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Evaluation of arterial blood sampling using the B 109 syringe (radiometer).

Arterial blood gas measurements were performed after sampling with two different syringes (B 109 Radiometer and "ONCE" ASIK) and storage of the samples at 0-4 degrees C for 15 min. The blood samples were analysed in an ABL3 blood gas analyser. We found no statistically significant difference between the mean PaO2, PaCO2 and pH values with either technique of sampling. The B 109 syringe does not offer any advantages over the common plastic 2.5 ml. syringe ("ONCE").

Blood Gas Analysis↗

Pharmacy-initiated implementation of a syringe pump infusion system.

The approach taken by a pharmacy department of a 310-bed community hospital to evaluate and implement a syringe infusion pump system is described. The cost of the minibag system used by the hospital was compared with the cost of the syringe system. A trial of the system involving three medications was implemented in two patient-care areas. After a six-week period, nurses favored expansion of the new system. After a detailed cost comparison was presented to hospital administration, hospitalwide conversion to the new system was approved. Groups of drugs were gradually added to the dispensing list. At the end of a five-month period, 80% of secondary intravenous medications were administered via the new system. Advice is offered to other hospitals considering the system. A smooth transition to a syringe infusion system was the result of the well-planned approach.

Costs and Cost Analysis↗

[The storage capability of pre-filled disposable plastic syringes].

The storage stability of a pre-filled plastic disposable syringe (piston type) of polypropylene as to solvents and ambient oxygen has been studied. To assess the permeability and impermeability of the sealing component parts, the syringes had been stored in a long-time test under different types of seal and different temperatures. Based on the results, the polypropylene plastic disposable syringes were on principal suited to be used in solvents as glycol, ethanol or water, the protection against ambient oxygen is, however, an insufficient one.

Drug Packaging↗

Stability of antibiotics frozen and stored in disposable hypodermic syringes.

The effect of freezing on the stability of several reconstituted antibiotics packaged in disposable hypodermic syringes was studied. The following drugs were reconstituted and, after taking samples for initial assay, were frozen at -20 degrees C in Hy-Pod hypodermic syringes: cephalothin, 1 g/5 ml; cefazolin (with water), 1 g/3 ml; cefazolin (with lidocaine injection), 1 g/3 ml; cefamandole, 1 g/3.5 ml; and nafcillin, 1 g/4 ml. At three, six, and nine months, samples of the frozen solutions were allowed to thaw at room temperature and then were assayed microbiologically. All antibiotics maintained at least 90% potency at the end of nine months. Cefazolin with lidocaine, however, turned cloudy after thawing. The data suggest that cephalothin, cefazolin with water, cefamandole, and nafcillin, when frozen and stored at -20 degrees C in Hy-Pod hypodermic syringes, may be used within nine months of initial freezing.

Anti-Bacterial Agents↗

Drug combinations in syringe drivers.

AIMS: Because of widely differing views on the drugs that can be administered in combination, this study was undertaken to record the combination of drugs in syringe drivers that we had found to be compatible. METHODS: The content of syringe drivers in 100 consecutive patients in whom continuous subcutaneous infusion was used, was recorded. The incidence of skin reactions with the different drugs was noted. The efficacy of combinations used was assessed clinically. RESULTS: A wide variety of drugs were used in many different combinations, with no clinical evidence of loss of efficacy. Some drug combinations are incompatible. Drugs known to cause skin reactions were not administered. In this study skin reactions depended on the number of drugs used in combination. CONCLUSIONS: The array of medications that can be used together in syringe drivers enable this method of drug administration to be used successfully in the control of the diverse symptoms that may arise in terminal illness. Further study is needed for quantitative measurement of drug stability.

Anti-Anxiety Agents↗

The safe use of disposable syringes in anesthesia: cost effective or costly?

Many anesthesia practitioners reuse disposable syringes and multidose drug vials from case to case despite the known hazards of blood-borne disease transmission. This practice may be hazardous to both patients and practitioners. Microscopic amounts of blood in the intravenous tubing can cause contamination of syringes, needles, and drug vials. Contaminated multidose vials have been associated with the transmission of both hepatitis B and bacterial infections. This article examines the potential risks of contamination from the reuse of disposable syringes and the myth about the cost savings of this practice.

