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PubMed1991

[Primary treatment of contaminated syringes and needles in a ward].

Body fluid transmitted viruses become the major enemies of human health. These viruses have been reported as occupational hazards for health care personnel, and they may become environmental hazards as well. We conducted this study to examine the primary treatment of used syringes and needles in a ward, and to evaluate the effects of re-education. For questions such as "The used syringes with bloody contamination should isolated from those without" and "The cover of used needles should not be put back on", we recorded error rates during the 1st one-week observation. A lecture about the standard treatment methods of discarding instruments was given to all nurses in this ward after the 1st observation. The 2nd and 3rd one-week observations were repeated one day and one month after the lecture, respectively. The misclassification rates of discarded syringes were 4.4% (33/758), 1.4% (9/661) and 3.9% (18/616). There was a significant decrease between the 1st and 2nd observations (p less than 0.05), but no significant difference between the 1st and 3rd observations (p greater than 0.05). The rates of covered discarded needles were 50.4% (287/569), 44.3% (198/447) and 38.5% (269/699), respectively. These rates showed a trend to decrease (p less than 0.05). The misclassification rates of discarded syringes were low. Although re-education achieved only temporary effects, self-protective education on not re-covering used needles was effective. However, about 40% of all discarded syringes were still being covered after use. Based on our finding, some improvements have been made in this ward.

Medical Waste↗
PubMed1990

Comparison of automated and manual methods of syringe filling.

A study to measure the time and cost associated with an automated and a manual method of syringe filling is reported. A stopwatch was used to measure the time needed by an experienced pharmacy technician to prepare batches of 200 syringes of each of seven drugs by a manual method and an automated method, the Multi-Ad Fluid Dispensing System. For each drug and method, time-and-motion data were collected during the preparation of four batches. The accuracy of each method was determined by dividing the actual by the expected number of syringes filled per batch. Material costs were calculated by summing the contract costs of the necessary equipment. The total cost of each method was determined by adding the labor and material costs. For all the drugs, the mean total time required to prepare one batch of syringes by the automated method was significantly less than that for the manual method. There was no significant difference in accuracy between methods for any of the drugs. The annual labor costs of the automated and manual methods were $4056 and $5761, respectively, and the annual material costs were $3364 and $2260, respectively. The total annual cost of the automated method was $7419, compared with $8021 for the manual method. The Multi-Ad system was significantly faster and somewhat less costly overall than a manual method for batch preparation of syringes of seven drugs.

Automation↗
PubMed1981

Syringing as a method of cell dispersal. II. Effect on abnormal cells.

The generation of turbulent shear force using a constant pressure syringing device has been demonstrated to be a simple, effective method for the dispersal of intermediate and superficial squamous cells. This paper reports results of an evaluation of the effects of syringing on the dispersal of abnormal cells. Gynecologic cell samples obtained from preinvasive and invasive lesions were syringed. Overall cell loss, as well as degree of dispersion, was evaluated. Doublet, triplet and larger abnormal cell groupings remained in most syringed aliquots regardless of pressure. Although some cell loss was observed in the majority of cases, the percentage of single abnormal cells was increased in 96% of the syringed aliquots.

Adenocarcinoma↗
PubMed1994

Preliminary laboratory studies of inactivation of HIV-1 in needles and syringes containing infected blood using undiluted household bleach.

To evaluate the effectiveness of bleach disinfection of injection equipment, we tested HIV-1 inactivation by household bleach in needles and syringes. We obtained blood from HIV-1 infected injecting drug users (IDUs), placed small aliquots in needles and syringes. Blood with and without anticoagulant was incubated at room temperature for 3, 6, 18, and 24 h, and some needles and syringes from each condition were exposed to undiluted bleach for 15 and 30 s. The needles and syringes were then rinsed and the rinses were used to inoculate peripheral blood mononuclear cells (PBMNCs). HIV-1 replication was monitored using p24 enzyme linked immunosorbent assay (ELISA). We describe results that HIV-1 is inactivated in clotted and unclotted blood allowed to stand at room temperature for 3, 6, 18, and 24 h in needles and syringes using undiluted household bleach at 30 s of exposure time. These results are consistent with earlier findings that micropellets of HIV-1 were inactivated by bleach under similar conditions of exposure to bleach; 10% bleach was not effective at an exposure time of 30 s and undiluted bleach was not effective at an exposure time of 15 s to inactivate HIV-1 in clotted blood. Bleach concentration and exposure time are critical and HIV disinfection may not occur with inadequate exposure to bleach HIV.

