Insulin Syringe Research Articles

A protocol for microbiologically safe preparation, storage, and use of autologous serum eye-drops in low-income countries.

The study aimed to investigate whether the preparation, storage, and use of autologous serum in insulin syringes is microbiologically safe. Blood samples (10 mL) were obtained from 10 volunteers. After centrifugation, the supernatant serum was removed and distributed in 5 sterile insulin syringes for each sample; syringes were numbered 0 to 4 and labelled with the subject's details. Syringes were immediately transported to the microbiology laboratory and stored in a refrigerator at +4°C. The "0" labelled syringes were separated from the others and 100 µl of serum from each syringe was immediately seeded on chocolate and Sabouraud agar plates, which were incubated aerobically at 37°C for 96 hours to detect any bacterial and/or fungal contamination. In the next 4 days, the same procedure was repeated for the remaining syringes: on day 1, the "1" labelled syringes were analyzed; on day 2, the "2" labelled ones, and so on. In a second experiment, blood samples were obtained from 5 different volunteers. The same procedure as above was followed, but each syringe was used for repeated cultures at 2-hour intervals, for a total of 12 cultures/day. The needle was removed and replaced for each inoculation and the syringes were stored in the refrigerator after use. Under these experimental conditions, none of the cultures showed microbial growth. Results suggest that, under the protocol described, preparation, storage and use of undiluted autologous serum in insulin syringes is inexpensive, fast, and microbiologically safe. This is of great importance for low-income countries.

Disinfection of syringes contaminated with hepatitis C virus by rinsing with household products.

Background. Hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is associated with the sharing of injection paraphernalia. People who inject drugs often "disinfect" used syringes with household products when new syringes are unavailable. We assessed the effectiveness of these products in disinfecting HCV-contaminated syringes. Methods. A genotype-2a reporter virus assay was used to assess HCV infectivity in syringes postrinsing. Hepatitis C virus-contaminated 1 mL insulin syringes with fixed needles and 1 mL tuberculin syringes with detachable needles were rinsed with water, Clorox bleach, hydrogen peroxide, ethanol, isopropanol, Lysol, or Dawn Ultra at different concentrations. Syringes were either immediately tested for viable virus or stored at 4°C, 22°C, and 37°C for up to 21 days before viral infectivity was determined. Results. Most products tested reduced HCV infectivity to undetectable levels in insulin syringes. Bleach eliminated HCV infectivity in both syringes. Other disinfectants produced virus recovery ranging from high (5% ethanol, 77% ± 12% HCV-positive syringes) to low (1:800 Dawn Ultra, 7% ± 7% positive syringes) in tuberculin syringes. Conclusions. Household disinfectants tested were more effective in fixed-needle syringes (low residual volume) than in syringes with detachable needles (high residual volume). Bleach was the most effective disinfectant after 1 rinse, whereas other diluted household products required multiple rinses to eliminate HCV. Rinsing with water, 5% ethanol (as in beer), and 20% ethanol (as in fortified wine) was ineffective and should be avoided. Our data suggest that rinsing of syringes with household disinfectants may be an effective tool in preventing HCV transmission in PWID when done properly.

Botulinum toxin for the treatment of hyperfunctional lines of the forehead.

Background:In the 21st century, we live longer and a more active life. However, while our adult longevity continues to extend, society does not welcome a tired and aged appearance. We wish to continue to look as young as possible. Most facial rejuvenation techniques such as surgery and injection of collagen, silicone, or autogenous fat do not address the fact that these lines are functional, i.e. they do not target the cause of hyperfunctional lines: the underlying facial mimetic musculature.Aim:To find the efficacy of Botulinum toxin for the treatment of hyperfunctional lines of the forehead.Materials and Methods:The present study consisted of 25 subjects in the age group of 25–65 years with forehead wrinkles, who visited the Department of Oral and Maxillofacial Surgery, CIDS, Virajpet. The materials used for Botulinum toxin treatment were Botulinum toxin A, a standard freezer, sterile saline solution, alcohol swabs, and insulin syringes with 30 gauge needles.Results:Of the 25 patients, 21 patients showed satisfactory improvement of their hyperfunctional facial lines within 72 h. Maximum improvement was noted in the age group of 25–40 years, while the older age group of 50–65 years showed less improvement. Maximum improvement was seen in type 5 skin, followed by type 4 and type 3 skin. Type 2 skin showed the least improvement.Conclusion:We conclude that Botulinum toxin A is a safe and efficacious method of nonsurgically eliminating hyperfunctional facial lines of the forehead in the aesthetic patient for a period of 4–6 months.

