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PubMed2006

Nodular herpes zoster with herpetic syringitis and no epidermal involvement in a patient with Burkitt lymphoma.

Herpes zoster (HZ) occurs with an increased incidence in immunosuppressed patients, in whom it frequently displays atypical clinical presentations. Herpetic syringitis, the involvement of the eccrine epithelium by herpes virus infection, is an infrequently described histologic pattern that has been rarely and almost exclusively reported in HIV-infected patients. We report the case of a woman with Burkitt lymphoma who developed 2 nodular, asymptomatic lesions while receiving treatment with chemotherapy and radiotherapy for her hematological disease. Histology showed viropathic changes in the epithelium of eccrine glands not in the epidermis. PCR was positive for varicella-zoster virus (VZV). Nodular herpes zoster seems to be an exceptional clinical presentation. We report another such case which is, as far as we know, the first report of herpetic syringitis with no concomitant epidermal involvement.

Adult↗
PubMed2006

Psychiatric comorbidity is associated with drug use and HIV risk in syringe exchange participants.

The present study evaluated the effects of psychiatric comorbidity on substance use disorder prevalence, HIV risk behavior, and other problem severity in male and female out-of-treatment injection drug users newly registered at a syringe exchange program. Participants (N = 338) were administered the Structured Clinical Interview for the DSM-IV, the Addiction Severity Index, and the Risk Assessment Battery, and classified into one of four diagnostic groups: (1) no antisocial personality disorder (APD) or Axis I psychiatric disorder (N = 162), (2) APD only (N = 74), (3) Axis I psychiatric disorder only (N = 55), or (4) APD plus Axis I psychiatric disorder (N = 47). Psychiatric comorbidity was associated with higher rates of substance use disorder and more HIV risk and other problem severity. In general, participants with both APD and an Axis I disorder exhibited the most problem severity. APD was uniquely associated with higher prevalence for each substance use disorder assessed in this study and with elevated HIV risk. These results support and extend studies conducted with opioid-dependent individuals recruited from treatment and community settings, and reinforce the need to develop interventions to encourage syringe exchange program participants to enroll in treatment.

Adolescent↗
PubMed2004

A novel option for dosing of proton pump inhibitors: dispersion of lansoprazole orally disintegrating tablet in water via oral syringe.

BACKGROUND: A new formulation of lansoprazole, the lansoprazole orally disintegrating tablet, rapidly disintegrates in water eliminating the need for swallowing whole pills. AIM: To assess the effect that dispersing the lansoprazole orally disintegrating tablet in water would have on lansoprazole pharmacokinetics. METHODS: Forty healthy adult men and women (18-43 years) received two single 15 mg lansoprazole orally disintegrating tablet doses separated by 3 days (one administered directly onto the tongue without water and one dispersed in water and administered orally via syringe) in a randomized, crossover fashion. Serial plasma samples were determined from 0 to 12 h for each dose. Ratios of central values for peak plasma exposure (C(max)) and mean overall extent of exposure (area under the plasma concentration) were used to compare the bioavailability. RESULTS: The two dosing regimens were bioequivalent, with the point estimate for area under the plasma concentration equalling 1.080 (confidence interval 1.012-1.152) and the point estimate for C(max) equalling 1.082 (confidence interval 0.961-1.218). CONCLUSIONS: Dispersing the 15 mg lansoprazole orally disintegrating tablet in water and administering the dose orally via syringe is bioequivalent to the 15 mg intact lansoprazole orally disintegrating tablet with respect to lansoprazole area under the plasma concentration and C(max). This dosing route provides an additional, convenient dosing option for lansoprazole.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2005

Stability of foam in sclerotherapy: differences between sodium tetradecyl sulfate and polidocanol and the type of connector used in the double-syringe system technique.

BACKGROUND: Foam sclerotherapy is an increasingly popular modality in the treatment of varicose veins. Worldwide, the most popular agents used are sodium tetradecyl sulfate (STS) and polidocanol (POL). The double-syringe system technique to make foam out of a sclerosing solution and air has received wide attention for its ease and reproducibility. This study examined the possibility that the relative silicone content of various disposable connectors may affect overall foam stability. We also evaluated the differences in the stability of foam between STS and POL. MATERIALS AND METHODS: In the first part of the study, one nondisposable stainless steel connector and five disposable plastic connectors were used to create foam from STS 0.50% and air. The procedure was then repeated to produce foam from POL 0.50% and air from each of the six different connector types. As a measure of foam stability, once foam was created with each type of connector, the time required for half of the original volume of sclerosing solution to settle was recorded. In the second part of the study, foam was created with a nondisposable stainless steel connector only and various concentrations of STS and POL. Foam stability was then measured for these different concentrations of sclerosants. RESULTS: The time for sclerosing solution to settle to half of its initial volume was found to vary according to the specific sclerosant and concentration used, with no statistically significant variation based on connector type. CONCLUSIONS: The type of connector used in the double-syringe system technique to produce foam for sclerotherapy is not a factor in foam stability. Sclerosing solutions differ in their foaming stability.

