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1.
Int J Pharm Compd ; 23(4): 320-323, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31315083

RESUMO

In some situations, drug solutions in higher concentrations are used in intensive care units. The objective of this study was to evaluate the physicochemical stability of concentrated solutions of valproate sodium in polypropylene syringes during 30 days at 5°C ± 3°C. Five syringes of 40 mL containing 20 mg/mL of sodium valproate in 0.9% sodium chloride were prepared and stored at 5°C ± 3°C during 30 days. Immediately after preparation and periodically during the storage, valproate concentrations were measured by high-performance liquid chromatography. Spectrophotometric absorbance at different wavelengths, pH measurement, and microscopic observations were also performed. All solutions were physically stable during the study period storage at 5°C ± 3°C. No color change, turbidity, precipitation, or opacity at visual observation was noticed. No significant pH variations or optic densities were observed. No crystals were seen by microscopic analysis. Concentrations of valproate remained stable during the period of storage. Solutions of sodium valproate 20 mg/mL in syringes of 0.9% sodium chloride were physically and chemically stable for at least 30 days when stored in syringes at 5°C ± 3°C. These solutions may be prepared in advance by a centralized intravenous additive service.


Assuntos
Polipropilenos/química , Seringas , Ácido Valproico , Cromatografia Líquida de Alta Pressão , Armazenamento de Medicamentos , Unidades de Terapia Intensiva
2.
J Stroke Cerebrovasc Dis ; 28(9): 2574-2579, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31239220

RESUMO

GOALS: While mechanical thrombectomy (MT) has been shown to be effective in the treatment of acute large vessel occlusions, adjunctive measures, such as balloon guide catheters (BGC) and aspiration techniques, are utilized heterogeneously. Clarifying the effects of aspiration applied to the anterior cerebral circulation with proximal flow arrest can shed light on embolic protection during MT. MATERIALS AND METHODS: Manual and pump aspiration were applied through a BGC in a synthetic cerebrovascular model with a 60 ml syringe and a Penumbra pump, respectively. Flow direction was observed during the procedure with fluorescent particles and ultraviolet light. Flow rates were monitored at the simulated internal carotid artery and middle cerebral artery (MCA). FINDINGS: Both aspiration methods produced retrograde flow in all the modeled cerebrovascular segments. In the syringe aspiration methods, an interval phase occurred during the experimental trial in which suction forces paused and MCA flow became anterograde through posterior communication artery collateral circulation. CONCLUSION: Flow patterns vary with different methods of aspiration. With proximal flow arrest, continuous aspiration methods induce constant retrograde flow in all vessels, whereas manual aspiration demonstrates various flow changes, including periods of anterograde flow during the procedure, which may be less effective at distal re-embolization prevention.


Assuntos
Artéria Carótida Interna/fisiopatologia , Circulação Cerebrovascular , Transtornos Cerebrovasculares/terapia , Artéria Cerebral Média/fisiopatologia , Trombectomia/métodos , Velocidade do Fluxo Sanguíneo , Transtornos Cerebrovasculares/fisiopatologia , Humanos , Embolia Intracraniana/etiologia , Embolia Intracraniana/fisiopatologia , Embolia Intracraniana/prevenção & controle , Modelos Anatômicos , Fatores de Risco , Sucção , Seringas , Trombectomia/efeitos adversos , Trombectomia/instrumentação , Fatores de Tempo , Dispositivos de Acesso Vascular
3.
Am J Vet Res ; 80(7): 625-630, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31246126

