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PubMed1994

[Pressure build-up in 2 rate-controlled syringe infusion pumps].

The use of rate controlled syringe infusion pumps has spread to departments where the need for accurate infusion exists. The simplicity in using these pumps has led to a false feeling of safety. A case of hazardous use of a syringe infusion pump has been reviewed. An Ohmeda 9000- and a Terumo STC 521 syringe pump was here tested, n = 20. The occlusion pressures of the two pumps were different. The occlusion pressure changed with different infusion rates for both pumps. The pressure was built up in a straight linear fashion. The bolus release depended on the occlusion pressure and the amounts given were in the range of 1.0-1.6 ml, both pumps included. The time from occlusion to alarm depended on the occlusion pressures. There might be an advantage in using a soft infusion system. It is recommended not to use syringe pump infusion via peripheral veins so as to avoid the risk of pressure build-up in the subcutaneous tissue in case of infiltration. In the event of occlusion disconnect the infusion system prior to reopening. Don't rely on the occlusion alarm. Use a smooth infusion system.

Child, Preschool↗
PubMed1994

Inadequate bleach contact times during syringe cleaning among injection drug users.

Objectives were to measure syringe cleaning strategies used by injection drug users (IDUs) and to assess syringe contact with bleach during cleaning demonstrations. IDUs were interviewed about cleaning activities during their most recent injection episode; they demonstrated these activities on videotape. Coders reviewed the videotapes, categorized activities, and used stop watches to record bleach exposure. Of 161, 146 subjects reported cleaning at last injection, 85 (58%) of 146 used full strength bleach. Of bleach users, 20% had total contact time (duration of bleach inside syringe) of > or = 30 s; combining draw (time taken to fill syringe) and contact times, 54% of bleach users had total "flush" times of > or = 30 s. Median observed time per bleach flush was 16 s. Median reported cleaning times were twice as long as observed. Recent reports indicate 30 s of exposure to undiluted bleach is necessary to inactivate HIV in the laboratory; here, 80% of IDUs using bleach had contact of < 30 s. Judgment of contact time was inaccurate. On average, instructions advocating two bleach flushes may reach 30 s; here, half the subjects had insufficient time with two flushes. The majority showed inadequate techniques, therefore, alternate cleaning strategies should be developed.

Adult↗
PubMed1996

Syringe liposculpture.

This article presents syringe liposculpture, a technique for the treatment of localized fat deposits, to remodel the body and the face, using disposable syringes and fine-tip cannulas. In March 1989, the author started working on a combination of syringe liposculpture and superficial liposuction to treat the superficial layer of fat, resulting in "superficial liposculpture." Syringe liposculpture of the face can offer an alternative to rhytidoplasty. This is a gentle facial recontouring procedure and a complement to other techniques to improve the appearance with minimal morbidity through a simple, fast procedure with the patient under local anesthesia and no need for hospitalization.

Adult↗
PubMed1996

Changes in practice in the use of subcutaneous diamorphine via syringe driver.

A study was undertaken in 1988 to examine various aspects of administering diamorphine subcutaneously by syringe driver at the time when its use had recently been introduced into the community. The results of this study and of a comparative study undertaken in 1994 are reported. It was found that in both studies the syringe driver was used mainly for patients who were unable to take oral medication or who were vomiting. However, in the first study, subcutaneous diamorphine was used in 31% of patients with no absorption problems, to improve pain control in those whose pain was poorly controlled on oral medication. In the second study, the syringe driver was used in only 8% of patients for this purpose. In both studies the use of the driver was continued until death in 37 of the 39 patients (95%) in each group. The syringe driver was used for longer than 14 days in most patients (56%) in the first study and the dose of diamorphine was increased in 54% of patients. In the second study, the driver was used mainly in the last week of life (69%) and the dose was more stable, remaining unchanged in 69% of patients. The incidence of site complications (5%) was the same in both groups, but other problems occurred with the use of the driver in the first group.

Adult↗
PubMed1997

Nonuniformity intrinsic flood artifact caused by point-source syringe needle.

UNLABELLED: The purpose of this study was to investigate the cause of a nonuniformity artifact seen on an intrinsic flood. METHODS: Intrinsic floods were acquired on three different cameras using a point source in a 1-cc syringe, with and without a needle attached. Floods were obtained with the syringe placed perpendicular and parallel to the camera face. RESULTS: A nonuniformity artifact was evident if a syringe with a needle was placed perpendicular to the crystal face. CONCLUSION: If a syringe is used as a point source during the acquisition of an intrinsic quality control flood, the needle should not be placed perpendicular to the camera face.

