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1.
Nucl Med Commun ; 41(9): 965-976, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32796486

RESUMO

OBJECTIVES: The aim of this study was to characterize national variation in radionuclide calibrator activity response to a single National Institute of Standards and Technology (NIST) traceable reference Ge source used as a surrogate for F at clinical PET centres in England using National Physical Laboratory approved techniques. METHODS: Readings from 20 instruments at 13 centres using local F and Ge factor settings were recorded with the source located in vial and syringe positions. Ten repeat measurements were conducted to investigate repeatability using % coefficient of variability (COV). Comparison ratios to investigate accuracy were made between calibrator responses and decay-corrected NISTref reference activity for syringe and vial position measurements. RESULTS: The maximum %COV was 0.79%, while 90, 95 and 80% of calibrators conformed to 5% accuracy for F syringe, Ge syringe and Ge vial position readings, respectively. We revealed a trend towards reduced bias in measurements using Veenstra devices for F and using Capintec devices for Ge factor settings. CONCLUSIONS: This study demonstrated good repeatability in local device measurements. In total, 70% of English calibrators tested and 88% of all measurements performed achieved 5% accuracy. While statistically significant bias was exhibited between different vendor equipment dependent upon radioisotope selected, our study recommends regular traceability checks for optimum instrument performance conducted within National Metrology Institutes guidelines.


Assuntos
Germânio , Tomografia por Emissão de Pósitrons/normas , Radioisótopos , Compostos Radiofarmacêuticos/análise , Algoritmos , Calibragem , Inglaterra , Radioisótopos de Flúor/análise , Humanos , Imagens de Fantasmas , Padrões de Referência , Reprodutibilidade dos Testes , Seringas
2.
PLoS One ; 15(6): e0235087, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584864

RESUMO

BACKGROUND: In nursing practice, flushing the catheters pre and post-drug administration is considered an important clinical procedure to prevent complications, and requires the use of several syringes to comply with international standards of care. We envisioned an innovative double-chamber syringe that enables the filling and administration of both solutions. Following current international recommendations, the development of new medical devices should integrate Health Technology Assessment. The Human-centred design is usually used for that assessment purposes, as a method that actively include end-users in the devices development process. METHOD: Application of the Human-Centred Design through the involvement of nurses in the initial stages of the device development in order to accomplish the initial stages of Technology Readiness Level. A multi-method approach was used, including literature/guidelines review, focus groups with end-users and expert panels. RESULTS: The involvement of nurses enabled the definition of user requirements and contexts of use, as well as the evaluation of design solutions and prototypes in order to accomplish with usability and ergonomic features of the medical device. CONCLUSIONS: Significant contributions were made regarding the final design solution of this innovative double-chamber syringe.


Assuntos
Enfermeiras e Enfermeiros , Seringas , Administração Intravenosa , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Preparações Farmacêuticas/administração & dosagem
3.
Yakugaku Zasshi ; 140(5): 711-722, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32378675

RESUMO

Suspended injectable formulations such as sustained-release luteinizing hormone-releasing hormone (LH-RH) analogue loaded in polylactic acid-glycolic acid copolymer (PLGA) particles have been developed on market. Such formulations have potential issue of suspended particles blocking the injection needle. In this research, two types of injectability tests (gliding force, particles discharge) were developed to evaluate the needle passageability of suspended particles. The model suspension was newly designed using mono-dispersed polyethylene (PE) spheres and qualified dispersing fluid to enhance universality and validity of the test. The suspension-filled syringe, in which three sizes of spheres (L, M, S) were dispersed, was vertically fixed and pushed by auto-compression/tensile tester. The gliding force was continuously detected during testing time and all discharged PE spheres were collected and weighed. The combination of sphere (L, M, S) and injection needle were varied to evaluate the effect of the diameter ratio of sphere against needle hole (D/W) on passageability through needle. These injectability tests revealed that the blockage of a needle hole was occasionally observed when the D/W value increased up to 0.35-0.5, which was detected by jump-up of gliding force and drastic decrease of discharged sphere. In addition, the effect of the formulation properties (concentration of suspended spheres, viscosity of dispersing fluid) and operational factor (injection speed) on injectability was also investigated. The results from this study would be valuable in developing suspended injections and predicting injection trouble at the medical scene.


