Removal Of Needle Research Articles

Soothing and Distress Behaviors of Infants, Parents, and Clinicians During Childhood Vaccinations

ObjectivesThe purpose of this study is to describe the behaviours of infants who were born preterm, their parent, and clinicians during two-, six-, twelve- and eighteen-month vaccinations. MethodsVaccination sessions were video recorded for 3-5 minutes. The proportion of five-second intervals in which distress and soothing behaviour occurred for infants, parents, and clinicians was coded using the Measure of Adult and Infant Soothing and Distress. Coding consisted of three phases: baseline/anticipatory (60 seconds prior to first needle), procedure (first needle to removal of final needle), recovery (up to 180 seconds after removal of final needle). Results64 infants were included. Distress behaviour for infants during baseline ranged from 13% (twelve-month) to 29% (two-month). There was limited anticipatory soothing behaviour from parents (10% (twelve-month) to 50% (two-month)) and clinicians (6% (twelve-month) to 17% (two-month)). Distress behaviour in infants during procedure ranged from 43% (eighteen-month) to 96% (two-month). There was limited soothing behaviour during procedure from parents (10% (twelve-month) to 81% (twelve-month)) and clinicians (13% (twelve-month) to 71% (two-month)). Few infants received additional pain reducing interventions of skin-to-skin contact, 24% oral sucrose, and topical anesthetic. DiscussionDespite infant distress, there was limited anticipatory behaviour from parents and clinicians. Two-month infants displayed the most distress across all timepoints yet received the least amount of treatment and proximal parent and clinician behaviour. Additional implementation efforts are required to increase awareness and practice uptake among parents and clinicians to ensure infants receive equitable and effective pain management.

Assessing Expected Neurological Deficit with Spinal Anesthetic Before Removal of Spinal Needle – A Case of Failed Spinal Anesthesia Due to Drug Failure

Assessing Expected Neurological Deficit with Spinal Anesthetic Before Removal of Spinal Needle – A Case of Failed Spinal Anesthesia Due to Drug Failure

Laparoscopic removal of a sewing needle from the liver in a child

Laparoscopic removal of a sewing needle from the liver in a child

Reporting of delayed adverse donor reactions in whole blood donors: Just the tip of an iceberg!

The study was planned to determine the incidence and analyze how various epidemiological factors tend to be associated with delayed adverse donor reactions (ADR). The prospective observational study was conducted in Department of Transfusion Medicine of tertiary care hospital from January to December 2019. Eligible blood donors were observed for any adverse reactions after 15 minutes of removal of phlebotomy needle. Further, telephonic calls were made to each enrolled blood donor on day-2 and day-7 of the whole blood donation. For each day, two calls were made at an interval of 4 hours before declaring the participant to be non-responder. A total of 1540 (84.1%) blood donors responded on day-2 and 1610 (87.9%) responded on day-7 of follow-up. Total 180 (11.2%) blood donors experienced delayed ADRs. Two donors (1.1%) experienced on-site while 178 (98.89%) reported off-site delayed ADRs when followed-up telephonically. The commonest delayed ADRs reported were bruise (n=72; 30.9%), arm-pain (n=61; 26.2%) and generalised weakness (n=44; 18.9%). Female donors (27.3% vs. 11.2%; P=0.004), first time donors (15.2 vs. 9.9%; P=0.002), donors with low body-weight (range of 45-60kg; 15.9% vs. 11.5% vs. 6.1%; P=0.011) and body mass index<18.5 (24% vs. 12.5% vs. 9.7% vs. 11.3%; P=0.028) experienced more delayed ADRs. Blood donors do experience delayed ADRs but these are not reported to the blood centers as these are usually mild. However, it is important to capture these delayed adverse donor reactions and report it to National Hemovigilance Program so that strategies can be formulated to prevent their occurrence and recurrence.

