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Just as tattoos continue to increase in popularity, many people with tattoos also seek removal, often due to career concerns. Prospective clients interested in laser tattoo removal may do research about the procedure online, as the internet increasingly becomes a resource to get preliminary health information. However, it is important that the online health information on the topic be of high quality and be accessible to all patients. We analyzed 77 websites from a Google search query using the terms "Laser tattoo removal patient Information" and "Laser tattoo removal patient Instructions" to assess this. The websites were evaluated for their readability using multiple validated indices and comprehensiveness. We found that websites had a broad readability range, from elementary to college, though most were above the recommended eighth-grade reading level. Less than half of the websites adequately discussed the increased risk of pigmentary complications in the skin of color clients or emphasized the importance of consulting with a board-certified dermatologist/plastic surgeon before the procedure. Over 90% of the websites noted that multiple laser treatments are likely needed for complete clearance of tattoos. The findings from our study underscore a significant gap in the accessibility and quality of online information for patients considering laser tattoo removal, particularly in addressing specific risks for patients with darker skin tones and emphasizing the need for consulting a board-certified physician before undergoing the procedure. It is important that online resources for laser tattoo removal be appropriately written to allow better decision-making, expectations, and future satisfaction for potential clients interested in the procedure. [ABSTRACT FROM AUTHOR]

Surgical management of a diseased thyroid depends on sonological and pathological evaluation and thereby, planning of the surgery. The definite surgery has two objectives: removal of the diseased gland and preservation of the nerves, namely EBSLN (External Branch of Superior Laryngeal Nerve) and RLN (Recurrent Laryngeal Nerve) and the Parathyroid glands. The objectives of the study were: (1) To identify the course of the RLN and EBSLN of both sides, during Thyroidectomy. (2) To discern various anatomical landmarks, the relations of the two nerves with them and anatomical variations, if any. In this Prospective observational study, fifty selected goitre patients underwent various types of thyroidectomies based on sonological and cytological criteria. The course and anatomical variations of EBSLN and RLN were photo-documented and results were analysed. Most of the EBSLN were found as Cernea type 1 type (25 out of 50), followed by Cernea type 2a (comprising 36%). The least common was type 2b. It was found that 36 out of 50 (72%) of RLN passed posterior to Inferior Thyroid Artery (ITA). Moreover, before piercing cricothyroid joint, the RLN showed bifurcation in 13 out of 50 subjects (26%), 1 participant had trifurcation and the remaining 36 (72%) had a single trunk. The EBSLN shows relation to the horizontal plane passing through the upper pole of the thyroid gland and it is more prone to get damaged when it passes within less than 1 cm to the plane. The RLN has various relations to the distinct anatomical landmarks thereby helping in safe dissection of the nerve. The study also noted the RLN in relation to ITA and branching before entering into the cricothyroid joint. [ABSTRACT FROM AUTHOR]

The popularity of esthetic medicine is growing every year, also among patients with autoimmune inflammatory rheumatic diseases (AIRD). The objective of this study was to evaluate the safety of esthetic medicine (AM) procedures in patients with AIRD. A semi-structured, anonymous questionnaire regarding rheumatic and concomitant diseases and AM procedures was distributed among adult patients hospitalized in the rheumatology department or attending outpatient clinic in the National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw. The main outcome was the occurrence of an adverse event. A number of 512 patients took part in the survey and 15 were excluded (AM procedure preceded the diagnosis of AIRD). The study group consisted of 497 patients, of whom 47 had undergone AM procedures. The procedures performed included: tattooing (22 patients), piercing (16 patients), hyaluronic acid (7 patients), botulinum toxin (5 patients) injections, laser procedures (6 patients), plastic surgery (4 patients), mesotherapy (3 patients) and others. The vast majority of patients had these performed during remission or low disease activity. 70.2% of patients received treatment with disease-modifying antirheumatic drugs (DMARDs) during the AM procedure, with TNF-alfa inhibitors being the most common (63.6%). Adverse events occurred in 15% of patients. All were mild and transient site reactions. Most patients would like to repeat the AM procedure in the future. The use of esthetic medicine procedures in patients with AIRD, including those treated with biologic DMARDs, was associated with a risk of mild site reactions. Most of the patients expressed satisfaction with the results of the AM procedure. [ABSTRACT FROM AUTHOR]