RESUMO

OBJECTIVE: To determine the amount of negative pressure generated by syringes of various sizes with and without an attached thoracostomy tube and whether composition of thoracostomy tubes altered the negative pressure generated. SAMPLE: Syringes ranging from 1 to 60 mL and 4 thoracostomy tubes of various compositions (1 red rubber catheter, 1 polyvinyl tube, and 2 silicone tubes). PROCEDURES: A syringe or syringe with attached thoracostomy tube was connected to a pneumatic transducer. Each syringe was used to aspirate a volume of air 10 times. Negative pressure generated was measured and compared among the various syringe sizes and various thoracostomy tubes. RESULTS: The negative pressure generated decreased as size of the syringe increased for a fixed volume across syringes. Addition of a thoracostomy tube further decreased the amount of negative pressure. The red rubber catheter resulted in the least amount of negative pressure, followed by the polyvinyl tube and then the silicone tubes. There was no significant difference in negative pressure between the 2 silicone tubes. The smallest amount of negative pressure generated was -74 to -83 mm Hg. CONCLUSIONS AND CLINICAL RELEVANCE: Limited data are available on the negative pressure generated during intermittent evacuation of the thoracic cavity. For the present study, use of a syringe of ≥ 20 mL and application of 1 mL of negative suction volume resulted in in vitro pressures much more negative than the currently recommended pressure of -14.71 mm Hg for continuous suction. Additional in vitro or cadaveric studies are needed.


Assuntos
Tubos Torácicos/veterinária , Pressão , Sucção/veterinária , Seringas/veterinária , Toracostomia/veterinária , Técnicas In Vitro , Estudos Prospectivos , Sucção/métodos , Toracostomia/métodos
4.
Int J Pharm Compd ; 23(2): 163-166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31085782

RESUMO

In some emergency clinical situations, the injection of a more concentrated drug solution in the intensive care units is common. The purpose of this study was to evaluate the physicochemical stability of concentrated solutions of amiodarone hydrochloride in polypropylene syringes during 28 days of storage at 5°C ± 3°C, with protection from light. Five syringes of 50 mL, containing 25 mg/mL of amiodarone in dextrose 5%, were prepared and stored at 5°C ± 3°C with protection from light during 28 days. Immediately after preparation and periodically during the storage, amiodarone hydrochloride concentrations were measured by ultra-performance liquid chromatography. Spectrophotometric absorbance at different wavelengths, pH measurement, and microscopic observations were also performed. All solutions were physicochemically stable during the study period when stored at 5°C ± 3°C. No color change, turbidity, precipitation, opacity, significant pH variations, or optic densities were observed in the solutions. No crystals were seen by microscopic analysis. The concentration of amiodarone did not decrease during the 28 days of storage. Solutions of amiodarone 25 mg/mL in syringes of dextrose 5% are physically and chemically stable for at least 28 days when stored in syringes at 5°C ± 3°C with protection from light and may be prepared in advanced by a centralized intravenous additive service.


Assuntos
Amiodarona , Estabilidade de Medicamentos , Cromatografia Líquida de Alta Pressão , Armazenamento de Medicamentos , Unidades de Terapia Intensiva , Seringas
6.
Drug Deliv ; 26(1): 384-392, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30905213

RESUMO

Biologic drugs (e.g. anti-tumor necrosis factors) are effective treatments for multiple chronic inflammatory diseases including rheumatoid arthritis, axial spondyloarthritis, and psoriatic arthritis. Administration of biologic drugs is usually via subcutaneous self-injection, which provides many patient benefits compared to infusions including increased flexibility, reduced costs, and reduced caregiver burden. However, it is also associated with challenges such as needle phobia, patient treatment misconceptions and incorrect drug administration, and can be impacted by dexterity problems. Evidence suggests these problems, along with other drug administration challenges (e.g. patient forgetfulness, busy lifestyles, and polypharmacy), can reduce patient adherence to treatment. To combat these challenges, patient feedback has been used to develop a range of self-injection devices, including pre-filled syringes, pre-filled pens, and electronic injection devices. Providing different devices for drug administration gives patients the opportunity to choose a device that addresses the challenges they face as an individual. Research suggests involving patients in medical device development, providing patients with a choice of devices and enrolling individuals in patient support programs can empower patients to take control of their treatment journey. By providing a portfolio of self-injection devices, designed based on patient needs, patient experience will improve, potentially improving adherence and hence, long-term treatment outcomes.


