Needle Breakage Research Articles

Migrating foreign bodies of penis: a case report and literature review

BackgroundOnly a few cases have been reported about active foreign body implantation in the cavernous body of the penis.Case presentationA 47-year-old man inserted two needles from the glans penis into the bilateral penile sponge body. Subsequently, two needles migrated through the penile cavernous body into the pelvic cavity. Attempts to remove the needles through the penis were unsuccessful. Eventually, after a duration exceeding one month, the displaced needles were removed in stages from the buttocks.ConclusionA few cases of intracavernosal-injection-therapy-associated needle breakage and retention have been reported globally. And this is the first case in China documenting the migration of foreign bodies within the penile region. In this condition, it is of utmost importance to engage the expertise of experienced andrologists to minimize the risk of excessive manipulation, thereby ensuring that inadvertent deep penetration of the needle into the penile tissue is prevented. In case the foreign body has migrated deeper into the tissues and the patient does not exhibit any specific symptoms or risks of macrovascular injury-related bleeding, close surveillance of its movement can be implemented. Surgical intervention can be initiated once the foreign body has reached a suitable position. Moreover, a psychiatric evaluation should be recommended for patient to discover any underlying mental health disorders.

Device malfunctions with use of EUS–guided fine-needle biopsy devices: Analysis of the MAUDE database

ABSTRACT Background The safety of endoscopic ultrasound–guided tissue acquisition through fine-needle biopsy devices is well-established in clinical trials. The real-world experience of using these devices is not known. The authors analyzed the postmarketing surveillance data from the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database to answer this question. Methods The Food and Drug Administration MAUDE database from January 2012 to June 2022 was accessed to evaluate for device malfunctions and patient-related adverse consequences of these malfunctions. Results There were 344 device-related issues. Most issues were due to detachment or breakage of the device (n = 185 [53.7%]). Seventy-six of the breakages (40.8%) occurred during the procedure, whereas 89 cases (47.8%) occurred while removing the needle from the endoscope. The most common site of tissue biopsy at the time of needle breakage was the pancreas (44 [23.8%]). The common patient-related adverse events were retained foreign body (n = 50 [14.5%]) followed by bleeding (16, 4.6%). Six patients (3.4%) required a second intervention for removal of the retained foreign bodies including surgery in 2 cases. The device breakage damaged the endoscope in 3 cases (1.7%), and there was 1 case of needlestick injury to the nurse. Conclusion The fine-needle biopsy devices can be associated with needle breakage and bending; these adverse events were not previously reported. Needle breakages can result in a retained foreign body that may require additional procedures including surgery. These real-world findings from the MAUDE database may inform clinical decisions and help improve clinical outcomes.

A Systemic Review of Spinal Needles Broken During Neuraxial Anesthesia.

Needle breakage during spinal anesthesia occurs infrequently and represents a serious complication with potentially adverse effects. The objective of this systemic review was to look at the incidence, risk factors, and preventative measures for broken spinal needles. A search of the literature on PubMed, Web of Science, and Embase databases and a manual web search was performed, with no filters and up to April 2023 from inception. Out of the 43 potential studies, 23 were included. The search terms for the full article reading were broken needle, spinal anesthesia, humans, and post-operative, and the exclusion criteria were systematic reviews, conference presentations, and non-full articles. A review of the 23 studies (24 cases) suggests an association between specific risk factors such as obesity and needle size and breaks. Identifying the risks and complications of needle breaks could help physicians modify their practice and inform their patients of any increased risks applicable to them.

Needle Fracture in Pterygomandibular Space during Loco-Regional Dental Anesthesia: Systematic Review

Background: Dentists administer hundreds of thousands of injections every day without particular concern, but the administration of local anesthetics can cause problems. One event, fortunately uncommon, that is discussed accurately but can cause significant concern is needle breakage. The purpose of this article is to review what has been reported in the literature on this topic to learn about patient symptomatology, management and possible complications. In addition, the case of a 34-year-old patient with needle persistence in the pterygoid space due to accidental rupture during inferior alveolar nerve block (IAN) was reported, for whom non-removal and monitoring over time was chosen. Materials and Methods: A literature search of the PubMed, Scopus, Web of Science and ScienceDirect databases was conducted analyzing anesthetic needle rupture during dental surgery. Results: At the end of the selection process, 17 articles resulted. Asymptomatic subjects were found, as well as those who had several symptoms. No issues were recorded by any of the authors, whether they withdrew the needle or simply monitored the patient. Conclusions: The literature on needle rupture during dental local anesthesia is scarce, and studies report conflicting results on treatment options. Most authors reported removing the fragment; however, others preferred conservative management limited to patient monitoring. No complications were reported in any study.

