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should you reuse pen needles
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<blockquote data-quote="Spiker" data-source="post: 533895" data-attributes="member: 102150"><p>Thanks very much for posting that, Noblehead. I think it's the same study that was posted earlier in the thread. Some points I would make on this</p><p></p><ol> <li data-xf-list-type="ol">Note that it mentions needle deformation is visible on <strong>electron </strong>micrographs. That I can believe. But the popular images on the web of deformed needles are from optical microscopes of maybe x10 - x20 power. Electron microscopes have power of up to x10,000,000. The images on the web are not electron micrographs. </li> <li data-xf-list-type="ol">Pain is reasonably solid finding. But the users on here who have done needle re-use are saying to discard the needle if it is painful. That wasn't an option in this study as the experimenters controlled when needles were replaced - in practice, few would continue with a needle once it started to hurt, and that alone would reduce the differences seen between the 3 groups in the needle study.</li> <li data-xf-list-type="ol">However the pain findings are actually a little odd, because reported pain increases even for the single use group, and the 21-use group reported much less pain after 12 uses than the 12-use group did (40% vs 60%), which is pretty much impossible to explain causally, since at that point both groups had used their needles 12 times. The likely explanation is random variation given the small sample size, only 15 patients per group. </li> <li data-xf-list-type="ol">While they showed a small (26.6% vs 33.3%) contamination increase between 1-use needles and 21-use needles, they didn't test the needle prior to use. Needles are not guaranteed sterile when issued. </li> <li data-xf-list-type="ol">The observed bacteria were all harmless. So there is no evidence of harm, only a theoretical small increased risk of harm IF harmful bacteria were to proliferate on the needle, which the study did not find. </li> <li data-xf-list-type="ol">They find evidence of increased hyperemia, which is noteworthy, but they don't demonstrate any link between hyperemia and lipoma or lipophypertrophy, nor do they adduce a reference for this link. Maybe some of their references establish this link - not clear?</li> <li data-xf-list-type="ol">One of the most interesting things about this study is that it reports how prevalent needle re-use is in the real population. That suggests that actually the whole diabetic population is a massive uncontrolled experiment in needle re-use. We can then draw some conclusions from what we <strong>don't </strong>see in the whole diabetic population. We don't see endemic skin infections or lipohypertrophy. </li> </ol></blockquote><p></p>
[QUOTE="Spiker, post: 533895, member: 102150"] Thanks very much for posting that, Noblehead. I think it's the same study that was posted earlier in the thread. Some points I would make on this [LIST=1] [*]Note that it mentions needle deformation is visible on [B]electron [/B]micrographs. That I can believe. But the popular images on the web of deformed needles are from optical microscopes of maybe x10 - x20 power. Electron microscopes have power of up to x10,000,000. The images on the web are not electron micrographs. [*]Pain is reasonably solid finding. But the users on here who have done needle re-use are saying to discard the needle if it is painful. That wasn't an option in this study as the experimenters controlled when needles were replaced - in practice, few would continue with a needle once it started to hurt, and that alone would reduce the differences seen between the 3 groups in the needle study. [*]However the pain findings are actually a little odd, because reported pain increases even for the single use group, and the 21-use group reported much less pain after 12 uses than the 12-use group did (40% vs 60%), which is pretty much impossible to explain causally, since at that point both groups had used their needles 12 times. The likely explanation is random variation given the small sample size, only 15 patients per group. [*]While they showed a small (26.6% vs 33.3%) contamination increase between 1-use needles and 21-use needles, they didn't test the needle prior to use. Needles are not guaranteed sterile when issued. [*]The observed bacteria were all harmless. So there is no evidence of harm, only a theoretical small increased risk of harm IF harmful bacteria were to proliferate on the needle, which the study did not find. [*]They find evidence of increased hyperemia, which is noteworthy, but they don't demonstrate any link between hyperemia and lipoma or lipophypertrophy, nor do they adduce a reference for this link. Maybe some of their references establish this link - not clear? [*]One of the most interesting things about this study is that it reports how prevalent needle re-use is in the real population. That suggests that actually the whole diabetic population is a massive uncontrolled experiment in needle re-use. We can then draw some conclusions from what we [B]don't [/B]see in the whole diabetic population. We don't see endemic skin infections or lipohypertrophy. [/LIST] [/QUOTE]
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