Becton Dickinson Research Articles

Roche IFCC methods for lactate dehydrogenase tested for duplicate errors with Greiner and Becton-Dickinson lithium-heparin and Greiner serum samples.

The new Roche IFCC-recommended method for lactate dehydrogenase (LD) has been reported (1)(2) to produce duplicate errors with Becton Dickinson (BD) lithium-heparin tubes with plasma separators. Separate studies (3) of Sarstedt tubes showed no such errors. To overcome and minimize duplicate errors, Roche has modified the method to incorporate a predilution step. This modified method can be used only on dilutor systems (Modular P and Hitachi 911, 912, and 917), but not on nondilutor systems (Modular D and Hitachi 747 and 902; Roche). We tested the modified method for duplicate errors and tested lithium-heparin tubes (with plasma separator) from another major supplier for duplicate errors. Blood samples were collected in three different tubes: Greiner Vacuette lithium-heparin tubes with plasma separator (prod. no. 455083); Greiner Vacuette serum tubes with plasma separator (prod. no. 455078); and BD Vacutainer PST II lithium-heparin tubes with plasma separator (prod. no. 367377). Three IFCC LD methods were set up on our Modular DP system: the Modular D, the Modular P IFCC method, and the Modular P IFCC modified method with predilution. The two LD methods on the Modular P system …

Influence of catheter, syringe and inclusion of air-fluid columns on the release of embryos in a continuous media in vitro model

The aim of the study was to assess the embryo release dynamics from the embryo transfer (ET) catheter contributed by the catheter components (syringe and cannula), as well as, the use of air-fluid columns and positioning of embryos within the catheter. The variables under consideration were: syringe and catheter configurations, and the location of the loaded embryos within the air-fluid or fluid alone columns. The specifications are described as follows: 1) three 1.0 cc syringes of different plunger design configurations (Becton-Dickinson (BD)=flat, Terumo=conical and Norm-Ject (HSW)=piston-like); 2) three catheters (Frydman 4.5 cm, Frydman-short and Wallace) and; 3) seven types of loading the catheters consisting of incorporating air-fluid or fluid alone and embryo placement within the columns. The air/fluid and embryo positioning combinations (beginning from the tip of the catheter) were: Type A (5 μl fluid/2.5 μl air/5 μl fluid + embryos/2.5 μl air); Type B-D (2.5 μl air/12.5 μl fluid + embryos); and Type E-G (15 μl fluid). Embryos were loaded within the first third of the fluid column in Type B and E; Type C and F embryos were loaded within the second third of the fluid column; and Type D and G embryos were loaded within the last third of the fluid column. In total, 63 combinations were tested and replicated 6 times. The loaded catheter was placed at a specific reference point in a 60 × 15 mm (marked at 0.5 cm intervals on the bottom) culture dish filled with 10 ml of media. The release and dispersion patterns of the embryos and the distance traveled from the tip of the catheter of each embryo was recorded. Syringe and loading type were the most significant variables affecting embryo release and distance traveled. Placing embryos at the first third of the fluid column resulted in the highest distance traveled regardless of the syringe or catheter. When assessing the effects of independent variables alone, it was realized that the most significant effect on embryo release distance was contributed by type of syringe (Norm-Ject>Terumo>BD). No significant differences were observed by comparing the different types of catheters. The findings of this study suggest that the type of syringe and positioning of embryos within the fluid column in the catheter may have a significant effect on the speed of embryo release. Syringes with a conical or piston-like plunger provide less control for the release of embryos resulting in the abrupt propelling of embryos, which could result in damage due to a ricochet/compression effect. Dispersion patterns resulting in embryos released in different directions were also noted for the syringes described above, and especially when air was introduced in the catheter. The incorporation of air may also result in entrapment of embryos after release from the catheter. Our findings suggest the use of syringes with a flat plunger, no air in the catheter, and positioning of the embryos within the proximal or middle of the fluid column in reference to the tip of the catheter.

