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Fast and sensitive environmental analysis utilizing microextraction in packed syringe online with gas chromatography-mass spectrometry: determination of polycyclic aromatic hydrocarbons in water.

A new sensitive, selective, fast and accurate technique for online sample preparation was developed. Microextraction in a packed syringe (MEPS) is a new miniaturised, solid-phase extraction (SPE) technique that can be connected online to GC or LC without any modifications. In MEPS approximately 1mg of the solid packing material is inserted into a syringe (100-250 ml) as a plug. Sample preparation takes place on the packed bed. The bed can be coated to provide selective and suitable sampling conditions. The new method is very promising. It is very easy to use, fully automated, of low cost and rapid in comparison with previously used methods. The determination of polycyclic hydrocarbons (PAHs) in water was performed using MEPS as sample preparation method online with gas chromatography and mass spectrometry (MEPS-GC-MS). The results from MEPS as sample preparation were compared with other techniques such as stir bar sorptive extraction (SBSE) and solid-phase microextraction (SPME). The method was validated and the standard curves were evaluated by the means of quadratic regression and weighted by inverse of the concentration: 1/x for the calibration range 5-1,000 ng/L. The MEPS applied polymer (silica-C8) could be used more than 400 times before the syringe was discarded. The extraction recovery was about 70%. The results showed close correlation coefficients (R>0.998) for all analytes in the calibration range studied. The accuracy of MEPS-GC-MS was between 90 and 113% and the inter-day precision (n=3 days), expressed as the relative standard deviation (RSD%), was 8-16%. MEPS reduced the handling time by 30 and 100 times compared to SPME and SBSE, respectively.

Gas Chromatography-Mass Spectrometry↗

Viability and adipogenic potential of human adipose tissue processed cell population obtained from pump-assisted and syringe-assisted liposuction.

BACKGROUND: Correcting soft tissue defects by autologous fat grafting has been a routine procedure in plastic surgery. Liposuction material for autologous fat grafting is normally obtained using a hand-held syringe. The pump-assisted liposuction technique is not used because of the belief that cells in the harvested fat tissue are necrotic from the physical forces created by the vacuum pump liposuction machine. OBJECTIVE: The metabolism and adipogenic potential of cultured mesenchymal precursor cells processed from pump and syringe lipoaspirates were studied. METHODS: Metabolic estimates were determined with alamarBlue assay. These cells were also induced along the adipogenic lineage with adipogenic induction factors. The extent of adipogenic differentiation was measured using a digital photo counting software. RESULTS: The cells obtained by pump-assisted liposuction are viable, have comparable metabolic activity and adipogenic potential which are comparable to cells using the syringe for aspiration. CONCLUSION: The implications of this study are that pump-assisted liposuction might be a possible alternative to aspirating adipose tissue for reimplantation during reconstruction procedures.

Adipocytes↗

The syringe driver and the subcutaneous route in palliative care: the inventor, the history and the implications.

Since the early 1980s, the syringe driver has become a commonly used technology in British palliative care, used to administer continuous subcutaneous infusions (CSCI) for symptom management. Although the device itself has not been adopted universally, it has stimulated interest in the use of CSCI in palliative care and played a significant role in the modern history of this approach. This historical case study of the syringe driver examines the life and work of its inventor, explores its development for use in childhood thalassemia, and analyzes the circumstances surrounding its adoption in palliative care. We conclude by considering the reasons for the continued popularity of the syringe driver, despite problems in its use, and reflect on the lessons which can be learned about the use of CSCI in palliative care internationally.

Analgesics↗

Shelf lives of aseptically prepared medicines--stability of netilmicin injection in polypropylene syringes.

There is no published information on the stability of netilmicin solutions in prefilled syringes. The purpose of this study was to evaluate the stability of netilmicin in polypropylene syringes and to determine the optimum validated shelf life so that they may be prepared in bulk in appropriately licensed facilities. The syringes containing netilmicin 10 or 100mg/ml were stored at 7 degrees C, room temperature in the light (RTL) and 25 degrees C/60% relative humidity for up to 300 days. Netilmicin concentration was determined by reversed phase high performance liquid chromatography (RP-HPLC) of the isoindole derivative formed with o-phthalaldehyde (OPA). The shelf lives were calculated using the maximum rate method applied to the netilmicin analytical data. At 7 degrees C 10 and 100mg/ml solutions were stable for 90 days falling to 30 days at 25 degrees C and 60% RH. At RTL the 10mg/ml solution was stable for 9 days.