Anesthesiology↗

A study of water flow efficiency in dental air/water syringe tips after repeated chemiclave sterilization.

In response to the need for dental office asepsis, many practitioners sterilize dental air/water syringe tips for each patient. It is hypothesized that repeated sterilization would lead to internal corrosion restricting the water flow. This study was conducted to evaluate consistency of water flow in a series of dental air/water syringe tips after multiple cycles of Chemiclave sterilization. An apparatus was constructed to deliver water at the same pressure and flow to each syringe tip. The flow rates between tips were significantly different (P < .001). Average water flow, in grams per minute, was determined by ten repeat trials for each tip. The tips were retested after 1, 5, and 25 cycles of Chemiclave sterilization. None of tips showed a decrease in water flow efficiency after repeated sterilization cycles. No difference in ability to remove etchant from enamel and dentin could be demonstrated using a 10-second wash.

Acid Etching, Dental↗

Stability of bupivacaine hydrochloride in polypropylene syringes.

The stability of bupivacaine hydrochloride injection 1.25 mg/mL in 0.9% sodium chloride injection in polypropylene syringes was studied. Plastic syringes containing bupivacaine hydrochloride 1.25 mg/mL in 0.9% sodium chloride injection or 0.9% sodium chloride injection alone were stored at 3 or 25 degrees C. A glass vial containing the admixture was stored at 25 degrees C as a control. For each condition, triplicate samples were observed immediately and 5, 11, 15, and 32 days after preparation for precipitation and color change and analyzed for pH and for drug concentration by high-performance liquid chromatography. No change in bupivacaine concentration was observed during the 32-day study period, nor was there any change in color or pH nor any development of precipitation. Bupivacaine hydrochloride 1.25 mg/mL in 0.9% sodium chloride injection in polypropylene syringes was stable for up to 32 days when stored at 3 or 23 degrees C.

Bupivacaine↗

Lifetime of reusable syringes and needles. A field study.

For planning of supplies and costs it is important for an immunization unit to know how many times reusable syringes and needles can be used. A field study found that BCG syringes, which had their rubber seals replaced once, could be used at least 150 times, and DPT syringes more than 200 times even when sterilized in tap water with a hardness of 88 mg calciumoxyde per liter. Needles could be used 100 times and when resharpened several times even more.

Calcium↗

[The self-aspirating syringe in local anesthesia].

Dentists routinely inject local anesthetic solutions in their daily practice. However, it is important not to inject intravascularly. Consequently, manufacturers offer two types of dental syringes: one with a mechanical aspirating device (harpoon) and the other with a self-aspirating mechanism. We have verified the efficacy of a self-aspirating syringe as presented on the market and another self-aspirating syringe which we lightly modified.

Anesthesia, Dental↗

Use of a prefilled insulin syringe (Novolin Prefilled) by patients with diabetes.

A study was conducted to assess patients' acceptance of a new insulin injection system, Novolin Prefilled, and to record their opinions about its use during a 4-week study period. Sixty-four patients, aged 20 to 69 years, with type I (n = 19) or type II (n = 45) diabetes mellitus entered and completed the study; 22 were new insulin users and 42 had been treated previously for 6 months to 43 years. Patients received insulin treatment via a prefilled syringe that was designed to provide a convenient alternative method for injecting insulin. The syringe is prefilled with 150 U of insulin and can deliver up to 58 U per dose. After 2 to 4 days of using the new system, patients reported no major problems when asked about mechanical difficulties, and the percentage reporting mild hypoglycemic events was comparable to baseline. During the 4-week study, no patients reported moderate or severe hypoglycemic episodes. The results of attitude questionnaires revealed that after treatment significantly more patients (P < 0.05) reported feeling energetic and full of pep, in good control, and not worried about giving themselves insulin injections. The increase in positive attitudes was most apparent among the patients new to insulin use. Most of the study patients (98%) reported that the prefilled syringe was convenient and easy to use, 95% found it took less time to use at home, and 91% wished to continue using it for insulin delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Addressing difficult areas in body contouring with emphasis on combined tumescent and syringe techniques.