Assuntos
Antirreumáticos/administração & dosagem , Produtos Biológicos/administração & dosagem , Doenças Reumáticas/tratamento farmacológico , Animais , Desenho de Equipamento , Humanos , Injeções Subcutâneas , Adesão à Medicação , Autoadministração , Seringas
8.
J Endod ; 45(4): 387-393.e2, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30833095

RESUMO

INTRODUCTION: This systematic review and meta-analysis aimed to assess whether machine-assisted agitation resulted in less postoperative pain (PP) compared with syringe irrigation with needle alone in adult patients undergoing root canal treatment. METHODS: A literature search was performed in 3 electronic databases for articles published before August 2018. Randomized clinical trials published in English that compared PP between machine-assisted agitation and syringe irrigation with needles as part of nonsurgical root canal treatment were included. Two authors were independently involved in the article selection process, data extraction, and assessment of the quality of included studies using the revised Cochrane risk of bias tool. The pooled effect estimates of the standardized mean difference (SMD) between machine-assisted agitation and syringe irrigation with needle was calculated by a random effects-modeled meta-analysis. A subgroup meta-analysis was performed. The quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development and Evaluations approach. RESULTS: Six studies were included for systematic review. Meta-analysis was performed using 3 studies and showed that machine-assisted agitation resulted in less PP compared with syringe irrigation with needle at 24 hours (SMD = -0.73; 95% confidence interval, -1.04 to -0.42; I2 = 30.6%) and 48 hours (SMD = -0.60; 95% CI, -0.85 to -0.35; I2 = 0%). The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the PP outcomes (24 hours and 48 hours) was graded as "moderate" quality. CONCLUSIONS: Machine-assisted agitation reduced PP compared with syringe irrigation with needles in nonsurgical root canal treatment. Future clinical trials are needed to support the result of this review.


Assuntos
Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Irrigantes do Canal Radicular/administração & dosagem , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular , Irrigação Terapêutica/instrumentação , Irrigação Terapêutica/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Bibliográficas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas , Seringas , Adulto Jovem
9.
Drug Alcohol Depend ; 197: 108-114, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30802734

RESUMO

BACKGROUND: Effective targeting of harm reduction programs for people who inject drugs (PWID) requires timely and robust estimates of the size of this population. This study estimated the number of people who inject drugs on a regular basis in Australia, calculated syringe coverage per person and the proportion of their injections covered by a sterile needle and syringe. METHODS: We used trends in indicators of injection drug use to extend the 2005 estimate of the population of people who regularly inject drugs from 2005 to 2016. Included indicators were lifetime/recent injection of illicit drugs, drug-related arrests, drug-related seizures, accidental deaths due to opioids, opioid-related hospital admissions/separations and new diagnoses of hepatitis C virus infection among those aged 15-24 years. Syringe distribution and frequency of injection data were used to assess syringe coverage per PWID and the proportion of their injections covered by a sterile syringe. RESULTS: The estimated number of people who regularly inject drugs in Australia increased by 7%, from 72,000 in 2005 to 77,270 in 2016. The annual number of syringes distributed per person increased 34%, from 470 syringes in 2005 to 640 syringes in 2016. Syringe coverage per injection first exceeded 100% in Australia in 2013. CONCLUSIONS: Despite Australia's high syringe coverage by international standards, the number of syringes distributed is likely to be only narrowly meeting demand. It is critical that needle syringe programs be provided with sufficient resources to continue their role as the key intervention required to prevent HIV and HCV transmission among PWID.


Assuntos
Programas de Troca de Agulhas/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Seringas/estatística & dados numéricos , Adolescente , Austrália/epidemiologia , Feminino , Hepacivirus , Hepatite C/epidemiologia , Humanos , Masculino , Agulhas/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Seringas/efeitos adversos , Adulto Jovem
10.
J Clin Pharm Ther ; 44(3): 463-470, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30763471