Comparison of Cleaning Efficacy and Instrumentation Time in Primary Molars: Mtwo Rotary Instruments vs. Hand K-Files.

Introduction:Pulpectomy is the preferred treatment for restorable primary teeth with symptomatic irreversible pulpitis or periradicular lesion. Considering the rather new application of rotary files for pulpectomy of primary teeth, the aim of this study was to compare the cleaning efficacy and instrumentation time of hand K-files and Mtwo rotary system for preparation of human primary molars. Methods and Materials:This experimental study was conducted on 100 extracted primary maxillary and mandibular intact molars with no resorption. Access cavities were prepared and India ink was injected into the root canal on a vibrator using an insulin syringe. Canals were then divided into 5 groups (n=20): in group I, canals were instrumented using K-files up to #25 for mesial and buccal canals and #30 for palatal and distal canals. In group II, canals were prepared using Mtwo rotary files (15/0.05, 20/0.06 and 25/0.06 for mesial and buccal canals and 15/0.05, 20/0.06, 25/0.06 and finally 30/0.05 for distal and palatal canals). In group III, root canals were only irrigated with saline. Groups IV and V were the positive and negative control groups, respectively. The time required for cleaning and preparation of the canals for each of the specimens in groups I, II and III was recorded. Results:The mean score of cleanliness of Mtwo was not significantly different from K-file group (P>0.05). However the mean instrumentation time in Mtwo group was significantly shorter (P<0.001).Conclusion:Although there were no differences regarding the cleaning efficacy of either system, Mtwo rotary files were far more time efficient.

Urgent Reimbursement Need for Diabetes Supplies in Blood Glucose Management of Diabetic Patients

To achieve long-term diabetic complication reduction and decrease the health care costs, all diabetic patients must have access to the components of diabetes care modality, such as medications, supplies, and self-management education programs. However, our current government policies for diabetic patients are not sufficient to allow for adequate blood glucose control. Our national insurer does not reimburse for diabetes supplies such as blood glucose testing monitors, blood glucose test strips, lancet devices and lancets, insulin syringes and pen needles, and alcohol swabs. The government officer states that national laws, regulations, executive order, and financial problems prohibit the reimbursement of diabetes supplies. However, to achieve good outcomes and decrease the public burden of medical care costs, all stake holders, health care professionals, and diabetic patients should exert effort to require reimbursement of diabetic supplies.

Preliminary study of intralesional bleomycin injection for the treatment of genital warts.

Preliminary study of intralesional bleomycin injection for the treatment of genital warts.