Artifacts↗
PubMed1997

[Study on particle contamination produced by syringe needles and rubber stoppers for pharmaceutical solutions].

The contamination of particles produced by syringe needles and rubber stoppers for pharmacal solution of venous transfusion was studied. The results showed that the contamination of particles was positive correlation with the usage frequency of syringe needles, so the syringe needles for single use were suggested. To compare two kinds of syringe needles with different structure (side hole and incline), the result was that the difference of particle contamination between them was similar and without statistic significance. The particles contamination produced by primary and used rubber stoppers which was protected by polyester film was studied. It was shown that the difference between them was no significant statistically. The results of this study supplyed a scientific evidence about repeated use of rubber stoppers.

Drug Contamination↗
PubMed1998

When not to syringe an ear.

This article reviews the potential hazards of ear syringing and the Accident Compensation Corporation Medical Misadventure Unit's experience of alleged iatrogenic injury over a 17-month period. Syringing claims account for about 25% of the total claims received by the ACC ENT Medical Misadventure Committee. Forty-seven claims were accepted as either mishap or error, and 63 claims were declined. Perforation of the drum was by far the commonest injury resulting in significant disability. Severe iatrogenic otitis externa accounted for most of the remainder. Practice nurses had syringed the ears of approximately two-thirds of the claimants with significant disability. The contraindications to ear syringing are listed and discussed. The correct technique, with a few "do and don't" pointers, is briefly reviewed. Management of the unintentional injury is discussed.

Adult↗
PubMed2002

Pressurized bag pump and syringe pump arterial flushing systems: an unrecognized hazard in neonates?

OBJECTIVE: Hand-held flushing of radial arterial lines at 0.5 ml/s in neonates can result in retrograde embolization of flush solution into the central arterial circulation. We studied flush flow velocities during intermittent arterial line purging using a flow regulating device with an infusion bag pump and a syringe pump system. MEASUREMENTS AND INTERVENTIONS: In this in vitro experiment we simulated flushing of a 24- and a 22-G cannula against a mean arterial pressure of 45 mmHg. Fluid flow velocities were gravimetrically measured during flushing from an infusion bag system pressurized to 100, 200, and 300 mmHg and from a syringe pump flush system after initialization of boluses of 0.5, 1.0, 1.5, 2.0, and 2.5 ml. The flow regulating device was opened for 1, 2, and 5 s. RESULTS: Both flush systems tested allowed delivery of flush flow velocities exceeding 0.5 ml/s (e.g., 22-G cannula; bag system, pressure 300 mmHg up to 0.64+/-0.08 ml/s; syringe pump, 2 ml bolus up to 0.74+/-0.05 ml/s). In syringe pump systems the main determinant of flow velocity was bolus size, in bag pump systems flushing time and bag pressure. CONCLUSIONS: Based on data about critical flow velocities through an radial arterial cannula in neonates, both tested flushing systems carry the risk of exceeding the critical value of 0.5 ml/s. They are likely to cause retrograde embolization of flushing solution into the central arterial circulation with the associated risk of clot and air embolization. In vivo studies should identify margins of safety to minimize the risk of retrograde flushing into the central arterial circulation.

Catheters, Indwelling↗
PubMed1997

Design flaw can convert commercially available continuous syringe pumps to intermittent bolus injectors.

OBJECTIVE: To investigate if unexpected behaviour of neonatal and paediatric patients connected to syringe pumps could be explained by transient elevation of these devices. DESIGN: Five different commercially available syringe-pumps were set at an infusion rate of 1 ml/h and then subjected to a vertical displacement manoeuvre (height 1 m). The actual delivered infusion volumes in association with the displacement manoeuvre were measured by a high precision weight scale connected to a computer. SETTING: A medical technology laboratory in a university hospital. MEASUREMENTS AND RESULTS: Elevation of the devices resulted in a rapid bolus injection of 0.19-2.28 ml. Returning the devices to their original positions resulted in an aspiration into the system of 0.06-0.34 ml. The times both for bolus injection and for aspiration into the system were less than 1 min in all cases. The updown manoeuvre was followed by a period with zero infusion ranging from 8 to 105 min. CONCLUSIONS: Design flaws in the construction of syringe pumps can expose patients to substantial danger following vertical displacement if potent drugs are being infused. If potent drugs are infused, care should be taken not to change the vertical position of the syringe pump even for short periods of time. Before buying new equipment, the authors recommend that the delivery characteristics of these devices should not only be tested during ordinary bench testing but should also include the reaction to a vertical displacement manoeuvre.