RESUMO

WHAT IS KNOWN AND OBJECTIVE: The International Organization for Standardization (ISO) created enteral device specifications to reduce tubing misconnections. The Global Enteral Device Supplier Association (GEDSA) supports a female design: standard and low dose tip (LDT). Concerns include increased complexity of use with adapters, dosing accuracy and workflow. No peer-reviewed studies have evaluated dosing accuracy of the complete female system with adapters. The objective of this study was to compare dosing accuracy of the female design to legacy syringes. METHODS: An in vitro study was conducted at the University of Florida College of Pharmacy pharmaceutics laboratory. Assessments were completed for syringe size, dispense methods and volumes, and adapters when applicable. A gravimetric scale and specific gravity were used to calculate administration volumes. The primary outcome was frequency administration volume exceeded 10% expected amount. RESULTS AND DISCUSSION: A total of 576 tests were performed. The LDT resulted in significantly higher rates of unacceptable dosing variance compared to legacy (21.2% vs 7.4%, P = 0.003). Variance exceeding 10% occurred more frequently with LDT 0.5 and 1 mL syringes, medication cup dispensing (liquid or tablet) and inappropriate LDT adapter use. Unapproved adapter processes compared to FDA-approved processes held a higher likelihood of unacceptable dosing variance (28% vs 7.4%, P < 0.001). FDA-approved use of adapters with prefilled syringes compared to bedside administration may result in higher rates of dosing inaccuracy (18.8% vs 5.6%, P = 0.06). WHAT IS NEW AND CONCLUSIONS: This study raises clinical concerns of dosing inaccuracies with the LDT syringes, particularly with 0.5 and 1 mL sizes. The use of adapters significantly increases the opportunity for inaccurate dosing.


Assuntos
Seringas/normas , Feminino , Humanos , Masculino , Erros de Medicação/prevenção & controle
11.
Ann Pharm Fr ; 77(3): 212-221, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30803767

RESUMO

OBJECTIVES: Norepinephrine is usually used in emergency situations such as in intensive care units (ICUs) for the restoration of blood pressure. The objective was to study the stability of highly-concentrated solutions of norepinephrine at 0.50mg/mL and 1.16mg/mL, diluted in glucose 5% (G5%) in polypropylene syringes, protected or not from light, up to 48h. MATERIALS AND METHODS: Chemical stability was analysed by high-performance liquid chromatography coupled to photodiode array detection at each time of the analysis. The method was validated according to the International Conference on Harmonisation Q2(R1). Physical stability was evaluated by visual and subvisual inspection. Three syringes for each condition were prepared. At each time of the analysis, three samples were analysed for each syringe. pH values were evaluated at each moment of the analysis. RESULTS: Solutions of norepinephrine at 0.50 and 1.16mg/mL, diluted in G5%, with or without protection from light, retained more than 95.0% of the initial concentration after a 48-hour storage at 20-25°C. No visual and subvisual modification occured during the stability study. No degradation product appearing during the stressed degradation was observed during the study but an additional peak with a relative retention at 0.66 was observed and constant. This peak was identified as 5-hydroxymethylfurfural, a degradation product of glucose. CONCLUSION: Norepinephrine diluted in G5% at 0.50mg/mL and 1.16mg/mL was physically and chemically stable over a period of 48hours at room temperature. These stability data of highly concentrated solutions provide additional knowledge to assist intensive care services in daily practice.


Assuntos
Unidades de Terapia Intensiva/estatística & dados numéricos , Norepinefrina/análise , Vasoconstritores/análise , Cromatografia Líquida de Alta Pressão , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Furaldeído/análogos & derivados , Furaldeído/análise , Concentração de Íons de Hidrogênio , Luz , Norepinefrina/administração & dosagem , Polipropilenos , Reprodutibilidade dos Testes , Seringas , Temperatura Ambiente , Vasoconstritores/administração & dosagem
13.
J Sep Sci ; 42(9): 1768-1776, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30809926

RESUMO

A homogeneous liquid-liquid extraction performed in narrow tube coupled to in-syringe-dispersive liquid-liquid microextraction based on deep eutectic solvent has been developed for the extraction of six herbicides from tea samples. In this method, sodium chloride as a separation agent is filled into the narrow tube and the tea sample is placed on top of the salt. Then a mixture of deionized water and deep eutectic solvent (water miscible) is passed through the tube. In this procedure, the deep eutectic solvent is realized as tiny droplets in contact with salt. By passing the droplets from the tea layer placed on the salt layer, the analytes are extracted into them. After collecting the solvent as separated layer, it is mixed with another deep eutectic solvent (choline chloride/butyric acid) and the mixture is dispersed into deionized water placed in a syringe. After adding acetonitrile to break up the cloudy state, the collected organic phase is injected into gas chromatography-mass spectrometry. Under optimal conditions, limits of detection and quantification in the ranges of 2.6-8.4 and 9.7-29 ng/kg, respectively, were obtained. The extraction recoveries and enrichment factors in the ranges of 70-89% and 350-445 were obtained, respectively.