Intravital Imaging of Pulmonary Neutrophils in Sickle Cell Anemia

Sickle cell disease (SCD) is a genetic disorder usually caused by a homozygous point mutation in the b subunit of hemoglobin. In sickle patients, hemoglobin polymerizes in low oxygen environments, resulting in red cell shape change, increased adhesiveness and fragility. Individuals with SCD experience periodic bouts of painful vaso-occlusive crises (pVOC), generalized damage to most tissues and sometimes life-threatening acute chest syndrome. Although pVOC is triggered by red blood cell sickling, it is associated with an inflammatory response that further reduces blood flow. pVOC is due in part to adhesion of red blood cells to leukocytes and adhesion of red blood cells and leukocytes to the endothelium. Our team has demonstrated that iNKT cells trigger an innate immune response in sickle cell patients. iNKT cells activation is followed by secondary activation of immune cells such as neutrophils and monocytes. We have developed procedures to image neutrophils in the lung, liver and spleen in living mice. In this study we sought to investigate in vivo neutrophil rolling and adherence to endothelial cells that occurs in multiple tissues including the lung during pVOC.To visualize vascular neutrophils in situ we used a Leica SP5 RS confocal/two-photon microscope. The microscope can be operated to a depth of 50-80 µm with resonant scanning in the confocal mode. Mice are anesthetized by intra-peritoneal injection of a mixture ketamine/xylazine in PBS. Anesthesia is maintained during the experiment by applying half-doses periodically. The depth of the anesthesia is verified by paw pinching before starting the surgical dissection and during imaging. Extra care is taken to minimize inflammation that results from invasiveness of the surgery. Before lung imaging mice are tracheostomized to enable mechanical ventilation and the chest is opened to allow for access to the lung left lobe through a window of few millimeters in diameter. Spleen and liver are accessed by a small incision in the abdomen wall. Organs are kept moist with a drop of PBS. A custom built suction device covered with a No 1.5 cover glass 12 mm in diameter (Electron Microscopy Sciences, Hatfield USA) is placed onto the organ of interest. At the same time, minimal working pressure is exerted to seal the organ and the cover glass together. Throughout the procedure, mice are maintained at 37°C by a heating pad. Once surgery is completed, a mixture of antibodies coupled to fluorophores is given by retro-orbital injection using a U-100 28 1/2 gauge BD insulin syringe. At the end of the experiment, mice are sacrificed by cervical dislocation while still anesthetized.To induce vaso-occlusion we have developped a hypoxia/reoxygenation protocol with 8% O2 for 12h followed by 4h of reoxygenation. We quantify the number of adherent and rolling neutrophils and their velocity in sickle Townes mice subjected to hypoxia/reoxygenation compared to normoxic Townes mice. By intravital confocal microscopy experiments we were able to detect a higher number of infiltrating neutrophils in the lung in sickle mice versus littermate controls in the normoxic state. Moreover, the infiltration of neutrophils was increased in sickle mice subjected to hypoxia/reoxygenation. Interstingly, the infiltration of neutrophils noted in sickle Townes mice subjected to hypoxia/reoxygenation is abrogated by prior NKT-14 antibody-mediated depletion of iNKT cells whereas mice treated with isotype control Abs were not affected. Our results agree with prior results suggesting that iNKT cell activation occurs prior to neutrophil infiltration in the lung. Furthermore, intravital imaging experiments allowed us to demonstrate that neutrophil infiltration and NKT cells are involved in vaso-occlusives crises in vivo. Intravital microscopy may be helpful for the evaluation of novel treatments for reducing vaso-occlusive events in SCD. DisclosuresNo relevant conflicts of interest to declare.

What do hemolyzed whole-blood specimens look like? Analysis with a CellaVision DM96 automated image analysis system.

We planned an original study to investigate the morphological changes caused by spurious hemolysis of whole-blood samples, analyzed using an automated image analysis system. Seven whole-blood specimens anticoagulated with EDTA were pooled and divided in two aliquots. The former was left untreated, whereas the latter was subjected to mechanical hemolysis by forced aspiration with an insulin syringe. The complete blood cell count was performed on a Sysmex XE-2100, and the aliquots were then processed with CellaVision DM96. In spuriously hemolyzed samples, the main findings included a rarefaction of erythrocytes, the presence of a remarkable number of cellular debris, a greater degree of microcytosis and anisocytosis, the appearance of band neutrophils, a shift of values between lymphocytes and monocytes, and an increase in smudge cells, artifacts, and large platelets. The results of this study demonstrate for the first time that blood cell morphology may be consistently biased in spuriously hemolyzed whole blood and that the use of an automated image analysis system such as the CellaVision DM96 may be a suitable approach to identify spurious hemolysis in whole-blood specimens.