The combined use of the tumescent and syringe techniques is a logical choice in addressing difficult areas in body contouring. Each technique complements the other. The magnification of the deformity by the tumescent technique allows for a more uniform and accurate contour correction. The syringe technique provides precision and accuracy that further contribute to body contouring refinement. The combined use of the tumescent and syringe techniques has allowed greater refinement and precision in achieving satisfactory body contouring and in minimizing complications associated with traditional techniques.

Anesthetics, Local↗

Single-drop microextraction followed by in-syringe derivatization and gas chromatography-mass spectrometric detection for determination of organic acids in fruits and fruit juices.

A simple analytical procedure based on single-drop microextraction combined with in-syringe derivatization and GC-MS was developed for determination of some phenolic acids in fruits and fruit juices. Cinnamic acid, o-coumaric acid, caffeic acid, and p-hydroxybenzoic acid were used as model compounds. The analytes were extracted from a 3-mL sample solution using 2.5 microL of hexyl acetate. The extracted phenolic acids were derivatized inside the syringe barrel using 0.7 microL of N,O-bis(trimethylsilyl)acetamide before injection into the GC-MS. The influence of derivatization conditions on the yield of in-syringe silylation was studied. Experimental SDME parameters such as selection of organic solvent, solvent volume, extraction time, extraction temperature, pH, and ionic strength of the solution on the extraction performance were studied. The method provided fairly good precision for all compounds (2.4-11.9%). Detection limits were found to be between 0.6 and 164 ng/mL within an extraction time of 20 min in the GC-MS full scan mode.

Acids↗

Effect of syringeal denervation in the budgerigar (Melopsittacus undulatus): the role of the syrinx in call production.

In the budgerigar, the left and right tracheosyringeal nerves (ts) were sectioned both above and below the common anastomosis in order to assess the roles of the hypoglossal nuclei and syringeal muscle halves in the control of call production. Signal processing software was used to quantify changes in contact call fundamental frequency and duration, and similarity analysis for pre- and postsurgical contact calls was performed by means of spectrogram cross-correlation. After resecting a portion of either the right or left ts nerve above the anastomosis (thereby eliminating the input from the ipsilateral half of the brainstem), contact call fundamental frequency decreased 40-50% on Day 1 postsurgery, while call structure and duration remained largely unaffected. Fundamental frequency returned to normal within 4-7 days after surgery. In contrast, nerve sectioning below the anastomosis on either side of the syrinx (thereby eliminating input to the ipsilateral half of the syringeal muscles) resulted in moderately noisy harsh-sounding calls with little change in temporal characteristics. Thus, budgerigars differ from many oscines studied to date in that they do not demonstrate laterality in vocal control at the level of the syrinx. Vocalizations produced by birds after bilateral syringeal denervation were abnormal, consisting entirely of broadband harmonic sounds with very low fundamental frequencies (i.e., less than 900 Hz) and poor frequency modulation. In contrast, individual call durations, as well as the rhythm and patterning of vocalizations resembling warble song, were remarkably similar to presurgical recordings after both unilateral and bilateral ts nerve resection.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Communication↗

Viability of fat obtained by syringe suction lipectomy: effects of local anesthesia with lidocaine.

The results of transplantation of free autologous fat obtained by blunt syringe suction lipectomy are unpredictable. We examined if adipose tissue viability is compromised by using syringe suction lipectomy and by infiltration of the tissue with local anesthetics. As reference, we used adipose tissue samples excised during elective surgery. Fat obtained intraoperatively and by lipectomy was digested with collagenase to isolate adipocytes. The mechanical damage associated with sample handling and cell isolation in both procedures was similar and did not exceed 6% of the total cell mass. In addition, cells isolated from intraoperative and lipectomy samples did not differ functionally, responded similarly to insulin stimulation of glucose transport and epinephrine-stimulated lipolysis, and retained the same growth pattern in culture. Since during fat transplantation the graft is exposed to local anesthetics at both the donor and the recipient sites, we reexamined adipocyte function in the presence of lidocaine. Lidocaine potently inhibited glucose transport and lipolysis in adipocytes and their growth in culture. That effect, however, persisted only as long as lidocaine was present; after washing, the cells were able to fully regain their function and growth regardless of whether the exposure was as short as 30 minutes or as long as 10 days. These results indicate that adipose tissue obtained by syringe lipectomy consists of fully viable and functional adipocytes, but local anesthetics may halt their metabolism and growth.

