First record of straight-needle pteropod Creseis acicula Rang, 1828 bloom in the Çanakkale Strait (NE Aegean Sea, Turkey)

Pteropods are marine pelagic calcifier mollusks sensitive to chemical changes in seawater due to their highly soluble aragonite shells. Increased acidity (reduced pH) of seawater causes difficulties in precipitating their shells and/or results in their dissolution, which is related to increased atmospheric CO2 concentrations and warming of seawater. They are therefore indicators of environmental changes. In this paper, we present the first record of the straight-needle pteropod Creseis acicula Rang, 1828 bloom in the surface waters of the Ҫanakkale Strait, Turkey (NE Aegean Sea), encountered in July 2020, when the highest sea surface temperatures and pH levels since 2007 were recorded. In coastal zones, such as the Ҫanakkale Strait, anthropogenic activity contributes significantly to environmental changes. Consequently, the increase in pH at elevated temperatures indicates an auxiliary factor (i.e. anthropogenic activity) that triggered the C. acicula bloom, rather than global atmospheric CO2 levels.

Comparison of Laparoscopic Steerable Instruments Performed by Expert Surgeons and Novices

As an alternative to the surgical robot, some medical companies have engineered new steerable devices that mimic the robot’s capacities. This study aimed to assess how steerable instruments ameliorate the efficacy of suturing in comparison with the traditional instrument, and a combination instruments, performed by experienced and novice surgeons. The study was performed by three experienced surgeons and three novice surgeons. The instruments employed were divided into three surgical sets: two steerable dissectors; one steerable dissector and one straight needle; two straight needle holders. The study supervisor recorded the total time for the procedure, the number of bites completed, the time for each bite, and the quality of the procedure. In our study, we found consistent data demonstrating that experienced laparoscopists completed the prescribed suture pattern with more bites in less time than novices. The use of two steerable instruments was more time consuming than standard straight instruments, but a combination of instruments was significantly less time consuming, as was the use of two straight needle holders. This result was even observed in novice surgeons. Combining a steerable instrument with a traditional straight needle holder provided more advantages in this study.

Helical Needle Suture Inserter Provides Increased Suture Retention Force Compared to a Straight Needle

This paper presents an evaluation of the effect of needle geometry on the strength of a tether made using a barbed suture inserted into phantom tissue using a unique device. This tether is designed to secure an intrauterine device (IUD) to uterine fundus, with the aim of improving retention of IUDs inserted in the immediate postpartum period. A factorial experiment was designed to evaluate the effect of needle geometry on tether strength. Tether strength was characterized by the peak retention force of a suture subjected to a uniaxial tensile load. Experiments were performed using phantom tissue. Two needle geometries and three suture sizes were evaluated. Sutures deposited in phantom tissue with the helical needle had up to 132% increase in retention forces compared to sutures inserted with a straight needle, with more advantage at greater active length. The helical needle provides increased suture retention force and is a suitable tether delivery mechanism for this application.

Suture-method versus Through-the-needle Catheters for Continuous Popliteal-sciatic Nerve Blocks

Background The basic perineural catheter design has changed minimally since inception, with the catheter introduced through or over a straight needle. The U.S. Food and Drug Administration recently cleared a novel perineural catheter design comprising a catheter attached to the back of a suture-shaped needle that is inserted, advanced along the arc of its curvature pulling the catheter past the target nerve, and then exited through the skin in a second location. The authors hypothesized that analgesia would be noninferior using the new versus traditional catheter design in the first two days after painful foot/ankle surgery with a primary outcome of average pain measured with the Numeric Rating Scale. Methods Subjects undergoing painful foot or ankle surgery with a continuous supraparaneural popliteal-sciatic nerve block 5 cm proximal to the bifurcation were randomized to either a suture-type or through-the-needle catheter and subsequent 3-day 0.2% ropivacaine infusion (basal 6 ml/h, bolus 4 ml, lockout 30 min). Subjects received daily follow-up for the first four days after surgery, including assessment for evidence of malfunction or dislodgement of the catheters. Results During the first two postoperative days the mean ± SD average pain scores were lower in subjects with the suture-catheter (n = 35) compared with the through-the-needle (n = 35) group (2.7 ± 2.4 vs. 3.4 ± 2.4) and found to be statistically noninferior (95% CI, −1.9 to 0.6; P < 0.001). No suture-style catheter was completely dislodged (0%), whereas the tips of three (9%) traditional catheters were found outside of the skin before purposeful removal on postoperative day 3 (P = 0.239). Conclusions Suture-type perineural catheters provided noninferior analgesia compared with traditional catheters for continuous popliteal-sciatic blocks after painful foot and ankle surgery. The new catheter design appears to be a viable alternative to traditional designs used for the past seven decades. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

The Value and Application of Personalized Needle Modification in Percutaneous Infrazygomatic Radiofrequency in Isolated Maxillary Nerve Pain through the Foramen Rotundum