Repeated reuse of insulin injection syringes and incidence of bacterial contamination among diabetic patients in Jimma University Specialized Hospital, Jimma, Ethiopia

ObjectiveTo determine the level of bacterial contamination of reused insulin syringes among diabetic patients. MethodsA facility based cross sectional study was conducted among diabetic patients. Data on socio-demographic variables, history of injection syringe reuse, and frequency of reuse of syringes were collected using predesigned questionnaire. Finally, the samples from the syringes were cultured according to standard microbiological techniques. ResultsEighteen diabetic patients at Jimma University Hospital participated. A total of 83.3% of participants reused a single injection syringe for >30 consecutive injections, while 16.7%, reused for ≤30 injections. Our results showed 22.2% of syringes were contaminated with methicillin resistant Staphylococcus aureus. ConclusionsWe conclude reuse of syringes is associated with microbial contamination. The findings that 4/18 syringes being contaminated with bacteria is an alarming situation. A mechanism should be designed for patient's to get injection syringes with affordable price. If reusing is not avoidable, reducing number of injections per a single syringe and avoiding needle touching with hand or other non-sterile material may be an alternative to reduce the risk of contamination.

English

&nbsp; Due to low side effects and costs as well as proper adaptation to body&rsquo;s physiology, there is a global trend in using herbal medications. To investigate the analgesic effects of Arum maculatum plant extract in rats via an experimental study, 60 healthy male Wistar rats were divided into 6 equal groups including 3 plant extract groups, a negative control with normal saline and 2 positive control groups with morphine and diclofenac Na injections. Morphine, diclofenac or different dosages of extract were injected subcutaneously into the left sole of rats via insulin syringes. Two hundred microliters of 1% formalin were then subcutaneously injected into the left paw of each rat for pain induction. The duration of the left paw licking was measured just after formalin injection (phase I) and 20 min after the injection (phase II). Finally, the mean duration of paw licks was compared between treatment and control groups. The shortest duration of licks was found in the morphine injected group (30.6 &plusmn;1.9 and 37.2&plusmn;1.1 seconds at phase I and II, respectively). Compared to diclofenac injection, plant extract of 500 and 750 mg/kg reduced the licks duration significantly during both phases (p&lt;0.0001). The lick durations, after the injection of 500 and 750 mg/kg extracts, were almost the same as that in the morphine injected group during phase I, but took longer during phase II. Rats in the 750 mg/kg extract injected group, compared to those in the 500 mg/kg extract injected group, showed a significantly shorter lick duration during phase II (p&lt;0.0001), but not phase I (p=0.708). Following further investigations in human, A. maculatum plant extract can be introduced as a natural and better analgesic substitution for diclofenac Na which has the same effect as morphine during phase I.&nbsp;&nbsp; &nbsp; Key words:&nbsp; Arum maculatum, morphine, diclofenac Na, formalin, Iran.

Stab Wound Injury of the Zebrafish Adult Telencephalon: A Method to Investigate Vertebrate Brain Neurogenesis and Regeneration

Adult zebrafish have an amazing capacity to regenerate their central nervous system after injury. To investigate the cellular response and the molecular mechanisms involved in zebrafish adult central nervous system (CNS) regeneration and repair, we developed a zebrafish model of adult telencephalic injury. In this approach, we manually generate an injury by pushing an insulin syringe needle into the zebrafish adult telencephalon. At different post injury days, fish are sacrificed, their brains are dissected out and stained by immunohistochemistry and/or in situ hybridization (ISH) with appropriate markers to observe cell proliferation, gliogenesis, and neurogenesis. The contralateral unlesioned hemisphere serves as an internal control. This method combined for example with RNA deep sequencing can help to screen for new genes with a role in zebrafish adult telencephalon neurogenesis, regeneration, and repair.

Stab wound injury of the zebrafish adult telencephalon: a method to investigate vertebrate brain neurogenesis and regeneration.