Child↗
PubMed2002

Preconcentration and separation of copper(II), cadmium(II) and chromium(III) in a syringe filled with 3-aminopropyltriethoxysilane supported on silica gel.

In this study, a syringe was filled with silica gel loaded with 3-aminopropyltriethoxysilane, for the separation and preconcentration of copper, cadmium and chromium prior to their determination by graphite furnace atomic absorption spectrometry (GFAAS) in seawater. For this purpose, a syringe was filled with 0.5 g of modified silica gel and the sample solution was drawn into the syringe and ejected back again. The analyte elements were quantitatively retained at pH 5. Then, the elements sorbed by the silica gel were eluted with 2.0 M of HCl and determined by GFAAS. At optimum conditions, the recovery of Cu, Cd and Cr were 96-98%. Detection limits (3delta) were 6.6, 7.5 and 6.0 micro g L(-1) for Cu, Cd and Cr, respectively. The elements could be concentrated by drawing and discharging several portions of sample successively but eluting only once. Cu, Cd and Cr added to a seawater sample were quantitatively recovered (>95%) in the range of the 95% confidence level. The method proposed in this paper was compared with a column technique. Optimum experimental conditions, reproducibility, precision and recoveries of both techniques are the same, but the syringe technique is much faster, easier and more practical than the column technique. It is a portable system and allows one to make the sorption process in the source of sample. In addition, the risk of contamination is less than in the column technique.

Cadmium↗
PubMed2006

New York City injection drug users' memories of syringe-sharing patterns and changes during the peak of the HIV/AIDS epidemic.

In this oral history, 23 injection drug users (IDUs) were interviewed about the mid-1970s to mid-1980s when they could not legally purchase or possess syringes, and the threat of AIDS began to loom large. Several themes emerged, including: abrupt changes in syringe-sharing patterns; the effects of illnesses or deaths of others on their understanding of AIDS; and, racial/ethnic differences in responses to the threat of AIDS. Settings, such as "shooting galleries," helped HIV spread rapidly in the earliest stages of the city's AIDS epidemic. HIV entered the drug scene in the mid-1970s, just when IDUs were shifting from sharing homemade "works" (consisting of steel needles and syringes devised from rubber baby pacifiers and similar sources) among many IDUs to mass produced and distributed plastic, disposable needle and syringe sets. IDUs remember when they first became aware of AIDS and began to adjust their behaviors and social assumptions.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Trypanosoma congolense: drug resistance during cyclical transmissions in tsetse flies and syringe passages in mice.

A drug-resistant Trypanosoma congolense strain with predetermined curative doses (CD50 and CD90) of samorin at 13.9 +/- 1.02 and 20.3 +/- 1.13 mg/kg body weight, respectively, was cyclically transmitted through tsetse flies and by syringe passages in mice in the absence of drug pressure. The changing levels of drug sensitivity were determined after every 3rd cyclic and 5th syringe passage intervals. It was noted that when the strain was maintained in tsetse flies through 12 cyclical transmissions, the CD50 and CD90 dropped slightly from 13.9 to 11.9 +/- 1.06 and from 20.3 to 18.0 +/- 1.08 mg/kg body weight, respectively. This decrease in the level of resistance was not significant (P greater than 0.05). However, when the trypanosomes were maintained by syringe passages in mice, there was a significant reduction (P less than 0.05) in the degree of resistance (CD50 from 13.9 to 11.4 +/- 1.07 and CD90 from 20.3 to 16.7 +/- 1.16 mg/kg), by the 15th syringe passage.

Animals↗
PubMed1993

The effects of different types of syringes on equine spermatozoa.