Laparoscopic removal of a broken acupuncture needle in pancreatic head: A case report

Laparoscopic removal of a broken acupuncture needle in pancreatic head: A case report

Removal of an intracardiac sewing needle without inflow occlusion or cardiopulmonary bypass in a dog

AbstractA 3.5‐year‐old Australian shepherd dog referred for the exploration and management of an intrathoracic sewing needle. The animal had a history of cardiovascular collapse the previous day. On presentation, the dog was asymptomatic, bright, alert and responsive. Computed tomography scan and echocardiography confirmed the presence of a sewing needle in the heart, with moderate pericardial and bilateral pleural effusions. Using careful blind palpation of the heart after sternotomy, the sewing needle was pushed through the myocardium and retrieved without haemorrhage. Recovery was uneventful and the dog returned to full exercise. This case report describes the migration of a sewing needle into the heart from an unspecified origin, an atypical removal, and a good postoperative outcome in a 3.5‐year‐old Australian shepherd dog.

Needle as foreign body in urethra: Successful removal

: Self-inserted foreign bodies in the lower urinary tract are rare among children. The treatment of foreign bodies in the urethra is determined by their type, size, location, shape, and mobility. : We describe here a 10-year-old boy who had self inserted a needle into his urethra. Initial attempts to remove the needle from the urethra by inserting a cystoscope failed. The patient presented to our institution with bleeding per urethra with feeding tube insitu per urethra. As already attempted for urethroscopic removal, direct removal of needle done under general aneathesia done.: Per Rectal examination plays an important role and gives adequate information and timely management of the child leads to uneventful hospital stay Psychiatric evaluation is mandatory to detect an underlying mental disorder.

Removal of a broken dental needle in the pterygomandibular space using an image intensifier: two case reports

Introduction: Accidents and complications are elements that can occasionally be associated with the procedures realized within work dentist environment. Among some accidents related to dental practice, needle fracture during local anesthesia is noteworthy due to its rarity. Objective: This work seeks to report two cases of removal of a broken dental needle in the pterygomandibular space using an image intensifier. Material and Methods: In both cases, the accident happened during an inferior alveolar nerve block. The surgeons requested image exams to locate the objects using general anesthesia. In the surgery, a transoral incision was made to remove the broken needle from the pterygomandibular space, guided by an image intensifier. Results: Both surgeries were a success. The broken needles were found quickly with the use of the image intensifier, and no postoperative complications were observed. Conclusion: The correct assessment of fractured dental position is essential for its removal. The use of the image intensifier has been showing advantages, such as offering fast transoperative dynamic images and at different angles, thus providing opportunity for calmer surgery and with less risk for the patient and the operator.

Regional tissue oxygen saturation as a predictor of post-spinal anesthesia hypotension for cesarean delivery.

Regional tissue oxygen saturation as a predictor of post-spinal anesthesia hypotension for cesarean delivery.

Intra-Arterial Infusion of Imipenem/Cilastatin Sodium through a Needle Inserted into the Radial Artery as a New Treatment for Refractory Trapeziometacarpal Osteoarthritis

PurposeTo evaluate the efficacy and safety of intra-arterial infusion of temporary embolic material with/without radiographic monitoring via a needle placed into the radial artery to occlude abnormal neovessels for trapeziometacarpal osteoarthritis. Materials and MethodsThirty-one patients having Eaton stage II or III osteoarthritis, with a symptom duration longer than 6 months, resistant to conservative therapy for at least 3 months were prospectively enrolled. All procedures were performed by infusing imipenem/cilastatin sodium through a 24-gauge needle that was percutaneously inserted into the radial artery. Seven patients underwent the procedure with fluoroscopy, and 21 patients underwent the procedure without fluoroscopy. The mean Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, numerical rating scale (NRS), and Patient Global Impression of Change (PGIC) scale were evaluated before and at 2, 6, and 24 months after the first procedure. ResultsTechnical success was 100%. The mean procedure time (from the beginning of local anesthesia to the removal of needle) was 2.9 minutes ± 1.6. The QuickDASH score improved from the baseline to 2, 6, and 24 months (49.2 ± 11.2 vs 22.1 ± 11.2, 20.9 ± 16.6, and 19.5 ± 16.1, respectively, all P <.001). The NRS improved from the baseline to 2, 6, and 24 months (7.2 ± 1.1 vs 3.1 ± 1.8, 2.8 ± 2, and 2.5 ± 2.1, respectively, all P <.001). Improvement on PGIC was observed in 84%, 81%, and 77% of patients at 2, 6, and 24 months, respectively. No major adverse events were encountered. ConclusionsIntra-arterial infusion of temporary embolic material is a feasible treatment option for trapeziometacarpal osteoarthritis.