Anti-Bacterial Agents↗

Leishmania in discarded syringes from intravenous drug users.

Needle sharing by intravenous drug users (IVDUs) has been proposed as providing an alternative, artificial, and anthroponotic cycle for leishmania transmission. We looked for parasites in syringes discarded by IVDUs using two different PCR techniques. Leishmania spp were detected in 65 (52%) of 125 syringes collected in southern Madrid, Spain, in 1998, and in 52 (34%) of 154 collected in southwestern Madrid in 2000-01. We found shared restriction fragment length polymorphisms in 12 of 65 positive samples tested, suggesting that syringe sharing can indeed promote the spread of leishmania clones among IVDUs.

Animals↗

Syringe and needle exchange as HIV/AIDS prevention for injection drug users in Puerto Rico.

This study evaluated the effectiveness of the first needle exchange program (NEP) established in Puerto Rico. The data for this study were collected during the first months of the NEP from July 1995 to March 1996 in 13 communities of the San Juan metropolitan area. Subjects were the participants of two modalities of the NEP: a mobile team and a community-based drug treatment program. During the 3-week evaluation period, 2401 injection drug users (IDUs) were recruited, resulting in a total of 19,195 exchange contacts and 146,323 syringes exchanged. No significant change in drug injection was observed. However, the program was effective in reducing sharing of syringes and cookers. The study suggests that the NEP did help in reducing needle sharing in Puerto Rico. However, the HIV seropositivity in returned syringes suggests the need to continue aggressive prevention programs to arrest the epidemic among IDUs. However, factors related to the socio-cultural environment as well as cultural norms and traditions need to be considered when planning and expanding NEPs.

HIV Infections↗

Clinical immunogenicity and tolerance studies of liquid vaccines delivered by jet-injector and a new single-use cartridge (Imule): comparison with standard syringe injection. Imule Investigators Group.

A new needleless jet-injector, Mini-Imojet, was developed that administers liquid vaccines from a single-use, pre-filled cartridge named Imule, which avoids the risk of cross-contamination. We conducted clinical trials in several settings in France and West Africa to compare the immunogenicity and tolerance of five vaccines (influenza vaccine, Vi capsular polysaccharide typhoid vaccine, tetanus toxoid vaccine, diphtheria-tetanus-whole cell pertussis vaccine, and inactivated hepatitis A vaccine) administered with the Imule system vs standard syringe technique. In each vaccine study, all subjects of either group were tested for serum antibody titres to calculate the geometrical mean titres and seroconversion rates after complete vaccination. Immediate local-reactions were noted after each injection, and local and general reactions were evaluated during a predetermined period of follow-up. When delivered by the Imule technique, all the administered vaccines were of equivalent or superior immunogenicity, compared to the syringe technique. The tolerance to vaccines injected by the Imule system was acceptable in all studies. The most frequently observed reactions were mild (e.g. minor bleeding, superficial papules, erythema and induration) and could be considered to be inherent to the injection technique. The technical and safety advantages of the Mini-Imojet/Imule system, compared to sterilizable, standard disposable or autodestruct syringes and to classical multi-dose vial jet-injectors, reinforces the interest of this new injection technique for collective immunizations.

Adolescent↗

Hepatitis B vaccine administration: comparison between jet-gun and syringe and needle.

An open randomized controlled clinical trial was conducted to compare the reactogenicity of a recombinant hepatitis B vaccine (Engerix-B) when injected with the Bioject device (a pneumatically powered drug delivery system using disposable syringes) or with conventional syringe and needle, according to a 0.1 and 6 month vaccination schedule. Ninety-seven healthy young adults were enrolled in this study. Participants were asked to record local and general solicited symptoms and signs after each vaccination and to report each unsolicited symptom and sign that occurred during the study. The use of the jet-gun induced a statistically significant higher incidence of local symptoms and signs (solicited and unsolicited) than the use of syringe and needle.