Formulation and characterization of thiolated chitosan/polyvinyl acetate based microneedle patch for transdermal delivery of dydrogesterone

Microneedle patches are promising transdermal drug delivery platforms with minimal invasiveness in a painless manner. Microneedle patch could be a promising alternate route for delivery of drugs having poor solubility and low bioavailability. This research work therefore, aimed to develop and characterize microneedle patch of thiolated chitosan (TCS) and polyvinyl acetate (PVA) for the systemic delivery of dydrogesterone (DYD). TCS-PVA-based microneedle patch was fabricated with 225 needles having a length of 575 µm with the sharp pointed end. Different ratios of TCS-PVA-based patch were employed to investigate the effects of mechanical tensile strength and percentage elongation. The scanning electron microscopy (SEM) revealed intact sharp-pointed needles. In vitro dissolution studies of microneedle patch (MN-P) were carried out by modified Franz-diffusion cell revealing the sustained release of DYD 81.45 ± 2.768 % at 48 hrs as compared to pure drug that showed 96.7 ± 1.75 % at 12 hrs. The transport of DYD (81%) across skin reaching the systemic circulation was evaluated through ex vivo permeation studies of MN-P. The skin penetration study through the parafilm M method showed good penetration with no deformation and breakage of needles along with no visible signs of skin irritation. Histological study of mice skins clearly showed the deeper penetration of needles into the skin. In summary, as-prepared MN-P show potential in developing an effective transdermal delivery system for DYD.

The design of a servo motor control system for an industrial sewing machine based on PLC s7-1200

A servo motor is used as a motor for industrial sewing machines because it produces less noise, consumes less power, and is lightweight. The only disadvantage of the servo motor is its low minimum speed of up to 5000 rpm, which is why the sewing machine cannot be used at high speeds. When working on complex parts or with thick fabrics, slowing down the machine allows for greater accuracy and avoids needle breakage. When the operator works with thinner fabrics and produces more products, the speed of the machine is usually increased. In this paper, a servo motor control system based on PLC S7-1200 is proposed. The system is designed to control the actuators of the machine, such as electromagnets and gas pedals, in addition to the main shaft motor. The comparison shows that the results obtained with the author's control system are identical to those obtained with the control system of the sewing machine JUKI DDL 8700-7.

Magnetic Field Analysis and Optimization of the Gauge of Hybrid Maglev Needles

Compared with the traditional needle driving method, hybrid maglev needle driving is a new weft knitting machine technology, which alleviates the problems of noise, heat, and needle breakage. However, in the structure of needle arrays, magnetic disturbance between permanent magnet knitting needles leads to unstable needle control. Therefore, this paper attempts to solve this problem through a performance analysis of hybrid maglev needle driving. Based on the structure, the magnetic force distribution model of permanent magnet knitting needles is established. Aiming at the magnetic interference between magnetic arrays, a magnetic shielding material, silicon steel with a high permeability, is proposed to optimize the driving structure of a magnetic levitation needle array. Through simulation and experimental analysis, the influence of different silicon steel thicknesses on magnetic field shielding is analyzed. It is concluded that the optimal value of a silicon steel sheet is 1 mm and that the optimal gauge of hybrid maglev knitting needles is 8 mm. Finally, compared with the theoretical and simulation analysis, the experimental results have indicated that the proposed optimized structure of the gauge of hybrid maglev knitting needles is correct and effective.

Mechanical mechanism of suture passer needle break in rotator cuff repair.