Body piercing has been practiced for centuries in Asian and African countries as a part of religious and cultural ceremonies. Complications like bleeding, pyogenic bacterial infections like staphylococcal and pseudomonas, viral infections like hepatitis B virus, allergic reactions, scarring, granuloma formation, and sarcoid-like foreign body formation have been reported. Thaipusam is a traditional religious festival observed in Asian countries, commonly in India and Malaysia. During the celebration, devotees allow their bodies to be pierced and decorated with needles, hooks, and skewers (Alagu kuthuthal) on cheeks, tongue, chest, and back, followed by "holy ash" (Vibhuthi). We report a case of cutaneous tuberculosis because of the body piercing during this traditional festival. The patient was started on anti-tubercular therapy, and the lesions disappeared within 2 months of ATT. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review explored dental complications associated with metal ion release from oral piercings using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Methods: Item retrieval from October 2022 to December 2022 from databases, such as Cochrane Central Register of Controlled Trials, Medline, PubMed, Embase, Scopus and Web of Science, using predefined search terms was undertaken by two independent reviewers. Data were extracted and risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. From 1509 identified studies, 25 were included for analysis. Results: Of the 25 studies, 20 included both clinical examination and questionnaire-based data. The remaining five studies were deemed low quality based on the Joanna Briggs Institute criteria. The average time piercings were worn ranged between 5 and 48 months. Most studies did not investigate complications from metal ion release. Only two studies examined the direct effects of metal ion release and showed that metal ions may cause hypersensitivity reactions and mucosal changes. Other soft tissue complications were reported, with gingival recession noted in 16 out of 25 studies, especially due to lip piercings. Studies reporting other complications were as follows: swelling (9), pain (8), infection (6), bleeding (6), inflammation (5), alterations to speech, eating and/or swallowing (5), changes to taste or metallic taste (5), and mucosal changes (4). Ten studies reported tooth chipping from tongue piercings. Conclusion: Oral piercings leach metal ions into surrounding tissues which may cause local mucosal changes. Furthermore, oral piercings cause damage to both soft and hard oral tissues, particularly gingival recession for lip piercings and tooth chipping for tongue piercings. Thus, to prevent such adverse injuries, dental professionals should discourage patients against oral piercings. [ABSTRACT FROM AUTHOR]

