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At least 973 records · Page 54Linked to original sources
PubMed2002

An evaluation of bioequivalence of two 7-day 17beta-estradiol transdermal delivery systems by anatomical site.

An open-label, randomized, crossover study was conducted to assess the bioequivalence of two 7-day transdermal 17beta-estradiol delivery systems following application to the buttock in 42 postmenopausal women. The systems tested were a generic Estradiol Transdermal System (Mylan Pharmaceuticals, Inc.) and Climara (Berlex Laboratories, Inc.), the reference product. Each system was labeled to deliver 17beta-estradiol 0.1 mg/day and was applied for 7 days. Serial serum samples were assayed for estradiol, estrone, and estrone sulfate using validated assays. The bioequivalence confidence intervals for the ratio of log-transformed 17beta-estradiol Cmax values for the Estradiol Transdermal System and Climara were outside the interval of 0.80 to 1.25, indicating that the products were not bioequivalent. Application site reactions and skin irritation were more common with the Estradiol Transdermal System than with Climara. The odds of patch lifting or detachment were 6.95 times higher with the Estradiol Transdermal System than with Climara. Because these two transdermal delivery systems had been previously shown to be bioequivalent after application to the abdomen, the findings of this study suggest that bioequivalence at one anatomical site is not indicative of bioequivalence at another.

Administration, Cutaneous↗
PubMed1999

Anaesthesia in the prone position for impalement injury.

A 22-year-old man was brought to the Emergency Department in the prone position, having been impaled in the right buttock with a large pitchfork. He was in excruciating pain and nauseated; attempts to move the patient or the pitchfork caused severe pain. Caudal blockade was carried out in the prone position, without moving the patient, and proved to be very efficacious. The pitchfork was then removed painlessly, allowing us to turn the patient supine. A conventional induction of general anaesthesia was then made possible.

Adult↗
PubMedDate not supplied

Validation of the lift-off test and analysis of subscapularis activity during maximal internal rotation.

We used electromyographic analysis to determine the muscle activity of the shoulder muscles during the lift-off test and during resisted internal rotation. The activity in the upper and lower subscapularis muscle during a lift-off test from the region of the midlumbar spine was approximately 70% of maximal voluntary contraction. This level was significantly higher than for all the other muscles tested (P < 0.05). The lift-off test with the hand placed in the region of the midlumbar spine resulted in one-third more electromyographic activity in the subscapularis muscle than when the test was modified and performed with the hand at the buttocks region. A resisted lift-off test resulted in higher activities in all the muscles, but only a small increase in the pectoralis major muscle. The pectoralis major muscle was significantly more active during resisted internal rotation with the arm in front of the body. Comparison of activity in the upper subscapularis with that in the lower subscapularis muscle showed no significant differences during any of the tests. This study documents the importance of the subscapularis muscle during the lift-off test and suggests that other potential internal rotators of the humerus have a limited role in maintaining internal rotation when the arm is placed behind the back.

Adult↗
PubMed2006

Soft-tissue sarcoma mimicking large haematoma: a report of two cases and review of the literature.

We report on 2 patients with soft-tissue sarcomas mimicking large haematomas. Neither patient had a medical history of trauma or bleeding tendency. In a patient with a large leiomyosarcoma in the buttock, insufficient biopsy material from initial surgeries precluded a correct diagnosis. In the second patient with epithelioid sarcoma of the forearm, fasciotomy was repeatedly performed for compartment syndrome arising from the tumour. It is important to reconfirm prior trauma and investigate the clinical course and images of patients with an unusual history of haematoma in the extremities. The possibility of a malignant tumour should be suspected, and repeated biopsies should be performed if necessary.

Adult↗
PubMed1983

Mycosis fungoides: subcutaneous and visceral tumors, orbital involvement, and ophthalmoplegia.

A patient with advanced severe mycosis fungoides presented several unusual features, including prominent lesions of the palate and tongue and an orbital tumor with exophthalmos and ophthalmoplegia. A hitherto undescribed feature was the development of multiple, massive subcutaneous tumors unrelated to the dermis or to lymph nodes, and large tumors in the connective tissues of the buttock, flank, and retroperitoneum. The usual sites of extracutaneous dissemination of mycosis fungoides--lymph nodes, spleen, liver, lungs, and blood--were not demonstrably involved. This may be a new pattern of dissemination for this disease. Of practical importance is the immediate and complete relief of exophthalmos and ophthalmoplegia that was obtained with emergency radiotherapy.

