Disease relevance of Needlestick Injuries

• Surveillance of HIV infection and zidovudine use among health care workers after occupational exposure to HIV-infected blood. The CDC Cooperative Needlestick Surveillance Group [1].
• Blood with anti-CP10 as the single serological marker for hepatitis C virus infection transmitted non-A, non-B hepatitis by needlestick exposure [2].
• Of the eight patients, three were treated for another illness 1-2 months before the onset of hepatitis, one was a parenteral drug abuser, one had an accidental needlestick injury and two had sexual contact with a partner with chronic hepatitis C virus (HCV) infection [3].
• Transmission of scrub typhus by needlestick from a patient receiving pefloxacin [4].
• With the first generation assay, anti-HCV was detected in 69% of post-transfusion acute hepatitis (AH), 44% of sporadic AH, 50% of needlestick exposed AH, 72% of chronic hepatitis (CH), 77% of liver cirrhosis (LC) and 86% of hepatocellular carcinoma (HCC) [5].

Psychiatry related information on Needlestick Injuries

• A further benefit of screening for infection control purposes occurs in the event of a sharps injury when prior testing of the source patient helps to facilitate decision making about the giving of immediate zidovudine prophylaxis [6].
• Internal locus of control and health value were positively associated with whether the doctor would take any action after needlestick injury, had a blood pressure or cholesterol test in the past 3 years or had their own GP [7].

High impact information on Needlestick Injuries

• Type B hepatitis: the infectivity of blood positive for e antigen and DNA polymerase after accidental needlestick exposure [8].
• Failed prophylactic zidovudine after needlestick injury [9].
• To assess the risk to hospital personnel of acquiring an hepatitis C virus (HCV) infection as a result of occupational exposure to needle-stick injuries, 81 employees who had parenteral exposure to an anti-HCV-positive source were followed for 12 months [10].
• In samples from the IV line there was a linear increase in IL-6 levels in both conditions, whereas the amount of IL-6 detected in the needle stick sample at the end did not differ from baseline [11].
• This finding raises the possibility that treatment with low-dose IFN following an accidental needlestick may be beneficial, even when it is started after the clinical onset of hepatitis [12].

Chemical compound and disease context of Needlestick Injuries

• OBJECTIVE: To determine whether pretreatment of skin with erbium:YAG (Er:YAG) laser-assisted delivery facilitates the penetration of lidocaine cream to provide anesthesia suitable for needlesticks after just 5 minutes [13].
• Accidental needlesticks in the phlebotomy service of the Department of Laboratory Medicine and Pathology at Mayo Clinic Rochester [14].
• Four injections of 1 mL epinephrine 1:10000 at 1 mm from the spurting artery (n = 7) were compared to four injections of normal saline solution 1 to 5 mL (n = 12) and to four dry needle sticks (n = 9) [15].
• Re-use of injection materials without sterilization, accidental needle-stick injuries among health care workers, and injection-related abscesses in patients were common in countries in the WHO African Region [16].
• Analysis of events leading to needlestick-related exposures revealed that the heparin lock intermittent intravenous procedure was involved in 26%; recapping accounted for 17%; improper disposal, 15%; manipulating equipment, 14%; phlebotomy, 12%; and other needlestick events, 16% [17].

Biological context of Needlestick Injuries

• The maximum Hoffmann reflex (H-reflex), M-wave, reflex activation history, plasma epinephrine, and norepinephrine were recorded at: baseline, post needle stick, post lidocaine, and 25 and 45 min post effusion [18].
• One accidental self-injection of a prostaglandin compound resulted in a spontaneous abortion, heightening awareness that occupational needlesticks may also represent a serious human reproductive health hazard [19].

Anatomical context of Needlestick Injuries

• CONCLUSION: Topical anesthetics based on a combination of lidocaine 2.5% + prilocaine 2.5% are significantly more effective than 20% benzocaine in reducing pain from needle stick in the maxillary vestibular mucosa [20].
• Reduction of pain from needle stick in the oral mucosa by topical anesthetics: a comparative study between lidocaine/prilocaine and benzocaine [20].
• A new vascular sheath design (anesthesia infusion sleeve or AIS) was developed to enable administration of local anesthetics or other medications into the subcutaneous tissue around the insertion site without any additional needle sticks or other manipulation [21].

Gene context of Needlestick Injuries

• Control levels of IL-6, TNF-alpha and sTNF-R p75 measured in plasma obtained by needle stick after 10 h did not differ from baseline, and those of sTNF-R p55 were even higher [22].
• A 25-year-old male physician with acute hepatitis C after needle-stick injury was treated with combination therapy including twice-a-day interferon-beta (IFN-beta) and standard interferon-alpha (IFN-alpha) [23].
• In contrast, sequences from the needle-stick case showed only 67% and 80% amino acid identity in env and gag, respectively, and were separated on a phylogenetic tree [24].
• These data indicate a significant increase in plasma PRL and HVA in children following needle stick which gradually decreases over a 1.5-2-h period [25].
• These results were remarkably increased by using the second generation assay (92% in post-transfusion AH, 72% in sporadic AH, 100% in needlestick exposed AH, 96% in CH, 96% in LC and 97% in HCC) [5].

Analytical, diagnostic and therapeutic context of Needlestick Injuries

• METHODS: Sixty subjects evaluated the effectiveness of a lidocaine-containing bioadhesive patch, or L-BP, to alleviate pain caused by needlesticks, or Ns, with or without injection, and with scaling and root planing, or Sc/RP, instrumentation [26].

References