Adolescent↗

A bone graft condensing syringe system for maxillofacial reconstructive surgery.

A new system of metallic syringes and pluggers specifically designed for delivery and condensation of particulate bone graft is reported, and the clinical application in maxillofacial reconstructive surgery is described. This bone graft condensing system has advantages over the conventional plastic injection syringes in enabling much better bone graft condensation as well as easier bone delivery and insertion of the syringe to the depth of the reconstruction crib.

Bone Transplantation↗

An experimental study on the aspirating reliability of different types of injection syringes with regard to the formation of punch cylinders.

Aspiration before local anaesthesia is essential to avoid an incorrectly placed needle. We tested 142 types of cannula in mucobuccal preparations from 29 cadavers. The cannulas were obtained from 23 different firms and the formation of punch cylinders caused by injection was studied at angles of penetration of 70 degrees and 90 degrees. The force of puncture was measured by a computer-controlled apparatus. In a second series of tests the aspirating ability of 121 cannulas with self-aspirating and actively aspirating syringes was tested in vitro. The results show that false negative aspirations are caused by: using a cannula that is too small (<= 27 Gauge); the cannula lumen becoming clogged with tissue punch cylinders; using a Carpule needle end that is too short to perforate the rubber of the ampoule; containing rubber fragments in the back of the Carpule needle end; and using an injection syringe with too small a viewport when the injection syringe was positioned at a 90 degrees. We recommend the construction of a system in which the distance between the cone and viewport is reduced.

Aged↗

Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment.

We undertook a qualitative study to explore the micro-environment of drug injecting, risk reduction and syringe exchange practices among injecting drug users (IDUs) in Togliatti City, Russia. Semi-structured qualitative interviews (n=57) were undertaken with current IDUs in May 2001. Findings highlight a recent transition away from hanka (a home-produced liquid opiate derived from opium poppy) towards the injection of heroin powder, and a drug use culture in which injecting predominates. Findings emphasise that risk reduction practices may be influenced less by availability of injecting equipment than by an interplay of situational and micro-environmental factors. Principal among these is a reported fear of police detainment or arrest among IDUs which encourages a reluctance to carry needles and syringes, and which in turn, is associated with needle and syringe sharing at the point of drug sale. We note the role of policing practices in influencing risk reduction and the potential role of policing agencies in supporting HIV prevention initiatives among IDUs.

Adolescent↗

Toomey syringe aspiration may be inaccurate in detecting esophageal intubation after gastric insufflation.

We sought to determine whether gastric distention from air insufflation affects the accuracy of the Toomey syringe in detecting esophageal intubation. We conducted a randomized, single-blinded, crossover trial using human cadavers in which cuffed endotracheal (ET) tubes were placed into the esophagus and trachea. Operators used the Toomey syringe to determine the location of the ET tube before and after gastric insufflation via Ambu-bag ventilation. Greater amounts of air were aspirated (35.4 cc vs. 13.7 cc, respectively, p < 0.001) and less resistance was noted on a five-point scale (3.2 vs. 4.8, respectively, p < 0.001) from esophageally placed ET tubes after gastric insufflation. Sensitivity in detecting esophageally placed ET tubes decreased from 100% in noninsufflated cadavers to only 58% after gastric insufflation (p < 0.001). In the thawed fresh frozen cadaveric model, the Toomey syringe was unreliable in detecting an esophageal intubation after gastric distention insufflation.

Adult↗

Inaccuracy in endotracheal tube verification using a Toomey syringe.

The Toomey syringe and other esophageal detection devices have been shown to be highly sensitive and specific for indicating whether an endotracheal (ET) tube is in the esophagus or the trachea. Many prehospital systems use the Toomey syringe method as the major determinant in deciding whether or not to remove an ET tube after an intubation attempt. We present three cases in which various pulmonary pathologies led to false positive results; that is, Toomey syringe aspiration indicated esophageal placement when the tube was correctly positioned in the trachea. A literature review follows the case reports.

