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This paper describes how a small, simple-to-use, help card was developed for use with a Graseby MS16A syringe driver that can be used with a variety of sizes and manufacturers' syringes. Also described are ways in which it may help to reduce the chance of accidental error when setting up and monitoring the delivery of 24-hour subcutaneous infusions for pain and symptom control.
In a dye penetration test and a scanning electron microscopic evaluation MOD-restorations made of a thixotropic material (ZKP-A-5(2)) and of two syringe system composites (Concise-Capsule-Composite3, Compocap-S4) were investigated with respect to microleakage and marginal adaptation. These materials did not reveal better marginal micromorphology than a comparable two-paste composite system (Concise3); Compocap-S showed markedly less microleakage. The quality of marginal adaptation, however, was improved to 52% when a low viscosity sealant (ZKP-A-2(2), Concise Enamel Bond3) was applied before insertion of the restorative. A sealant pretreatment is therefore compulsory in thixotropic and syringe packed composites as well. The perfection reached with these composite brands is equal to that of adhesive restorations made of Concise or Adaptic5 [6,7]. Restorations performed with new, complete composite systems (Nimetic6, GC's Epolite 100/Epobond7) revealed moderate results when compared to standard materials like Concise or Adaptic [6,7].
A manually operated 3-ml insulin catheter and syringe injector system was evaluated in 26 insulin-dependent ketosis-prone patients for a mean of 11 months per patient. Eighteen patients had normal kidney function, 5 had renal insufficiency (plasma creatinine 2.0-4.8 mg/dl) and 3 had successful kidney transplants. Regular insulin was infused 15-30 min before each meal. The subcutaneous route of delivery was used in all patients except the 3 renal transplant patients who received regular insulin intraperitoneally through a chronically placed intraperitoneal microbore catheter. Basal insulinization was obtained using subcutaneous long-acting insulin. Blood glucose control improved in all 3 groups of patients. Mean blood glucose decreased from 203 +/- 10-118 +/- 3 SEM; hemoglobin A1 decreased from 12.5 +/- 0.4-9.2 +/- 0.25 SEM (normal range 5-9%). We conclude that a manually operated syringe injector can be used to make multiple dose insulin management less painful and more convenient. The injector can be worn and activated beneath clothing and also worn while showering or swimming. Yet it can be removed while sleeping, when sexually active or when engaged in strenuous athletic activity.
The performance of a calculator was studied on 19 patients requiring therapy with mechanical ventilation. Values of total compliance displayed by this calculator device were compared with values obtained with the syringe method. The determination of compliance were made at a series of values for Tidal volume (T. V.): 3, 4, 5, 6, 8, 10, 12, 15, 18, 20, 23 and 26 ml.kg-1. Measurements were performed while patients were paralysed by pancuronium bromide. In each patient the calculator device displayed values that correlate closely with the value obtained by the syringe method. Compliance increased between 3 and 26 ml.kg-1 of T. D. Between 4 and 15 ml.kg-1 of TD the changes of compliance were nearly identical whatever the method of measurement used. The calculator can be used for reliable monitoring or recordings of total compliance.
The potential adverse effects on the neonatal/pediatric population of administering concentrated intravenous medications are a concern. After an adult minibag was successfully converted to a syringe pump system, a similar system for neonates and children was developed. Additional factors considered with this conversion included: osmolarity, fluid volumes, and i.v. administration procedures. Charts that provided information on appropriate final concentrations of commonly used drugs were developed for nursing and pharmacy staffs. Inservice education was given to ensure understanding and compliance with the charts as well as the procedures developed for this delivery system (such as i.v. line setup, flushing procedures, and tubing changes). When this system was implemented, aminoglycosides were administered in a uniform manner. Previously, each area had its own method of aminoglycoside administration, which was not conducive to reliable therapeutic drug monitoring. Significant improvements in patient care, drug waste, and therapeutic drug monitoring resulted from using the pediatric syringe pump delivery system.
