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At least 37 records · Page 2Linked to original sources

PubMed2004

The long core needle with an end-cut technique for prostate biopsy: does it really have advantages when compared with standard needles?

OBJECTIVE: To evaluate the failure rate, core length and fragmentation rate for each different stroke length of the end-cut (BioPince) needle in order to show the performance of the needle for different stroke lengths and compare these with the standard side-notch needle. METHODS: TRUS guided biopsy of the prostate was performed on 86 consecutive men between June 2002 and May 2003. The patients were randomized into two groups with 43 men in each group. Patients in group A underwent 8 core biopsy with the end-cut needle in different stroke lengths; 13, 23 and 33mm respectively. Patients in group B underwent 8 core biopsy with the side-notch needle. The cores have been evaluated and compared for failure rates, core lengths, number of core lengths under 5mm and fragmentation rates. RESULTS: When the end-cut needle was used, a significant number of failure rates was noted; with an overall failure rate of 16%. The failure rates were 26% for 13mm stroke length, 18% for 23mm stroke length and 10% for 33mm stroke length respectively. These failure rates showed statistically significant difference from standard needle for overall and for every separate stroke length ( p<0.001 for all). Standard needle and the cores taken with 33mm stroke length of the end-cut needle had similar low fragmentation rates while 13 and 23mm stroke lengths had higher rates. Of the overall cores taken by BioPince needle, 46/344 (13%) of the cores were shorter than 5mm and this was significantly higher than the standard needle with 3/344 cores less than 5mm ( p<0.001). The end-cut needle when used with the 33mm stroke length has improved the core length by 68% according to the standard side-notch needle. CONCLUSIONS: Our results showed that the performance of the end-cut needle worsens with decreased stroke lengths. The end-cut needle showed high failure rates which necessitates new punctures for taking a core. Additionally, the fragmentation rates are not lower than the standard needle and it has higher rates of taking small core samples. The only significant advantage of this needle over the standard needle is taking longer cores when it has been used at 33mm stroke lengths.

Adult↗

PubMed1990

Needle growth in Sitka spruce (Picea sitchensis): effects of nutrient deficiency and needle position within shoots.

Needle development and shoot growth were studied in 14- and 20-year-old Sitka spruce (Picea sitchensis (Bong.) Carr.) planted on an oligotrophic peat and fertilized with N, P and K (control), N and P (-K), N and K (-P) or unfertilized (-NPK). Shoot extension, needle number, and the size and number of needle cells were observed throughout the season. Beginning with bud burst in early May, needle growth continued for nine weeks in the control treatment. Needle growth in the mineral deficiency treatments terminated at the same time as in the controls, although it did not begin until up to three weeks later than in the control trees. Needles developed acropetally along the shoot, with basal needles completing their development first. Cell division in needles of control trees lasted about 3 weeks, with cell expansion continuing for a further 3 weeks. Initial mean cell cycle times were shortest for proximal needles following bud burst, but lengthened as the season progressed. Cell number increased from 6600 in the primordia to 200 000 in mature needles. Final needle dimensions and cell number varied according to the position of the needle on the shoot. The largest needles with the most cells were near the middle of the shoot. Relative to the controls, all mineral deficiency treatments reduced shoot length, bud and needle dimensions, and needle cell number, particularly the -P treatment. Potassium and P deficiency treatments reduced primordial cell number by up to 42%, whereas final mean cell size was 30% greater in the -P treatment, 17% greater in the -NPK treatment, but 14% smaller in the -K treatment. Mean cell size was constant for needles at all positions in any particular treatment at any time, so that final needle size was determined by cell number alone. Needle dry weight/fresh weight ratio continued to increase until early August, with significantly higher ratios in the -K and -P treatments than in the controls.

Journal Article↗

PubMed1999

Comparison of rebiopsy rates after stereotactic core needle biopsy of the breast with 11-gauge vacuum suction probe versus 14-gauge needle and automatic gun.