Dosage Forms↗
PubMed1987

Syringe driver in terminal care.

Continuous subcutaneous infusions of drugs by syringe driver are used often and successfully in the terminal care of patients when drugs cannot be given orally. Diamorphine is the opioid of choice because of its high solubility. If other drugs such as antiemetics, anticholinergics, sedatives, or steroids are required they may also be given by syringe driver. This method is particularly useful for domiciliary care, where the practical difficulties of providing regular parenteral analgesia are otherwise formidable.

Antiemetics↗
PubMed2002

Aquagenic syringeal acrokeratoderma (transient reactive papulotranslucent acrokeratoderma).

In 1996, English and McCollough described an unusual entity in 2 sisters characterized by a transient and recurrent keratoderma exclusively on the palms after water exposure. The condition developed 3-5 min after exposure to water and resolved within a short time after drying. This finding was associated with a tightening sensation. Yan et al. coined the term 'aquagenic palmoplantar keratoderma', and the designation 'aquagenic syringeal acrokeratoderma' was suggested by MacCormack et al. Until now, a total of 8 cases have been reported. We documented 2 new cases with acquired aquagenic syringeal acrokeratoderma. A 25-year-old female had observed within the last 3 months a burning sensation on the palms after some minutes of water contact. Physical examination revealed a perfectly normal skin on the palms. Three minutes after water immersion of 20 degrees C, a whitish discoloration appeared on the palms and a thickening of the palmar skin was visible. In addition, the eccrine pores were much more prominent. Few minutes after drying the skin, the situation returned to a normal state. The second patient, a 33-year-old female noticed a painful whitish discoloration of the skin on the palms after a short period of water immersion. Sometimes the white skin could be peeled off. In the last year, hyperhidrosis developed, and a more reddish aspect of the palms appeared. In our office after rinsing the hands with water at room temperature, a whitish discoloration in the center of the palms appeared which was associated with a painful sensation. After drying, the whitish lesions disappeared almost completely within 30 min. Aquagenic palmar keratoderma describes an acquired and transient condition which occurs after brief exposure to water and disappears after drying within minutes to an hour. Only rarely may a slight hyperkeratosis remain for a longer time. The possible pathophysiology and treatment options are discussed.

Acrodermatitis↗
PubMed2002

The most effective products available to facilitate ear syringing.

Loss of hearing from accumulation of cerumen (ear wax) is a commonly seen problem. Treatment for this condition often involves use of a wax softening or dispersing agent (cerumenolytic) before syringing. A mini-review was undertaken to find out what is the best preparation to use before syringing to facilitate the procedure. Five databases were searched using subject searches combined with methodological filters to find the highest level of evidence to answer the question. Nine randomized controlled trials (RCTs) were found and seven in vitro studies that researched the efficacy or effectiveness of a range of products. The RCTs do not show any one product to be more effective. The in vitro studies show Waxsol to be better at dispersing wax followed by sodium bicarbonate. This needs to be demonstrated with in vivo testing comparing all products for effectiveness. Many of the studies suffered from a lack of information. Side effects were not adequately investigated.

Cerumen↗
PubMed2006

Developing guidelines for syringe driver management.

The aim of this project was to develop clinical practice guidelines for the use and administration of pharmacological agents for symptom control via syringe drivers within Australia. By developing evidence-based clinical practice guidelines for the use of this common device, this project aimed to improve patient outcomes, reduce practice variation, minimize errors and encourage more efficient use of resources. A literature review identified current literature regarding syringe driver management and an expert panel was assembled to assist in the development of the guidelines. The development of these practice guidelines provides an example of how palliative care practitioners can use a framework of contemporary evidence to enhance clinical practice.

Clinical Nursing Research↗
PubMed2000

A benefit-cost analysis of syringe exchange programs.

To date, a paucity of systematic economic evaluations have been applied to syringe exchange programs. In today's cost-conscious environment, with public health officials contending with restricted HIV prevention budgets, what amount of scarce resources should be allocated toward the operation of SEPs? To address this question, benefit-cost analyses emerge as useful strategies to inform decision-makers about which programs hold the most promise for preventing HIV infection among intravenous drug users. This review article balances the benefits of HIV prevention via syringe exchange against the costs of operating such programs.