This paper develops a statistical procedure for estimating the HIV infection rate among needle exchange clients without using any self-reported information. Instead, data are accumulated by following the distribution and return of sequentially labeled syringes and by testing a sample of returns for the presence of HIV-1 proviral DNA using polymerase chain reaction. For each drug injector in the sample, a maximum likelihood change point model is constructed to determine if a statistically significant upward shift in the fraction of needles testing HIV positive is evident, as would occur if the drug injector in question became infected. A second maximum likelihood model is formulated to estimate the HIV incidence rate among needle exchange participants by aggregating the individual change point results. When these methods are applied to the syringe tracking and testing data collected to evaluate the legal needle exchange program in New Haven, Connecticut, the maximum likelihood incidence estimate equals zero, with a 95% confidence interval of 0-10.2 new infections per 100 drug injectors per year. Given these data, we cannot reject the null hypothesis that no new infections have occurred among needle exchange participants between November 1990 and May 1992.
The most common method of syringe exchange program (SEP) development in the United States has been for SEPs to be started by activists without funding and then to become a government-funded community-based organization. This developmental process, which has not been studied to date, involves major organizational change. We report our findings on three New York City syringe exchanges experiencing this type of transition. Our data illustrate that following legalization, increased legitimacy and funding allowed all three SEPs to expand the size and scope of their programs (e.g., adding hours, sites, referral services, and the ability to support user groups), resulting in a rapid growth in participation (over 15,000 in 18 months). Regulation accompanying legalization posed significant challenges to SEPs, including added record-keeping and reporting tasks, increased demand for referrals, and accommodating evaluation, which affected already overburdened staffs. The transition process poses significant challenges to these developing organizations as well as opportunities for improved services.
We developed a software to control a Graseby 3500 syringe pump for propofol infusion through the serial port of Apple Macintosh/Power-Macintosh computer. This software, "ConGrase", was developed with Metrowerks CodeWarrior Professional (CWP 1) and PowerPlant framework using C++. ConGrase communicates with the syringe pump at least every three seconds, and calculates the estimated blood concentration (EBC) of propofol based on the amount of propofol actually infused by applying either the Euler or Runge-Kutta method using the three-compartment pharmacokinetic model. The parameter sets reported by Gepts et al. are used. ConGrase was released at the 44 th Annual Meeting of the Japan Society of Anesthesiology, and is distributed freely. The mean and S.D. of the emergence EBC calculated by ConGrase were 1.22 micrograms.ml-1 and 0.16 microgram.ml-1, respectively. These values are almost the same as values already reported outside Japan. The necessary wake-up time can be calculated with this estimated concentration. With this system, anesthetists can control the EBC at the required level and avoid long delays before the patients wake up after anesthesia.
PURPOSE: Gefurulimab, a novel dual-binding nanobody targeting complement component 5 (C5), is in clinical development for anti-acetylcholine receptor antibody-positive generalized myasthenia gravis. Gefurulimab has a low molecular weight, enabling subcutaneous (SC) self-administration by autoinjector (AI) or prefilled syringe with needle safety device (PFS-SD). We compared gefurulimab pharmacokinetic (PK) exposure and safety in healthy adults following a single SC dose administered by AI versus PFS-SD. METHODS: In this phase 1, open-label, randomized, parallel-group study (NCT06208488), healthy participants aged 18 to 65 years were stratified by weight and randomized equally to 1 of 6 combination groups of device and injection site (abdomen/thigh/upper arm). Participants received a single SC dose of gefurulimab on day 1 and were assessed throughout the 92-day evaluation period. Primary endpoints were PK parameters for each device: maximum observed concentration (Cmax) and area under the serum concentration-time curve (AUCinf, AUClast). PK across injection sites, pharmacodynamics, safety, immunogenicity, and device performance were also assessed. FINDINGS: Overall, 175 participants were randomized: AI (n = 87), PFS-SD (n = 88). Geometric least squares mean ratios (90% CI) comparing AI/PFS-SD for Cmax, AUCinf, and AUClast were 97.6% (94.5-100.8), 99.6% (96.1-103.3), and 98.8% (95.2‒102.6), respectively. Secondary analyses found no meaningful differences in PK parameters across injection sites. Serum-free C5 concentrations over time, treatment-emergent adverse event (TEAE) profiles, and antidrug antibody responses were similar between cohorts. Most TEAEs were mild; none led to study discontinuation. IMPLICATIONS: SC administration of gefurulimab by AI and PFS-SD was well tolerated with comparable exposure, meeting bioequivalence criteria.
A new technique of injecting insulin without a needle employs a jet injector to administer a high-pressure stream of medication. This method causes very little pain and affords great accuracy, ease of administration, and safety. The medication is more widely diffused in the body by jet injection than by the needle-and-syringe technique. The control of blood sugar (with similar doses of insulin) achieved by the two techniques is similar, and their effect on local tissues is also similar. In the patients studied, jet injection appeared to be a very satisfactory method of administering insulin and has met with good patient-acceptance. Jet injection is also a useful method for the visually handicapped.