OBJECTIVE: The 11-gauge vacuum suction probe is an alternative to the 14-gauge needle and automatic gun for performing stereotactic core needle biopsies. This study compares rebiopsy rates after stereotactic core needle biopsies that were performed with the two methods. The study also assesses the outcomes of those repeat biopsies. MATERIALS AND METHODS: Five hundred ninety-two stereotactic core needle biopsies using a 14-gauge needle and automatic gun and 354 using an 11-gauge vacuum suction probe were performed consecutively. Excluding malignancies, the number of cases requiring rebiopsy and the reasons for rebiopsy were determined for each group. The histologic diagnoses of the repeat biopsies were assessed. RESULTS: The rebiopsy rate was significantly lower with the 11-gauge vacuum suction probe (9.0%) than with the 14-gauge needle and automatic gun (14.9%) (p = .013). Significant reductions were found in cases of insufficient sampling (probe, 1.7%; needle, 4.4%; p = .042) and mammographic-pathologic discrepancy (probe, 0.8%; needle, 3.4%; p = .026). The rebiopsy rate for masses was 6.1% with the vacuum probe versus 10.7% with the 14-gauge needle (p = .12) and for calcifications was 11.6% with the vacuum probe versus 23.7% with the 14-gauge needle (p = .003). After rebiopsy, the percentage of cases in which malignancy was found was 18.5% with the vacuum probe versus 13.7% with the 14-gauge needle. On rebiopsy, the percentage of malignancies found in each category were atypical hyperplasia: probe 26.7%, needle 20.0%; insufficient sample: probe 0%, needle 9.5%; pathologist recommendation: probe 50.0%, needle 12.5%; and lobular carcinoma in situ: probe 0%, needle 100%. CONCLUSION: Use of the 11-gauge vacuum-assisted device significantly decreases but does not eliminate the need for rebiopsy after stereotactic core needle biopsy. The rebiopsy rate for calcifications was significantly reduced by using the vacuum suction probe rather than the 14-gauge needle; however, the rate for masses was reduced only slightly. On rebiopsy, malignancies were found in both groups.

Biopsy, Needle↗

PubMed2003

Extended prostate needle biopsy improves concordance of Gleason grading between prostate needle biopsy and radical prostatectomy.

PURPOSE: We examined the concordance of Gleason scores in prostate needle biopsy specimens and the corresponding radical retropubic prostatectomy specimens in a cohort of patients grouped according to the number of cores obtained during diagnostic needle biopsy. MATERIALS AND METHODS: We reviewed clinical and pathological data on a cohort of 466 men diagnosed with localized prostate cancer by needle biopsies who underwent radical retropubic prostatectomy between January 1, 1990 and July 31, 2001. Two study groups were identified, including 126 patients diagnosed with prostate cancer by extended needle biopsies (10 or more cores) and 340 diagnosed with cancer by nonextended needle biopsies (9 or fewer cores). Mean age was 60 years and median prostate specific antigen was 5.8 ng./ml. The median number of cores in the extended and nonextended biopsy groups was 12 and 6, respectively. The concordance of Gleason score in the needle biopsy and prostatectomy specimens was compared and correlated with the number of cores on needle biopsy. RESULTS: In the whole cohort 311 patients (67%) had identical Gleason scores on the needle biopsy and prostatectomy specimens, while 53 (11%) were over graded and 102 (22%) were under graded on needle biopsy. In patients who underwent extended needle biopsies the accuracy rate for Gleason scoring was 76% with 10% over and 14% under graded. The highest accuracy rates were in patients with 13, 14 and 16 cores (89%, 87% and 100%, respectively). No patients in the extended needle biopsy group had a discrepancy of more than 2 Gleason units in grade in the biopsy and surgical specimens. In those who underwent nonextended needle biopsies the accuracy rate for Gleason scoring was 63% with 12% over and 25% under graded. There were significantly different rates of accuracy (p = 0.008) and under grading (p = 0.01) in the 2 needle biopsy groups. Patients with a needle biopsy Gleason score of less than 7 had significantly higher concordance with the prostatectomy Gleason score when extended biopsies were done compared with nonextended biopsies (p = 0.001). CONCLUSIONS: Prostate cancer grading by extended needle biopsy is a better predictor of the final Gleason score than nonextended needle biopsy, as determined by radical prostatectomy histological evaluation. Therefore, extended prostate needle biopsy provides better guidance to determine the appropriate treatment in patients with prostate cancer.