Background: Percutaneous infrazygomatic radiofrequency (PIR) is a common approach used to block isolated maxillary nerve (V2) pain through the foramen rotundum (FR) in patients with trigeminal neuralgia (TN). Nevertheless, when using this method, there is a risk of accidental penetration of the superior orbital fissure (SOF) and the optic canal (OC) that may result in the injury of the vessels and nerves in that area, and in some severe cases may lead to blindness. According to the blocking of the external orifice of the FR and whether a curved needle was used, combined angle deviation from the path of percutaneous infrazygomatic approach, the FR to the SOF or the OC in the treatment of V2 pain, in which no research has reported the angle, we analyzed the value and application of personalized needle modification in PIR in isolated maxillary nerve pain through the FR. Objectives: The following study examined the relationship between the FR and the SOF, and analyzed the clinical significance of personalized needle modification in computed tomography (CT)-guided PIR ablation of the maxillary nerve through the FR in patients with TN. Study Design: Randomized, review, clinical research study. Setting: Department of Anesthesiology and Pain Medical Center, Jiaxing, China. Methods: Three-dimensional reconstruction was performed in 88 patients and 136 patients with PIR ablation in isolated maxillary nerve pain through the FR. According to the blocking of the external orifice of the FR and whether a curved needle was used, patients were divided into 4 groups: curvedneedle blocking group (CB), straight-needle blocking group (SB), straight needle no-blocking group (SN), and curved-needle no-blocking group (CN). Results: The results obtained revealed minimum H (shortest diameter of the FR) = 1.0 mm and minimum L (length of the FR tubes) = 3.7 mm. The distance between the external orifice of the FR and the SOF (FS) was 5.16 ± 1.33 mm. The angle A (between the radiofrequency needle and the sagittal plane) was 39 ± 3.95°; the angle between the canthomeatal line and the CT scan line (ACT) was 58.99 ± 6.23°; the puncture depth (LS) was 63.99 ± 4.24 mm; the deviation angle of the misplacement into the SOF (SAF) was 2.96 ± 0.71°; the deviation angle of the misplacement into the OC (OAF) was 4.95 ± 0.73°. In addition, the postoperative Numeric Rating Scale scores in the CB group were significantly lower compared with the SB group, whereas the probability of entering the SOF in the CB group was significantly lower compared with the SB group. The total number of punctures in the SN group was less than that in the CN group. Limitations: Additional clinical data should be collected to preserve the results in future work. Conclusions: The distance between the FR and the SOF or the OC was only few millimeters, and slight angle error could lead to the SOF and the OC. For patients with blockage in the path, the treatment of radiofrequency with personalized needle modification could improve the curative effect and reduce the risk of accidental SOF penetration. Key words: Trigeminal neuralgia, foramen rotundum, superior orbital fissure, radiofrequency, personalized needle modification

Hang-up IUD, New Technique for Suturing CuT-380A IUD to Uterine Fundus in Immediate Postplacental Insertion during Cesarean Delivery: Twelve Months Follow up

Objective: The aim of this study was to evaluate the effectiveness, side effects and acceptability of postplacental CuT-380A IUD insertion using new technique for suturing to uterine fundus during cesarean section (hang up technique). Method: Prospective cohort study of postplacental IUD CuT-380A insertion during cesarean delivery. Hang-up technique consists of performing a puncture in the center of the fundus wall using straight needle into the uterine cavity and subsequently using chromic catgut no. 1 to tie the IUD using anchor knot and hanging the IUD to the fundus. Our subjects were women who underwent caesarean delivery at dr. Kariadi Hospital between 1st June 2009 to 31st April 2011 and followed up at 12 months follow-up, one woman underwent IUD removal because of severe dysmenorrhea. No perforation or expulsion was reported. Conclusion: Immediate postplacental insertion of IUD CuT-380A using hang-up technique is safe and effective. Typical use effectiveness is high (Pearl Index 0.93) and there were no reported incidents of expulsion or perforation. Acceptance and continuation rate were high, 98.15% and 95.37% respectively. [Indones J Obstet Gynecol 2014; 2-31: 132-139] Keywords: anchor knots, cesarean section, hang-up IUD, postplacental IUD insertion

Efficacy of Hayman Suture Technique in the Management of Atonic Post-Partum Hemorrhage

Objective: To study the effectiveness of Hayman suture technique to control postpartum hemorrhage.Method: Hayman suture was applied in 43 cases. A No-1 Vicryl suture was used on a round body or a straight needle. In 36 cases (83.72%) Hayman suture was the only intervention. In 4 cases (9.30%) uterine vessels and ovarian vessels were also ligated along with Hayman suture. In 3 cases (7%), along with Hayman suture, Gunashila’s circumferential sutures were taken. Results: None of the 43 patients required hysterectomy.Conclusion: Hayman suture technique is an easily and rapidly applied, effective, simple, safe, life saving and fertility preserving method to control atonic postpartum hemorrhage.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 14-17