Suture passer needle, as one of commonly used instrument in the arthroscopic rotator cuff repair, often breaks at the notch of the needle, which originally was designed to facilitate suture with thread. Our study aimed to evaluate the suture failure rate and stitch success rate between intact suture needle and broken needle and explore the mechanism of the needle breakage and achieving better future designs. From 2017 to 2021, consecutive 437 shoulders (11 cases were bilateral) underwent arthroscopic repair for full-thickness rotator cuff tear at the authors' institution. The breakage of needles was recorded. Finite elements analysis and mechanical test were utilized to compare stress distribution, puncture performance, and loaded puncture performance between the broken needle and the intact needle. We identified 19 consecutive patients for whom the needle tip of the TruePass™ suture passer was broken in the 437 shoulder surgeries. Based on the finite element analysis of Abaqus, around the tip and the notch of the intact needle was a large stress concentration. The average puncture force required by intact needle tip and the broken tip is 61.78N and 78.23N respectively. While the intact tip with notch is easier to break than the broken tip. The notch of the needle is a weak point in mechanics. The broken needle without the notch still has good tendon piercing and thread passing ability. The notch of needle may be not necessary, and the tip of the needle should be modified.

Preparation and evaluation of dissolving microneedle loaded with azelaic acid for acne vulgaris therapy

Anti-acne microneedle technology is an emerging approach to acne vulgaris and acne scars therapy. Currently, solid microneedle is the most common one in clinical practices. Nevertheless, it needs to be operated by professionals. Additionally, there is a potential risk of needle breakage, leading to a biohazard inside the skin. This study prepared and evaluated a dissolving microneedle (DMN) containing azelaic acid (AZA), providing a novel self-administered and rapid-onset pathway for acne patients. The AZA-loaded DMN can be inserted into the skin under the loaded force of 5 N. We examined the safety, transdermal release, stability, antibacterial activity, and pharmacokinetic studies of AZA-DMN to provide reference and guarantee for clinical trials. Besides, to evaluate the efficacy of DMN containing AZA, a randomized and controlled pilot study was conducted on adult acne patients. The results indicated that AZA-DMN had good skin compatibility and formulation stability. Furthermore, there was no significant difference in AZA concentrations in rats’ plasma before and after administration, revealing that AZA-DMN mainly worked on local skin. Compared to the control groups, more remarkable inflammation subsidence appeared in the AZA-DMN group. Meanwhile, it was shown that the delivery of AZA using DMN significantly shortened the therapy cycle compared with commercially available AZA cream. In summary, our studies confirmed that AZA-loaded DMN provided a promising treatment strategy for acne patients due to the enhanced transdermal permeability of AZA and its noticeable antibacterial effect on Propionibacterium acnes and Staphylococcus epidermidis.

Determination of Optimum Speed of a Knitting Machine by Analyzing the Different Parameters

The objective of this research was to determine the optimum speed of a knitting machine. This study compared the different parameters of a knitting machine running at various speeds. For this, a knitting machine of 22-inch diameter and 24 gauge with 66 feeders knitting 24 Ne yarn was selected and was run at 40 rotations per minute (r.p.m.).; 42 rotations per minute (r.p.m.).; and 44 rotations per minute (r.p.m.) for total 24 hours for each speed. Data was collected for two days for 12 hours each. The different causes of stoppages were recorded with their frequencies and time for total of a 24 hours. Again, actual fabric production and the defective amount were recorded in kg. Moreover, different machine problems (like needle breakage, oil problem etc.) that occurred during the machine running was also recorded. Finally, the efficiency at different speeds was calculated with the help of calculated production and actual production of the knitting machine. Considering the stoppage data, machine efficiency, defective fabric production, and different machine problems, it was found that the optimum speed for the knitting machine is 40 rotations per minute among the three different speeds.