Purpose: Identifying tumor location is important in colorectal tumor resection. Preoperative endoscopic India ink marking is a widespread practice, but local injection of ink is an unstable procedure. Although it is often invisible, the ink may be sprayed into the peritoneal cavity and contaminate the surgical field. At our hospital, we introduced fluorescent clip marking (FCM) using the Zeoclip FS®, an endoscopic clip developed using near-infrared fluorescent resin. We tested the usefulness of FCM by retrospectively comparing cases in which FCM was used with cases in which conventional ink marking was used. Methods: We enrolled 305 patients with colorectal tumors who underwent colorectal surgery after preoperative marking from January 2017 to April 2022. We classified the patients into the FCM group (86 patients) and the India ink tattoo group (219 patients). Endoscopic marking was completed in the FCM group by the day before surgery, and fluorescence was evaluated during surgery with a fluorescent laparoscopic system. Patient backgrounds, marking visibility, adverse effects, and early postoperative results were retrospectively compared between groups. Results: Marking was visually confirmed in 80 patients in the FCM group (93.02%) and in 166 patients in the India ink tattoo group (75.80%) (p = 0.0006). In the group with India ink tattoos, contamination of the surgical field was observed in seven cases (3.20%). No adverse events were observed in the FCM group. Conclusion: In colorectal surgery, FCM provides better visibility than the conventional India ink tattooing method and is a simple and safe marking method. Clinical trial registration: Examination of fluorescence navigation for laparoscopic colorectal cancer surgery. Research Ethics Committee of the Kawaguchi Municipal Medical Center (Saitama, Japan) approval number: 2020-3. https://kawaguchi-mmc.org/wp-content/uploads/clinicalresearch-r02.pdf. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this review was to reveal the prevalence rate of viral hepatitis in Pakistan and diverse risk factors that are associated with infections. The distribution of the genotype was also discussed. Subject: Hepatitis is the inflammation of hepatic tissue. It has major health concerns to humanity, specifically in developing countries in Asia. Methods: The portals PubMed, Google Scholar, Directory of Open Access Journals (DOAJ), PakMediNet, and ScienceDirect were searched for literature retrieval. The weighted average was calculated to show the national prevalence rate. Results: The weighted averages of hepatitis B antigen, hepatitis C virus (HCV), and antibodies in non-blood donors were 1.98%, 7.44%, and 5.62%, respectively, while in blood donors, the hepatitis B virus (HBV) prevalence were 2.41% and 3.31%. Both showed different levels of association with other diseases, e.g., HBV showed the highest association with chronic liver disease (44.45%) and HCV in thalassemia (27.33%). Among high-risk groups, the highest rate of HCV was 68.3% in intravenous drug users (IDUs) and HBV in healthcare workers. Genotype 3 was more prevalent than genotypes 1 and 2. An increasing seropositivity was found in HCV during previous years, from 6.8% to 7.44%. Conclusions: Punjab was the most infected region in Pakistan, along with the interior of Sindh and war-affected regions. Mass movement programs result in internally displaced persons (IDPs) in many temporary camps of Pakistan, which act as safe havens for the transfer of viruses. Barbers, blood transfusion, and IDUs are the most prevalent routes of transfer, along with new emerging factors, such as ear and nose piercings and IDPs. [ABSTRACT FROM AUTHOR]

Ear piercing is a simple office procedure commonly done in India for traditional purposes and after repair of the split ear lobule and ear lobule reconstruction. Multiple methods have been described, but the main goals of any procedure are that it should be simple, easily reproducible, inexpensive, and accurate and should allow the formation of a neat straight tract without complications, most commonly infection. We have devised a simple and reproducible method for ear piercing using an easily available, sterile intravenous cannula. The cannula creates a precise hole, and the earring can be easily threaded through the sheath after removing the needle. This method of piercing mitigates the risk of infection normally associated with the procedure especially when done through cartilage. The same technique can also be used in children with a slight modification as described in the article. [ABSTRACT FROM AUTHOR]

Tattoos are widely regarded as morally neutral, and the decision to have them as carrying no ethical implications. The aim of this paper is to question this assumption. I argue that (at least some) decisions to have tattoos involve risks that are not merely prudential—they are normative. The argument starts with a thesis that the power we presently have over our lives is constrained by the need to respect our future selves. If we make a discretionary choice that disregards our future interests and preferences, then, under certain circumstances, we can be morally to blame. I argue that certain decisions to get tattoos fit this description. Therefore, getting some tattoos makes us blameworthy. [ABSTRACT FROM AUTHOR]

Neck contains several vital structures, in a small close space, in complex relationship to each other, and unprotected by any bony framework. Any injury to this crucial region, hence mostly becomes an acute emergency. Appropriately managing the same has always been a point of constant discussion amongst head and neck surgeons. The basic aim of the study was to discuss the management, comorbidities, prognosis and associated complications encountered in a series of patients with penetrating neck trauma (piercing platysma), presenting to the emergency over a period of 1 year. Combat injuries and patients declared as brought dead at the time of first examination were excluded. This was a retrospective study of patients with cut throat injury, managed at a tertiary center of northern India from June 2014 to September 2015. Following management in the ER as per ATLS guidelines, all patients were then operated for specific injuries. Graph pad software was used for statistical analysis. Of the 15 patients studied in total, 11 (73.3%) were males. The mean patient age was 33.67 years. Mean duration of presentation was 20.85 h. 60% patients had homicidal injuries. Tracheostomy and Ryle's tube insertion was done in 8 (53.3%) patients. Exploration and surgical repair was done in all patients without any mortality. 4 patients developed post-operative complications. Mean duration of hospital stay was 9.2 days. Immediate resuscitation followed by exploration and primary repair is a must in all patients of penetrating neck injury. [ABSTRACT FROM AUTHOR]