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.

Evaluation of Our Cases of Foreign Body in Various Anatomical Regions of the Body

Aim: It can be quite difficult to remove foreign bodies located within soft tissue. The location needs to be defined for the procedure to be successful. The aim of this study was to present our cases where a foreign body had been detected and then removed from various anatomical regions. Material and Method: This article is about the evaluation results of our foreign body cases referred to the Kafkas University Faculty of Medicine from the Family Medicine practices in Kars and the surrounding regions. The charts of 15 patients who had presented to the General Surgery or Orthopedics and Traumatology Departments of the Kafkas University Faculty of Medicine after being referred from the emergency or outpatients departments between November 2015 and July 2019 were retrospectively reviewed. The demographic findings, surgical treatment and results, etiological causes and postoperative complications of the patients were recorded. Follow-up duration was 6 months to 3 years depending on the patient's condition. Results: There were 8 male and 7 female patients. The mean age was 30.79 years. The symptoms were pain, redness, swelling, itching and serous or purulent discharge for foreign bodies in the hand, foot, femur-tibia soft and bone tissue areas and acute abdomen symptoms in the patient where we found an intra-abdominal foreign body. The imaging methods used were conventional radiography and computed tomography. Treatments included removal of needle from soft tissue, bullet fragment from bone intramedullary tissues and intrauterine device from transverse colon meso. We also observed the rectal passage with feces of an intestinal intraluminal metallic device after it was swallowed. There was only one complication among all our patients and consisted of partial radial nerve damage. Conclusion: Foreign bodies should be located with imaging methods and removed under sterile conditions in the operating room. Early detection and removal of foreign bodies from anatomical regions are vital. Key Words: Foreign body, Radio-opaque, Soft Tissue DOI: 10.7176/JSTR/7-04-01

Laparoscopic removal of an aberrant acupuncture needle in the gluteus that reached the pelvic cavity: a case report

BackgroundIntrapelvic aberrant needles are rare in clinical practice. Long-term foreign bodies in the abdominal cavity may form granulation tissue or an abscess, and may cause organ injury. Therefore, such foreign bodies need prompt removal.Case presentationA 26-year-old male athlete was referred to our hospital for investigation of an aberrant acupuncture needle in the gluteus. The needle was unable to be removed during acupuncture treatment, and the end broke off and remained in the gluteus. Abdominal X-ray examination showed a thin, 40-mm-long, metallic foreign body resembling an acupuncture needle. Abdominal computed tomography showed an abnormal shadow in the gluteus. However, it was unclear whether the tip of the needle reached the pelvic cavity. Thus, it was decided to surgically extract the needle via laparoscopic surgery under X-ray guidance as a safe and minimally invasive method. Although X-ray fluoroscopy confirmed that the aberrant needle was located in the gluteus, the needle could not be felt with the forceps, as the peritoneum surrounding the needle had granulomatous changes due to inflammation. Therefore, the retroperitoneum was further dissected to search for the needle. Once the needle was identified, its flexibility enabled it to be easily removed by grasping it directly with a needle holder. The length of the aberrant needle was 40 mm. The postoperative course was uneventful, and the patient was discharged from hospital on postoperative day 2.ConclusionsWhen a foreign body remains in the gluteus and its tip touches intrapelvic organs, such as the rectum, it is critical to determine the best approach for its safe removal. Given the anatomical location of the foreign body and the patient background, laparoscopic removal was considered the best approach in the present case.