Disinfection↗
PubMed1996

[Clinical evaluation of a new programmable syringe infusion pump].

A new programmable syringe infusion pump, Auto Syringe Model AS 40 A, was evaluated for infusion of muscle relaxants, vasodilators and opioids in 4 surgical patients. Every drug mentioned above was easily adjusted according to surgical requirement in these patients. Auto Syringe Model AS40A is light and compact. Its major advantages lie in the mechanisms for delivery of a bolus dose and automated delivery of intermittent doses, automatic rate calculation, and the applicability to various sizes of syringes. Auto Syringe Model AS40A was found to be very useful for intravenous infusion of drugs.

Adult↗
PubMed1997

Gas compression artefacts when testing peak expiratory flow meters with mechanically-driven syringes.

Mechanically-driven syringes used to test peak expiratory flow (PEF) meters must produce the American Thoracic Society (ATS) standard waveforms with PEF accuracy of 2%. However, gas compression within the syringe could result in significant PEF inaccuracy when testing high resistance meters. The gas compression artefact was investigated in a mechanical syringe (PWG; MH Custom Design & Mfg L.C., Midvale, Ut, USA) of 13.6 L connected to a standard range mini-Wright PEF meter (Clement Clarke International, Harlow, UK). Scaled versions of the ATS standard waveform No. 24, with peak flows of 750 and 450 L x min(-1), were discharged through the PEF meter from different starting piston positions to vary syringe volume (Vsyr). The PEF recorded by the meter decreased linearly with increasing Vsyr. PEF decreased by 0.31 and 0.27% per litre for the ATS standard waveforms with PEF of 750 and 450 L x min(-1), respectively. The target PEF computed from piston displacement overread the actual PEF delivered into the PEF meter by approximately 4% when Vsyr = 13.6 L. Overreading fell to approximately 1% when Vsyr was reduced to 3.62 L. Therefore, gas compression error in commercially available large mechanical syringes can exceed the 2% inaccuracy limit when testing high resistance portable PEF meters. Measurements can be corrected for gas compression by linearly extrapolating PEF recordings to zero volume.

Artifacts↗
PubMed1998

[The switching time of propofol syringes for the propofol specific pump is dependent on the familiarity of pumps].

The switching time of syringes during propofol anesthesia was investigated among various anesthesiologists. One hundred and thirty times of exchanges were observed in the early 82 propofol anesthesia cases using a propofol specific syringe pump STC-525 X (Terumo, Japan) since the introduction of propofol in our hospital. The anesthesiologists were divided into three groups: group A; the board certified anesthesiologists with more than one month experience of propofol anesthesia, group B; the board certificed anesthesiologists with less than one month experience, group C: the trainee. There were no cases of intraoperative recall case. The median times of switching syringes were 14 seconds, 26 seconds, 56 seconds in the group A, group B, group C, respectively. Group A is significantly quicker than the other groups. This indicates that switching time is dependent on the experience with propofol and syringe pumps. We conclude that not only trainees but also expert anesthesiologists should be accustomed to switching syringes in order to avoid intraoperative awareness.

Anesthesiology↗
PubMed1998

[Accidental contact with syringes used by intravenous drug users (IDU): a decade of study].

OBJECTIVE: The increase in drug addiction, AIDS, hepatitis C and B transmission is a problem the society faces with growing frequency, mainly due to syringes and other material used by seropositive patients being left in public place, with children being one of the groups being at greatest risk. We present our experience in accidents with syringes used by intravenous drug users (IDU) in patients less than 16 years of age during the last 11 years. PATIENTS AND METHODS: All patients attending our emergency department with diagnosis of contact with syringes used by IDU were prospectively studied. All patients were treated according to the follow-up protocol of accidental contact with syringes used by IDU. RESULTS: We studied 183 patients between 0 and 16 years of age, with a male gender predominance, the average age at presentation was 6.7 years. The majority of cases occurred during the months of April through August. One hundred twenty-eight cases completed the control after 1 year. At the one year control after the accident, 99% of the patients were anti-HBs antibody positive. Other markers positive for HBV were found in 15% of the cases. Markers for HCV were found in only 9 of 84 patients studied. Only one patient that did not receive either the gamma globulin nor the vaccine developed hepatitis B infection. No patient showed HIV conversion during the time of the study. CONCLUSIONS: The risk of HIV and HCV after accidental puncture with syringes used by IDU is nearly none. Hepatitis B virus infection is the major risk. HBV transmission in the workplace can be largely eliminated due to the increased use of hepatitis B vaccine.