Assuntos
Desenho de Equipamento , Agulhas , Tamanho da Partícula , Seringas , Composição de Medicamentos , Injeções , Fenômenos Mecânicos , Polietileno , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Suspensões
4.
AAPS J ; 22(3): 72, 2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32415524

RESUMO

A recent paper reviewed clinical studies intending to bridge a prefilled syringe (PFS) to an autoinjector (AI) based on regulatory submission packages sent to the FDA. An AI generally uses the identical PFS within the AI and the AI typically results in a more consistent injection than can be achieved with a PFS. It is noted that several studies submitted to the FDA did not demonstrate bioequivalence (BE) between the PFS and AI, yet the products were approved anyway. The author of this Commentary believes that formal BE studies should not be required for such bridging studies.


Assuntos
Medicamentos Biossimilares , Seringas , Injeções Subcutâneas , Equivalência Terapêutica
5.
J Pain Symptom Manage ; 60(2): e75-e78, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32387139

RESUMO

The current coronavirus disease 2019 (COVID-19) pandemic has put significant strain on all aspects of health care delivery, including palliative care services. Given the high mortality from this disease, particularly in the more vulnerable members of society, it is important to examine how best to deliver a high standard of end-of-life care during this crisis. This case series collected data from two acute hospitals examining the management of patients diagnosed with COVID-19 who subsequently died (n = 36) and compared this with national and local end-of-life audit data for all other deaths. Our results demonstrated a shorter dying phase (38.25 hours vs. 74 hours) and higher rates of syringe driver use (72% vs. 33% in local audits), although with similar average mediation doses. Of note was the significant heterogeneity in the phenotype of deterioration in the dying phase, two distinct patterns emerged, with one group demonstrating severe illness with a short interval between symptom onset and death and another group presenting with a more protracted deterioration. This brief report suggests a spectrum of mode of dying. Overall, the cohort reflects previously described experiences, with increased frailty (median Clinical Frailty Scale score of 5) and extensive comorbidity burden. This brief report provides clinicians with a contemporaneous overview of our experience, knowledge, and pattern recognition when caring for people with COVID-19 and highlights the value of proactive identification of patients and risk of deterioration and palliation.


Assuntos
Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Hospitalização , Cuidados Paliativos , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Assistência Terminal , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Gerenciamento Clínico , Progressão da Doença , Fragilidade , Humanos , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Seringas , Fatores de Tempo
7.
Br Dent J ; 228(6): 396-397, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32221421
8.
Food Chem ; 320: 126612, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32197124

RESUMO

In this work, in-syringe membrane solid-phase extraction (MSPE) device was fabricated for the on-site sampling of sulfamethoxazole (SMX) in food samples followed by solid-phase fluorescence spectra analysis. The samples and fluorescamine (FA) were added to a syringe for derivation. Then, the derivative of SMX was extracted by a membrane in the syringe SPE device. Subsequently, the derivative on the membrane was measured immediately without additional elution procedure. The method was successfully applied in plasma, milk, and egg samples for the trace SMX detection, with the recovery of 98%-102%, RSDs from 1% to 6%. Compared with liquid chromatography, direct detection of the concentrated analyte significantly improved the sensitivity. Moreover, fluorescamine made it unnecessary to separate SMX from the interference. Consequently, it was a time-saving, low-cost, and easy-operation method, which demonstrated the potential of in-syringe SPE as a promising candidate for on-site analysis.