Five benzothiazole derivatives leached into injections by the rubber plunger-seals of disposable syringes were identified by electron impact (EI) and chemical ionization (CI) mass spectrometry. These are 2-hydroxybenzothiazole, 2-mercaptobenzothiazole, 2-(methylmercapto)benzothiazole, 2-(2-hydroxyethoxy)benzothiazole and 2-(2-hydroxyethylmercapto)benzothiazole. 2-Mercaptobenzothiazole is used as a vulcanization accelerator. The other four compounds are formed from the zinc derivative of 2-mercaptobenzothiazole during sterilization with ethylene oxide. Toxicological, technological and legal consequences of the leaching are discussed briefly.
It is important to measure the exact volume of 5% dextrose injected when thermodilution cardiac output determinations are made. The marked volume on plastic syringes and their variability may contribute to a small but significant error in the results.
The determination of ropivacaine and its major metabolites in urine was performed using microextraction in a packed syringe as an on-line sample preparation method with LC and MS/MS. The sampling sorbent utilized was polystyrene polymer. [2H7]ropivacaine was used as the internal standard. The lower LOQ was 5.0 nmol/L. The calibration curves were obtained within the concentration range 5-2000 nmol/ L in urine. The regression correlation coefficients for urine samples were > or = 0.999 for all runs. The between-batch accuracy and precision values were determined from six replicates of quality control (QC) samples at three different concentrations in human urine. The mean accuracy values for the QC samples, reported as the percentage difference from the nominal value, were in the range of 99-115%. The precisions, given as the RSDs, were in the range 1.9-11%. The present method is miniaturized and fully automated and can be used for pharmacokinetic and pharmacodynamic studies.
A facile fabrication of a cross-linked hyaluronic acid (HA) hydrogel nanofibers by a reactive electrospinning method is described. A thiolated HA derivative, 3,3'-dithiobis(propanoic dihydrazide)-modified HA (HA-DTPH), and poly(ethylene glycol) diacrylate (PEGDA) are selected as the cross-linking system. The cross-linking reaction occurs simultaneously during the electrospinning process using a dual-syringe mixing technique. Poly(ethylene oxide) (PEO) is added into the spinning solution as a viscosity modifier to facilitate the fiber formation and is selectively removed with water after the electrospinning process. The nanofibrous structure of the electrospun HA scaffold is well preserved after hydration with an average fiber diameter of 110 nm. A cell morphology study on fibronectin (FN)-adsorbed HA nanofibrous scaffolds shows that the NIH 3T3 fibroblasts migrate into the scaffold through the nanofibrous network, and demonstrate an elaborate three-dimensional dendritic morphology within the scaffold, which reflects the dimensions of the electrospun HA nanofibers. These results suggest the application of electrospun HA nanofibrous scaffolds as a potential material for wound healing and tissue regeneration. [image: see text] Laser scanning confocal microscopy demonstrates that the NIH3T3 fibroblast develops an extended 3D dendritic morphology within the fibronectin-adsorbed electrospun HA nanofibrous scaffold.
Electroporation for gene delivery has attracted considerable attention recently, because of both the site-specific nature of the delivery and the high efficiency of the method. Electrotransfer of genes involves the application of an electric field to cells to enhance their permeability, facilitating exogenous polynucleotide transit across the cytoplasmic membrane. However, the relatively high electric field strength required for electroporation induces tissue damage, thus limiting its widespread application. We describe here a syringe electrode of our design, with which the same transfection efficiency can be achieved by using much lower electric field strength than that of conventional electrodes, such that the tissue damage is minimized.
Dose rates around and at the surface of disposable polypropylene syringes of 1 and 2 ml volume filled with 99mTc and 131I solutions were determined by thermoluminescence dosimetry. Data for the efficacy of 0.5 and 1 mm lead shielding of 99mTc and for the dose contribution due to beta- -radiation from 131I are given.
A portable means of temperature control for thermodilution injectate syringes is described. This approach is relatively simple to produce and maintains constant satisfactory temperature in the injectate.
A syringe can be used to place dental stone into the deepest part of an impression, filling it from the bottom up, expressing air as the impression fills.