Empty Vials Research Articles

SUICIDE WITH REMIFENTANIL AND MIDAZOLAM : A CASE REPORT

Background : Remifentanil (Ultiva®) is a recently introduced esterase-metabolized potent opioid (EMO) μ-receptor agonist with a rapid onset and offset of action for use as part of general anaesthesia in association with isoflurane or propofol or with midazolam (Dormicum®) and in combination with mivacurium.Case Report : A nurse from the anaesthesiology department of a hospital was found dead at home with a syringe and empty vials of Ultiva® (2 mg) and of Dormicum ® (1 mg/mL). At autopsy several injection sites were found on her body.Usual toxicology screening operated in our laboratory revealed only the presence of benzodiazepines in blood. Regarding the case history, we decided to adapt a method specially designed for remifentanil and its inactive metabolite testing. The analytes were isolated by SPE on a Clean-Screen column. After silylation with BSTFA with 1% TMCS, the analytes were detected by GC/MS-EI operating in the SIM mode. No Remifentanil could be detected, whereas the metabolite of remifentanil GR90291 was determined in femoral blood, liver, kidney and lung. Furthermore, midazolam could be detected in femoral and cardiac blood. Hair analysis of a segment of 5 cm revealed the presence of diazepam and midazolam, whereas neither remifentanil nor its metabolite could be detected.

Supercritical fluid extraction of fat from ground beef: effects of water on gravimetric and GC-FAME fat determinations.

This study investigated the supercritical carbon dioxide (SC-CO(2)) extraction of fat from ground beef and the effects of several factors on the gravimetric determination of fat. The use of ethanol modifier with the SC-CO(2) was not necessary for efficient fat extraction; however, the ethanol did increase the coextraction of water. This coextraction of water caused a significant overestimation of gravimetric fat. Oven-drying ground beef samples prior to extraction inhibited the subsequent extraction of fat, whereas oven-drying the extract after collection decreased the subsequent gas chromatographic fatty acid methyl ester (GC-FAME) fat determination. None of the drying agents tested were able to completely prevent the coextraction of water, and silica gel and molecular sieves inhibited the complete extraction of fat. Measurements of collection vial mass indicated that CO(2) extraction/collection causes an initial increase in mass due to the density of CO(2) (relative to displaced air) followed by a decrease in vial mass due to the removal of adsorbed water from the collection vial. Microwave-drying of the empty collection vials removes approximately 3 mg of adsorbed water, approximately 15-20 min is required for readsorption of the displaced water. For collection vials containing collected fat, microwave-drying effectively removed coextracted water, and the vials reached equilibration after approximately 10-15 min. Silanizing collection vials did not significantly affect weight loss during microwave-drying. SC-CO(2) can be used to accurately determine fat gravimetrically for ground beef, and the presented method can also be followed by GC-FAME analysis to provide specific fatty acid information as well.

Serratia liquefaciens bloodstream infections from contamination of epoetin alfa at a hemodialysis center.

In a one month period, 10 Serratia liquefaciens bloodstream infections and 6 pyrogenic reactions occurred in outpatients at a hemodialysis center. We performed a cohort study of all hemodialysis sessions on days that staff members reported S. liquefaciens bloodstream infections or pyrogenic reactions. We reviewed procedures and cultured samples of water, medications, soaps, and hand lotions and swabs from the hands of personnel. We analyzed 208 sessions involving 48 patients. In 12 sessions, patients had S. liquefaciens bloodstream infections, and in 8, patients had pyrogenic reactions without bloodstream infection. Sessions with infections or reactions were associated with higher median doses of epoetin alfa than the 188 other sessions (6500 vs. 4000 U, P=0.03) and were more common during afternoon or evening shifts than morning shifts (P=0.03). Sessions with infections or reactions were associated with doses of epoetin alfa of more than 4000 U (multivariate odds ratio, 4.0; 95 percent confidence interval, 1.3 to 12.3). A review of procedures revealed that preservative-free, single-use vials of epoetin alfa were punctured multiple times, and residual epoetin alfa from multiple vials was pooled and administered to patients. S. liquefaciens was isolated from pooled epoetin alfa, empty vials of epoetin alfa that had been pooled, antibacterial soap, and hand lotion. All the isolates were identical by pulsed-field gel electrophoresis. After the practice of pooling epoetin alfa was discontinued and the contaminated soap and lotion were replaced, no further S. liquefaciens bloodstream infections or pyrogenic reactions occurred at this hemodialysis facility. Puncturing single-use vials multiple times and pooling preservative-free epoetin alfa caused this outbreak of bloodstream infections in a hemodialysis unit. To prevent similar outbreaks, medical personnel should follow the manufacturer's guidelines for the use of preservative-free medications.