Budgets↗
PubMed2005

Clinical comparison of pain perception rates between computerized local anesthesia and conventional syringe in pediatric patients.

The purpose of this study was to evaluate pain perception rates in pediatric patients by comparing computerized injection device and traditional injection procedure. In a clinical trial, by using a crossover design, sixty-four patients were randomly assigned to receive, in consecutive sessions, dental anesthetic techniques with either traditional or computerized device. Visual Analogue Scale qualification and heart rate monitoring as physiologic indicator of pain response were used for the evaluation. Results showed that traditional syringe injections were more painful than computerized injection device (p < 0.001). Results suggested that computerized injection device reduces pain perception compared to the traditional syringe during the dental anesthetic management.

Anesthesia, Local↗
PubMedDate not supplied

Plasma free insulin profiles after administration of insulin by jet and conventional syringe injection.

Plasma free insulin profiles in insulin-dependent diabetic subjects were compared after jet and syringe injection of insulin. Jet injection of insulin resulted in a shift of the free insulin profile to the left. Thus higher plasma free insulin levels were found over the first 30 min after injection (P less than 0.05), while after 240 min plasma free insulin levels were lower than those seen following syringe injection (P less than 0.05). Significant differences in the response of blood glucose and 3-hydroxybutyrate levels reflected the differences in plasma free insulin levels. Jet administration results in more rapid absorption of insulin and could be useful in providing a more physiologic postprandial insulin profile than that seen after conventional injection.

Adult↗
PubMedDate not supplied

Comparison of insulin levels after injection by jet stream and disposable insulin syringe.

Intermediate-acting biosynthetic human (NPH) insulin was administered by disposable insulin syringe into the right upper thigh of nine insulin-dependent diabetic youths. Seven days later, the same amount and type of NPH insulin was given in the same anatomic site with a Medi-Jector II, which delivers insulin as a jet stream. Blood was collected before insulin injection and at hourly intervals subsequently for the measurement of glucose and insulin. The total serum insulin measured before the first morning dose with the needle and syringe and the Medi-Jector II was 41.2 +/- 10.7 microU/ml and 46.2 +/- 10.7 microU/ml, respectively. During the next 9 h, the areas under the respective total insulin curves were not different, but the area under the free-insulin curve after jet injection was greater than the free-insulin area after needle injection (P less than .01). The ratio of free/total serum insulin was 0.31 +/- 0.02 after needle injection and 0.40 +/- 0.03 after jet injection (P less than .0025). The peak of total insulin concentration occurred 4.2 h after jet injection of NPH: 1 h earlier than the peak after needle injection. The plasma glucose at time zero was 197 +/- 15 mg/dl before needle injection and 242 +/- 19 mg/dl before jet injection. Although the diet consumed by each subject on the 2nd study day was identical to that of the 1st day, the mean glucose increase was greater after needle-injected insulin than after jet-spray injection. This indicates that the greater amount of free insulin observed after jet-injected insulin had a direct effect in lowering the plasma glucose. Jet injection may reduce insulin requirements by increasing the availability of free insulin.

Absorption↗
PubMed1990

Treatment of the neck in facial rejuvenation surgery using a simplified method of syringe assisted microlipoextraction.

Twenty-seven patients underwent syringe-assisted liposuction of the neck, the amount of fat removed ranging from 20-110 ml. There were no complications except slight skin laxity (n = 1) and transient hypoaesthesia (n = 10). No patient required a second procedure, and all were satisfied with the results. Syringe-assisted microlipoextraction of cervical fat is a simple, safe, and rewarding procedure that has obvious advantages over open procedures or machine-assisted liposuction with large cannulas.

Adult↗
PubMed2004

[Significance of working environment improvement based on determination of source of harmful substance--example of an endoscope syringe room using glutaraldehyde].

Because a worker complained of irritated eyes and throat due to glutaraldehyde (GA) in an endoscope syringe room, the automated endoscope washers and GA liquid stored in reserve were isolated in a separate room. A ventilation system was installed in this room, and the packing of the automated endoscope washers was changed. However, since the obnoxious smell of GA still remained in the endoscope syringe room, we had to determine the source of the smell. A plastic bucket with a cap was found to be filled with GA for disinfection of the endoscope apparatus. GA had evaporated when dispersed around the bucket, resulting in the obnoxious smell. The plastic bucket was replaced with a different type of container. Moreover, GA from the separate room did not affect the concentration of GA in the working area because the separate room for the automated endoscope washers had twice the ventilation volume proposed by the guidelines of the Society of Gastroenterology Nurses and Associates of the USA and the Healthcare Engineering Association of Japan. Consequently, we reconfirmed the significance of working environment improvement after clarifying the source of the harmful substance.

