substance Abuse Treatment, Prevention, and also Policy volume 12, Article number: 51 (2017) point out this post


Background

Illicit medicine use has become raising public health and social worry in the past decades worldwide. Intravenous injection has actually an elevated hazard of infection. Needle embolism is a rarely complication of intravenous drug users, Retained damaged needles deserve to lead to local complications, such together infection, but they additionally have the potential to embolize to heart or lung, and lead to severe complications.

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Method

We reported a rare situation of an intravenous medicine user which a retained broken needle pieces in the inferior wall surface of the ideal ventricle.

Results

We carry out a effective surgery and give our comments and recommendations because that illicit medicine use an international and in China.

Conclusions

Illicit Drug use becomes a an international problem since of that health and also social harmfulness. To assist drug addicts and administer prevention and treatment services are the obligations and responsibilities of all medical workers.


Illicit drug use has attracted much more social concern and also become a publicly health concern in the past decades worldwide. Intravenous medicine users has actually an higher risk the infection. Needle embolism, as a rarely complication the intravenous drug users <1>, can lead to local complications, such as infection. Retained damaged needles have actually the potential to end up being the emboli in heart or lung, and also lead to major complications. Here we reported a rare case which a retained damaged needle fragment in the inferior wall of the appropriate ventricle, us performed a effective surgery and also give ours comments and recommendations for illicit drug use in China.


A 40-year-old guy presented to the emergency department after a needle damaged in his ideal groin while acquisition heroin intravenously 20 days ago. There to be neither one-of-a-kind symptoms nor proof of infection or infarction. Critical signs and electrocardiogram to be normal, and he was hepatitis C virus (HCV) positive, a heavy user that heroin and also cocaine end 20 years. Transthoracic echocardiography revealed a kept needle fragment in the inferior wall surface of the best ventricle (Fig. 1a), and no detectable pericardial effusion. Computed tomography confirmed the place of a needle in the inferior wall of the ideal ventricle and near the ventricular septum (Fig. 1b and c). Emergency open-heart surgical treatment through a average sternotomy under cardiopulmonary bypass was performed. Chest roentgenogram was performed by the moving bedside X-ray an equipment in the procedure room to dominion out unsuspected migration of the needle during patient positioning before proceeding through an incision. The needle was found and removed native the inferior wall of the appropriate ventricle (Fig. 1d and also e).The patience recovered uneventfully after ~ the surgery and was discharged house on postoperative day 6.


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Retained needle fragment in the ideal ventricle. a Transthoracic echocardiography revealed a retained needle fragment in the inferior wall of the right ventricle, and also no detectable pericardial effusion. b and also c Computed tomography evidenced the location of a needle in the inferior wall surface of the best ventricle and also near the ventricular septum. d and e The needle was found and also removed indigenous the right ventricle


Needle embolism is an infrequent complication that intravenous drug customers (IDUs) <1>. Damaged needles occur most commonly when the needle separates and comes apart from the hub. Inflammation and also infection after needle embolism are fairly common in regional wound site. If the central embolim that needle fragmentscan potentially reason serious complications such together cardiac perforation, pericarditis, infective endocarditis, arrhythmias, and also pulmonary abscess <1>. In most cases, the is recommended to remove the needle once the embolism is uncovered in bespeak to prevent delayed complications <2>.

Illicit drug usage is an intractable and an international public health and wellness problem. Follow to the civilization Drug Report 2016 <3>, 250 million of people between the eras of 15 and also 64 years used drugs in 2014. End 29 million world who supplied drugs suffer from drug use disorders, of who 1 in 6 is in treatment. Those worse, the most present data obtainable showed that 12 million civilization had a history of injecting drugs globally <4>.Compared v the traditional way of taking drugs, IDUs are exposed to an ext health-related harms and have a high risk of premature birth death. Poor health conditions, unsterilized injecting sites and also drug dissolving agents are the leading causes of bacterial infection. Since of poor or convenience, sharing and also repetitive usage of needles is a common phenomenon which is the main reason of person Immunodeficiency Virus (HIV) and HCV infection. About fifty percent of IDUs are approximated to re-publishing needles an international <5>. A recent surveillance surveys among IDUs in China also showed that 47.7% reported ever before sharing needles <6>. The statistics from civilization Drug Report 2016 reflects that 14% the IDUs space living through HIV and 50% v hepatitis C in 2014 <3>.Several studies have shown that IDUs have actually a disproportionate pervasiveness (60–80%) of HCV infection worldwide <7,8,9>. The most present data easily accessible in China likewise showed that in 2011, 67% of IDUs space living with HCV <8>. In addition, studies have actually reported that world often have actually risky sexual behaviors after injecting opiates, causing the danger of HIV epidemic <7,8,9>.