Adult zebrafish have an amazing capacity to regenerate their central nervous system after injury. To investigate the cellular response and the molecular mechanisms involved in zebrafish adult central nervous system (CNS) regeneration and repair, we developed a zebrafish model of adult telencephalic injury.In this approach, we manually generate an injury by pushing an insulin syringe needle into the zebrafish adult telencephalon. At different post injury days, fish are sacrificed, their brains are dissected out and stained by immunohistochemistry and/or in situ hybridization (ISH) with appropriate markers to observe cell proliferation, gliogenesis, and neurogenesis. The contralateral unlesioned hemisphere serves as an internal control. This method combined for example with RNA deep sequencing can help to screen for new genes with a role in zebrafish adult telencephalon neurogenesis, regeneration, and repair.

Development of simple equations for effective screening of spurious hemolysis in whole-blood specimens.

We aimed to identify simple but reliable indices for effective screening of spurious hemolysis in whole-blood specimens. Thirteen inpatient whole-blood samples were divided in two aliquots. The former was left untreated, whereas the latter was mechanically hemolyzed by forced aspiration with an insulin syringe. All aliquots were tested on Siemens Advia 2120 and Sysmex XE-2100. The hemolysis index (HI) was also assessed in centrifuged plasma. The mechanical hemolysis generated a 4-40% decrease in red blood cells (RBCs). A statistically significant decrease was observed for hematocrit (Ht) and mean corpuscular volume (MCV), whereas mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and platelet count were increased. The values of hemoglobin (Hb) and white blood cells remained substantially unchanged. Two specific equations ([Ht/Hb] × √MCV and [Ht/Hb] × 100) were developed. Both equations displayed an area under the curve of ≥0.99 for identifying spurious hemolysis, much greater than that of both RBC ghosts and immature platelet fraction. A highly significant correlation was also observed between results of these equations and percentage reduction in RBCs or HI increase. Provided that these results will be confirmed in further studies, these equations may provide a reliable means for screening spurious hemolysis in whole-blood samples.

LONGITUDINAL COLLECTION OF CEREBROSPINAL FLUID IN RATS: A MINIMALLY INVASIVE METHOD

Cerebrospinal fluid (CSF) levels of Aβ 1-42, total tau and phosphorylated tau are currently acknowledged as biomarkers of Alzheimer's disease (AD) pathophysiology. Advances in genetics allow for the development of transgenic rats harbouring APP mutations. In comparison to transgenic mice, AD transgenic rat models are more suitable for longitudinal studies designs using imaging and fluid biomarkers due to its larger brain and CSF volumes, respectively. Here, we aimed to develop a procedure that allows for longitudinal collection of CSF in rats. McGill-R-Thy1-APP, a model harbouring APP double mutation, and wild-type rats were anesthetized with isoflurane and placed in a stereotaxic apparatus. CSF was collected by direct puncture in the cisterna magna with an insulin syringe (27 gauge 1/2-inch length) and stored at - 80 °C. CSF Aβ1-42 levels were measured using ELISA kit. Additionally, we performed three structural resonance magnetic imaging (MRI) scans (before, immediately following and three days after CSF sampling). We sampled 100-150 uL of CSF from each McGill-R-Thy1-APP and wild-type without blood contamination. Structural MRI showed signs of needle puncture immediately after the procedure, which disappeared three days after. Additionally, CSF from McGill-R-Thy1-APP (age: 10-14 months) showed high and detectable levels of Aβ1-42 in the CSF (ranging from 1800-2500pg/mL).

A brief history of the development of realization on insulin

The islet cells were found in 1869 and officially named "ilots de Langerhans" in 1893. The secretions of pancreas were found to contain ingredients to control blood sugar in 1890 which was named insulin in 1909. However, it was not until 1921 that insulin was purified, which was used to treat diabetes in 1922. American scholars obtained insulin crystals firstly in 1926. Since then, increasing knowledge were found in insulin, thus arousing a rapid development of its synthesis. Furthermore, Chinese scholars synthesized crystalline of bovine insulin firstly in 1965. Due to the presence of immunogenicity in animal insulin, Novo Nordisk used recombinant DNA technology to synthesize human insulin and for clinical use in 1980s. And Tonghua Dongbao Company developed the first recombinant human insulin of China in 1998. Meanwhile, insulin injections have also been changed from the ordinary syringes to dedicated insulin syringes, from the insulin pens to the insulin pumps, and eventually to the most advanced needleless syringes. Currently, academia is endeavored in the development of non-injectable insulin formulations.