Assuntos
Sulfametoxazol/análise , Animais , Galinhas , Cromatografia Líquida de Alta Pressão , Análise de Alimentos , Leite/química , Óvulo/química , Soro/química , Extração em Fase Sólida/instrumentação , Espectrometria de Fluorescência , Seringas , Fatores de Tempo
9.
Int J Pharm Compd ; 24(2): 156-162, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32196478

RESUMO

Intrathecal analgesia is a method using various molecules alone or in combination. Among these, a preparation of sufentanil-ropivacaine-baclofen is widely used. Instead of moving patients to the few expert centers taking charge of these specific preparations, it could be beneficial to transport syringes to peripheral centers who manage pump refills. The objective of this study was to determine the physicochemical compatibility and stability of a preparation of sufentanil, ropivacaine, and baclofen in polypropylene syringes. Drugs were mixed together at different concentrations and stored with light protection at 5°C ± 3°C and 25°C ± 2°C. The stabilities were determined by visual inspection, turbidity, pH measurement, and ultra-high-pressure liquid chromatography assay of drug concentrations. The concentrations of ropivacaine, baclofen, and sufentanil were stable after 7 days at 5°C ± 3°C and no degradation of product appeared. The drug mixtures were clear in appearance and no color change or precipitation was observed. Throughout this period, the absorbance and the pH value of samples remained stable. The preparations of sufentanil, baclofen, and ropivacaine remained stable for at least 7 days when stored in polypropylene syringes at 5°C ± 3°C.


Assuntos
Analgesia , Baclofeno/química , Polipropilenos/química , Ropivacaina/química , Sufentanil , Cromatografia Líquida de Alta Pressão , Estabilidade de Medicamentos , Humanos , Sufentanil/química , Seringas
10.
Mayo Clin Proc ; 95(2): 216-217, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32029078
11.
Int J Pharm Compd ; 24(1): 64-68, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32023217

RESUMO

In order to avoid fluid overload, more concentrated drug solutions in intensive care units are commonly used. This study evaluated the physicochemical stability of concentrated solution of isosorbide dinitrate in polypropylene syringes during 28 days at 5°C ± 3°C with protection from light. Five syringes of 50 mL, containing 0.60 mg/mL of isosorbide dinitrate in sodium chloride 0.9% were prepared and stored at 5°C ± 3°C with protection from light during 28 days. Immediately after preparation and periodically during the storage, isosorbide dinitrate concentration was measured by an ultra-performance liquid chromatography. Spectrophotometric absorbance at different wavelengths, pH measurements, and microscopic observations were also performed. All solutions were physicochemically stable during the whole period storage at 5°C ± 3°C. No color change, turbidity, precipitation or opacity, significant pH variations, or optic densities were observed in the solutions. Any crystals were seen by microscopic analysis. The concentration of isosorbide dinitrate remained above 90% of the initial concentration during the 28 days of storage. Solutions of isosorbide dinitrate 0.60 mg/mL in syringe of sodium chloride 0.9 % injection can be considered physically and chemically stable for 28 days when stored in syringes at 5°C ± 3°C with protection from light and may be prepared in advance by a centralized intravenous additive service.


Assuntos
Polipropilenos , Seringas , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Unidades de Terapia Intensiva , Dinitrato de Isossorbida
12.
Am J Public Health ; 110(4): 517-519, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32078343

RESUMO

Objectives. To report on the expansion of syringe service programs (SSPs) in the United States from 2015 to 2018.Methods. We obtained data from records of the Buyers' Club of the Dave Purchase Project/North American Syringe Exchange Network (NASEN), including the number of US SSPs and the numbers of sterile syringes purchased by programs. We conducted a subset analysis of states with high numbers of counties defined as "vulnerable" by the Centers for Disease Control and Prevention.Results. SSP participation in the Buyers' Club increased from 141 in 2015 to 292 in 2018, with an increase in syringes purchased from 42 million to 88 million. In addition to these large increases in numbers of programs and in syringes purchased, there were also indications of instability among new programs in vulnerable states.Conclusions. There have been substantial increases in the number of programs established and the number of syringes distributed in response to the opioid epidemic. Ensuring high-quality services in these new programs will be critical to successfully addressing the current epidemic.