Protein standardization II: Dry mass determination procedure for the determination of the dry mass of a pure protein preparation.

A procedure has been developed for the determination of the dry mass of a pure protein preparation dissolved in one electrolyte. The procedure not only renders the concentration (in g/l), but additionally gives the partial specific volume of the protein (in ml/g). The latter is an important parameter for the characterization of a specific protein. Furthermore, the importance of extensive dialysis against one electrolyte is discussed. For the drying of human serum proteins it is clearly shown that KCl is preferred to NaCl due to its stable temperature curve. By observing the parallel fluctuations in the weight of the empty vials during drying, an average correction factor is introduced, which greatly minimizes these changes. The assay principle is discussed from a mathematical as well as from a practical point of view. A detailed procedure is described and the final results for three primary pure proteins (prealbumin, orosomucoid and transferrin) are presented. Finally, important parameters such as the wavelength of maximum absorbance, the absorption coefficient and the specific refractive increment are discussed and values for the three proteins are presented. When these parameters have been established the future determination of concentration and the characterization of pure protein solutions are greatly facilitated. These procedures were important tools for ascribing mass values for prealbumin, orosomucoid and transferrin to the international reference preparation CRM 470.

Plant cues influence searching behaviour and parasitism in the egg parasitoid Trichogramma nr. brassicae

Abstract.1. The effect of experience of plant cues at emergence on searching behaviour and parasitism was investigated in two strains of Trichogramma nr. brassicae (Hymenoptera: Trichogrammatidae).2. Wasps reared on Sitotroga cereallela were allowed to emerge on a tomato plant or in a vial, with or without food. For one of the strains, females emerging on tomato searched significantly longer on a tomato seedling than females emerging in a vial.3. The experience effect lasted between 1 and 2 days. It involves associating plant stimuli with the remains of the host, because females emerging from their host on a tomato plant had an increased searching response to tomato, but females transferred to the plant immediately after emergence did not.4. The effect of emergence environment on parasitism of the host Helicoverpa punctigera on tomato and lettuce seedlings was tested. Wasps were allowed to emerge on seedlings of tomato or lettuce, or in an empty vial. For one strain, females experienced with tomato at emergence parasitized significantly more hosts on tomato than did females emerging on lettuce or in a vial. Parasitism on lettuce was not influenced by the treatments.

Sharps disposal in the operating room: current clinical practices and costs.

In the evolving medical environment, fiscal constraints on medical practice are becoming the norm. The new days of austerity have revived interest in the economics of medical practice. Economic measures, however, should not impinge on the quality of patient care. Waste disposal, in particular, is an area without any direct patient benefit but which carries both short- and long-term ecological costs. Much of how we dispose of waste is dictated in the United States by the Joint Commission for the Accreditation of Hospital Organization, Occupational Safety and Health Administration, state regulations, and individual hospital protocols. In an attempt to elucidate the waste in waste management, we examined the use of standard operating room sharp boxes. Full sharp boxes from three different operating sites were randomly saved. Boxes were weighed and opened, and contents were separated into appropriate sharps: loose needles, scalpels, syringes with uncapped needles, and other. Weight and volume assessments were performed on the nonsharps. True sharp values were derived from nonsharps data. Less than 50% of the contents were appropriate for sharps disposal, with empty glass vials constituting the greatest percentage by weight of nonsharps material. We believe that encouraging the appropriate use of sharps boxes is a potential source for savings. Sharp boxes were randomly saved from university operating rooms and analyzed for content. The full boxes contained 14% appropriate sharps by weight and <50% appropriate sharps by volume. The largest fraction of nonsharps weight was found to be glass.