Ménière’s disease and allergy: allergens and cytokines

The aim of this article is to evaluate the role of allergy in the pathogenesis of Meniere's disease by means of cytokine profiles, allergic parameters and lymphocyte subgroups. A total of 46 patients aged between 26-68 years diagnosed with Meniere's disease between 1993-2002 were recruited to this study. The control group consisted of 46 healthy volunteers who were from the same age group, living in the same region and possessing similar socioeconomic indicators. Lymphocyte subgroups were measured from the peripheral blood by employing Becton Dickinson (BD) monoclonal CD4, CD8, CD23 antibodies. IFN-gamma, IL4, total IgE levels, and specific IgE levels pertaining to tree, fungus, fruit, egg-white, cow's milk, wheat flour, corn flour, beef, and rice allergens, in all seasons, were measured and compared in the patient and control groups. In patient serum samples there were positive correlations between CD23 and IgE, CD8 and IgE, CD4/CD8 and IgE, and CD23 and CD8 (p <0.01). There were negative correlations between IL-4 and IFN-gamma, IFN-gamma and IgE, and a positive correlation between IL-4 and IgE. Total IgE levels were above the normal values in 19/46 (41.3 per cent) of the patient group, but the ratio was nine out of 46 (19.5 per cent) in the control group. A history of allergy was found in 31/46 (67.3 per cent) when the patients were questioned. The ratio of a history of allergy was 16/46 (34.7 per cent) in the control group. When specific IgE levels were evaluated the ratio of patients with all the panels negative was eight out of 46 (17.9 per cent), but it was 31/46 (67.3 per cent) in the control group. This study found that the prevalence of allergy was higher in patients with Meniere's disease than in the control group. Thus the authors suggest that allergy should be taken into account when patients with this disease are treated.

Assessing possible wastage associated with commonly used syringes for drug administration in controlled ovarian stimulation

Objective: During COS for ART many different medications are administered daily by subcutaneous or intramuscular injections. Utilizing the most patient-friendly COS regimen, with oral contraceptive pill pre-treatment, ten days of follicular phase treatment, including one daily dose of rFSH, 4 doses of GnRH antagonist, one dose of hCG and the use of vaginal progesterone, 15 injections will be administered. If GnRH agonist is used for 14–21 days instead of a GnRH antagonist, plus two daily doses of FSH and hMG, plus progesterone in oil, the number of injections is closer to 100. Variables, such as injection technique errors and compliance, are known to affect final treatment outcomes. A variable not widely examined is the precision of drug delivery by the most commonly used syringes. This study was undertaken to determine if there is a true difference between the amount of drug delivered by different brands of syringes, to precisely measure these differences and to detect the origin of these differences. Design: Comparative trial. Materials and Methods: Four syringes were examined from three different suppliers: Becton Dickinson (BD) 3 mL leur-lok, BD and Monoject(r) 1 mL, with detachable 27G × 1/2 inch needle, and Serono/Terumo customized 1 mL syringe with fixed 27G × 1/2 inch needle. Knowing that 1 mL Sterile Water for Injection, USP (SWI) weighs 1 gm, 1 mL SWI was drawn up in each syringe. The 1 mL SWI in each syringe was then expelled into a tube that was weighed before and after receiving the SWI, utilizing a highly sensitive AX204 Mettler Toledo-Sartorius balance. To detect any potential variation, the four syringes were weighed five times under the following three conditions during the trial: (A) syringe + needle, empty, (B) syringe + needle + 1 mL SWI, and (C) syringe + needle after delivering 1 mL SWI, as well as the weight of the SWI collected in the tube receptacle. The mean of these measurements per syringe was calculated. Results: After delivering 1 mL SWI the mean weight of the solution was 0.98 ± 0.02, 0.99 ± 0.005, 1.02 ± 0.015, and 0.99 ± 0.005 gm, for BD 3 mL, BD 1 mL, Monoject 1 mL and Serono/Terumo 1 mL, respectively. Hence, the same amount of solution was delivered by each syringe (mean 0.997 ± 0.002). The differences in the mean weight of the syringes before and after delivering the solution were 0.056 gm for BD 3mL (5.6%), 0.056 gm for BD 1 mL (5.6%), 0.028 gm for Monoject 1 mL (2.8%) and 0.002 gm for Serono/Terumo 1 mL (0.22%). These differences represent the solution that remains in the dead space of the syringe hub and in the cavity of the needle. Tabled 1 Conclusion(s): The results of this trial show that there is minimal variability in the amount of drug delivered by the syringes tested, although the most precise syringe delivering the most consistent dose as measured by Weights A and C was the Serono/Terumo customized syringe.