Biopsy, Needle↗

PubMedDate not supplied

Prefilled syringe needles versus standard removable needles for intravitreous injection.

PURPOSE: To investigate differences in the scleral resistance between standard disposable 27 gauge (G) needle versus the Macugen prefilled syringe needle. METHODS: Observational study at one eye center. One injecting physician performed 46 intravitreous injections using standard Becton Dickinson 27 G needles and 71 intravitreous injections using Macugen needles during January to May 2005. The procedure in two patients was videotaped and analyzed frame by frame. Microphotographs of used needles were analyzed. RESULTS: There were no complications during the injection procedure in either group. Microphotographic analysis after injection revealed 3 and 5 facets on standard 27 G needle and Macugen needles, respectively. The bevel forming the tip of the 27 G needle was steeper and longer than that of the Macugen needle. The inside diameter in the standard 27 G needle was 220 microm versus 210 microm in the Macugen needle. CONCLUSION: There are differences in needle design between commonly used disposable 27 G needles and 27 G Macugen needles which result in higher resistance to penetration with Macugen needle. Careful needle design is an important concern in manufacturing prefilled syringes with needles attached to them.

Animals↗

PubMedDate not supplied

Abdominal and pelvic needle aspiration biopsies: can we perform them well when using small needles?

BACKGROUND: The aim of this study was to compare abdominal fine-needle aspirations (FNAs) performed with large (>/=20-gauge) or small (</=21-gauge) needles for diagnostic rate, number of samples required for diagnosis, diagnostic accuracy, and complication rates. METHODS: Abdominal and pelvic FNA procedures were retrospectively reviewed. Needle size, imaging guidance used, number of pathology slides created, complications, and cytologic and final diagnoses were obtained by reviewing radiologic, medical, and cytology records. RESULTS: Two hundred ninety procedures were included in the study. Two hundred fifty-seven were performed in patients having only one biopsy during the study interval. Of these, 159 had biopsies using small needles and 98 using large needles. Small needle biopsies had as high a diagnostic rate as did large needle biopsies (97.5% vs. 92. 9%, p = 0.11). Small and large needle biopsies showed high diagnostic accuracy (96.1 and 98.9%, respectively; p = 0.27). Incorrect cytologic diagnoses plus nondiagnostic examinations composed 6.3% of biopsies using small needles and 8.2% of biopsies using larger needles (p = 0.62). Complication rates were low. Average number of needle passes tended to be lower when small needles were used. CONCLUSION: Small needles can be successfully used for abdominal and pelvic FNAs. Small needles require the same or fewer needle passes, have low risk, have the same or improved ability to obtain diagnostic material, and achieve correct diagnoses compared with larger needles.

Abdomen↗

PubMed2004

An "optimal" k-needle placement strategy and its application to guiding transbronchial needle aspirations.

This article addresses the problem of finding an "optimal" strategy for placing k biopsy needles, given a large number of possible initial needle positions. We consider two variations of the problem: (1) Calculate the smallest set of needles necessary to guarantee a successful biopsy; and (2) Given a number k, calculate k needles such that the probability of a successful biopsy is maximized. Note that "needle" is used as shorthand for the parameter vector that specifies the needle placement. Both problems are formulated in terms of two general, NP-hard optimization problems. Our k-needle placement strategy can be considered as "optimal" in the sense that we are able to formulate it as a known NP-hard problem for which it is believed (NP not equal P conjecture) that no efficient algorithm exists that computes the optimal solution. In other words, our strategy is "optimal" with respect to the best approximative algorithm known for the respective NP-hard problem. For the second variation we have implemented an approximative algorithm that is guaranteed to be within a factor of approximately 0.63 of the exact solution. Given a number k, the algorithm calculates k sets of parameters, each set specifying the placement of a needle and the corresponding probability of success. The resulting probabilities show that our approach can provide valuable decision support for the physician in choosing how many needles to place and how to place them.A typical example of a biopsy where the initial needle position is known approximately is a transbronchial needle aspiration (TBNA). We demonstrate how our "optimal" needle placement strategy can be used to achieve sensor-less guidance of TBNA. The basic idea is to use a patient-specific model of the tracheobronchial tree (from CT/MR) and our model for flexible endoscopes to preoperatively estimate the unknown position of the bronchoscope. The result is a set of candidate shapes for the unknown shape of the bronchoscope before needle placement or, in other words, a (large) number of possible initial needle positions. By parameterizing the handling of the bronchoscope, including the insertion of the biopsy needle, we are able to apply our "optimal" strategy. The result is a TBNA protocol that, if executed during the procedure, prescribes how to handle the bronchoscope to maneuver the needle into the target. With the aforementioned endoscope model, we present a new way of modeling long, flexible instruments. The algorithm requires no initialization or preprocessing and calculates the workspace of an instrument based on its insertion depth and a set of internal and external constraints.