Assuntos
Programas de Troca de Agulhas/estatística & dados numéricos , Epidemia de Opioides , Seringas/estatística & dados numéricos , Estados Unidos
14.
Environ Monit Assess ; 192(2): 133, 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31970566

RESUMO

In this study, a new liquid-phase microextraction method termed sieve-conducted two-syringe-based pressurized liquid-phase microextraction (SCTS-PLPME) was developed as a preconcentration tool for indium. Here, two syringes were connected to each other by an apparatus to produce an environment subject to pressure. The pressure created between the two syringes by simultaneous movements of the syringe plungers (to and fro) generated an efficient dispersion and this eliminated the need for dispersive solvents. Determination of indium after preconcentration was carried out with a slotted quartz tube attached flame atomic absorption spectrometer (SQT-FAAS). The detection limit (LOD) and quantification limit (LOQ) of the developed method were calculated as 19.2 and 72.2 µg L-1, respectively. The reliability and accuracy of the developed method was tested by performing recovery studies on lake water spiked at different concentrations and the obtained percent recoveries were between 101.2 and 106.9%.


Assuntos
Microextração em Fase Líquida , Poluentes Químicos da Água , Monitoramento Ambiental , Índio/análise , Limite de Detecção , Microextração em Fase Líquida/métodos , Quartzo , Reprodutibilidade dos Testes , Espectrofotometria Atômica , Seringas , Poluentes Químicos da Água/análise
16.
Talanta ; 209: 120566, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31892018

RESUMO

In this work, a simple device for extraction glutathione (GSH) in biological fluids using a hybrid monolithic material within a polypropylene syringe is developed. For this purpose, glycidyl methacrylate-based monolith was firstly prepared within this housing material, and the polymer was modified with different ligands (ammonia, cysteamine and cystamine). The resulting materials (containing amine or thiol groups, respectively) were then functionalized with gold nanoparticles (AuNPs). The hybrid material that gave the largest AuNPs coverage was selected as solid-phase (SPE) sorbent and several variables affecting the extraction recovery of this compound were investigated. Under optimal conditions, GSH was quantitatively retained at pH 6.0, and then it was desorbed with aqueous dithiothreitol solution and determined, after derivatization with o-phthaldialdehyde, via reversed-phase LC with fluorometric detection. The limit of detection was ca. 1.5 ng mL-1, and the reproducibility between extraction units was below 8% (expressed as relative standard deviation), which demonstrates the robustness of the method. The developed material was also applied for the extraction of GSH in saliva and urine samples yielding recoveries ranging from 86 to 105%.


Assuntos
Glutationa/isolamento & purificação , Ouro/química , Nanopartículas Metálicas/química , Extração em Fase Sólida/métodos , Cromatografia Líquida de Alta Pressão/métodos , Compostos de Epóxi/química , Glutationa/análise , Glutationa/urina , Humanos , Limite de Detecção , Metacrilatos/química , Reprodutibilidade dos Testes , Saliva/química , Seringas
18.
J Neurointerv Surg ; 12(1): 72-76, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31273074

RESUMO

INTRODUCTION: Improved functional outcomes after mechanical thrombectomy for emergent large vessel occlusion depend on expedient reperfusion after clinical presentation. Device technology has improved substantially over the years, and several commercial options exist for both large-bore aspiration catheters and suction pump systems. OBJECTIVE: To compare various vacuum pumps and examine the aspiration forces they generate as well as the force of catheter tip detachment from an artificial thrombus. METHODS: Using an artificial thrombus made from polyvinyl alcohol gel, we tested various mechanical characteristics of commercially available suction pumps, including the Penumbra Jet Engine, Penumbra Max, Stryker Medela AXS, Microvention Gomco, and a 60 cc syringe. Both aspiration pressure and tip force generated were analyzed. Subsequently, a cohort of thrombectomy catheters were assessed using the Penumbra Jet Engine to determine tip forces generated on an artificial thrombus. One-way analysis of variance was used to assess statistical significance. RESULTS: The Penumbra Jet Engine system generated both the highest maximum aspiration pressures (28.8 inches Hg) and the highest tip force (23.68 grams force (gf)) on an artificial thrombus, with statistical significance compared with the other pump systems. Using the Jet Engine, the largest-bore catheter was associated with the highest tip force (32.12 gf). The overall correlation coefficient between catheter inner diameter and tip force was 0.98. CONCLUSIONS: The Penumbra Jet Engine pump generates significantly higher vacuum pressures and tip forces than the other commercially available aspiration pump systems. Furthermore, catheters with a larger inner diameter generate higher tip suction forces on aspiration. Whether these mechanical features lead to improved clinical outcomes is yet to be determined.