Hemoptisis de etiología desconocida. Informe de caso

Introducción: La hemoptisis es una cantidad variable de sangre que pasa por la glotis proveniente de las vías aéreas y de los pulmones.&#x0D; Caso Clínico: Hombre, 32 años, obeso, tabaquista, ingresó por disnea de moderados a mínimos esfuerzos de 4 meses de evolución. El paciente refirió tos con expectoración hemoptoica de 05 años de evolución, predominio nocturno, constatada al despertar. Refirió haberse sometido a varios procedimientos quirúrgicos: por sospecha de torsión testicular, lamectomía descompresiva y extracción de aguja de costura en región parietal posterior a una TAC por episodios tónico-clónicos. Durante su internación, se le realizaron varios exámenes todos sin éxito. Un día, se identificó actitud sospechosa, comprobándose la ingesta de sangre del conducto de poliflex, la cual colaboró con el diagnóstico definitivo de “síndrome facticio”.&#x0D; Discusión: Como parte de la salud integral no debemos olvidar la evaluación de la salud mental y hacer más hincapié en la historia clínica.

Duodenotomy in a cat for removal of a sewing needle: A case report

An unusual case of 4-years old female cat was presented to the Teaching and Training Pet Hospital and Research Center (TTPHRC), Purbachal, Dhaka with a complaint of accidental ingestion of sewing needle connected with long thread on the day of incidence. The presented cat didn’t have any other complication on physical examination. Lateral and ventrodorsal radiograph of the abdomen showed the location of sewing needle in the stomach. On the 2nd day of incidence, presurgical radiographs confirmed the migration of sewing needle to the posterior location. Following laparotomy, stomach and intestine were gently checked by manual palpation for any perforation and location of sewing needle detected in the duodenum. The needle was successfully extracted by duodenotomy. The owner was contacted regularly till two weeks postoperatively and the cat recovered without any complication.

Inhalation of low-dose desflurane prevents the hemodynamic instability caused by target-controlled infusion of remifentanil and propofol during laparoscopic gynecological surgery: A randomized controlled trial.

The objective of the present study was to determine whether the addition of inhaled desflurane is superior to remifentanil-propofol total intravenous anesthesia (TIVA) alone in patients undergoing laparoscopic gynecological surgery. A total of 60 patients who were scheduled to undergo laparoscopic gynecological surgery were prospectively enrolled and randomly allocated to receive either propofol-remifentanil (PR group; n=30) or combined propofol-remifentanil and low-dose desflurane (PRD group; n=30) for the maintenance of anesthesia. Hemodynamics [mean arterial pressure (MAP); heart rate (HR)], recovery parameters and complications were recorded. The results of the present study indicated that the addition of desflurane significantly reduced the amount of propofol and remifentanil that was administered in the PRD group, compared with that in the PR group. MAP and HR were significantly higher at T3 (5 min post-pneumoperitoneum), but significantly lower at T4 (removal of pneumoperitoneum needle) and T5 (post-operation immediately) in the PR group, compared with the PRD group. Moreover, MAP and HR were significantly altered at multiple time points within the PR group; however, they were relatively stable in the PRD group. There were no significant differences in the recovery parameters and complications between the two groups. In conclusion, combining low-dose desflurane with PR may represent an efficient anesthesia regimen to prevent the hemodynamic instability of TIVA in patients undergoing laparoscopic gynecological surgery.

Outcomes of intravitreal melphalan for vitreous seedings in retinoblastoma resistant to systemic chemotherapy

PurposeTo determine the efficacy of intravitreal injection of melphalan for vitreous seedings resistant to systemic chemotherapy. Methods and materialProspective non comparative study investigates 105 consecutive eyes of 105 retinoblastoma patients in a tertiary care hospital. Patients with persistent or recurrent vitreous seeds were included in the study. Injection melphalan was prepared under aseptic conditions. Injection was given at 2–4 mm away from the limbus using 27gauge needle. Cryotherapy was applied at injection site before and during removal of needle. Eye was copiously irrigated soon after the injection to minimize the chances of surface toxicity. After injection intravitreal melphalan, eye pad was applied for 2 h and patients were instructed to instill topical antibiotic and steroid drops for one week. Patients were examined the next day and then weekly till 3rd week. At each follow up, examination under microscope (EUA) and indirect ophthalmoscopy was done. Retinal images were taken using retcam MII for comparison with the previous ones. ResultsTwenty-five (23.8%) out of 105 eyes showed complete regression of vitreous seeds with one injection of intravitreal melphalan after one month. Thirty-one (29.5%) eyes required further 3 intravitreal injections for complete regression, while thirty-four (32.4%) eyes required further 6 intravitreal injections for complete regression. Fifteen (14.3%) eyes did not show regression of vitreous seeds even after 6 intravitreal injections and were planned for second line chemotherapy. ConclusionIntravitreal injection melphalan shows promising results in the treatment of vitreous seeds in retinoblastoma, resistant to systemic chemotherapy.