Assuntos
Herbicidas/isolamento & purificação , Microextração em Fase Líquida/métodos , Extração Líquido-Líquido/métodos , Chá/química , Contaminação de Alimentos/análise , Cromatografia Gasosa-Espectrometria de Massas , Herbicidas/química , Microextração em Fase Líquida/instrumentação , Extração Líquido-Líquido/instrumentação , Seringas
15.
Anal Chim Acta ; 1055: 44-55, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-30782369

RESUMO

Chemical isotope labelling in combination with high-performance liquid chromatography-tandem mass spectrometry (CIL-HPLC-MS/MS) is a powerful method for quantitative profiling of targeted molecules. In the current work, we successfully developed a novel CIL-HPLC-MS/MS method for quantitative profiling of residual organophosphorus thioester pesticides (OPTPs) in agricultural products through the determination of the cleavage products of thiol (CP-thiol) compounds. In this method, we synthesized a novel pair of CIL reagents, i.e., N-(4-(carbazole-9-yl)-phenyl)-N-maleimide (NCPM-d0) and its deuterated analogue NCPM-d2, both of which contain a maleimide moiety as the reactive group and an isotope tag to sensitively label CP-thiol compounds. NCPM-d0 was used to label CP-thiol compounds cleaved from OPTPs in the investigated agricultural product samples, and NCPM-d2 was used to label CP-thiol compounds cleaved from OPTPs in the standard substance-spiked organic agricultural product samples. The heavily labelled derivatives were used as the internal standards (ISs) to compensate for the matrix effects during MS analysis. The NCPM-d0- and NCPM-d2-labelled derivatives generated two characteristic product ions (PIs) at m/z 372.5 and 374.5 under collision induced dissociation, respectively, which are used to establish the multiple reaction monitoring (MRM) mode-based detection. The precursor ions of NCPM-d0 and NCPM-d2 labelled derivatives of CP-thiol compounds were deduced according to the structures of the OPTPs. The peak pairs with a fixed mass difference and similar retention times were assigned as potential CP-thiol candidates for the identification of the corresponding OPTPs. Using the proposed method, we successfully determined seven residual OPTPs in agricultural product samples. Taken together, the presented method was demonstrated to be a promising new technique in the quantitation of OPTPs in agricultural product samples with high reliability.


Assuntos
Agricultura , Cromatografia Líquida de Alta Pressão/instrumentação , Ésteres/química , Compostos Organofosforados/análise , Compostos Organofosforados/química , Seringas , Espectrometria de Massas em Tandem/instrumentação , Marcação por Isótopo , Resíduos de Praguicidas/análise , Resíduos de Praguicidas/química , Reprodutibilidade dos Testes , Compostos de Sulfidrila/química
16.
Am J Health Syst Pharm ; 76(Supplement_1): S28-S33, 2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30689695

RESUMO

Purpose: The implementation of a commercially available, Web-based, barcode-enabled workflow management system for filling and checking patient-specific oral syringes at the Cleveland Clinic is described. Summary: Historically, the process for preparing oral syringes has been a manual, repetitive procedure at Cleveland Clinic. Within this process, paper logs are the sole source of information. These logs can be difficult to locate or interpret. It remains a rote process with numerous manual steps offering opportunity for human error. Traditionally, automation, such as barcode scanning, has not been available during oral syringe preparation and checking. Based on increasing regulatory demands and documentation gaps identified, solutions were explored in the pharmacy's nonsterile compounding environment. An electronic verification workflow system was developed, implemented, and evaluated with a focused assessment of throughput and patient safety relative to oral syringe preparation. This was a retrospective study conducted in an academic, tertiary, acute care medical center. Analysis was completed at 3 months to evaluate efficiencies. Data regarding experiences at the Cleveland Clinic shows promising benefits with regards to United States Pharmacopeia chapter 795 compliance, the pursuit of incorporating advanced informatics and automation in manual processes, and standardization of workflow within an enterprise setting. Conclusion: Implementation of an electronic workflow verification system that integrates barcode verification and image-capture capabilities has maintained regulatory compliance in the nonsterile compounding environment including preparation of oral syringe doses without impacting throughput.


