Catheter Securement Systems for Peripherally Inserted and Nontunneled Central Vascular Access Devices: Clinical Evaluation of a Novel Sutureless Device.

Sutureless catheter securement systems are intended to eliminate risks associated with sutures. The clinical acceptability of a novel system was investigated compared with the current method of securement for peripherally inserted central catheters (19 facilities using StatLock or sutures) or nontunneled central vascular access devices (3 facilities using StatLock or sutures or HubGuard + Sorbaview Shield). More than 94% of respondents rated the novel system as same, better, or much better than their current product. More than 82% of respondents were willing to replace their current system with the new one.

Randomized comparison of a silicone tape and a paper tape for gentleness in healthy children.

PURPOSE: To compare the relative gentleness of a silicone tape to a paper tape in healthy infants and children. DESIGN: A randomized, grader-blinded, comparative study. SUBJECTS AND SETTING: The sample group comprised 24 healthy infants and children 9.1 to 46.7 months of age (mean ± SEM, 34.0 ± 2.21). The study was conducted at a dermatological research facility (cyberDERM, Inc) located in Broomall, Pennsylvania. All volunteers were recruited from the surrounding community. METHODS: Tapes measuring 1 × 1.5 inches were randomly applied to the left and right intrascapular regions of the upper back. Tapes were removed in a standardized fashion after 24 hours. The primary study outcome, gentleness, was based on visual assessments of skin damage, discomfort, and quantification of keratin removal. Four-point scales were used to assess skin damage, and a 10-point Faces, Legs, Activity, Cry, and Consolability instrument was used to assess discomfort. Secondary assessments included hair removal, tape edge-lift assessments, and parent preference for either tape. RESULTS: There was a significantly lower mean ± SEM erythema response for the silicone tape (0.93 ± 0.14 vs 1.35 ± 0.11, P = .0129) than for the paper tape. No measurable epidermal stripping occurred with the silicone tape compared to a mean ± SEM response of 0.29 ± 0.11 for the paper tape (P = .0039). Discomfort was significantly lower (P = .0002) for the silicone tape as compared to the paper tape (Faces, Legs, Activity, Cry, and Consolability score mean difference from baseline 0.5 vs 3.3, P = .0002). Keratin removal was significantly less with the silicone as compared to paper tape (8.7 ± 0.5 µg/mL vs 15.2 ± 1.3 µg/mL, P < .0001). Few hairs were removed with either tape. There was significantly less (P < .0001) edge-lift with the paper tape than the silicone tape; no statistically significant differences in parent preferences for silicone versus paper tapes were measured (P = .3359). CONCLUSIONS: Gentleness assessments favored the silicone tape compared to a paper tape and warrant further clinical investigation in the neonatal intensive care unit.

A randomized and controlled comparison of gentleness of 2 medical adhesive tapes in healthy human subjects.

PURPOSE: To compare gentleness of a silicone tape to a paper tape and to an untreated control. DESIGN: Controlled, randomized, grader-blinded cohort trial. SUBJECTS AND SETTING: The sample group comprised 28 healthy volunteers aged 55 years and older (median age = 63 years) with a Fitzpatrick Skin Type of I, II, or III. All volunteers were recruited from the greater Philadelphia area and the study was conducted at a dermatological research facility specializing in noninvasive instrumental measurements. METHODS: Tapes were applied and removed daily (excluding weekends) to 2 of 3 sites on the left and right volar forearms over an 11-day period. The center site on each forearm was left untreated and tapes were randomized to the proximal and distal sites. The primary assessment was transepidermal water loss (TEWL); secondary assessments included erythema/edema, denudation/skin-stripping, and subject self-evaluations. Study personnel conducting the primary and secondary assessments were not involved with treatments to maintain the blinded nature of the study. The identity of the 2 tapes was not revealed to the subjects until after conclusion of the study. RESULTS: On day 11 the mean TEWL value for the paper tape was significantly higher than that for both the untreated control and silicone tape (P < .001). End-of-study mean TEWL values were 2.65 ± 0.68 g/mh for the silicone tape, 6.85 ± 4.97 g/mh for the paper tape, and 3.73 ± 1.19 g/mh for the untreated control. At all assessments, the silicone tape exhibited net changes from baseline that were significantly less than the paper tape (P < .05 day 1, P < .001 days 4, 7, and 11) and similar for the untreated control. Only at days 4 (P < .01) and 11 (P < .001) was the paper tape significantly higher than that for the untreated control. Throughout the study, both tapes exhibited mean TEWL values within the range of normal intact forearm skin, indicating that both tapes were gentle. No differences in erythema/edema scores occurred but the silicone tape resulted in lower denudation/skin-stripping scores than the paper tape at days 4 to 11 (P < .0001). Self-assessment of pain at removal was low for both tapes but significantly lower for the silicone tape (days 1-7, P = .02; day 11, P = .009). Forty-four percent of participants expressed a preference for the silicone tape as compared to the paper tape (19%), with 37% stating no preference. CONCLUSIONS: Based on TEWL assessment of disruption of the stratum corneum water barrier, the silicone tape proved gentler to the skin than the paper tape. After 9 applications and removals over 11 days of study, the silicone tape was similar to the untreated control, whereas the paper tape exhibited significantly higher mean TEWL values than both the untreated control and the silicone tape. Expert grader assessments corroborate these findings. These data indicate that the silicone tape may provide additional gentleness when it is clinically needed.

CYP3C1, the first member of a new cytochrome P450 subfamily found in zebrafish (Danio rerio).

We report a new cytochrome P450 (CYP) subfamily CYP3C and the cloning through PCR from zebrafish (Danio rerio) of the first member, CYP3C1. The CYP3C1 gene is on Chromosome 3 with 13 ORF exons encoding a 505 amino acid protein which has 44-54% identities with mammalian and teleost CYP3A and CYP3B forms. As evidenced by spectral analysis, the CYP3C1 protein heterologously expressed in yeast is functional. In silico analysis identified, on the same region of the chromosome, three more genes encoding CYP3C1-like proteins that formed a clade with CYP3C1 in a phylogenetic tree. Using RT-PCR, the CYP3C1 mRNA was detected in 1-6dpf embryo/larvae and in adult fish liver and seven extrahepatic tissues. Whole-mount in situ hybridization using a riboprobe demonstrated expression in the brain during 12-120 hpf. At the 120 hpf larval stage, CYP3C1 mRNA was also detected in the pharynx and gastrointestinal tract. TCDD, dexamethasone, and rifampicin, which up-regulated CYP3A65 mRNA in zebrafish larvae, did not alter the CYP3C1 transcript levels suggesting regulatory differences between CYP3A and CYP3C enzymes in this species.

Assignment of sockeye salmon (Oncorhynchus nerka) to spawning sites using DNA markers.

Randomly amplified polymorphic DNA (RAPD) markers were used to assign individual adult sockeye salmon to their spawning sites using a genotype assignment test. Six primers were selected for use by screening bulked DNA samples for markers missing in fish from one or more of 5 sites in British Columbia or Alaska. Of 73 markers scored, 54 showed variation between or within sites among the sampled fish. Thirty-seven of the variable markers were not detected in any fish from one or more sites; 18 variable markers were detected in all fish from one or more other sites. Thus 25% of markers scored were found in all fish of some sites and in no fish of some other sites. An assignment test placed all 70 fish tested into their correct populations. Principal coordinate analysis of genetic variation produced clusters of fish corresponding to each sampling site. No sex-specific RAPD markers were detected among more than 1300 screened.