Accidents↗
PubMed1991

Contributions of syringeal muscles to respiration and vocalization in the zebra finch.

Acute and chronic electromyographic (EMG) recordings from individual syringeal muscles were used to study syringeal participation in respiration and vocalization. In anesthetized birds, all syringeal muscles recorded were active to some degree during the expiratory phase of respiration, following activity in the abdominal musculature and preceding the emergence of breath from the nostril. In awake birds, the ventralis (V) muscle fired a strong, consistent burst, but the dorsalis (D) was variable both in strength and timing. Denervation of V is sufficient to produce the wheezing respiration originally seen in birds with complete bilateral section of the tracheosyringeal nerve. Complete syringeal denervation also removed almost all the acoustic features that distinguish individual song syllables, but had a minor effect on the temporal structure of song. When activity in V and D was recorded in awake, vocalizing birds, D was active before and during sound production, and V showed a small burst before sound onset and a vigorous burst timed to the termination of sound. During song, V was consistently active at sound offset, but also participated during sound for narrow bandwidth syllables. For some syllables (simple harmonic stacks), neither muscle was active. These data suggest that V contributes to syllable termination during vocalization and may silence the syrinx during normal respiration. D contributes to the acoustic structure of most syllables, and V may contribute to a special subset of syllables. In summary, the syringeal muscles show different activity patterns during respiration and vocalization and can be independently activated during vocalization, depending on the syllable produced.

Animals↗
PubMed1980

Androgen affects cholinergic enzymes in syringeal motor neurons and muscle.

We examined the role of testosterone (T) in regulating the weight of the songbird syrinx and the activity of two cholinergic enzymes, choline acetyltransferase (CAT) and acetylcholinesterase (AChE). Castration of adult male zebra finches or neonatal canaries results in a lowering of syringeal weight and CAT and AChE activity. Administration of T for 1-4 weeks restores syringeal weight and AChE to intact levels in male zebra finches. Activity of CAT in muscle is not fully restored. Ovariectomy of female zebra finches and canaries does not affect these syringeal parameters, but T administration to ovariectomized females for 1 month increases syringeal weight and AChE activity. In the zebra finch tracheosyringealis nerve, activity of CAT and AChE is decreased one month after castration. T administration to castrates maintains nerve AChE activity but not CAT. In contrast to changes in the syrinx, tongue muscles do not change in weight or enzyme activity when circulating T levels are altered. Effects of muscle use and disuse were found on syringeal weight and AChE activity, but an androgenic effect also operates in addition. Results suggest that one mechanism for T regulation of singing in passerine birds is through induction of specific enzymatic proteins in androgen target neurons and muscles.

Acetylcholinesterase↗
PubMed1983

Vacuum aspiration with the IPAS Modified Gynecologic Syringe.

The IPAS Modified Gynecologic Syringe was compared with the electric pump and standard hand pump in a clinical trial of 1227 women undergoing vacuum aspiration. This modified double-valve syringe was designed to fit larger 8 mm, 10 mm and 12 mm cannulae, which are more suitable for late first trimester procedures. The study was conducted at four centers in which the double-valve syringe was used alternately with the vacuum source normally used at each clinic. Although there were notable inter-center differences with respect to certain outcome variables, results were similar for procedures performed at the same center. The only significant finding was the lower proportion of women requiring D & C to complete uterine evacuation among double-valve syringe patients than among hand pump cases at one center. The data indicate that the double-valve syringe is safe and effective for uterine aspiration in women up to 14 weeks' gestation and may be preferable for use in clinics with limited facilities.

Abortion, Induced↗
PubMed1985

Contamination of intradermal skin test syringes.

Syringes used in intradermal skin testing have commonly been used for multiple patients. Recently the safety of this practice was questioned, raising the possibility that these syringes may transmit disease from one patient to another. Since this practice is so widespread and because of a scarcity of articles linking the spread of disease with this practice, we repeated these studies and performed other experiments to test this hypothesis. With the use of Escherichia coli, Staphylococcus aureus, and tritiated thymidine, we found contamination of syringe contents that indicated a clear potential for common syringes to spread disease. These studies and studies reported elsewhere suggest that common syringes should not be used in skin testing.