This paper provides an overview of lessons from mosquitoes’ locomotion and their painless piercing and from wasp stinging. Based on the understanding, conceptual schematics of bioinspired microneedle designs are presented for biomedical applications. In the first part, mosquitoes locomotory attributes, which are used by them to hunt a host, are described. Next, microanatomy, feeding process, and nanomechanical properties data of mosquitoes’ labrum are presented. A hypothesis behind the painless piercing is presented followed by mosquito-inspired microneedle design guidelines. In the second part, wasp anatomy and stinging process are described. Their structure and nanomechanical properties data, modeling of the penetration process, and stinger-inspired microneedle design guidelines are presented. [ABSTRACT FROM AUTHOR]

Self-piercing riveting (SPR) is a new high-speed mechanical fastening technique which is suitable for point-joining dissimilar sheet materials, as well as coated and pre-painted sheet materials. With an increasing application of SPR in different industrial fields, the demand for a better understanding of the knowledge of static and dynamic characteristics of the SPR joints is required. In this paper, the SPR process has been numerically simulated using the commercial finite element software LS-Dyna. For validating the numerical simulation of the SPR process, experimental tests on specimens made of aluminium alloy have been carried out. The online window monitoring technique was introduced in the tests for evaluating the quality of SPR joints. Good agreements between the simulations and the tests have been found, both with respect to the force-travel (time) curves as well as the deformed shape on the cross-section of the SPR joint. Monotonic tensile tests were carried out to measure the ultimate tensile strengths of the bonded joints, SPR joints and SPR-bonded hybrid joints. Deformation and failure of the joints under monotonic tensile loading were studied. The normal hypothesis tests were performed to examine the rationality of the test data. This work was also aimed at evaluating experimentally and comparing the strength and energy absorption of the bonded joints, SPR joints and SPR-bonded hybrid joints. [ABSTRACT FROM AUTHOR]

We aimed to investigate the association of psychopathology with tattooing and body piercing among adolescents in Istanbul by means of self-report questionnaires. Tenth, eleventh and twelfth grade students from 2 high schools in Istanbul with a total number of 607 participated in the study. The Youth Self Report, Children's Depression Inventory and a detailed semi-structured inquiry assessing tattooing, body piercing and some psychiatric and psychosocial variables were administered to the students. The prevalence of tattooing and body piercing were 4.8 and 7 %, respectively. The adolescents with tattooing and body piercing were found to have a higher frequency of alcohol and drug use, smoking, going to bars/night clubs and lower school grades when compared to those without tattooing and body piercing. Externalizing problems, mainly delinquent and aggressive behaviours were more prominent in the adolescents with tattooing and body piercing. Tattooing and body piercing in adolescents may be indicative of mental health risks. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate tooth and periodontal damage in subjects wearing a tongue piercing (TP) in comparison to matched control subjects without tongue piercing. Members of the German Federal Armed Forces who had TP (group TP) and a matched control group (group C) volunteered to take part in the study. The time in situ, localization and material of TP were documented. Dental examinations included DMF-T, oral hygiene, enamel fissures (EF), enamel cracks (EC) and recessions. Statistical analysis was determined by χ test and the t test. Both groups had 46 male subjects (mean age 22.1 years). The piercings had been in situ for 3.8 ± 3.1 years. Subjects in the TP group had a total of 1,260 teeth. Twenty-nine subjects had 115 teeth (9.1%) with EF (67% lingual). In group C (1,243 teeth), 30 subjects had 60 teeth with EF (4.8%, 78% vestibular) ( p < 0.01). Thirty-eight subjects belonging to group TP had EC in 186 teeth (15%). In group C, 26 subjects with 56 teeth (4.5%) were affected by EC ( p < 0.001). Twenty-seven subjects in group TP had 97 teeth (7.7%) with recessions. Lingual surfaces of anterior teeth in the lower jaw were affected most frequently (74%). In group C, 8 subjects had 19 teeth (1.5%) with recessions (65% vestibular). Differences between the two groups were statistically significant ( p < 0.001). Tongue piercing is correlated with an increased occurrence of enamel fissures, enamel cracks and lingual recessions. Patients need better information on the potential complications associated with tongue piercing. [ABSTRACT FROM AUTHOR]