A cross-sectional survey examine in united Kingdom published in 2002 found that 20% that IDUs had actually experienced a broken needle throughout the food of your injecting careers <10>. Offered the great number of IDUs in China, subsequent needle embolization might be an ext common than it appears, specifically as drug misusers have tendency to stop hospital uneven seriously ill. Damaged needles space hidden dangers for IDUs and main needle embolism could even result in significant complications in heart and lung. Thus it is crucial to increase the familiarity with needle embolism, together an unusual yet life-threating complication that IDUs.

In Mainland China and also other districts in Asia, compulsory drug rehabilitation is a main strategy for drug users. However, harm reduction viewpoints such together methadone maintenance therapy (MMT) and needle-syringe exchange jobs (NSPs) are widely supported in current years. In Mainland China, a complete of 767 methadone maintenance treatment clinics had actually been collection up in 28 provinces by the finish of 2014 <11>.While in Changsha, the city wherein our hospital located, 1990 patients received treatment in a complete of 3 MMT clinics in 2013 <12>. Meanwhile, needle-syringe exchange tasks were driven forward in Mainland China. In 2014, NSPs were hosted in 14 provinces, with 814 needle exchange sites. End 56,000 drug individuals participated in the projects and much more than 11 million needles and syringes to be handed the end <11>.

It was crucial for this patient to have drug rehabilitation treatment after being discharged. We recommended the to to visit MMT and NSP. Follow to numerous studies in China, MMT can substantially reduce criminal task and enhance employment rate and also social well-being, the helps drug users to resume societal and familial functions <6, 13, 14>. And NSPs lessened levels that injecting frequency, repetitive use and sharing the injecting equipment amongst Chinese IDUs.


Illicit drug use becomes a global problem due to the fact that of the health and also social harmfulness. To aid drug addicts and administer prevention and treatment solutions are the obligations and responsibilities that all clinical workers.


HCV:

Hepatitis C virus

HIV:

Human Immunodeficiency Virus

IDUs:

Intravenous medicine users

MMT:

Methadone maintain treatment

NSPs:

Needle-syringe exchange projects


References


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Acknowledgements


Thank Changming Tan and Xinmin Zhou for their Help.

Funding

None.

Availability of data and materials

The datasets during and analyzed throughout the current study accessible from the corresponding writer on reasonable request.


Affiliations

Department of Cardiovascular Surgery, The second Xiangya Hospital, central South University, Changsha, Hunan, People’s Republic that China

Xianming Fu

Mental wellness Institute the The 2nd Xiangya Hospital, main South University, Changsha, Hunan, People’s Republic the China

Kai Chen

Department of Cardiovascular Surgery, The 2nd Xiangya Hospital, main South University, Changsha, Hunan, People’s Republic of China

Xiaobo Liao

Department of Cardiovascular Surgery, The second Xiangya Hospital of main South University, 139. Renmin Road, Changsha, Hunan, 410011, People’s Republic of China

Kangjun Shen


Contributions

XMF conceived and also analyzed the data. XMF, KC and KJS were significant contributors in composing the manuscript. XBL and KJS checked and also approved the manuscript. All authors read and also approved the final manuscript.

Corresponding author

Correspondence come Kangjun Shen.


Ethics approval and also consent to participate

The examination conforms to the principles approved by the values committee the the second Xiangya Hospital. We derived written informed consent indigenous the patient.

Consent because that publication

The patient offers him consent for the information around himself to show up in the journal and associated publications.

Competing interests

The authors declare that they have actually no completing interests.

Publisher’s Note

Springer Nature stays neutral through regard come jurisdictional cases in released maps and institutional affiliations.

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Cite this article

Fu, X., Chen, K., Liao, X. Et al. Situation report: operation removal of a migrated needle in appropriate ventricle of an intravenous drug user. Subst Abuse act Prev plan 12, 51 (2017). Https://doi.org/10.1186/s13011-017-0134-1

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Received: 06 might 2017

Accepted: 14 November 2017

Published: 08 December 2017


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