Adult↗

Can syringe exchange serve as a conduit to substance abuse treatment?

To determine how the city-run New Haven syringe exchange program (SEP) expedited requests, for entry into treatment, records of the SEP's drug treatment coordinator were analyzed. During the study period, a majority of those requesting treatment did not use the SEP to obtain sterile syringes. Comparisons between the people requesting treatment and those exchanging syringes revealed that those requesting treatment were more likely female and less like White. Factors associated with failure to enter treatment included long lag times, worse insurance, cocaine use, and requesting primary detoxification only. Majorities of the requests, appointments, and entries came from individuals whose treatment was to be paid through city welfare. A managed care initiative from the city welfare department, which excluded the SEP, halved requests or entries. Subsequent addition of the SEP to the initiative did not significantly increase requests or entries. Although the SEP initially acted as a conduit to treatment its effectiveness was curtailed by the imposition of bureaucratic restrictions.

Adolescent↗

Syringe labels in anaesthetic induction rooms.

A survey of 35 hospitals in the United Kingdom has uncovered a wide variety of syringe drug labels. Use of different systems in different hospitals may result in wrong drug administrations, particularly when trainees move from one hospital to another. There is an urgent need to standardise the colour coding of syringe labels in the United Kingdom. Such standards are already in place in Australia, New Zealand and in the United States of America. This survey of syringe drug labels highlights the existing risks and recommendations for change are made.

Anesthesiology↗

The effect of syringe size on the performance of an infusion pump.

This study investigated the effect of using three different sized syringes on the accuracy of fluid delivery when using an infusion pump at low infusion rates (1 ml.h-1). The study also measured the influence of the syringe size on the time to occlusion alarm, and on the size of the subsequent bolus dose that might be infused after relief of the occlusion which triggered the alarm. The use of a larger size syringe was found not to affect the accuracy of infusate delivery, but delayed the time to occlusion alarm and increased the size of the postocclusion bolus dose.

Equipment Design↗

[Effect of femoral intramedullary irrigation on periprosthetic cement distribution: jet lavage versus syringe lavage].

INTRODUCTION: The purpose of this experimental study was to determine quantitatively the cement penetration into periprosthetic femoral bone by Icomparing the use of jet-lavage with the conventional syringe irrigation. METHODS: 10 pairs of fresh-frozen human cadaver femora were used for cemented stem implantation, The left femora were irrigated with a syringe device, the right femora with a jet-lavage system. After implantation, all femora were cut into 5-mm slices from proximal to distal with a diamond saw. The scanned slices were analysed using an image processing system which provided a discrimination between implant, cement, and bone as well as an exact determination of the cement area. RESULTS: In all 10 femora, a recognizable improvement of the cement penetration into the periprosthetic bone was demonstrated using the jet-lavage. In the proximal part, the mean cement penetration was 8.6% higher in the jet-lavage group than in the syringe device group. An equivalent tendency towards the jet-lavage pretreated femora was seen in the middle part with 8.7% on average mean and in the distal part with 6.4% on average. Also, when subdividing the periprosthetic area into 4 quadrants, a significant improvement of the cement penetration was found with the exception of the ventro-medial region. CONCLUSION: Cement distribution and penetration is improved using the jet-lavage technique for cleaning the medullary canal of the femur. Therefore, the jet-lavage should be used as a standard procedure in clinical cementing techniques.

Arthroplasty, Replacement, Hip↗

Variations in the gliding characteristics of 10-ml plastic syringes used to locate the extradural space by "loss of resistance" techniques.

The gliding characteristics were evaluated of 10-ml plastic syringes used to identify the extradural space by "loss of resistance" techniques. This was undertaken quantitatively, by measuring the force necessary to depress syringe plungers, and qualitatively, by examining travel characteristics in terms of the force applied, together with the rate and uniformity of plunger travel. An important cause of inadvertent dural puncture is the use of syringes with plungers that do not move freely; this study has identified wide variations between makes which may be of particular relevance to anaesthetists inexperienced in techniques of extradural analgesia.

Epidural Space↗