Assuntos
Trombectomia/instrumentação , Trombectomia/métodos , Curetagem a Vácuo/instrumentação , Curetagem a Vácuo/métodos , Cateteres , Humanos , Sucção/instrumentação , Sucção/métodos , Seringas , Resultado do Tratamento
19.
J Chromatogr A ; 1609: 460430, 2020 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-31445806

RESUMO

Syringe filters are used to separate solids from liquids prior to analysis of poly- and perfluoroalkyl substances (PFASs). This is a critical step in sample preparation, as losses of PFASs to the filter material can be significant and lead to underestimation. This study evaluated losses of 21 PFASs in three different matrices (methanol, MilliQ water, and water containing 10 mg L-1 dissolved organic carbon (DOC)) to six different types of syringe filter (0.45 and 0.22 µm). Regarding sample matrix, the lowest average ∑21PFAS losses were observed in methanol (13%), followed by DOC water (19%) and MilliQ water (26%). Regarding syringe filter material, the lowest average losses of ∑21PFAS in DOC water and MilliQ water were observed for a recycled cellulose filter (average losses 16% and 21%, respectively), while a polypropylene filter had the lowest ∑21PFAS losses in methanol (9%). A smaller polyethersulfone (PES) filter (0.22 µm, 17 mm Ø) showed significantly (p < 0.05) lower ∑21PFAS losses in DOC water (on average 7.3%) than a larger PES filter (0.45 µm, 37 mm Ø) (23%). In DOC water, losses to the filter increased by 3.8%, 5.1%, and 8.4% per CF2-moiety for C3-C11 perfluoroalkyl carboxylates (PFCAs), perfluoroalkyl sulfonates (PFSAs), and fluorotelomer sulfonic acids (FTSAs), respectively. Comparing different functional groups of PFASs, losses increased as follows: PFCAs < PFSAs < FTSAs < perfluorooctanesulfonamides (FOSAs). Thus, care is needed when including filtration in PFAS analysis, since losses can be significant (up to 100%) depending on the type of syringe filter, target PFAS, and matrix.


Assuntos
Filtração , Fluorcarbonetos/análise , Seringas , Carbono/análise , Compostos Orgânicos/análise , Análise de Componente Principal , Água/análise
20.
World Neurosurg ; 135: 367-374.e1, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31770599

RESUMO

BACKGROUND: Intracerebral hematomas (ICH) is a common disease in the developing countries, and minimally invasive transportal resection of ICH is a widely accepted surgical technique. Many port systems are available, but most are disposable and expensive. We present a safe and cost-effective glove-syringe substitute for endoscopic hematoma evacuation, suitable for developing countries such as China. METHODS: A port substitute of different sizes and lengths was constructed using sterile gloves and syringes, commonly found in a surgical environment. RESULTS: We successfully performed endoscopic hematoma removal in 7 patients including 1 cerebellar hemorrhage case and the remaining 6 supratentorial basal ganglia cases (1 patient taking oral aspirin). Bipolar electrocoagulation was used to control bleeding from the ruptured blood vessels. There were no postsurgical complications. CONCLUSIONS: The glove-syringe port is a convenient, safe, and cost-effective tubular port system for endoscopic surgery of ICH. Such ports can be used as substitutes when commercial sleeves are unavailable, especially in rural areas and developing countries.


Assuntos
Hemorragia dos Gânglios da Base/cirurgia , Doenças Cerebelares/cirurgia , Luvas Cirúrgicas , Neuroendoscopia/instrumentação , Seringas , Idoso , Hemorragia Cerebral/cirurgia , China , Análise Custo-Benefício , Países em Desenvolvimento , Drenagem , Feminino , Hematoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
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