Algorithms↗

PubMedDate not supplied

Long-tapered double needle used to reduce needle stick nerve injury.

BACKGROUND AND OBJECTIVES: Needle trauma may cause peripheral nerve injuries during performance of peripheral nerve block. METHODS: Four types of 21-gauge needles for regional anesthesia were compared: a beveled nerve block needle (Quincke type); a short-tapered needle with a side orifice (Whitacre type); a long-tapered needle with a side orifice (Sprotte type); and a long-tapered double needle combining an inner pencil-point fine needle with an outer truncated conical needle (a new type). This new needle was developed to reduce the potential for nerve injury while retaining a suitable flow rate of anesthetic solution and the ability to inject the solution precisely at the point of paresthesia elicited by the tip. Each type of needle was used to produce puncture injuries to rabbit sciatic nerves. Eighteen specimens were studied within each needle group. The beveled needle was used to produce two different types of nerve injuries by inserting it either transverse or longitudinal to the nerve fibers. Each histologic specimen of the nerve with the needle puncture was surface-stained with hematoxylin-eosin and Bodian's method. Subsequently, the number of damaged axons was histomorphologically counted and statistically evaluated. RESULTS: Both long-tapered needles produced significantly fewer transected axons than the beveled needle inserted with the bevel longitudinal to the nerve fibers. CONCLUSIONS: The long-tapered needles produced the least number of transected nerve fibers after sciatic nerve puncture.

Anesthesia, Conduction↗

PubMed1990

[Comparative study of fine needle aspiration and large caliber needle biopsy under echographic control for the diagnosis of abdominal tumors].

The aim of this study was to compare the results of fine needle aspiration (22 G) with large caliber needle biopsy (18 G) in patients suspected of having abdominal malignancy. From November 1988 to December 1989, 73 patients aged 32 to 78 years (mean 66 years), suspected sonographically of having hepatic malignancy (66 cases) or extrahepatic tumors (7 cases), underwent ultrasonography guided percutaneous fine needle aspiration (22 G) and biopsy with a large caliber needle (18 G). There were no complications. Overall sensitivity for diagnosis of malignancy was significantly better (p less than 0.01) with 18 G needle biopsies (91.2 percent) than with fine needle cytology (71.4 percent). Specificity was 100 percent. The distinction between primary and secondary malignant tumor was possible in 87.5 percent with the large caliber needle and in only 42.9 percent with the fine needle (p less than 0.001). Histological findings were adequate hepatic metastases in 86.5 percent with the 18 gauge needle and in 51.4 percent with the 22 gauge needle (p less than 0.001). In the 7 extra-hepatic tumors, the 18 G biopsy was always positive whereas fine needle cytology was positive in only 5 out of 7 cases. Correct diagnosis for benign diseases was possible in 7 out of 10 cases with the large caliber needle whereas the fine needle cytology was always negative. These results show the superiority of large caliber needle (18 G) compared to fine needle (22 G) guided punction for both diagnosis of malignancy and origin of the tumor. Complications did not occur more frequently than with fine caliber needles.