Equipment Contamination↗
PubMed2004

A syringe compressor for vertebroplasty: technical note.

OBJECTIVE: Percutaneous vertebroplasty (VP) has become a popular technique to treat osteoporotic vertebral compression fractures and spinal column neoplasms. The consistency of the bone cement mixture during the procedure would appear to be increasing with time, but the physician experiences injection difficulty, and there are also concerns with the limited injection time available for such a procedure. METHODS: We describe a special-design screw-syringe compressor to be used with the ordinary 10 mL Luer-Lok syringe and a short connecting tube for the injection of bone cement during VP. RESULTS: The syringe compressor could yield maximum 2,772 psi compression pressure and could finely control the cement delivery rate to 0.2 mL/ a turn. We have used this technique to treat 296 consecutive patients with 384 vertebral compression fractures who were suffering from disabling back pain refractory to analgesic therapy. Using this technique, the injection time can be prolonged to 12 min and the delivery volume can be better controlled. CONCLUSION: With the aid of the syringe compressor, the cementing material can be accurately and steadily injected as desired by the physician. Bone-cement injection can be better controlled with this syringe compressor. Furthermore, this delivery system would reduce per treatment cost.

Decompression, Surgical↗
PubMed2001

The effects of heparin anticoagulants and fill volume in blood gas syringes on ionized calcium and magnesium measurements.

We studied the effects of several heparin anticoagulants on ionized calcium and ionized magnesium measurements. Venous blood from 24 healthy donors was drawn into 20-ml syringes without an anticoagulant, and immediately analyzed for control results. They were then transferred to completely fill and half-fill each of four brands of syringes, and an evacuated non-anticoagulated blood-collection tube. All were analyzed for ionized calcium and magnesium. In some cases, either saline or a Ca/Mg solution was added to increase the range of concentrations. The final concentrations ranged from 0.94 to 2.09 (ionized calcium) and from 0.41 to 1.06 mmol/l (ionized magnesium). In full syringes, mean changes in ionized calcium or magnesium were <0.01 mmol/l over a range of concentrations usually encountered. The only definite effect was noted in half-full Martell syringes, where ionized calcium was lower by 0.028 mmol/l. At very high ionized calcium concentrations (>1.95 mmol/l) and ionized magnesium concentrations (>0.95 mmol/l), a few changes were noted of little clinical significance. We conclude that all the syringes evaluated have no clinically significant effects on ionized calcium or ionized magnesium concentrations when filled to capacity. When half-full, a few changes of marginal clinical significance were noted. All these effects were less than observed in serum, which is apparently affected by sample processing and/or clotting.

Anticoagulants↗
PubMed2001

Gender differences in syringe exchange program use in Oslo, Norway.

AIMS: To examine gender differences in syringe exchange program (SEP) use, particularly frequent SEP use, within and across survey years. DESIGN: Three consecutive, anonymous cross-sectional surveys. SETTING: The SEP in Oslo, Norway. PARTICIPANTS: Two hundred and eighty-eight, 449 and 523 SEP participants interviewed during comparable 1-week periods in 1992, 1994 and 1997, respectively. MEASUREMENTS: Brief structured questionnaires assessed SEP use, HIV risk behaviors and self-reported HIV status. Chi square statistics, t-tests and analysis of variance were used to identify gender differences; logistic regression was used to identify independent correlates of frequent SEP use. FINDINGS: Women reported injecting more frequently than men, but neither reported more frequent SEP use nor acquiring more syringes during an exchange. Although syringe sharing decreased significantly over time, in 1997, 51% of SEP participants continued to share. HIV prevalence remained low (3-5%) over time. After controlling for gender, age and HIV risk factors, frequent SEP use was significantly correlated with frequent injection for both women (OR = 1.4) and men (OR = 1.5). A lack of income or benefits independently increased the likelihood of being a frequent SEP user (OR = 3.0), while having shared a syringe at last injection independently decreased this likelihood (OR = 0.5). CONCLUSIONS: Gender was not associated with frequent SEP use; rather, the single most important correlate of frequent SEP use was injection frequency. Women's need for sterile syringes may not be fully addressed, despite the existence of a well-established and well-utilized SEP.