Microdroplet and spatter contamination during phacoemulsification cataract surgery in the era of COVID-19.

ImportanceDetermine phacoemulsification cataract surgery risk in a Covid‐19 era.BackgroundSARS‐CoV‐2 (Covid‐19) transmission via microdroplet and aerosol‐generating procedures presents risk to medical professionals. As the most common elective surgical procedure performed globally; determining contamination risk from phacoemulsification cataract surgery may guide personal protection equipment use.DesignPilot study involving phacoemulsification cataract surgery on enucleated porcine eyes by experienced ophthalmologists in an ophthalmic operating theatre.ParticipantsTwo ophthalmic surgical teams.MethodsStandardized phacoemulsification of porcine eyes by two ophthalmologists accompanied by an assistant. Fluorescein incorporated into phacoemulsification irrigation fluid identifying microdroplets and spatter. Contamination documented using a single‐lens reflex camera with a 532 nm narrow bandpass (fluorescein) filter, in‐conjunction with a wide‐field blue light and flat horizontal laser beam (wavelength 532 nm). Quantitative image analysis using Image‐J software.Main Outcome MeasuresMicrodroplet and spatter contamination from cataract phacoemulsification.ResultsWith phacoemulsification instruments fully within the eye, spatter contamination was limited to <10 cm. Insertion and removal of the phacoemulsification needle and bimanual irrigation/aspiration, with irrigation active generated spatter on the surgeons' gloves and gown extending to >16 cm below the neckline in surgeon 1 and > 5.5 cm below the neckline of surgeon 2. A small tear in the phacoemulsification irrigation sleeve, presented a worse‐case scenario the greatest spatter. No contamination above the surgeons' neckline nor contamination of assistant occurred.Conclusions and RelevanceCataract phacoemulsification generates microdroplets and spatter. Until further studies on SARS‐CoV‐2 transmission via microdroplets or aerosolisation of ocular fluid are reported, this pilot study only supports standard personal protective equipment.

Thoracoscopic removal of intrathoracic needle in body after extended period -Case report

Thoracoscopic removal of intrathoracic needle in body after extended period -Case report

Removal of a broken acupuncture needle in retroperitoneum by laparoscopy: a case report

BackgroundAcupuncture is a famous traditional medicine in China, but the complications caused by broken acupuncture needles have been rarely reported. It seems easy to remove the foreign matters usually, but things become difficulty in special issues. Here, we reported a recently encountered case to provide an important teaching point of treating a chronically retained broken needle in retroperitoneum.Case presentationA 42-year-old man presented with a chronically retained broken needle in his body after acupuncture therapy two years ago. However, due to the discomfort at the left back recently and ordinary inconvenience such as security check, he came to our hospital for minimally invasive surgery. He was introduced to our department because the broken needle had migrated from subcutaneous to adipose tissue in retroperitoneum during the two years. Considering the position of the broken needle, the patient was performed by laparoscopy in general anesthesia. The operation time was about 31 min and there were only three 7 mm incisions in the left lateral abdominal wall. The X-ray exam was performed to confirm that the broken needle was removed integrally. The patients begun normal activity at 6 h after surgery and was discharged on the second day after surgery.ConclusionsAcupuncture is widely used for pain treatment in China, but how to handle the complication of acupuncture needle broken in body are rarely reported. Laparoscopy will be the reasonable choice for treating needles broken in retroperitoneum.