Adult↗

PubMed1992

Fine-needle aspiration biopsy of abdominal lesions: diagnostic yield for different needle tip configurations.

Four fine-needle aspiration biopsy needles with different tip configurations were used in 133 patients with abdominal lesions. The 20-gauge needles were used in random sequence by several physicians. The specimen from each of the 522 needle passes was evaluated by two cytopathologists for adequacy to render a diagnosis and for the presence of cell block material. The Franseen needle produced a 16% and 9% better yield for diagnostic material than did the cut biopsy and spinal needles (P less than .05), respectively. The Westcott needle was better than the cut biopsy needle by 13%, and the spinal needle produced an 11% better yield than did the cut biopsy needle. Differences did not exist in liver biopsies but were present in pancreatic biopsies. The spinal needle was the least successful in yielding cell block material. Use of the cut biopsy needle resulted in the largest proportion of inadequate specimens, except its yield in cell blocks in the liver was 25% higher than that of the Westcott needle. The authors conclude that not all unusual designs for 20-gauge needle tips render results superior to those of the simple spinal needle.

Adolescent↗

PubMed2007

Comparison of core needle biopsy and fine-needle aspiration of enlarged peripheral lymph nodes for antemortem diagnosis of enzootic bovine lymphosarcoma in cattle.

OBJECTIVE: To determine whether antemortem core needle biopsy and fine-needle aspiration of enlarged peripheral lymph nodes could be used to distinguish between inflammation and lymphosarcoma in cattle. DESIGN: Prospective study. ANIMALS: 25 cattle with enlarged peripheral lymph nodes. PROCEDURES: Antemortem biopsies of the selected lymph nodes were performed with an 18-gauge, 12-cm core needle biopsy instrument. Fine-needle aspirates were performed with a 20-gauge, 4-cm needle. Specimens were analyzed by pathologists who were unaware of clinical findings and final necropsy findings, and specimens were categorized as reactive, neoplastic, or nondiagnostic for comparison with necropsy results. RESULTS: Sensitivity and specificity of core needle biopsy ranged from 38% to 67% and from 80% to 25%, respectively. Sensitivity of fine-needle aspiration ranged from 41% to 53%, and specificity was 100%. Predictive values for positive test results ranged from 77% to 89% for core needle biopsy and were 100% for fine-needle aspiration. Predictive values for negative test results were low for both core needle biopsy and fine-needle aspiration. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that core needle biopsy and fine-needle aspiration can aid in the antemortem diagnosis of bovine enzootic lymphosarcoma. Results of fine-needle aspiration of enlarged peripheral lymph nodes were more specific and more predictive for a positive test result than were results of core needle biopsy.

Animals↗

PubMed2005

Variation in needle longevity is related to needle-fascicle production rate in Pinus sylvestris.

Latitudinal variation in needle longevity of conifers in response to climatic variability is a well-known phenomenon, but its significance has only rarely been studied. Scots pine (Pinus sylvestris L.) stands were investigated in four locations in Lapland (northern Finland and northern Sweden, 67-68 degrees N) and in four locations in Estonia (59 degrees N) to test the hypothesis that plasticity in needle longevity results in similar needle biomass per foliated shoot length across latitudes. The needle-trace method (NTM) revealed the dynamics of needle fascicles attached to stem shoots. Long-term mean needle age was 2 years greater in Lapland than in Estonia. In both regions, mean needle age was strongly and negatively related to yearly needle-fascicle production rate relative to the number of needles on the same shoot axis. Although significantly fewer needle-fascicles were produced annually in trees in Lapland than in Estonia, the overall number of fascicles attached to the stem shoots, needle-fascicle density and individual needle dry mass did not differ between regions. Consequently, needle biomass per foliated shoot length was similar in trees in both regions. Thus, our results support the theory that plasticity in needle longevity helps Scots pine to compensate for reduced needle production so that the same foliar biomass per shoot is retained under a wide range of growth conditions.

Climate↗

PubMed2004

A modified needle-inside-needle technique for the ganglion impar block.