Control extender was incubated at 4 degrees C for 24 hours. Rubber or plastic syringe plungers were separately incubated in semen extender for 24 hours at 4 degrees C. Following incubation, the extender was stored at -20 degrees C until the time of semen collection. The treatments consisted of the following: Group A = equine semen plus control extender; Group B=equine semen plus extender incubated with rubber plungers and Group C=equine semen plus extender incubated in plastic plungers; Group D=equine semen plus control extended in rubber plunger syringes and Group E=equine semen plus control extender in plastic plunger syringer. Each group contained a 5-ml volume of semen and extender at a concentration of 1.0 x 10(8) sperm/ml. The number of live spermatozoa, percentage of progressively motile spermatozoa and rate of progressive motility were taken following collection and every 15 minutes for 1 hour following application of treatments. In experiment 2, treatments were allowed to incubate with semen for 45 minutes, then the extender was removed and was replaced with fresh extender. The rate of progressive motility and the percentage of progressively motile spermatozoa were taken immediately, at 45 minutes, and then every 15 minutes for 1 hour. In experiment 1, the number of live spermatozoa was not affected among the 5 groups. However, there was a decrease (P<0.01) in the rate of progressive motility and in the percentage of progressively motile spermatozoa in Group B compared with the remaining 4 treatment groups at 30, 45 and 60 minutes, with no differences noted when semen was held in syringes with a rubber or a plastic plunger. In experiment 2, the percentage of progressively motile spermatozoa increased after the addition of the control extender.

Journal Article↗
PubMed2005

Circumstances surrounding the first injection experience and their association with future syringe sharing behaviors in young urban injection drug users.

Young injection drug users are at heightened risk for acquisition of blood-borne infections because of their high rates of unsafe injection behaviors, yet there has been little research examining the circumstances surrounding injection drug users' first injection experience ('hit'). We examined the relationship between factors associated with young drug users' first hit and their future syringe sharing behaviors among 420 new initiates to injection drug use (less than 5 years), aged 15-30 years old in urban Baltimore, Maryland. Contingency table analysis and logistic regression were used to determine the association between circumstances surrounding the first hit and recent receptive syringe sharing. Participants were primarily male (58.8%), White (71.2%), and were a median age of 24 years (interquartile range [IQR]: 21-27 years). Adjusting for race, gender, and homelessness, the following variables were independently associated with recent receptive syringe sharing: age at first hit (adjusted odds ratio [AOR] = 0.92 per year increase; 95% confidence interval [CI]: 0.87-0.98), self-injection at initiation (AOR = 0.55; 95% CI: 0.32-0.97) and using a syringe that had previously been used by someone else at first hit (AOR = 2.81; 95% CI: 1.70-4.64). These data suggest that injection-related risk behaviors may be established as early as the onset of injection initiation, supporting the need to educate non-injectors of the harms associated with unsafe injection practices.

Adolescent↗
PubMed2000

The multiperson use of non-syringe injection equipment and risk of hepatitis c infection in a cohort of young adult injection drug users, chicago 1997-1999.

PURPOSE: The possibility that hepatitis C virus (HCV) is transmitted via the multiperson use of injection paraphernalia other than syringes has been suggested, but epidemiologic studies to examine the association are difficult to design due to saturation levels of infection in most samples of injection drug users (IDUs). This study (1) assembled a sample of young adult IDUs, among whom hepatitis C infection prevalence was still moderate, (2) measured incident HCV infection, and (3) determined the risk for seroconversion associated with specific forms of sharing injection paraphernalia.METHODS: Between 1997 and 1999, 702 IDUs, 18-30 years old, were interviewed and screened for antibodies to HCV at baseline and at 6 and 12 months post-baseline. Participants were recruited through street outreach, advertising and chain-referral from ethnically diverse neighborhoods in metropolitan Chicago. Data were analyzed using standard survival statistical methods.RESULTS: HCV prevalence was 27% at enrollment. During 296.5 person-years of observation, we observed 37 HCV seroconversions (incidence: 12.5/100 person-years). The adjusted relative hazard (RH) of seroconversion, after controlling for demographic and drug use covariates, was highest for sharing cookers (RH, 3.58; 95% CI 1.47-8.70), followed by sharing rinse water (RH, 2.16; 95% CI 1.03-4.52), and cottons (RH, 1.84; 95% CI 0.95-3.56). Risk associated with syringe sharing was marginally significant, and backloading was unassociated with hepatitis C seroconversion. Adjusting for syringe sharing, the independent effects of sharing cookers and cottons remained significant, and a final model that included each sharing practice demonstrated that sharing cookers had at the strongest association with seroconversion (RH, 3.03; 95% CI 1.05-8.72).CONCLUSIONS: This study suggests that sharing non-syringe paraphernalia may be an important cause of hepatitis C virus transmission between IDUs.