Body and earlobe piercing are common practices in the USA today. Minor complications including infection and bleeding occur frequently and, although rare, major complications have been reported. Healthcare professionals should be cognizant of the medical consequences of body piercing. Complications vary depending on the body-piercing site, materials used, experience of the practitioner, hygiene regimens, and aftercare by the recipient. Localized infections are common. Systemic infections such as viral hepatitis and toxic shock syndrome and distant infections such as endocarditis and brain abscesses have been reported. Other general complications include allergic contact dermatitis (e.g. from nickel or latex), bleeding, scarring and keloid formation, nerve damage, and interference with medical procedures such as intubation and blood/organ donation. Site-specific complications have been reported. Oral piercings may lead to difficulty speaking and eating, excessive salivation, and dental problems. Oral and nasal piercings may be aspirated or become embedded, requiring surgical removal. Piercing tracts in the ear, nipple, and navel are prone to tearing. Galactorrhea may be caused by stimulation from a nipple piercing. Genital piercings may lead to infertility secondary to infection, and obstruction of the urethra secondary to scar formation. In men, priapism and fistula formation may occur. Women who are pregnant or breastfeeding and have a piercing or are considering obtaining one need to be aware of the rare complications that may affect them or their child. Though not a 'complication' per Se, many studies have reported body piercing as a marker for high-risk behavior, psychopathologic symptoms, and anti-social personality traits. When it comes to piercing complications, prevention is the key. Body piercers should take a complete medical and social history to identify conditions that may predispose an individual to complications, and candidates should choose a qualified practitioner to perform their piercing. As body piercing continues to be popular, understanding the risks of the procedures as well as the medical and psychosocial implications of wearing piercing jewelry is important for the medical practitioner. [ABSTRACT FROM AUTHOR]

