Ritz-Carlton and EMC: The gold standards in operational behavioral differentiation

2004 ◽  
Vol 23 (2) ◽  
pp. 61-76 ◽  
Author(s):  
Terry R. Bacon ◽  
David G. Pugh
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Aya Bahaa Hussien ◽  
Hesham Mostafa Abdel Samad ◽  
Hatem Mohamed Said El-Azizi

Abstract Background Hand tendon injuries are recognized clinical entities that are frequently seen. Clinical examinations usually warrant radiological correlative studies for confirmation and as a postoperative screening test. Here is a prospective observational cohort study enrolling 30 patients who were diagnosed clinically to have hand tendon injuries either pre- or postoperative; their ages were ranging from 5 to 64 years with a mean ± SD of 31.43 ± 12.19 years; 23 male patients (76.7%) and 7 female patients (23.3%) were evaluated by high-resolution ultrasound examination and a correlative evaluation was done by either intra-operative assessment or MRI study as gold standards. Results High-resolution ultrasound (HRUS) findings were binned into seventeen cases (56%) that had tendon tears, of which 10 cases (33.3%) had a complete tear and 7 cases (23.3%) had a partial tear. Postoperative tendon integrity was present in 13 cases (43.3%), a tendon callus was found in 2 cases (6.66%), and a postoperative abnormal motion on the dynamic study was present in 15 cases (50%). Intra-tendinous foreign bodies were detected in two cases (6.66%), a gap between the torn ends was found in 10 cases (33.3%), and re-tear (rupture) of the repaired tendons was present in four cases (13.3%). Coexistent nerve injuries were seen in two cases (6.66%); for the forementioned findings, HRUS had gained high accuracy measures as correlated to the gold standards (100% sensitivity and 100% specificity). Conclusion High-resolution ultrasound serves as a highly accurate potential diagnostic modality for preoperative evaluation of hand tendon injuries and the postoperative follow-up.


2021 ◽  
Vol 14 (2) ◽  
pp. e240214
Author(s):  
Lenny Thinagaran Vasanthan ◽  
Manigandan Chockalingam

Identification of the primary source of pain determines the success of musculoskeletal pain management. A detailed history and physical examination are the current gold standards for identifying musculoskeletal pain source in day-to-day clinical practice. This process, at times, may potentially result in inadequate/inappropriate identification of the pain source. In this case report, we present the usefulness of a simple and inexpensive vacuum cup. We found that this accurately identified the primary pain source, distant from and unrelated to the site of pain presentation in a 30-year-old man with back pain. Routine use of this simple technique in conjunction with the regular musculoskeletal examination may better identify primary restrictions in the body tissues. Based on our experience, we propose that this approach has the potential to offer better outcomes in the treatment of musculoskeletal pain in the future.


2018 ◽  
Vol 37 (3) ◽  
pp. 264-273 ◽  
Author(s):  
Yukihiro Nomura ◽  
Naoto Hayashi ◽  
Shouhei Hanaoka ◽  
Tomomi Takenaga ◽  
Mitsutaka Nemoto ◽  
...  
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