Journal Article↗
PubMed2001

Follitropin-beta administered by pen device has superior local tolerance compared with follitropin-alpha administered by conventional syringe.

A receiver- and assessor-blind, randomized, single-centre, crossover study was performed in 60 healthy women volunteers, to compare the local tolerance of two recombinant FSH preparations administered by a pen device (delivering 150 IU follitropin-beta) or by conventional syringe (delivering 150 IU follitropin-alpha). Volunteers were randomized to one of two treatment sequences: pen device followed by conventional syringe, or the reverse. Each preparation was injected once, subcutaneously in the umbilical region and local tolerance reactions were assessed within 5 min, at 1 and 24 h after each administration. In addition, subjects were asked to rate the pain experienced during a period of 24 h after each injection by means of a visual analogue scale (VAS). At administration (within 5 min), severe to moderate pain was experienced in 70.0% of subjects injected by the conventional syringe, whereas only 21.7% of subjects treated with the pen device experienced pain. This difference was highly significant (P </= 0.001). The overall pain score (VAS) was low but significantly lower in subjects treated with the pen device (P </= 0.01). In this study, follitropin-beta administered by the pen device was far less painful than follitropin-alpha administered by conventional syringe. The pen device is the first multiple-use device available for the self-administration of recombinant FSH (rFSH) during ovarian stimulation for assisted reproduction.

Journal Article↗
PubMed2005

A syringe exchange programme in prison as prevention strategy against HIV infection and hepatitis B and C in Berlin, Germany.

In two prisons in Berlin, Germany, provision of sterile injection equipment for injecting drug users (IDUs) started in 1998. To assess the programme's impact, the frequency of injecting drug use and syringe sharing, and the incidence of HIV, HBV, and HCV infection were determined in a follow-up study. Of all IDUs (n=174), 75% continued to inject. After the project start the level of syringe sharing declined from 71% during a 4-month period of previous imprisonment to 11% during the first 4 months of follow-up, and to virtually zero thereafter. Baseline seroprevalences for HIV, HBV, and HCV were 18, 53, and 82%. HIV and HCV seroprevalence at baseline was significantly associated with drug injection in prison prior to the project start. No HIV and HBV seroconversions, but four HCV seroconversions occurred. The provision of syringes for IDUs in appropriate prison settings may contribute to a substantial reduction of syringe sharing. However, the prevention of HCV infection requires additional strategies.

Adult↗
PubMed2005

Generalized synthesis of metal phosphide nanorods via thermal decomposition of continuously delivered metal-phosphine complexes using a syringe pump.

We synthesized uniform-sized nanorods of transition metal phosphides from the thermal decomposition of continuously delivered metal-phosphine complexes using a syringe pump. MnP nanorods with dimensions of 8 nm x 16 nm and 6 nm x 22 nm sized were synthesized by the thermal decomposition of Mn-TOP complex, which was prepared from the reaction of Mn(2)(CO)(10) and tri-n-octylphosphine (TOP), using a syringe pump with constant injection rates of 10 and 20 mL/h, respectively. When Co-TOP complex, which was prepared from the reaction of cobalt acetylacetonate and TOP, was reacted in a mixture solvent composed of octyl ether and hexadecylamine at 300 degrees C using a syringe pump, uniform 2.5 nm x 20 nm sized Co(2)P nanorods were generated. When cobaltocene was employed as a precursor, uniform Co(2)P nanorods with 5 nm x 15 nm were obtained. When Fe-TOP complex was added to trioctylphosphine oxide (TOPO) at 360 degrees C using a syringe pump and then allowed to age at 360 degrees C for 30 min, uniform-sized FeP nanorods with an average dimension of 12 nm x 500 nm were produced. Nickel phosphide (Ni(2)P) nanorods with 4 nm x 8 nm were synthesized successfully by thermally decomposing the Ni-TOP complex, which was synthesized by reacting acetylacetonate [Ni(acac)(2)] and TOP. We measured the magnetic properties of these nanorods, and some of the nanorods exhibited different magnetic characteristics compared to the bulk counterparts.

Journal Article↗