Removal of a suture needle: a case report

BackgroundForeign bodies may be embedded or left behind in the oral cavity during oral surgical procedure. The loss of instruments such as impression material, surgical gauze, and broken injection needles are commonly reported in the dental field. These complications are generally symptomatic and show signs of inflammation, pain, and purulent discharge. Accidental breakage of suture needles is a rare but potentially dangerous event.Case presentationIn this report, we present one case of lost suture needle during the procedure of flap operation at local dental clinic and its successful removal under local/general anesthesia administration via CBCT with a help of two reference needles to localize the 6-0 nylon needle and consulting with the clinician.ConclusionCT scanning taken while mouth-closing may not be accurate with regard to real location measurement performed while mouth-opening. If so, other up-to-date radiographic devices and methods to retrieve a needle are recommended.

Bone Marrow Aspiration Using 18g Lumbar Puncture Needle

INTRODUCTION: Bone marrow aspiration (BMA) has an important role in the investigation and diagnosis of hematologic as well as nonhematologic malignancies and various other diseases. The procedure varies from one setting and person to the other. AIMS: The aim of the study is to study the role of 18G lumbar puncture (LP) needle in the diagnosis of bone marrow involvement in hematologic malignancies and metastasis for certain solid tumors. MATERIALS AND METHODS: During this hospital-based retrospective study, 708 patients who clinically and histopathologically diagnosed with the malignant lesion and subsequently undergone BMA were included in this study. RESULTS: BMA was done in 607 patients diagnosed with hematologic malignancies and 101 patients diagnosed with nonhematologic malignancies. Adequate marrow material was obtained in the first attempt in 683 (96.5%) cases. Multiple aspirations were needed in 25 (3.5%) cases. The majority (86.3%) of the patients experienced less pain by the 18 G LP needle compared to their previous experience with the conventional BMA needle. Needle breakage was not seen in any of the cases. CONCLUSION: The results of this study suggest that the 18G LP needle can be easily adopted for BMA and could be a great help in significantly reducing pain and complications in patients undergoing BMA.

Cutaneous Complications Associated With Intraosseous Access Placement.

Intraosseous (IO) access provides a potentially lifesaving means of vascular access in settings of trauma and advanced cardiovascular life support in which patients often require prompt and large volumes of fluid resuscitation, blood products, and medications. An additional benefit of IO access is the rare incidence of complications, with many studies reporting rates of less than 1%. The most commonly cited complications include compartment syndrome, osteomyelitis, traumatic bone fracture, and epiphyseal plate damage. To evaluate the dermatologic sequelae, we performed a retrospective chart review spanning 18 consecutive months to identify patients who underwent IO line placement, either at or en route to a large metropolitan level I trauma center in the Midwestern United States. Our review identified a complication rate of 2.7%, with complications including compartment syndrome, needle breakage, and a previously unreported cutaneous complication of traumatic bullae.

Adverse effects following dental local anesthesia: a literature review

Local anesthesia is indispensable in dentistry. Worldwide, millions of local anesthetic injections are administered annually, and are generally considered safe invasive procedures. However, adverse effects are possible, of which dentists should be aware of. This scoping review aimed to provide an extensive overview of the reported literature on the adverse effects of dental local anesthesia. The types of papers, what is reported, and how they are reported were reviewed. Additionally, the incidence and duration of adverse effects and factors influencing their occurrence were also reviewed. An electronic search for relevant articles was performed in PubMed and Embase databases from inception to January 2, 2020. The titles and abstracts were independently screened by two reviewers. The analysis was narrative, and no meta-analysis was performed. This study included 78 articles. Ocular and neurological adverse effects, allergies, hematomas, needle breakage, tissue necrosis, blanching, jaw ankylosis, osteomyelitis, and isolated atrial fibrillation have been described. Multiple adverse effects of dental local anesthesia have been reported in the literature. The results were heterogeneous, and detailed descriptions of the related procedures were lacking. Vital information concerning adverse effects, such as the dosage or type of anesthetic solution, or the type of needle used, was frequently missing. Therefore, high-quality research on this topic is needed. Finally, the adverse effects that are rarely encountered in real-world general practice are overrepresented in the literature.