Aged↗
PubMed2003

Painful vascular compression syndrome of the sciatic nerve caused by gluteal varicosities.

The authors report three patients with chronic sciatic pain without focal neurologic deficit. Sitting or lying on the affected side provoked pain, and standing and walking relieved it. MRI revealed varicotic gluteal vessels compressing the sciatic nerve. Decompression of the nerve resulted in complete and permanent pain relief. Sciatic or buttock pain in patients with varicosities and pain provocation in the sitting or lying position suggests this neurovascular compression syndrome.

Aged↗
PubMed1989

Pseudoaneurysm of the inferior gluteal artery presenting as sciatic nerve compression.

A pseudoaneurysm of the inferior gluteal artery presenting as sciatic nerve compression is reported in a 40-year-old woman. Following a transvaginal needle biopsy for endometriosis, the patient developed left sciatic pain and a nonpulsatile mass palpable in the left buttock thought to represent a pyriformis hematoma. Sequential computed tomographic scans were consistent with this diagnosis. Persistent pain and progression of neurological deficits led to surgical exploration. Posterior exposure of the pyriformis muscle and proximal sciatic nerve revealed a large pseudoaneurysm of the inferior gluteal artery compressing the nerve. A laparotomy was performed and the internal iliac artery was ligated, followed by evacuation of the aneurysm contents and repair of the aneurysm neck via a posterior approach. The patient has remained pain-free with progressive improvement in neurological function after 1 year follow-up. Aneurysms of the gluteal artery are unusual, predominantly occur after significant pelvic trauma, and rarely present as sciatica. Pertinent aspects of the patient history and clinical findings are atypical for discogenic sciatica. Because of the rarity of this entity, preoperative diagnosis is usually not achieved. Angiography or magnetic resonance imaging should be performed in patients with atypical sciatica and a mass in the region of the proximal sciatic nerve, particularly after trauma.

Adult↗
PubMed2004

Traumatic venous varix causing sciatic neuropathy: case report.

OBJECTIVE AND IMPORTANCE: Sciatic neuropathy rarely presents in nonpenetrating trauma because of protection of the nerve by the pelvis, the gluteal muscles, and the tissues in the posterior thigh. We present the case of a patient who fell and subsequently developed a traumatic venous varix of the inferior gluteal vein that caused compression sciatic neuropathy. CLINICAL PRESENTATION: Seven days after a fall onto her right buttock, the patient developed a painful burning paresthesia in her leg and numbness on the dorsum of her foot. Numerous studies ruled out lumbar spine pathological abnormalities as the cause of the pain. Conventional magnetic resonance imaging revealed a lesion adjacent to the sciatic nerve. Gradient echo and two-dimensional time-of-flight magnetic resonance imaging sequences confirmed this to be a vascular lesion originating from the inferior gluteal vein and compressing the sciatic nerve. INTERVENTION: Operative resection obliterated the venous varix, thereby relieving the patient's pain and neurological deficit. CONCLUSION: No case of a traumatic venous varix of the inferior gluteal vein compressing the sciatic nerve has been reported to date. Surgical resection was successful in obliterating the lesion and relieving the symptoms.

Accidental Falls↗
PubMed1985

The pre-operative embolisation of vascular malformations.

Large arteriovenous malformations frequently require surgical excision in order to prevent or treat the potentially serious problems they can cause ranging from haemorrhage and pain to cardiac failure. The surgery itself is usually difficult and often dangerous due to the serious risk of major intraoperative haemorrhage. Transcatheter arterial embolisation has greatly facilitated the management of small arteriovenous malformations but may only afford temporary relief of symptoms in very large lesions. Recanalisation of occluded vessels and revascularisation via previously insignificant collateral vessels means that large lesions cannot be effectively managed by this method alone. Previous surgery and ligation of feeding vessels may make effective embolisation difficult or impossible and a combined radiological and surgical approach to these lesions may permit definitive treatment. We present three cases in whom the pre-operative embolisation of buttock arteriovenous malformations facilitated successful surgical excision.

Arteriovenous Fistula↗
PubMed1981

Clinical studies of isolated disc resorption in the lumbar spine.