Adipocytes↗

Cytokines (IL-4 and IFN-gamma) and antibodies (IgE and IgG2a) produced in mice infected with Borrelia burgdorferi sensu stricto via nymphs of Ixodes ricinus ticks or syringe inoculations.

Mice were tolerant to tick bites during three infestations with nymphs of Ixodes ricinus infected with Borrelia burgdorferi sensu stricto. To determine whether tick bites influence the immune response against B. burgdorferi, we examined the production of cytokines IL-4 and IFN-gamma by lymph node cells of BALB/c mice and IL-4 deficient BALB/c mice after tick inoculation versus syringe inoculation of B. burgdorferi. We also measured IgG2a anti-borrelial antibodies and total IgE in these mice. Results showed that BALB/c mice developed a Th2 immune response against B. burgdorferi after tick inoculation and a mixed Th1/Th2 response after syringe inoculation of B. burgdorferi. IL-4 deficient mice produced a Th1 immune response in both cases. IL-4 produced following tick bites greatly decreased the production of anti-borrelial IgG2a antibodies by comparison with the production of anti-borrelial IgG2a antibodies produced following syringe injection of B. burgdorferi.

Animals↗

Increasing syringe access and HIV prevention in California: findings from a survey of local health jurisdiction key personnel.

This article presents results from the first survey of California local health jurisdictions (LHJs) subsequent to passage of legislation that allows for over-the-counter pharmacy sales of syringes. In 2004 Governor Arnold Schwarzenegger signed Senate Bill 1159 (SB1159) into law to "prevent the spread of HIV, hepatitis and other blood-borne disease among drug users, their sexual partners and their children." This legislation permits counties and cities to authorize a local disease prevention demonstration project (DPDP). Once authorized, a DPDP permits individuals to legally purchase and possess up to ten syringes from registered pharmacies without a doctor's prescription. From June to August 2005, we surveyed health departments in all 61 LHJs to assess implementation status of SB1159. Fifty-seven (93%) LHJs responded. Nine (16%) had approved a DPDP by August 2005, 17 (30%) were in the process of obtaining authorization, and 18 (32%) anticipated that SB1159 would never be authorized in their LHJ. Among LHJs that do not plan to approve a DPDP (n = 18), the reasons included: strong community opposition (41%), competing priorities (35%), law enforcement opposition (29%), and little or no interest among pharmacies (29%). In LHJs that have authorized a DPDP, 31.4% of pharmacies registered to legally sell nonprescription syringes. Preliminary results indicate that local coalitions, comprised of public health, waste management and pharmacy officials, have been instrumental in facilitating DPDP authorization. Further research is needed to identify facilitators and barriers to adopting SB1159, to identify areas for improving technical assistance to implementers, and to assess the public health impact of the legislation.

California↗

The extent of injecting and syringe sharing in prison reported by Edinburgh drug clinic attenders.

68 outpatient attenders at Edinburgh's Community Drug Problem Service who reported a history of drug injecting and who had spent 1 week or more in prison between March 1987-March 1990 were interviewed about drug injecting behaviour and syringe sharing before and during each prison episode they reported. One-third of those injecting prior to prison continued to do so in prison, most doing so twice weekly or more. 80% of prison injectors shared syringes in prison. No subjects commenced their injecting career in prison, and being imprisoned did not cause past injectors who had stopped to resume injecting in custody. Being imprisoned tended to cause non-sharing injectors to resume sharing in prison. Prison injectors tended to have started both their oral and their injecting drug use careers at an earlier age, and to have been sharing syringes in the community prior to custody. Half of prison sharers used unofficially acquired bleach or disinfectant to sterilise injecting equipment. Continuing involvement with the courts and thus risk of reimprisonment was common. The findings support the case for harm reduction policies in Scottish prisons, and diversion from custody and into treatment for this high risk group.

Journal Article↗