Evaporated extracts of samples for pesticide residue analysis simplifies transport from remote places.

The increasing use of pesticides demands a world-wide control of residue levels in food and the environment. However, pesticide residue analysis is challenging and needs both experience and instrumentation. Although much can be done with fairly simple means, many countries with limited resources can only perform certain analyses. Also in technologically more advanced countries, different laboratories may specialize in certain kinds of analyses and there is also a need to confirm results with an exchange of samples between laboratories. There are usually several technical difficulties connected with the transport of pesticide samples, in addition to the risk of transmission of pests and diseases and related customs control; and in many areas of the world transport of pesticide samples is not feasible at all. A way to circumvent these difficulties is presented here. Even if a laboratory lacks the basic requirements to purchase, run and maintain instrumentation to analyze pesticide residues, there are often possibilities to extract the pesticide samples. The extracts are taken to dryness in the presence of a ‘keeper’ substance, and the residues can then be sent in apparently empty glass vials. We have investigated the use of polyethylene glycol as a keeper at harsh conditions, for up to three weeks at 44°C. This was done to find out whether the residues remain in the vials at simulated transport conditions. In all, 64 pesticides were tested and of these 56 substances give recoveries of at least 70% after storage at 44°C for 3 weeks. Thus, according to the results it would be possible to send pesticide samples as evaporated extracts even in a hot climate. In conclusion, the results presented here clearly show that a much simplified method of transfer of samples between laboratories is adequate, which enables monitoring of pesticide residues in any part of the world.

Legislation & Regulation

Investigations have shown that pharmacists' use of child-resistant containers for dispensing prescriptions has been inconsistent. Use of new child-resistant containers when refilling prescription orders, however, has not been studied. for this study, an investigator presented a prescription order for 30 amitriptyline 50-mg tablets to 50 randomly selected pharmacies in Memphis. Approximately three weeks later, the investigator returned the empty prescription vials to the pharmacies for refills.Of the 44 pharmacies that completed the study, 39 (89%) dispensed the original drug in child-resistant containers, and 38 (86%) dispensed the refill in child-resistant containers. Only 29 (66%) refilled prescriptions were placed in new prescription vials, as specified by federal regulation. Chain pharmacies were twice as likely (p < 0.005) to dispense the refills in new containers as were independent pharmacies.

Pharmacists' Use of Safety Caps on Refilled Prescriptions: Despite federal requirements for pharmacists to dispense refills in new containers with child-resistant caps, this study found only 66% did.

Investigations have shown that pharmacists' use of child-resistant containers for dispensing prescriptions has been inconsistent. Use of new child-resistant containers when refilling prescription orders, however, has not been studied. for this study, an investigator presented a prescription order for 30 amitriptyline 50-mg tablets to 50 randomly selected pharmacies in Memphis. Approximately three weeks later, the investigator returned the empty prescription vials to the pharmacies for refills.Of the 44 pharmacies that completed the study, 39 (89%) dispensed the original drug in child-resistant containers, and 38 (86%) dispensed the refill in child-resistant containers. Only 29 (66%) refilled prescriptions were placed in new prescription vials, as specified by federal regulation. Chain pharmacies were twice as likely (p < 0.005) to dispense the refills in new containers as were independent pharmacies.