The risks of injection anesthesia in dentistry

The article intends to study the risks of performing injection anesthesia for dentists experiencing chronic fatigue syndrome. Materials and methods used: The survey was conducted from August to November 2019 at various dental clinics of Moscow, with 308 dentists having filled in the questionnaire. Information source: The “Questionnaire on Assessing Injection Security and Chronic Fatigue Syndrome” was offered to dentists from clinics representing different types of ownership and contained 88 questions. Results: 97,14% of the respondents were feeling anxious while performing local anesthesia, yet, regrettably, 14,28% of them had to refer the patient to a dental surgeon for this procedure. 17,14% (n=53) of the 308 respondents noted that they had to confront the patient’s general condition worsening significantly due to a local anesthetic injection prior to the start of dental treatment. The mistakes made mostly had to do with anesthetic choice (26,73%), needle choice (12%), and needle breakage (3,78%). 17,14 per cent of dentists had the experience of confronting grave, even fatal outcomes of anesthesia. The majority of dentists (74,29%) work from 41,2 to 57,7 hours weekly. The risk of developing chronic fatigue syndrome was assessed as high in 11,43% of all cases. Conclusion: Given the absence of prophylaxis in 45,71% of cases related to anesthetic injection and the increased concentration of vasoconstrictor in the anesthetic in 88,57% of all instances, keeping records of complications caused by injection anesthesia is recommended.

Intracranial Air Embolism after Inferior Alveolar Nerve Block: A Case Report.

IntroductionThe number of nontraumatic dental pain emergency department (ED) visits continues to substantially rise in frequency every year. While there are several methods for treating dental pain, an inferior alveolar nerve block (IANB) is a non-narcotic alternative that provides instantaneous relief of severe pain.Case ReportA 59-year-old male presented to the ED from a dentist’s office for evaluation of a right-sided headache with an associated episode of palpitations and near syncope that developed while receiving an inferior alveolar nerve block. Computed tomography of the patient’s head revealed multiple small foci of air in the right temporalis muscle and in the intracranial venous drainage system. Given the patient’s history of dental procedure, the intravascular introduction of air and local anesthetic was suspected.ConclusionInferior alveolar nerve block procedures can have complications, including hematoma formation, trismus, facial palsy, needle breakage, and in this case, intravascular injection and cerebral air embolism. To perform a successful IANB, it is critical for providers to be familiar with anatomical landmarks and to consistently perform aspiration to confirm that needle placement is not intravascular.

Intracorporeal Needle Breakage During Intracavernous Injection Therapy: a Case Report

Intracavernous injection (ICI) therapy is an effective treatment for erectile dysfunction (ED) that has been used since 1982. Intracorporeal needle breakage is a rare complication of this procedure, with a few case reports in the literature. Thus, we present a case of a 54-year-old man with needle breakage during routine application. The precise location of the needle was confirmed by radiography and ultrasonography. This patient was successfully treated with surgical exploration and needle withdrawal. No postoperative complication was reported and he maintained his usual response to intracavernous vasoactive agents. Although rare, it can be solved with immediate surgical exploration with no long-term complications.

Needle Breakage during Local Anesthesia in The Oral Cavity: A Case Report

Needle Breakage during Local Anesthesia in The Oral Cavity: A Case Report

The key role of thread and needle selection towards ‘through-thickness reinforcement’ in tufted carbon fiber-epoxy laminates

Tufting of dry preforms is one of the means of accomplishing through-thickness reinforcement (TTR) in a liquid composite molding process. Herein, once a preform is laid up, an automated robotic tufting setup is used to introduce the TTR. The selection of thread and needle for tufting process go hand-in-hand as tufting operation involves the act of penetrating preform by the needle as well as the trauma thread has to endure during this act. This paper explores the methodology of thread and needle selection through studies at different levels right from tufting of preforms to testing of tufted laminates. Glass, carbon and Kevlar threads in combination with a tufting needle and two different sewing needles are explored in this study. The effect of tufting speed on the quality of tuft is analyzed in terms of damage of fabric yarn, thread, and needle breakage. Layer-wise analysis of damage due to needle penetration in fabric yarns is carried out. Key mechanical properties of tufted composite samples are evaluated to determine the effect of tufting on the in-plane and out-of-plane properties.

Accidental Breakage of an Aspiration Needle During EBUS-TBNA

Accidental Breakage of an Aspiration Needle During EBUS-TBNA