High-Grade Loss of Leukocytes and Hematopoietic Progenitor Cells Caused by Erythrocyte-Lysing Procedures for Flow Cytometric Analyses

All current-flow cytometric techniques use erythrocyte-lysing procedures before leukocyte analysis. We investigated the impact of four lysing procedures with different flow cytometric techniques on the loss of leukocytes and hematopoietic progenitor cells in blood samples. A total of 280 determinations out of 10 samples were measured by two flow cytometers (FCMs), using a FACS-Calibur (Becton Dickinson) and a particle-analyzing system (PAS) with a "true volumetric unit" (Partec). All samples were prepared with four different commercially available erythrocyte-lysing reagents (n = 10, respectively). CD34(+) cells were determined in relation to counted leukocytes with both FCMs (dual platform determinations, 2-PF). In addition, further immunologic and nuclear staining determinations of cells with and without erythrocyte-lysing procedures were performed in the "true volumetric unit" (single platform mode 1-PF) using the PAS system (n = 10, respectively). In the 2-PF mode, both systems showed identical results for CD34(+) cells (r = 0.997). The comparison of 1-PF and 2-PF modes with immunologic stainings revealed a mean decrease of 34.5% for absolute amounts of CD45(+) cells [in detail: Becton-Dickinson (BD) lysis 40%; Ortho Diagnostics (OD) lysis 31%; Uti lyse (UL) 38%; Cylyse (CL) 29%] and of 41.3% for absolute concentration of CD34(+) cells [in detail: BD lysis 45%; OD lysis 40%; UL lysis 45%; CL lysis 34%] by the lysing procedures. In contrast, the nuclear stainings revealed a mean leukocyte loss of only 5% for the nonlysed samples and of 12% for lysed samples. All investigated lysing procedures induced a large loss of leukocytes and progenitor cells, obviously due to cell membrane destruction as demonstrated for identical samples in the 1-PF and 2-PF modes by immunologic and nuclear staining methods.

The Evolution of Evacuated Blood Collection Tubes

“A laboratory test is no better than the specimen, and the specimen no better than the manner in which it was collected.” So stated the advertising language of BD (Becton Dickinson and Company) to promote the first evacuated blood collection tubes, back in the late 1940s and early 1950s.1 This technology for blood collection, patented in 1949, is substantially similar to the technology pervasive in clinical practice today.

Effects of Blood-Collection Systems and Tubes on Hematologic, Chemical, and Coagulation Tests and on Plasma Hemoglobin

Numerous preanalytical variables may affect the outcome of clinical laboratory tests (1)(2)(3). Blood-collection procedures are considered an important impact factor because they are associated with several possible sampling problems, including the use of a tourniquet with hand-clenching, the site of venipuncture, hemolysis because of venipuncture, and the inappropriate use of sample tubes. In our hospital, two systems are used for venous blood collection: the Becton Dickinson (BD) VacutainerTM system and the Greiner Vacuette® system (Greiner Labortechnik GmbH). The BD product includes a specific blood-collection needle, a holder into which the needle is assembled before phlebotomy, and evacuated blood collection tubes. The Greiner product consists of a sterile holder (Holdex®) with a luer adapter to fit regular needles and evacuated blood collection tubes. The design of the BD needle holder enables direct linear flow of blood from the venipuncture site into the blood collection tubes. The Greiner Holdex was designed with an offset luer adapter to enable a convenient puncture angle. Therefore, the straight path within the Holdex is interrupted twice by angles of 90°, thus forming three consecutive flow segments. These changes in the linear flow of blood might …