Solventless collection of analytes by rapid depressurization after static supercritical fluid extraction

A method has been developed to collect analytes from supercritical fluid extraction (SFE) that utilizes no flow restrictor and an empty collection vial. Following static SFE, the analytes are collected by rapidly (3-30 s) depressurizing the CO 2 effluent through a 178-μm i.d. stainless steel tube into a capped screw-top vial. Collection efficiencies of analytes as volatile as n-heptane are quantitative (>95%), and wet samples showed no evidence of restrictor plugging in contrast to the plugging associated with the SFE of wet samples when small i.d. flow restrictors are used

Multiple headspace extraction-capillary gas chromatography (MHE-CGC) for the quantitative determination of volatiles in contaminated soils

A multiple headspace extraction-capillary gas chromatographic method for the quantitative, accurate, and rapid determination of volatiles in multicontaminated soil samples has been developed. A thick film fused silica column has been used and a nine-step multiple headspace extraction (MHE) determination performed. Calibration was achieved by introducing 1 μl of a standard solution of mixed volatiles into empty headspace vials, the presence of the matrix being unnecessary in multiple headspace extraction. Accuracy of determination by MHE-CGC and a simple method employing standard additions have been compared.

Lifespan of the Parasitic Honeybee Mite,Tropilaelaps Clareae, onApis Cerana, DorsataandMellifera

SummaryT. clareae survived in cages with adulees of A. mellifera up to 25 h and with A. cerana up to 27 h. On A. dorsata, the maximum life span was 57 h. In an empty glass vial, the mites lived for 30 h. In similar vials with a pupa of A. mellifera they survived for more than 5 days. Dead T. clareae collected from the A. dorsata experiments showed injuries which were apparently caused by the biting of A. dorsata bees.

Airborne drug levels in a laminar-flow hood

The airborne levels of fluorouracil and cefazolin sodium injections after manipulation of these drug products inside a horizontal laminar-flow hood were measured. The Biotest RCS Centrifugal Air Sampler, generally used to measure microbial levels in air, was adapted with a paper filter to measure drug levels in air. In each of nine trials, five ampuls of fluorouracil were opened in the hood and transferred to empty vials. Likewise, in each of nine trials, 50 vials of cefazolin sodium 1 g were reconstituted and transferred to small-volume i.v. solutions. Drug manipulations were performed between the hood's filter and the Biotest, which was placed inside the hood. Drug collected on the filter in the Biotest was assayed with ultraviolet spectrophotometry after extraction. The range of fluorouracil collected by the Biotest was from 0 to 14 microgram, corresponding to 0-0.07 microgram/liter of sample air. Recovered cefazolin sodium ranged from 28 to 131 microgram, or 0.02-0.11 microgram/liter of sampled air. Following routine manipulation of drug products in a laminar-flow hood, the drug can contaminate, the air flowing over the product.

Make a 'Cartesian Diver'

To the Editor.— A simple, endlessly amusing toy called a cartesian diver, which can be rapidly (2 minutes) and cheaply (no cost at all) made, exquisitely illustrates some fundamental physical principles—resulting in admiration from one's own or others' smaller children with a disproportionate increase in self-esteem. This toy is made from any clear, empty plastic bottle like those used for shampoo or mouth wash and from what to us in medicine is commonplace and worthless, an empty ampule medicine vial. The plastic bottle is filled to overflowing with water. The empty ampule vial is filled about two-thirds full of water so that it just barely floats. The vial is then inverted and placed with the open end down in the filled plastic bottle. The bottle is sealed, and the toy is complete. The action of the toy occurs when the bottle is squeezed from front to back. When this is

Effects of permeability of polyethylene vials in liquid scintillation counting

The effects of the permeability of polyethylene counting vials on the liquid scintillation counting of radioactive materials and channels ratios have been examined. The count rate of toluene-soluble and water-soluble radioactive material dissolved in a suitable scintillation mixture altered by not more than 5 per cent in 4 days. The sample channels ratio altered only slightly or not at all. Changes in external standard channels ratio varied between 3 and 25 per cent in that time, depending on scintillation mixture and temperature of storage. Changes were in all cases greater if vials containing prepared samples were kept at 20°C than if they were kept at 5°C. If n-hexadecane radioactive standard was dispensed into empty polyethylene vials there was a reduction in counting efficiency related to the delay before adding scintillation mixture; the efficiency fell 5 per cent within 2 hr.

Specific death sites in a Drosophila population cage.

