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


Background

Illicit drug use has become an increasing public health and social concern in the past decades worldwide. Intravenous injection has actually an elevated risk of infection. Needle embolism is a rare complication the intravenous drug users, Retained broken needles deserve to lead to regional complications, such as infection, yet they likewise have the potential to embolize to heart or lung, and also lead to serious complications.

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Method

We reported a rare case of one intravenous drug user i m sorry a retained broken needle fragments in the inferior wall surface of the appropriate ventricle.

Results

We performed a effective surgery and give our comments and also recommendations because that illicit medicine use worldwide and in China.

Conclusions

Illicit Drug usage becomes a an international problem due to the fact that of that health and also social harmfulness. To assist drug addicts and provide prevention and treatment solutions are the obligations and also responsibilities that all medical workers.


Illicit drug use has attracted much more social concern and also become a publicly health issue in the past years worldwide. Intravenous medicine users has an higher risk that infection. Needle embolism, as a rare complication that intravenous drug customers <1>, deserve to lead to neighborhood complications, such as infection. Retained broken needles have the potential to become the emboli in love or lung, and lead to serious complications. Below we report a rare case which a retained damaged needle fragment in the inferior wall surface of the right ventricle, we performed a effective surgery and also give ours comments and also recommendations because that illicit drug use in China.


A 40-year-old guy presented come the emergency department after a needle broke in his right groin while taking heroin intravenously 20 days ago. There to be neither distinct symptoms nor evidence of infection or infarction. Vital signs and also electrocardiogram were normal, and also he to be hepatitis C virus (HCV) positive, a heavy user the heroin and also cocaine over 20 years. Transthoracic echocardiography revealed a kept needle fragment in the inferior wall of the appropriate ventricle (Fig. 1a), and no detectable pericardial effusion. Computed tomography evidenced the ar of a needle in the inferior wall of the appropriate ventricle and near the ventricular septum (Fig. 1b and c). Emergency open-heart surgery through a mean sternotomy under cardiopulmonary bypass to be performed. Chest roentgenogram to be performed by the relocating bedside X-ray machine in the operation room to ascendancy out unsuspected migrate of the needle throughout patient positioning prior to proceeding v an incision. The needle was found and removed indigenous the inferior wall surface of the right ventricle (Fig. 1d and e).The patience recovered uneventfully after ~ the surgery and was discharged home on postoperative work 6.


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Retained needle fragment in the ideal ventricle. a Transthoracic echocardiography revealed a retained needle fragment in the inferior wall surface of the ideal 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 right ventricle and near the ventricular septum. d and also e The needle was found and also removed from the right ventricle


Needle embolism is an infrequent complication of intravenous drug users (IDUs) <1>. Damaged needles occur most typically when the needle separates and also comes except the hub. Inflammation and also infection ~ needle embolism are reasonably common in local wound site. If the central embolim of needle fragmentscan potentially cause serious symptom such as cardiac perforation, pericarditis, infective endocarditis, arrhythmias, and also pulmonary abscess <1>. In many cases, the is recommended to eliminate the needle once the embolism is discovered in bespeak to stop delayed complications <2>.

Illicit drug use is one intractable and worldwide public health and wellness problem. According to the world Drug Report 2016 <3>, 250 million of people between the ages of 15 and also 64 years provided drugs in 2014. Over 29 million world who supplied drugs suffer from drug use disorders, of whom 1 in 6 is in treatment. What’s worse, the most existing data obtainable showed the 12 million world had a history of injecting drugs globally <4>.Compared through the traditional means of acquisition drugs, IDUs space exposed to an ext health-related harms and also have a high threat of premature birth death. Negative health conditions, unsterilized injecting sites and also drug dissolving agents are the leading reasons of bacterial infection. Since of poor or convenience, sharing and also repetitive use of needles is a common phenomenon i beg your pardon is the main reason of person Immunodeficiency Virus (HIV) and also HCV infection. About fifty percent of IDUs are approximated to share needles global <5>. A current surveillance surveys amongst IDUs in China likewise showed the 47.7% reported ever sharing needles <6>. The statistics from people Drug Report 2016 mirrors that 14% that IDUs space living through HIV and 50% through hepatitis C in 2014 <3>.Several researches have displayed that IDUs have a disproportionate pervasiveness (60–80%) of HCV infection internationally <7,8,9>. The most current data available in China likewise showed the in 2011, 67% of IDUs room living v HCV <8>. In addition, studies have actually reported that civilization often have actually risky sexual actions after injecting opiates, causing the danger of HIV infection <7,8,9>.

A cross-sectional survey research in unified Kingdom released in 2002 uncovered that 20% of IDUs had actually experienced a broken needle throughout the course of their injecting careers <10>. Provided the an excellent number of IDUs in China, subsequent needle embolization may be much more common than it appears, an especially as medicine misusers often tend to stop hospital unless seriously ill. Broken needles are hidden dangers for IDUs and central needle embolism can even an outcome in major complications in heart and lung. Hence it is necessary to boost the familiarity through needle embolism, as an unusual but life-threating complication that IDUs.

In Mainland China and other districts in Asia, compulsory medicine rehabilitation is a primary strategy for medicine users. However, damage reduction philosophies such as methadone maintenance therapy (MMT) and needle-syringe exchange jobs (NSPs) are widely advocated in current years. In Mainland China, a complete of 767 methadone maintenance treatment clinics had actually been set up in 28 provinces by the finish of 2014 <11>.While in Changsha, the city whereby our hospital located, 1990 patients got treatment in a full of 3 MMT clinics in 2013 <12>. Meanwhile, needle-syringe exchange jobs were moved forward in Mainland China. In 2014, NSPs were held in 14 provinces, with 814 needle exchange sites. Over 56,000 drug customers participated in the tasks and much more than 11 million needles and syringes to be handed out <11>.

It was important for this patience to have drug rehabilitation therapy after being discharged. Us recommended him to attend MMT and also NSP. According to numerous studies in China, MMT can substantially reduce criminal task and boost employment rate and also social well-being, the helps drug individuals to resume societal and also familial attributes <6, 13, 14>. And also NSPs diminished levels the injecting frequency, repeated use and sharing that injecting equipment among Chinese IDUs.


Illicit drug usage becomes a an international problem because of that is health and also social harmfulness. To assist drug addicts and carry out prevention and also treatment solutions are the obligations and also responsibilities of all clinical workers.


HCV:

Hepatitis C virus

HIV:

Human Immunodeficiency Virus

IDUs:

Intravenous drug 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 that data and also materials

The datasets during and also analyzed throughout the existing study available from the corresponding author on reasonable request.


Affiliations

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

Xianming Fu

Mental health Institute that The 2nd Xiangya Hospital, central South University, Changsha, Hunan, People’s Republic of China

Kai Chen

Department that Cardiovascular Surgery, The second Xiangya Hospital, central South University, Changsha, Hunan, People’s Republic that 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 analyzed the data. XMF, KC and also KJS were major contributors in creating the manuscript. XBL and also KJS checked and approved the manuscript. Every authors read and approved the last manuscript.

Corresponding author

Correspondence to Kangjun Shen.


Ethics approval and also consent come participate

The investigation conforms to the ethics approved by the values committee that the second Xiangya Hospital. We acquired written informed consent indigenous the patient.

Consent for publication

The patient gives him consent because that the information about himself to show up in the journal and also associated publications.

Competing interests

The writer declare that they have no contending interests.

Publisher’s Note

Springer Nature continues to be neutral with regard come jurisdictional claims in released maps and also institutional affiliations.

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

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Received: 06 may 2017

Accepted: 14 November 2017

Published: 08 December 2017


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