PURPOSE: The ganglion impar is the fused terminus of the paired sympathetic chain located at the level of the sacrococcygeal junction. It has been blocked using a bent and a curved spinal needle via the anococcygeal ligament. It has also been approached through the sacrococcygeal disc using a straight spinal needle. We describe a needle-inside-needle modification of the latter approach.Technical features: A 22-gauge (G), 1(1/2)-inch (38 mm) needle is introduced through the sacrococcygeal ligament under fluoroscopy via the sacrococcygeal disc. A 25-G, 2-inch (50 mm) needle is introduced through the 22-G needle. Placement is confirmed with injection of iopamidol 300, 0.2 mL in the retroperitoneal space with the comma sign. CONCLUSIONS: The bent and curved needle techniques are associated with significant discomfort, tissue trauma and risk of rectal perforation due to difficulty in obtaining a midline needle tip position. The straight spinal needle approach minimizes these problems, however there is increased risk of discitis and a longer spinal needle may help also raise incidence of needle breakage. The needle-inside-needle technique may reduce these risks.

Anesthetics, Local↗

PubMed1996

The effects of needle type, gauge, and tip bend on spinal needle deflection.

Although the use of fine-gauge spinal needles reduces the incidence of postdural puncture headache, they are associated with increased risk of placement failure as a result of deflection and bending. This in vitro study quantifies spinal needle deflection from the axis of insertion with respect to needle type, gauge, and tip bend. In addition to straight-tip needles, those with standardized 5 degrees and 10 degrees tip bends were studied. The purpose was to examine the effect of tip bend, which has been described with small gauge spinal needles after bony contact, on needle path deflection. Needles studied included Quincke (Q), Sprotte (S), and Whitacre (W) in sizes ranging from 18-gauge to 29-gauge. Needles were inserted perpendicularly into porcine paraspinous muscle followed by radiologic investigation. Measurements of needle deflection from the axis of insertion at depths of 20, 40, and 60 mm were performed in a blinded fashion. Straight-tip Q needle deflection, but not W or S, was correlated with gauge and depth of insertion. Although there were differences within needle type groups, needle deflection was generally correlated with the degree of tip bend. We conclude that spinal needle deflection is dependent on the type of needle (W < S < Q), and that the magnitude of deflection is related to gauge (large < small) and tip bend (straight < 5 degrees < 10 degrees).

Animals↗

PubMed2001

Patterns of needle acquisition and sociobehavioral correlates of needle exchange program attendance in Baltimore, Maryland, U.S.A.

OBJECTIVES: This study examined factors associated with obtaining syringes from a needle exchange program (NEP) and other safer sources in Baltimore, Maryland, U.S.A. DESIGN AND METHODS: A cross-sectional face-to-face survey was administered to 741 current drug injectors recruited by snowball sampling techniques. A brief open-ended interview was conducted on a subsample. RESULTS: Most (85%) participants obtained needles from street needle sellers. Only 8% obtained their needles exclusively from safer sources (NEPs, pharmacies, hospitals, or patients with diabetes). Cocaine use was associated with obtaining needles from the NEP but not from exclusively safer sources. Obtaining needles from only safer sources was associated with being female and less frequent needle sharing and shooting gallery attendance. Among HIV-seropositive participants, those who were diagnosed before the year that the NEP began were more likely to obtain needles from safer sources. Participants who sold needles reported that it was easy to make used needles appear to be unused, and some admitted to selling used syringes as new. CONCLUSIONS: Street needle sellers are an important source of needles for drug injectors, and few injectors appear able to determine whether these needles are clean. Individual sealing of diabetic syringes may reduce the risk of blood-borne infections by enabling both drug injectors and patients with diabetes to better judge the sterility of the needles they purchase.

Adult↗

PubMed1989

Raja pleural biopsy needle. A comparison with the Abrams needle in experimental pleural effusion.