The associations of body piercing with other social characteristics, personality, and sexual behavior were investigated in a population-based sample of young adults, in light of the theory that body piercing has meaning in terms of a corporeal expression of the self. At age 26 years, 966 (95%) of 1019 members of the birth-cohort of the Dunedin Multidisciplinary Health and Development Study were asked about body piercing (at interview) and sexual behavior (questions presented by computer). Assessment of personality traits was conducted at ages 18 or 21 years. In total, 183 participants (9% of the men and 29% of the women) had piercings at a site other than the earlobes. People who lived outside New Zealand or who were of Maori descent were more likely to be pierced, but unemployment and low occupational status were not significantly related to piercing. Women who were pierced, compared with those without piercings, were more likely to have personality traits of low constraint or high negative emotionality. Women with piercings were also more likely to report having had, during the previous year, five or more heterosexual partners (odds ratio, 5.8, 95% CI: 2.3-14.6) or any same-sex partner involving genital contact (odds ratio, 10.3, CI: 2.9-37.2). The associations with sexual behavior in men were weaker and not statistically significant. In this population, body piercing in women was associated with sexual behavior. Having multiple heterosexual partners or any same-sex partner was very rare among women without piercings. The theory of meaning for body piercing was generally supported, offering the possibility of a richer understanding of this phenomenon in the general population. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Public Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the prevalence and range of complications following tongue piercing.Methods A survey of individuals with tongue piercings ('piercees') and tongue piercers was undertaken in the South West of England. One hundred and twenty-three piercees completed a self-administered questionnaire and 22 piercers took part in an interviewer-led questionnaire.Results The mean age of an individual having a tongue piercing was 19 years old. Almost all the subjects reported problems following piercing; early problems were mainly due to tissue trauma, whereas later, ingestion of jewelry and tooth fracture were common events. A minority (7%) of piercees required the advice of a healthcare professional following tongue piercing. The majority of piercers reported adequate cross-infection measures and enquired about their clients' health prior to piercing. However, only one piercer was aware of the risk of bacterial endocarditis following tongue piercing. Most of the piercers reported that they would advise their clients to attend an Accident and Emergency department if a serious complication ensued.Conclusion Tongue piercing may be associated with significant short-term and long-term morbidity, including tooth damage. Although the majority of piercers interviewed reported adequate cross-infection controls, knowledge of the medical risks associated with tongue piercing varied widely. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess attitudes of patrons and medical school faculty about physicians with nontraditional facial piercings. We also examined whether a piercing affected the perceived competency and trustworthiness of physicians. Survey. Teaching hospital in the southeastern United States. Emergency department patrons and medical school faculty physicians. First, patrons were shown photographs of models with a nontraditional piercing and asked about the appropriateness for a physician or medical student. In the second phase, patrons blinded to the purpose of the study were shown identical photographs of physician models with or without piercings and asked about competency and trustworthiness. The third phase was an assessment of attitudes of faculty regarding piercings. Nose and lip piercings were felt to be appropriate for a physician by 24% and 22% of patrons, respectively. Perceived competency and trustworthiness of models with these types of piercings were also negatively affected. An earring in a male was felt to be appropriate by 35% of patrons, but an earring on male models did not negatively affect perceived competency or trustworthiness. Nose and eyebrow piercings were felt to be appropriate by only 7% and 5% of faculty physicians and working with a physician or student with a nose or eyebrow piercing would bother 58% and 59% of faculty, respectively. An ear piercing in a male was felt to be appropriate by 20% of faculty, and 25% stated it would bother them to work with a male physician or student with an ear piercing. Many patrons and physicians feel that some types of nontraditional piercings are inappropriate attire for physicians, and some piercings negatively affect perceived competency and trustworthiness. Health care providers should understand that attire may affect a patient's opinion about their abilities and possibly erode confidence in them as a clinician. [ABSTRACT FROM AUTHOR]

This investigation characterizes five surgical stainless steel piercings and one niobium piercing that caused adverse reactions during use, culminating with the removal of the jewelry. Chemical composition shows that none of the materials are in accordance with ISO (International Organization for Standardization) standards for surgical implant materials. Additionally, none of the stainless steel piercings passed the pitting-resistance criterion of ISO 5832-1, which implies that %Cr + 3.3 × %Mo >26. Under microscopic examination, most of the jewelry revealed the intense presence of linear irregularities on the surface. The lack of resistance to pitting corrosion associated with the poor surface finishing of the stainless steel jewelry may induce localized corrosion, promoting the release of cytotoxic metallic ions (such as Cr, Ni, and Mo) in the local tissue, which can promote several types of adverse effects in the human body, including allergic reactions. The adverse reaction to the niobium jewelry could not be directly associated with the liberation of niobium ions or the residual presence of cytotoxic elements such as Co, Ni, Mo, and Cr. The poor surface finish of the niobium jewelry seems to be the only variable of the material that may promote adverse reactions. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To review the current information on medical complications, psychological implications, and legislative issues related to body piercing, a largely unregulated industry in the United States. METHODS: We conducted a MEDLINE search of English language articles from 1966 until May 1998 using the search terms “body piercing” and “ear piercing.” Bibliographies of these references were reviewed for additional citations. We also conducted an Internet search for “body piercing” on the World Wide Web. MAIN RESULTS: In this manuscript, we review the available body piercing literature. We conclude that body piercing is an increasingly common practice in the United States, that this practice carries substantial risk of morbidity, and that most body piercing in the United States is being performed by unlicensed, unregulated individuals. Primary care physicians are seeing growing numbers of patients with body pierces. Practitioners must be able to recognize, treat, and counsel patients on body piercing complications and be alert to associated psychological conditions in patients who undergo body piercing. [ABSTRACT FROM AUTHOR]