Low lumbar pain with radiation into the leg is a common symptom pattern caused by a number of pathological processes. Isolated disc resorption is one such entity which can be readily identified and is amenable to surgical treatment. This study consisted of two groups of patients. Group I were 50 patients suffering from isolated disc resorption at L5--S1 with ill-defined low backache extending into the buttocks and down one or both legs, but not into the feet. Clinical signs of nerve root dysfunction were found in 16 per cent of patients. Radiographic changes with loss of disc height, facet over-riding and intrusion into the nerve root canal and intervertebral foramen were common and frequently associated with sclerosis of the vertebral end-plate. Group II were a series of 45 patients with isolated disc resorption independently reviewed an average of 45 months after surgical decompression of the S1 (98 per cent) or lower lumbar nerve roots. Based on objective grading by the clinician and subjective assessment by the patient complete success was achieved in 62 per cent of the patients and partial success in 24 per cent. Provided there is full appreciation of the pathological anatomy, strict diagnostic criteria and meticulous surgery, decompression of the nerve root canal is a useful surgical procedure in severely disabled patients suffering from isolated disc resorption.

Adolescent↗
PubMed1986

Spontaneous regression of a desmoid tumour.

A 15-year-old girl presented with a very large desmoid tumour in her buttock; it extended into the pelvis and thigh and would have required hindquarter amputation for its removal. This was not performed and the tumour underwent spontaneous regression. Fourteen years later the patient is alive and well. The suggestion is made that in some cases a more expectant approach to treatment might be justified for what is essentially a non-malignant condition.

Adolescent↗
PubMed2003

Skin breakdown and blisters from senna-containing laxatives in young children.

BACKGROUND: At the direction of the Food and Drug Administration, phenolphthalein was removed from all over-the-counter laxatives in 1999. Phenolphthalein was then replaced in most laxative products with the natural product senna from Cassia acutifolia Delile, which contains various anthraquinones. No data are available on the safety of senna use in children <6 years of age. OBJECTIVE: To describe the clinical outcomes of exposure to unintentional ingestion of senna-containing laxatives in young children. METHODS: All ingestion exposures of senna-containing laxatives in children <5 years of age from 6 poison centers over a 9-month period were evaluated. Inclusion criteria required 24-hour follow-up and the presence of diarrhea to confirm ingestion. Parents were told routinely that severe diaper rash was possible and to protect the perianal area with frequent cleansing and a barrier ointment if the child was wearing diapers. RESULTS: During the study period, 111 cases were reported: 19 children experienced no diarrhea, 4 were lost to follow-up, and 88 exposures were evaluated. Fifty-two children (59%) were </=2 years old. Fifty children remained in diapers, 28 children were fully toilet trained, and 10 wore diapers (pull-up pants) overnight. Twenty-nine children (33%) experienced severe diaper rash. The mean +/- SD time to recognition of the diaper rash was 15.6 +/- 8.6 hours. Ten children (11%) had blisters and skin sloughing. There was a significant increase in severe diaper rash (p < 0.05) and onset of blisters and skin breakdown (p < 0.05) in children wearing diapers versus those who were fully toilet trained. The mean time to onset of blisters was 14.5 +/- 6.8 hours. Skin burns and loss were seen primarily on the buttocks and perineum, loosely following the diaper area. CONCLUSIONS: Unintentional ingestion of senna-containing laxatives in young children may potentially cause severe diaper rash, blisters, and skin sloughing.

Blister↗
PubMed2004

Changes in matrix gene and protein expressions after single or repeated exposure to one minimal erythemal dose of solar-simulated radiation in human skin in vivo.

Damage to the skin extracellular matrix (ECM) is the hallmark of long-term exposure to solar UV radiation. The aim of our study was to investigate the changes induced in unexposed human skin in vivo after single or repeated (five times a week for 6 weeks) exposure to 1 minimal erythemal dose (MED) of UV solar-simulated radiation. Morphological and biochemical analyses were used to evaluate the structural ECM components and the balance between the degrading enzymes and their physiologic inhibitors. A three-fold increase in matrix metalloproteinase 2 messenger RNA (mRNA) (P < 0.02, unexposed versus exposed) was observed after both single and repeated exposures. Fibrillin 1 mRNA level was increased by chronic exposure (P < 0.02) and unaltered by a single MED. On the contrary, a single MED significantly enhanced mRNA levels of interleukin-1alpha (IL-1alpha), IL-1beta (P < 0.02) and plasminogen activator inhibitor-1 (P < 0.05). Immunohistochemistry demonstrated a significant decrease in Type-I procollagen localized just below the dermal-epidermal junction in both types of exposed sites. At the same location, the immunodetected tenascin was significantly enhanced, whereas a slight increase in Type-III procollagen deposits was also observed in chronically exposed areas. Although we were unable to observe any change in elastic fibers in chronically exposed buttock skin, a significant increase in lysozyme and alpha-1 antitrypsin deposits on these fibers was observed. These results demonstrate the existence of a differential regulation, after chronic exposure compared with an acute one, of some ECM components and inflammatory mediators.