The Raja pleural biopsy needle, 3 mm in external diameter and fitted with a titanium alloy biopsy flap, was compared with the Abrams needle in six dogs with experimentally induced pleural effusion. One hundred twenty-four pleural biopsies were performed using either the Raja needle or the Abrams needle (62 with each needle). No complication occurred with either needle. The Raja pleural biopsy needle yielded a statistically significant larger pleural tissue specimen with a statistically significant lower frequency of crush artifacts. The size of the pleura obtained by the Abrams needle averaged 4,401 +/- 559 microns2 (mean +/- SE) compared with 8,652 +/- 1,099 microns2 with the Raja needle (p less than 0.01; Student two-tailed t test). Biopsies by the Abrams needle showed crush artifacts in 25.8% of the specimens, whereas 8.06% of biopsies with the Raja needle showed crush artifacts (p less than 0.02; Fisher's two-tailed exact test). In conclusion, the Raja pleural biopsy needle is safe to use and, despite its smaller diameter (3mm versus 4mm external diameter of the Abrams needle), yields significantly larger and less frequently distorted pleural specimens.

Animals↗

PubMed2006

Comparison of a new aspiration needle device and the Quick-Core biopsy needle for transjugular liver biopsy.

AIM: To evaluate sample adequacy, safety, and needle passes of a new biopsy needle device compared to the Quick-Core biopsy needle for transjugular liver biopsy in patients affected by liver disease. METHODS: Thirty consecutive liver-disease patients who had major coagulation abnormalities and/or relevant ascites underwent transjugular liver biopsy using either a new needle device (18 patients) or the Quick-Core biopsy needle (12 patients). The length of the specimens was measured before fixation. A pathologist reviewed the histological slides for sample adequacy and pathologic diagnoses. The two methods'specimen adequacy and complication rates were assessed. RESULTS: Liver biopsies were technically successful in all 30 (100%) patients, with diagnostic histological core specimens obtained in 30 of 30 (100%) patients, for an overall success rate of 100%. With the new device, 18 specimens were obtained, with an average of 1.1 passes per patient. Using the Quick-Core biopsy needle, 12 specimens were obtained, with an average of 1.8 passes per patient. Specimen length was significantly longer with the new needle device than with the Quick-Core biopsy needle (P < 0.05). The biopsy tissue was not fragmented in any of the specimens with the new aspiration needle device, but tissue was fragmented in 3 of 12 (25.0%) specimens obtained using the Quick-Core biopsy needle. Complications included cardiac arrhythmia in 3 (10.0%) patients, and transient abdominal pain in 4 (13.3%) patients. There were no cases of subcapsular hematoma, hemoperitoneum, or sepsis, and there was no death secondary to the procedure. In particular, no early or delayed major procedure-related complications were observed in any patient. CONCLUSION: Transjugular liver biopsy is a safe and effective procedure, and there was significant difference in the adequacy of the specimens obtained using the new needle device compared to the Quick-Core biopsy needle. Using the new biopsy needle device, the specimens showed no tissue fragmentation and no increment in major procedure-related complications was observed.

Adult↗

PubMed2005

Using insulin pen needles up to five times does not affect needle tip shape nor increase pain intensity.

AIMS: Reusing insulin pen needles could help to reduce the increasing economic burden of diabetes. We tested the hypothesis that reusing insulin pen needles leads to needle tip deformity and increased pain. METHODS: Three blinded reviewers assessed 123 electron microscope pictures analyzing needle tip deformity of insulin pen needles used up to four times by diabetic subjects and up to five times by blinded non-diabetic volunteers. The estimated frequency of needle use was correlated to the actual number of needle use. Pain intensity and unpleasantness of each injection were measured by a visual analogue scale and their differences analyzed by Kruskal-Wallis analysis of variance. RESULTS: Unused needles could be differentiated visually from used needles. However, there was no correlation between the actual and guessed number of times a needle was used (r = 0.07, P = 0.2). Evaluating all 270 injections, neither pain intensity nor unpleasantness increased with repeated injections of the same needles in people with diabetes (P = 0.1 and 0.96) and in the volunteers (P = 0.63 and 0.92). CONCLUSIONS: Using pen needles four to five times does not lead to progressive needle tip deformity and does not increase pain intensity or unpleasantness, but could increase convenience and lead to substantial financial savings in Europe of around EUR 100 million/year.

Adult↗