Background: Sleeve gastrectomy (SG) is one of the commonest bariatric procedure performed worldwide (Asian Journal of Endoscopic Surgery 7:314–6, 2014). Leaks reported in 1 to 7% of cases are difficult to manage after SG. Leaks can be graded into acute (within 7 days), early (within 1–6 weeks), late (after 6 weeks) and chronic (after 12 weeks) (Asian Journal of Endoscopic Surgery 7:314–6, 2014). Oesophageal stents can be used for acute leaks. Gastro-colic fistula (GCF) is a rare complication following a chronic leak after SG (Asian Journal of Endoscopic Surgery 7:314–6, 2014). We would like to share our experience of a rare and challenging case of GCF after SG leak. Method: Prospectively collected data in our tertiary bariatric centre was retrieved. Results: A 31-year-old female with body mass index (BMI) of 46.2 kg/m2 with history of bipolar disorder had an uneventful SG. On sixth day post-operatively, she presented to other unit with lower chest pain and had a computed tomography (CT) scan which was normal. At 6-week follow-up (FU), she had lost 44% excess weight loss (EWL) and complained of epigastric pain and reflux. CT scan showed collection with active leak in SG. This was successfully treated with partially covered stent placement. Imaging confirmed control of leak. Ten days later, endoscopic removal of the stent was successfully done. At 6-month FU, she had 86% EWL. At 1-year FU, she had 102% EWL with complain of reflux despite being on proton pump inhibitor (PPI). There were no nutritional parameter concerns. There was no history of diarrhoea. CT scan showed GCF (Image 1). OGD confirmed the findings and the site was tattooed. Colonoscopy was equivocal, and no clear fistula visualised which would explain the lack of diarrhoea. Operation was planned with colorectal team after multidisciplinary team discussion. At laparoscopy (Video 1), GCF was identified between SG and splenic flexure at the site of the previous leak. Adhesinolysis was done with a combination of blunt, sharp and energy device and the gastric sleeve and the splenic flexure were mobilised. The fistulous tract was isolated, divided and excised with Endo GIA tristapler taking partial lumen of colon. Intra-operative oesophagogastroduodenoscopy (OGD) showed no leak and colonoscopy showed no leak or narrowing of the lumen and showed healthy tissue. Post-operative recovery was uneventful. She was closely monitored by the bariatric dietician throughout the journey. At 6-month FU, she regained weight under close supervision, had EWL of 88% and is doing well. Conclusion: SG leaks can add long-term morbidity. Stent can be used successfully to treat SG leak if used judiciously. There should be low threshold for investigating patients with EWL of > 100% for anatomical complications like stricture, fistula or kink in the gastric sleeve. We wanted to make the bariatric fraternity aware of a rare late (> 12 weeks) complication of gastro-colic fistula after successfully treated SG leak. Limited literature is published about this rare complication and its management which ranges from conservative management to stent placement to surgical intervention (Asian Journal of Endoscopic Surgery 7:314–6, 2014; Clinical Case Reports 6:1342–1346, 2008; Surgery for Obesity and Related Diseases 6:308–12, 2010). It can be dealt with successfully with minimally invasive technique by a multidisciplinary team in an experienced tertiary bariatric unit. [ABSTRACT FROM AUTHOR]

The article presents the dental complications following an oral piercing. It says that pain and swelling which can affect breathing are the most common complications of oral piercing. It adds that gingival recession in the lower lingual region of the anterior teeth can be developed in individuals with tongue piercing. Moreover, misalignment of the dentition can be resulted from the habits of moving the oral jewelry around in the mouth.