Disinfectants↗
PubMed1999

[Effect of needle and syringe exchange programs on the spread of viral hepatitis C].

The authors examined a total of 224 clients (147 men and 77 women) of the Contact centre for drug-dependent subjects "Drug out" in Ustí nad Labem. The subjects, parenteral abusers of hard drugs. The majority of examined subjects were 20-24 years old and accounted for 50.9% of the whole group. In all the history of abuse was assessed, the type of drug they took and are taking at present, how long they have been taking it, route of administration of the drug. Participation in the exchange programme was focused on the adherence to using their own injection tools. In addition the authors assessed whether the subjects had hepatitis. After they obtained informed consent, if possible, 4 ml venous blood samples were taken. The blood was examined for anti-HCV by the method of micro-enzyme immunoassay (MEIA) on an Axsym apparatus of Abbott Co. The positive response to anti-HCV was assessed in 83, i.e. 37.1%. Abusers who took drugs for longer periods were more frequently infected. So far it proved possible to obtain samples repeatedly from 38 clients who were originally negative. In the latter new positivity was found in 36.8%. The incidence of new positivity is 35.7/100/year. Evaluation of the participation in the exchange programme of needles and syringes was made with the following conclusion the provisions resolve the position only partly, they reduce the rate of spread of infections but do not eliminate the risk. The spread of VHC in the population of drug abusers is due to the risky procedure during preparation of the drug dose and lack of adherence to the principle of using their own needles and syringes. During implementation of preventive programmes in the population a comprehensive approach is needed including information on the spread of viral hepatitis and HIV infection. VHC is a problem to which systematic attention must be paid on account of its impact on health and economics. These problems cumulate and develop after a certain time interval.

Adolescent↗
PubMed1975

[Experience with the Contrac III syringe in carotid angiography (author's transl)].

Report on a comparison between the use of the Contrac III syringe and manual injection for carotid angiography. 100 cases of injector angiograms were compared with 100 unselected manual arteriograms. The injector angiograms needed less contrast fluid and were distinctly better than the manual angiograms. Evaluation was based on the frequency of visualization of the posterior cerebral artery, the anterior cerebral arteries on either side and the filling of lenticulostriary vessels. Using the injector raises the percentage of bilateral filling of the anterior cerebral artery; the posterior cerebral artery, too, is rendered visible much more often. The quality of filling of the basal arteries depends largely on the speed of the injection. According to our present experience complications with the injector are no more frequent than with manual injection. Injection with the Contrac III syringe is, therefore, a definite advance, since it permits producing angiograms of very good, even, reproducible quality.

Angiography↗
PubMed1998

Use of a Disposable Syringe as a Novel Economic Breath-Collection Chamber for Mice.

We modified commercially available 50-ml syringes to allow their use as breath-collection chambers for mice. By drilling holes at the flanged end and applying 3-way valves to the opposite (tip) end, a syringe can be ventilated, then quickly and simply converted to a closed chamber for collection of breath samples. We evaluated the influence of sample collection time on CO2 content of breath samples and found that 30 sec was required to obtain a CO2 concentration of 3 to 5%. We believe this is an economic, simple, and safe alternative to conventional breath-collection chambers.

Journal Article↗
PubMed2002

The use of the local analgesia syringe in children. Should it be kept out of sight? A clinical trial of two methods of presentation.

AIM: The study was carried out to determine whether showing a local analgesia (LA) syringe to a child would influence behaviour during subsequent administration of LA, as opposed to concealing it. MATERIALS AND METHODS: 25 children were randomly assigned to either a show (13) or no-show (12) group. The children were aged 4 years and 3 months to 8 years and 9 months, mean age 7 years and 9 months. One operator carried out all LA administrations. The procedure and dialogue were strictly standardised. Each child was filmed during LA administration. Three paediatric dentists scored the video recorded behaviours, using the Frankl Behaviour Rating Scale. The raters were blind as to which group the child belonged to. RESULTS: No statistical difference was found between the behaviour ratings of the no-show and the show groups during LA administration (p>0.05). CONCLUSION: Overall, the behaviour of the children in the show group did not differ from the behaviour of children in the no-show group. Whether to show or not to show the LA syringe is probably dependent on the behavioural skills of the operator.

Clinical Trial↗