the pain radiated from the left ischial tuberosity to the left perineum, groin and medial thigh. An ischial bursa injection was performed, but only resulted in 1 day of excellent pain relief. A diagnosis of inferior cluneal neuralgia was then made. Subsequent inferior cluneal nerve radiofrequency ablation was performed, and provided sustained 50% relief in pain. The patient had a concomitant sensation of ‘ball like’ pressure at her rectum which was determined to be due to levator ani syndrome. She was prescribed pelvic floor physical therapy and botulinum toxin injection, which resulted in further notable improvement of her symptoms.

Der akute anale Schmerz

2013 ◽  
Vol 70 (7) ◽  
pp. 399-402
Author(s):  
Olivier Pittet ◽  
Nicolas Demartines ◽  
Dieter Hahnloser
Keyword(s):  
Levator Ani ◽  
Klinische Untersuchung ◽  
Proctalgia Fugax ◽  
Chronische Analfissur ◽  
Levator Ani Syndrome

Anale Schmerzen sind häufig in der Proktologie. Eine detaillierte Anamnese der Schmerzen und die klinische Untersuchung führen meistens zur Diagnose und damit zur unmittelbaren Therapie. Die akute Perianalvenenthrombose soll innerhalb 72 Stunden exzidiert werden. Akute Analfissuren werden konservativ mit Stuhlregulation und sphinktertonus-senkender Medikation sehr erfolgreich therapiert. Die chronische Analfissur muss meistens operiert werden. Perinalabaszesse können häufig in Lokalanästhesie abgedeckelt werden. Die proctalgia fugax und das levator ani syndrome sind Auschlussdiagnosen und werden symptomatisch therapiert.

scholarly journals Impact of the COVID-19 pandemic on neuroimaging scan volumes at a teaching hospital

2021 ◽  
pp. 197140092098866
Author(s):  
Daniel Thomas Ginat ◽  
James Kenniff
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
The United States ◽  
Radiology Department ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Academic Medical Centre ◽  
Academic Medical ◽  
The Impact

Background The COVID-19 pandemic led to a widespread socioeconomic shutdown, including medical facilities in many parts of the world. The purpose of this study was to assess the impact on neuroimaging utilisation at an academic medical centre in the United States caused by this shutdown. Methods Exam volumes from 1 February 2020 to 11 August 2020 were calculated based on patient location, including outpatient, inpatient and emergency, as well as modality type, including computed tomography and magnetic resonance imaging. 13 March 2020 was designated as the beginning of the shutdown period for the radiology department and 1 May 2020 was designated as the reopening date. The scan volumes during the pre-shutdown, shutdown and post-shutdown periods were compared using t-tests. Results Overall, neuroimaging scan volumes declined significantly by 41% during the shutdown period and returned to 98% of the pre-shutdown period levels after the shutdown, with an estimated 3231 missed scans. Outpatient scan volumes were more greatly affected than inpatient scan volumes, while emergency scan volumes declined the least during the shutdown. In addition, the magnetic resonance imaging scan volumes declined to a greater degree than the computed tomography scan volumes during the shutdown. Conclusion The shutdown from the COVID-19 pandemic had a substantial but transient impact on neuroimaging utilisation overall, with variable magnitude depending on patient location and modality type.

scholarly journals Where is the leak in the pipeline? Investigating gender differences in academic promotion at an academic medical centre

2016 ◽  
Vol 5 (2) ◽  
pp. 125-128 ◽  
Author(s):  
Jessica K. Paulus ◽  
Karen M. Switkowski ◽  
Geneve M. Allison ◽  
Molly Connors ◽  
Rachel J. Buchsbaum ◽  
...  
Keyword(s):  
Gender Differences ◽  
Medical Centre ◽  
Academic Medical Centre ◽  
Academic Promotion ◽  
Academic Medical

scholarly journals Speaking up about care concerns in the ICU: patient and family experiences, attitudes and perceived barriers

2018 ◽  
Vol 27 (11) ◽  
pp. 928-936 ◽  
Author(s):  
Sigall K Bell ◽  
Stephanie D Roche ◽  
Ariel Mueller ◽  
Erica Dente ◽  
Kristin O’Reilly ◽  
...  
Keyword(s):  
Perceived Barriers ◽  
Family Education ◽  
Speaking Up ◽  
Academic Medical Centre ◽  
Know How ◽  
Family Attitudes ◽  
Conflicting Information ◽  
Academic Medical ◽  
Internet Sample ◽  
Speak Up

BackgroundLittle is known about patient/family comfort voicing care concerns in real time, especially in the intensive care unit (ICU) where stakes are high and time is compressed. Experts advocate patient and family engagement in safety, which will require that patients/families be able to voice concerns. Data on patient/family attitudes and experiences regarding speaking up are sparse, and mostly include reporting events retrospectively, rather than pre-emptively, to try to prevent harm. We aimed to (1) assess patient/family comfort speaking up about common ICU concerns; (2) identify patient/family-perceived barriers to speaking up; and (3) explore factors associated with patient/family comfort speaking up.MethodsIn collaboration with patients/families, we developed a survey to evaluate speaking up attitudes and behaviours. We surveyed current ICU families in person at an urban US academic medical centre, supplemented with a larger national internet sample of individuals with prior ICU experience.Results105/125 (84%) of current families and 1050 internet panel participants with ICU history completed the surveys. Among the current ICU families, 50%–70% expressed hesitancy to voice concerns about possible mistakes, mismatched care goals, confusing/conflicting information and inadequate hand hygiene. Results among prior ICU participants were similar. Half of all respondents reported at least one barrier to voicing concerns, most commonly not wanting to be a ‘troublemaker’, ‘team is too busy’ or ‘I don’t know how’. Older, female participants and those with personal or family employment in healthcare were more likely to report comfort speaking up.ConclusionSpeaking up may be challenging for ICU patients/families. Patient/family education about how to speak up and assurance that raising concerns will not create ‘trouble’ may help promote open discussions about care concerns and possible errors in the ICU.

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