Adult↗
PubMed2005

Primary perineal posterior hernia: an abdominoperineal approach for mesh repair of the pelvic floor.

Spontaneous development of perineal hernias is a very rare condition and many techniques have been described for repairing the floor defect. The authors describe the use of a combined approach in the surgical treatment of primary perineal hernias, by reconstructing the muscle pelvic floor and restoring the rectum to its sacral position with mesh repair. The case of one patient with a huge primary perineal hernia is reported, with clinical manifestations of progressive bulging in the buttock area, obstipation and fecal incontinence. Long-term follow-up has shown no recurrence of the condition and normal bowel function. It is concluded that primary perineal hernia can be repaired by a combined surgical approach, by using prosthetic material.

Aged↗
PubMed2004

Finding the optimal setting of inflated air pressure for a multi-cell air cushion for wheelchair patients with spinal cord injury.

Pressure distribution patterns of the seating interface on the multi-cell air cushion (ROHO High Profile) of 36 adults with spinal cord injury (SCI) (Neurological level Th3 -L1) were measured at different air pressure levels by a pressure mat measurement system. Stress distribution relative to the inflated air pressure in the air cushion on the patients' wheelchairs was analyzed to determine the appropriate inflated air pressure of the cushion for patients. The maximum pressure points in all subjects were at the areas of the ischial tuberosities (82 to 347 mmHg). The optimal reduction in interface pressure at the ischial tuberosities was obtained just before bottoming out. The cushion air pressure at that point was between 17 and 42 mmHg, and correlated well to body weight (r = 0.495, P = 0.0021). In contrast, the maximum pressure levels did not correlate to body weight or the Body Mass Index (BMI). Pressure at the ischial area could be reduced, but not eliminated, by adjusting the air pressure. The maximum pressure levels seemed to be related to the shape of the buttocks, especially the amount of soft tissue, and exceeded the defined threshold for pressure ulcers (> 80 g/cm2).

Adolescent↗
PubMed1999

Aggressive angiomyxoma: findings on CT and MR imaging.

OBJECTIVE: Aggressive angiomyxoma is a benign tumor affecting the pelvis and perineum, predominantly in women. Because of its variable presentation as a soft mass in the vulva, perianal region, buttock, or pelvis, the tumor is often clinically misdiagnosed and initial surgery is usually unsuccessful in extirpating it. This study describes the imaging features of these tumors. CONCLUSION: Aggressive angiomyxomas display unusual growth patterns of translevator extension with growth around perineal structures. Both CT and MR imaging show the transdiaphragmatic extent of these tumors. High signal intensity on T2-weighted MR images may reflect the myxomatous stroma of these tumors.

Adult↗
PubMed1999

Variations of nerves located in deep gluteal region.

The relation of the nerves with the piriformis muscle in the deep gluteal region examined in 50 buttock from 18 male and 7 male newborn cadavers. The nerves were found in usual position in 74% of sides, while one or more nerves perforated the piriformis in 16% and, unusual location of the nerves with intact piriformis was in 10% of sides. Abnormal located nerves are utilised in view of whether originating from dorsal or ventral part of the sacral plexus.

Buttocks↗
PubMed1993

Blue rubber bleb nevus syndrome with manifestations in the vulva.

The blue rubber bleb nevus syndrome (BRBNS) is a rare vascular disorder, manifesting with hemangiomas which are usually located in the gastrointestinal tract and/or in the skin. These lesions can cause local, sometimes severe bleedings or cosmetic problems. This report describes a young woman with BRBNS manifestations on the buttocks and in the vulva, the latter giving rise to symptoms specific to this location. The blood-filled blebs were successfully treated by argon laser. As far as we know, manifestations of this disease in the female genital tract have not previously been described.

Adult↗