Assuntos
Serviço de Farmácia Hospitalar/organização & administração , Seringas , Fluxo de Trabalho , Administração Oral , Humanos , Sistemas de Registro de Ordens Médicas/organização & administração
17.
Mikrochim Acta ; 186(2): 57, 2019 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-30617909

RESUMO

Disposable syringes were used in a novel point-of-care visual test for detecting pathogenic bacteria (Escherichia coli O157:H7 and Salmonella typhimurium). Hybrid nanoflowers composed of platinum nanoparticles and concanavalin A (Pt-nanoflowers) were prepared through a one-pot reaction and were found to be viable catalase mimics. They catalyze the decomposition of hydrogen peroxide (H2O2) to generate O2. When used as labels in immunoassays, they integrate both the functions of biological recognition and signal amplification. The disposable syringe pressure readout was combined with Pt-nanoflower signal conversion and successfully applied to a visual bacteria detection scheme. Both Escherichia coli O157:H7 and Salmonella typhimurium can be quantified with detection limits of as low as 15 and 7 CFU·mL-1, respectively. Graphical abstract One-pot synthetic platinum nanoparticle (PtNP)-concanavalin A hybrid nanoflowers (Pt-nanoflowers), have been used as ideal signal labels for immunoassays and integrating both essential functions of biological recognition and signal amplification. Disposable syringes were used as a readout to detect pathogenic bacteria.


Assuntos
Escherichia coli O157/isolamento & purificação , Peróxido de Hidrogênio/química , Imunoensaio/métodos , Nanopartículas Metálicas/química , Salmonella typhimurium/isolamento & purificação , Seringas , Animais , Anticorpos/imunologia , Concanavalina A/química , Escherichia coli O157/química , Escherichia coli O157/imunologia , Microbiologia de Alimentos/instrumentação , Microbiologia de Alimentos/métodos , Imunoensaio/instrumentação , Limite de Detecção , Leite/microbiologia , Platina/química , Pressão , Salmonella typhimurium/química , Salmonella typhimurium/imunologia
18.
Drug Alcohol Depend ; 195: 40-44, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30580202

RESUMO

BACKGROUND: People who inject image and performance enhancing drugs (IPEDs) are often the largest group using needle and syringe programmes (NSPs) in the UK. NSP providers report these clients repeatedly collecting large amounts of equipment for others. The extent of secondary distribution of injecting equipment is unknown. METHODS: Data from national surveillance of people injecting IPEDs were used. Participants completed a questionnaire and provided a dried-blood spot sample. Data from two biennial surveys was combined; repeat participants were excluded. Self-reported data was used to explore the extent of secondary distribution. RESULTS: Of the participants, 87% (467) reported NSP use; median age was 31 years; 98% were male. A third (34%, 157) reported collecting equipment for others. Of those collecting for others, 154 reported how many people they had collected for: 55% had collected for one person, 27% for 2-9 people, 5% for 10-19 and 13% for 20 or more (no difference by psychoactive drug use). Those vaccinated for hepatitis B were more likely (22% [15/68] vs 6% [5/86], p = 0.003), and those reporting redness/swelling at an injection site were less likely to collect equipment for at least 20 others (8% [8/106] vs 25% [12/48], p = 0.003). Overall, 154 people collected equipment for 639-1569 people injecting IPEDs. CONCLUSIONS: Secondary distribution of injecting equipment is common among those injecting IPEDs and using NSPs. Whilst not allowing for rotational collection within groups, our analysis suggests that many of those injecting IPEDs are not in direct contact with NSPs. Innovation approaches for harm reduction interventions are needed.