More than half the flies that die in a Drosophila melanogaster population cage do so in empty vials if they are provided. Before dying, the flies exhibit characteristic erratic behavior; if placed in uncrowded conditions they are fertile and they live for several weeks. This phenomenon is neither light-dependent nor exclusively age-dependent. Crowding is clearly important.It appears that the healthier flies maintain moving territories, keeping others at a distance and thus minimizing crowding. The others emigrate, in this case into a resourceless chamber, so that socially-induced emigration becomes socially induced death. This physiologically unnecessary death is viewed as a component of an intrinsic population-density-regulating mechanism in Drosophila melanogaster, and presumably in many other organisms that have no fixed territories.

Naloxone for Propoxyphene Overdosage

To the Editor.— Fraser (204:549, 1968) initially advocated narcotic antagonists, nalorphine hydrochloride, and levallorphan tartrate in the treatment of propoxyphene hydrochloride overdosage. Since that time, reported cases of propoxyphene abuse and overdosage have significantly increased. 1-6 A recent discussion of the treatment of propoxyphene overdosage 7 has suggested that the new narcotic antagonist, naloxone, should be the agent of choice in counteracting propoxyphene overdosage. We report two cases of successful reversal of propoxyphene overdosage with naloxone. Case 1.— A 21-year-old man complained of low back pain. Prescriptions for secobarbital, methocarbamol, and propoxyphene were given. One week later, he was found on the floor, unresponsive, with shallow respirations and several empty prescription vials at his side. At the emergency room, the patient was in respiratory arrest. Endotracheal intubation and oxygen therapy were initiated. Naloxone, 0.4 mg, was administered intravenously to the comatose patient who did not respond to pain. Pupils were

Liquid scintillation counting: Determination of background counts of quenched samples using an external standard channels ratio

A Cs-137, 2 mc, external standard has been used to study the effect of quenching and sample volume on background counts. Background calibration curves in which the external standard ratio is plotted against the background counts have been prepared for methyl red, a color quenching agent, and chloroform, a chemical quenching agent. Using these curves, the background counts of some quenched test samples have been estimated to within 5% of the actual background. The reproducibility of the external standard ratios and of the background counts of replicate quenched and unquenched samples, and empty vials, has been determined. For replicate samples (5–13) the standard deviation for the external source ratio is smaller than ±1.0% and for the background counts smaller than 5.0%.

EFFECT OF OVIPOSITION SITES ON EGG PRODUCTION AND LONGEVITY OF TROGODERMA PARABILE (COLEOPTERA: DERMESTIDAE)

AbstractPairs of adults of Trogoderma parabile Beal were held in glass vials and provided with one of seven types of oviposition sites. Among the types of oviposition sites tested, the highest mean egg production was recorded on cotton balls and the lowest in empty glass vials. Egg production was not increased by adding food to vials that contained cotton balls. A suitable oviposition site, which provided crevices for insertion of the ovipositor, was more important than food in stimulating egg production. Non-ovipositing females lived longer than productive females on the various oviposition media. Adults fed, but did not require food to lay eggs. Mated females laid practically the same number of eggs during the oviposition period whether or not males were present.

A plastic scintillator method for the radioassay of H 3- and C 14-labelled ompounds on filter paper

A simple and efficient technique for the radioassay of H 3- and C 14-labelled ompounds on filter paper is described. The technique onsists in laying a paper tissue soaked in a solution of plastic scintillator in benzene at a oncentration of ∼200 g/l, and placed onto each side of the filter paper supporting the activity. The sample is then held for a few minutes in benzene vapour to prevent premature evaporation of the solvent and dried at a temperature of about 60°C. The dried sample is then placed vertically in an otherwise empty ounting vial and ounted in a onventional Tri-Carb liquid scintillation spectrometer. Efficiencies of about 20 per cent were obtained for tritiated non-polar ompounds, and of about 10 per cent for tritiated polar ompounds. The use of dioxan as a solvent for the plastic scintillator appears to be advantageous when ounting tritiated polar ompounds on filter paper. The assay of C 14-labelled ompounds on filter paper gave exceptionally good results using this technique.