Needle phobia and stress-reducing medical devices in pediatric and adult chemotherapy patients.

Needle phobia--fear of medical devices--is a significant problem in pediatric and adult chemotherapy patients. Stress-reducing medical devices is a new, effective cognitive therapy for needle phobia. Twenty-five pediatric and 25 adult chemotherapy patients were randomly exposed to conventional or stress-reducing decorated butterfly needles and syringes. Emotional stress responses were determined with the Visual Aversion Scale, Visual Analogue Fear Scale, Visual Analogue Anxiety Scale, and Visual Overall Stress Score for each needle and syringe design. Sixty-eight percent of the pediatric and 52% of the adult patients were overtly needle phobic, but children demonstrated significantly more aversion and stress (P < .001). Stress-reducing medical devices effectively and significantly reduced aversion, anxiety, fear, and overall stress, and were 76% effective in preventing overt needle phobia in children and 92% effective in adults (P < .001). One hundred percent of children and adults felt that stress-reducing medical devices should be available in chemotherapy clinics. Needle phobia and stress in pediatric and adult chemotherapy patients are significantly reduced by the use of stress-reducing medical devices.     

Are 1 or 2 dangerous? Clozapine and olanzapine exposure in toddlers

Clozapine (Clozaril) and olanzapine (Zyprexa) are two relatively new atypical antipsychotics that are structurally and pharmacologically related. There are currently no therapeutic indications for these pharmaceuticals in infants and toddlers.Presumably, as the usage of these medications in adults increases, the frequency of unintentional pediatric ingestions will increase. In 2001 the annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System included a separate subcategory for atypical antipsychotics under the heading of sedatives/hypnotics/antipsychotics. The toxidrome resulting from these drugs is predominately central nervous system depression and anticholinergic effects. Although the desirable lack of extrapyramidal symptoms in adults results in their greatest clinical utility, several reports of toxic ingestions in small children are noteworthy for having extrapyramidal manifestations. We review here the available reported clinical experience with toxic doses of these medications that in small children may amount to as little as a single tablet. Although such doses may be lethal, supportive care and gastrointestinal decontamination in this population will generally lead to a good outcome.     

Novel Technique for Defogging and Cleaning the Laparoscope Lens uring Minimally Invasive Surgery

Background

Condensation on the lens of the laparoscope resulting from differences between room temperature and intra-abdominal temperature is a disturbing problem for laparoscopic surgeons. Anti lens condensation solutions prevent fogging in the intra-abdominal environment, but are troublesome to apply to the scope. We describe a technique that allows the antifogging solution to be applied to the endoscope without removing it from the patient.

Methods

A simple technique is described for cleaning the lens with anti-fogging solution without the need to remove the laparoscope from the abdomen, using a syringe and cheap plastic sheath introduced through a laparoscopic port.

Results

The technique described is a cost-effective and time-efficient way to maintain the correct laparoscope temperature while cleaning and de-fogging the lens as required throughout laparoscopic procedures.

Conclusion

The use of a syringe and cheap plastic sheath can allow application of antifog solution to the laparoscope lens without removing it from the body cavity, overcoming the main issues associated with maintaining lens clarity during laparoscopic surgery.

     

Feasibility of a Kinect®-based rehabilitation strategy after burn injury

Introduction

The advent of consoles that deliver both interactive games and therapy may augment rehabilitation options in burn patients. The Jintronix software combines therapy-specific software and interactive gaming as a form of coaching and records patient performance on the Kinect^® platform. Our objective was to determine the feasibility of a set of Jintronix games and therapy modules in hospitalized adult burn patients.