Adolescent↗
PubMed2003

An open, randomized single-centre study to compare the efficacy and convenience of follitropin beta administered by a pen device with follitropin alpha administered by a conventional syringe in women undergoing ovarian stimulation for IVF/ICSI.

BACKGROUND: A pen device, similar to an insulin pen, has been recently marketed for the administration of follitropin beta in cartridges. A randomized controlled trial was performed to compare the efficacy and convenience of this pen device delivering follitropin beta with a conventional syringe delivering follitropin alpha. METHODS: A total of 200 patients needing IVF/ICSI treatment and willing to self-inject were enrolled in the study. All subjects had ovarian stimulation according to a long protocol and were randomized to the pen or the conventional syringe group during down-regulation by means of a computer-generated randomization list using random numbers. Patients were asked to fill in a daily local tolerance book after each injection. On the day of hCG the patients scored a Visual Analogue Scale (VAS) for pain and convenience. RESULTS: The average duration, total dose of recombinant FSH and number of cumulus oocyte complexes retrieved were 10.8/12.0 days (P = 0.001), 1880/2226 IU (P < 0.001) and 15.2/13.1 respectively in the pen device and conventional syringe groups; the presence of pain after the daily injection was significantly higher in the conventional syringe group (P = 0.027); the visual analogue scale score was similar for pain but significantly more convenient for the pen device (P < 0.001). The live birth rate per embryo transfer was 32.9 and 34.4% respectively in the pen device and conventional syringe groups. CONCLUSIONS: Self-injection with the pen device is safe and easy, more convenient and less painful for the patient, requires less FSH and shortens the treatment duration.

Adolescent↗
PubMed1985

The value of syringe shields in a nuclear medicine department.

The radiation dose to the pulp of both index fingers has been measured in a radiopharmacy supplying 11 000 patient doses a year, in a hospital dispensary (4500 doses a year) and in its injection area. Tungsten syringe shields were used for one week and not used during the other week. In the radiopharmacy and the dispensary the highest finger dose recorded was 6.8 mSv, which corresponds to an annual figure of 330 mSv. Syringe shields gave a protection factor of less than two, and the dose to the left hand was approximately half that to the right. When giving injections the corresponding weekly and annual doses were 4.6 and 220 mSv respectively. If all injections had been given by a single person the corresponding annual dose would have been 430 mSv. Using syringe shields this could be reduced by factors of at least eight for the right hand but only 1.3 for the left hand. Dose rates for unshielded syringes expressed per 10 GBq handled are similar to other data in the literature. However, syringe shields reduce the dose rates less than anticipated. Tungsten 1.94 to 3.05 mm thick would be expected to give an attenuation factor of 27 to 178.

Body Burden↗
PubMed1991

Safety and immunogenicity of Haemophilus type b-tetanus protein conjugate vaccine, mixed in the same syringe with diphtheria-tetanus-pertussis vaccine in young infants.

As new vaccines are developed there is increasing interest in reducing the number of injections given to children by combining vaccines in one syringe. We studied the safety and immunogenicity of Haemophilus influenzae type b-tetanus protein conjugate vaccine (PRP-T) administered at ages 2, 4 and 6 months mixed in the same syringe with DTP vaccine and its effects on the seroresponse to DTP vaccine. A group of 112 healthy 2-month-old infants received DTP-PRP-T or DTP-placebo mixed immediately before immunization in the same syringe. The addition of PRP-T to DTP did not increase the rate of local or systemic reactions. After the first, second and third dose, the PRP-T recipients showed a geometric anti-PRP antibody mean of 0.13, 2.31 and 6.40 micrograms/ml vs. 0.07, 0.05 and 0.05 micrograms/ml among the DTP-placebo recipients, respectively. Of the PRP-T recipients, 94 and 98% attained antibody concentration of greater than or equal to 0.15 micrograms/ml protein after the second and third dose, respectively, and 65 and 94% attained a concentration of greater than or equal to 1.0 micrograms/ml after the second and third dose, respectively. At the age of 1 year 94 and 52% of the DTP-PRP-T recipients vs. 12% and 0% of the placebo recipients still maintained titers of greater than or equal to 0.15 and greater than or equal to 1.0 micrograms/ml, respectively. The administration of DTP in the same syringe with PRP-T did not affect significantly the antibody response to diphtheria and tetanus toxoid and to pertussis agglutinins. It is concluded that PRP-T vaccine could be administered in the same syringe as DTP.

Antibodies, Bacterial↗