Evaluation of AVL988/4 analyzer for measurement of ionized magnesium and ionized calcium

Ionized magnesium (Mg++) and ionized calcium (Ca++) are the physiologically active forms of these elements in the body and their concentrations have clinical value. Though the AVL988/4 instrument that measures concentrations of Mg++ and Ca++ has been evaluated, some clinically important parameters were unknown. In this study, we evaluated AVL988/4 analyzer for measuring Mg++ and Ca++ concentrations and provided the following information: (1) The newly formulated Becton Dickinson (BD) Vacutainer plastic tubes with clot activator and silicone as the stopper lubricant (serial no. 367820) caused a significant high bias for the Mg++ measurement but had no effect on the Ca++ measurement; (2) the optimal conditions for specimen storage were no exposure to air at 4°C for up to 24 h; (3) no significant difference in the results of the Ca++ concentration determined using AVL988/4 or i-STAT; (4) no carryover between samples was found.

Is the direct quantitation of antibiotics in agar by high-performance liquid chromatography useful?

The direct quantification of antibiotics in agar allows one to study the quality of the agar matrix, the kinetics of diffusion and the bacteria–antibiotic interaction. Mueller–Hinton agar (MHA) plates from three manufacturers were tested using HPLC and the disc diffusion test of ceftazidime (CAZ). Notable differences in the chromatographic profiles of MHA plate extracts from OXOID, DID and Becton Dickinson (BD) were shown, with a higher CAZ concentration after 24 h at 6 mm in BD P. aeruginosa inoculated plates (5.1±1.7 μg/ml, n=6) vs. OXOID and DID (1.6±0.3 μg/ml, n=12). BD plates gave also a different inhibition zone diameter (26±0.5 mm, n=3) with respect to DID and OXOID (29±0.5 mm, n=3).

Multicentre study to assess quality of life and glycaemic control of Type 2 diabetic patients treated with insulin compared with oral hypoglycaemic agents

AbstractQuality of life, glycaemic control and frequency of hypoglycaemia were compared in 93 moderate to poorly controlled Type 2 diabetes patients randomly allocated to one of three treatment groups: Group A continued on oral hypoglycaemics, Group B switched to twice‐daily fixed mixture of human insulin using a standard syringe, Group C switched to similar insulin given by a Becton‐Dickinson (B‐D) insulin pen. After 12 weeks patients in Groups B and C were changed to B‐D pen or syringe respectively for a further 12 weeks. Patients in Group A continued on oral hypoglycaemics. At entry, 12 weeks and 24 weeks, subjects completed a ‘well‐being’ and ‘satisfaction with treatment’ questionnaire. At the end of the study, patients in Groups B and C completed an ‘insulin delivery acceptability’ questionnaire.There was no significant difference between scores for the ‘well‐being’ and ‘satisfaction with treatment’ questionnaires but, for those patients on insulin, the ‘insulin delivery acceptability’ questionnaire demonstrated a marked preference in most patients for the pen rather than the syringe as the method of insulin delivery. Patients on insulin showed an improvement overall in HbA1c, with a mean reduction of 1.46% (95% confidence interval–2.76 to −0.16%, p=0.021) compared with tablet treatment, but at the expense of an increased frequency of hypoglycaemia and weight gain.We conclude that in ‘moderately’ controlled Type 2 diabetes there is no significant change in quality of life when patients are switched to insulin, although once on insulin, most prefer an insulin pen to a syringe. The improvement in HbA1c may, however, be of clinical significance given the increasingly powerful evidence associating good diabetes control with reduced risk of long‐term microangiopathic complications.

The strategic human resource management process in practice

Becton Dickinson (BD) is a $2.5 billion medical technology company. Our primary product lines are disposable medical devices such as syringes, needles and scalpels. The other half of the business is diagnostic instruments and systems, ranging from one‐step pregnancy tests to large instrument systems. Fifty‐five percent of our sales are in the U.S., although our international segment is growing much faster than our domestic operations.

A large multicenter evaluation of the becton dickinson HLA-B27 screening system

A large multicenter evaluation of the becton dickinson HLA-B27 screening system