Assuntos
Imagem Corporal , Programas de Troca de Agulhas/métodos , Substâncias para Melhoria do Desempenho/administração & dosagem , Abuso de Substâncias por Via Intravenosa/epidemiologia , Seringas , Adulto , Imagem Corporal/psicologia , Estudos Transversais , Inglaterra/epidemiologia , Feminino , Redução do Dano , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Hepatite B/psicologia , Humanos , Masculino , Programas de Troca de Agulhas/normas , Substâncias para Melhoria do Desempenho/efeitos adversos , Abuso de Substâncias por Via Intravenosa/psicologia , Abuso de Substâncias por Via Intravenosa/terapia , Inquéritos e Questionários , Seringas/normas , País de Gales/epidemiologia
19.
Lab Chip ; 19(2): 214-222, 2019 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30534798

RESUMO

Precise, portable, low-cost sample injection is strongly demanded for use in point-of-care testing devices in resource-poor settings; however, current microfluidic sample injection techniques are often expensive, bulky and electricity-powered. To address this issue, we propose a novel syringe flow-stabilizer for hand-powered, precise, continuous-flow microfluidic sample injection. Our syringe flow-stabilizer applies the principle of passive flow-resistance compensation to stabilize the unstable sample flow and has the special advantages of easy-to-use, simple structure, low cost and high stability. The flow stabilizing performance of the stabilizer is characterized via a series of experiments and the results show that our stabilizer is capable of outputting a constant flow rate up to several milliliters per minute under a low threshold pressure. Finally, the fabricated syringe flow-stabilizer is integrated with an inertial microfluidic cell concentrator for high-throughput continuous concentration of trace blood cells from large-volume biofluids. The use of our stabilizer makes the concentration performance totally independent of operation. We envision wide applications of our syringe flow-stabilizer as a hand-powered sample injection unit in various point-of-care testing devices in resource-poor settings.


Assuntos
Técnicas Analíticas Microfluídicas/instrumentação , Técnicas Analíticas Microfluídicas/métodos , Seringas , Análise Química do Sangue , Desenho de Equipamento , Mãos/fisiologia , Humanos
20.
Anaesthesia ; 74(1): 64-68, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30133695

RESUMO

Alongside ultrasonic visualisation, measurement of injection pressure is an effective tool for reducing the risk of intraneural injection during peripheral nerve block. The aim of this study was to compare injection pressure profiles when measured along the injection line with the pressure measured directly at the needle tip using different rates of injection. A syringe pump delivered a 5-ml injection of saline into silicone gel at three different speeds (5 ml.min-1 , 10 ml.min-1 and 15 ml.min-1 ). Fibreoptic pressure sensors recorded real-time pressure profiles of the injection pressure directly at the needle tip and along the injection line. A total of 15 injections were successfully performed, five for each injection rate, totalling 30 recorded pressure profiles. More rapid rates of injection caused peak pressure measured in-line to increase, whereas pressure measured at the needle tip remained constant (mean (SD) pressure in-line 30.76 (3.45) kPa vs. 72.25 (1.55) kPa and mean (SD) pressure at needle tip 19.92 (1.22) kPa vs. 20.93 (2.66) kPa at 5 ml.min-1 and 15 ml.min-1 , respectively). Injection pressure profiles showed that in-line pressure measurement failed to record precise real-time pressure changes occurring at the needle tip (mean (95%CI) pressure difference 10.8 (6.98-14.70) kPa vs. 51.2 (47.52-54.89) kPa for in-line and needle-tip measures, respectively). We conclude that, in order to accurately monitor the true injection pressure generated, independent from operator and injection parameters, measurement at the needle tip is necessary, as injection pressure measured along the injection line is an unreliable surrogate.


Assuntos
Injeções , Agulhas , Pressão , Géis , Bombas de Infusão , Manometria , Bloqueio Nervoso/efeitos adversos , Bloqueio Nervoso/métodos , Seringas
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