Partial Segmental Thrombosis of the Corpus Cavernosum Associated With Inappropriate Sildenafil Use.

The case presented is of a 39-year-old male with severe right groin pain and perineal pain the morning after sexual intercourse with the use of sildenafil without a diagnosis of erectile dysfunction. Partial segmental thrombosis of the corpus cavernosum (PSTCC) was diagnosed using magnetic resonance imaging and treated with direct oral anticoagulation without complications. Sildenafil use has been noted as an inciting factor for PSTCC in only two other cases of less than 60 cases reported in the literature and has even been used successfully as a component of therapeutic management of PSTCC in another previous case.

A 25-Year-Old Military Recruit with Isolated Myositis Following Routine Chemoprophylaxis with Intramuscular Benzathine Penicillin G.

BACKGROUND Myositis is an inflammatory myopathy that can be caused by a variety of drugs, diseases, and toxins. The U.S. military uses chemoprophylaxis with intramuscular penicillin G to prevent group A streptococcal infection. We present a case of penicillin G-induced myositis, a rare cause of drug-induced myositis with limited discussion in the medical literature. CASE REPORT A 25-year-old man with no pertinent medical history presented to the Emergency Department with right hip and leg pain after receiving a single dose of intramuscular penicillin G as part of standard prophylaxis for group A streptococcal infection during basic military training. He reported pain and leg weakness that was exacerbated by physical exertion and weight bearing but had no systemic symptoms, such as fevers or chills. Initial radiographs of the hip were normal; however, subsequent magnetic resonance imaging of the hip revealed intramuscular edema and features consistent with myositis of the right proximal thigh and hip musculature. He was admitted for isolated right gluteal myositis, attributed to his preceding local penicillin injection. He recovered with symptomatic care over the following 2 weeks, with return to baseline function. CONCLUSIONS This case highlights a rare complication of intramuscular penicillin G as a cause of acute isolated myositis. It serves to inform physicians of this rare complication and to recommend the consideration of intramuscular penicillin G as a causative etiology in individuals presenting with myositis and recent penicillin G exposure.

"Incorporating a Gym Facility in a Lifestyle Medicine Practice for Patients with Diabetes Mellitus".

Incorporating a gym or fitness facility into a lifestyle-focused clinic is potentially one of the most critical facets of the patient-focused care, especially for those with obesity, cardiometabolic disease, and all types of diabetes mellitus. The evidence for prioritizing physical activity and exercise as medicine is well-researched and universally recommended as first-line therapy plus prevention of many chronic disease states. Having a fitness center on-site as part of any clinic could improve patient utilization, reduce barrier to entry, and decrease hesitation to engage in exercise like resistance training. While the conceptualization may seem simple, the pragmatic application and implementation takes proper planning. Developing such a gym will depend upon gym size preference, program development, cost, and available personnel. Thought needs to be put into deciding which type of exercise and ancillary equipment, ranging from aerobic or resistance machines to free weights, will be included and in what format. Fee and payment options should be carefully considered to assure the budget works financially for both the clinic and patient population. Finally, graphic examples of clinical gyms are described to convey the potential reality of such an optimal setting.

An exploration of low back pain beliefs in a Northern America based general population.

BACKGROUND: Prior research has demonstrated that people across different populations hold beliefs about low back pain (LBP) that are inconsistent with current evidence. Qualitative research is needed to explore current LBP beliefs in Northern America (NA). OBJECTIVES: We conducted a primarily qualitative cross-sectional online survey to assess LBP beliefs in a NA population (USA and Canada). METHODS: Participants were recruited online using social media advertisements targeting individuals in NA over the age of 18 with English speaking and reading comprehension. Participants answered questions regarding the cause of LBP, reasons for reoccurrence or persistence of LBP, and sources of these beliefs. Responses were analyzed using conventional (inductive) content analysis. RESULTS/FINDINGS: 62 participants were included with a mean age of 47.6 years. Most participants reported multiple causes for LBP as well as its persistence and reoccurrence, however, these were biomedically focused with minimal to no regard for psychological or environmental influences. The primary cited source of participants' beliefs was healthcare professionals. CONCLUSIONS: Our findings align with prior research from other regions, demonstrating a need for updating clinical education and public messaging about the biopsychosocial nature of LBP.