This paper presents the development of a novel micro drill device for single living organisms. Currently, microinjection for mice and some other species is performed with the help of piezo-driven actuators with a very small amount of mercury column in the proximal end of the pipette in order to increase the success rate. However, the toxicity of mercury exhibits a risk factor both for the operator and the injected cells. Therefore, mercury-free devices have become a necessity. Here, a novel micro drill is developed based on the same principle of Ros-DrillⒸ piercing approach; piercing via rotational movements. The new drill is driven by a brushless motor, and it incorporates the micropipette holder. Both the amplitude and the frequency of rotational oscillations can be adjusted in very wide ranges. The experiments reveal that the drill is suitable for different tasks such as microinjection and biopsy of different organisms. It presents good performance in terms of success rate, ease of usage, compactness and compatibility with different manipulation systems. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article regarding the study which investigates the impact of surface piercing, a cosmetic piercing, in surgical practice and its complications.

A letter to the editor is presented which describes a potential anesthetic implication of body piercing.

Comments on the issue of whether physicians should be allowed to have facial piercings. Inappropriateness of facial piercings for physicians according to patients and physicians themselves; Need to know the relative impact of facial piercings on physician-patient interactions; Considerations for restricting physicians to display facial piercings and other forms of self-expression..

Discusses a case of complication of tongue piercing. Case history; Sexual connotation of tongue piercing; Possible chipping or cracking of the teeth.

Copyright of European Journal of Orthopaedic Surgery & Traumatology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Presents a case of gingival recession due to trauma caused by a lower lip stud. Damage caused by a lip stud to previously healthy gingival tissue; Dangers of certain body art.

Tongue piercing remains popular. A variety of complications have been reported, including life-threatening infection, airway problems and damaged teeth or mucosal surfaces. A patient who collapsed after continuous profuse bleeding following tongue piercing is presented. It is recommended that piercing practitioners be licensed and inspected. A list of written post piercing instructions for customers is included on how to deal with, or who to contact regarding potential complications including haemorrhage. [ABSTRACT FROM AUTHOR]

What are the real risks associated with oral piercings? [ABSTRACT FROM AUTHOR]

Oral piercings were associated with more pain and swelling than facial piercings. [ABSTRACT FROM AUTHOR]

Lip piercing is associated with buccal recession and narrow attached gingiva. [ABSTRACT FROM AUTHOR]

The article presents an abstract about "Oral and dental complications of intra-oral piercing," by L Levin and Y Zadik.

ObjectiveTo investigate the prevalence and range of complications following tongue piercing.MethodsA survey of individuals with tongue piercings ('piercees') and tongue piercers was undertaken in the South West of England. One hundred and twenty-three piercees completed a self-administered questionnaire and 22 piercers took part in an interviewer-led questionnaire.ResultsThe mean age of an individual having a tongue piercing was 19 years old. Almost all the subjects reported problems following piercing; early problems were mainly due to tissue trauma, whereas later, ingestion of jewelry and tooth fracture were common events. A minority (7%) of piercees required the advice of a healthcare professional following tongue piercing. The majority of piercers reported adequate cross-infection measures and enquired about their clients' health prior to piercing. However, only one piercer was aware of the risk of bacterial endocarditis following tongue piercing. Most of the piercers reported that they would advise their clients to attend an Accident and Emergency Department if a serious complication ensued.ConclusionTongue piercing may be associated with significant short-term and long-term morbidity, including tooth damage. Although the majority of piercers interviewed reported adequate cross-infection controls, knowledge of the medical risks associated with tongue piercing varied widely. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor discussing the unusual complication of tongue piercing, in which a bifid tongue resulted.

The recent warm weather might have caused further debate on global warming but has also revealed some extra knowledge about our patients - that the most unexpected of them have tattoos. [ABSTRACT FROM AUTHOR]