Bartonella henselaeandB. koehleraeDNA in Birds

<i>Bartonella henselae</i>and<i>B. koehlerae</i>DNA in Birds

PS-031 Insulin infusion: the right equipment for good care!

BackgroundPolyvinyl chloride (PVC) infusion tubes are too widely used in our hospital. Even in intensive care units (ICU), PVC is commonly used although polyethylene (PE) is specifically recommended to limit...

PP-025 Treatment for suprachoroidal haemorrhage with intraocular alteplase: a case report

BackgroundThe intraocular inoculation of alteplase helps to dissolve blood clots.PurposeTo evaluate the effectiveness and safety of the use of alteplase in a patient with massive SCH who had to undergo...

The comparison of heparinized insulin syringes and safety-engineered blood gas syringes used in arterial blood gas sampling in the ED setting (randomized controlled study)

IntroductionThe arterial blood gas measurement process is a painful and invasive procedure, often uncomfortable for both the patient and the physician. Because the patient-related factors that determine the difficulty of the process cannot be controlled, the physician-related factors and blood gas measurement techniques are a modifiable area of improvement that ought to be considered. Many hospitals use insulin syringes or syringes washed with heparin for the purpose of blood gas measurement because they do not have blood gas–specific syringes. In this prospective cross-sectional study, we aimed to compare safety-engineered blood gas syringes and conventional heparinized syringes used during the arterial blood gas extraction process in terms of ease of operation, the physician-patient satisfaction, laboratory appropriateness, and complications. MethodsOur study included patients whose arterial blood gas needed to be measured in the emergency department and who agreed to participate in the study. Patients were randomly divided into 2 groups. The arterial blood gas of the patients from the first group was measured by using conventional heparinized syringes, whereas safety-engineered blood gas syringes were used to measure the arterial blood gas of the patients from the second group. The groups were compared in terms of demographic data, the number of attempts, the physician and patient satisfaction, early and late-term complications, and laboratory appropriateness of the taken sample. ResultsA total of 550 patients were included in our study in a 2-month study period. There were no significant differences between patients in terms of sex, age, weight, height, body mass index, and wrist circumference. In addition, the number of attempts (P=.489), patients' pain level during the procedure (P=.145), and the degree of difficulty of the procedure according to the patient (P=.109) and physician (P=.554) were not significantly different between the groups. After arterial blood gas extraction procedure, 115 patients (20.9%) developed complications. In the conventional heparinized syringe group, the complication rate (n=69; 25.1%) was significantly higher compared with the group that used safety-engineered blood gas syringes (n=46; 16%; P=.0211). Localized pain, which is one of the most common early complications, was more frequent in the conventional heparinized syringe group (19.3%). Complications in women (P=.003) and local pain (P=.01) developed lesser in the second group that used safety-engineered blood gas syringes, and the patient-physician satisfaction was higher in that group, as well. In the evaluation 48 hours after the procedure, the ratios of infection and local hematoma were higher in the conventional heparinized syringe group (P=.0213 and P < .0001). ConclusionIn this study, we did not find any significant differences between the conventional heparinized syringes and safety-engineered blood gas syringes in terms of ease of operation, physician and patient satisfaction, and appropriateness of the taken sample. However, patients whose arterial blood gas was extracted by using safety-engineered blood gas syringes felt less pain and experienced fewer infections and hematomas at their puncture site.

Platelet-rich plasma in androgenic alopecia: Myth or an effective tool

Platelet-rich plasma (PRP) has become a newer method for the treatment of various types of alopecia. In this prospective study, safety, efficacy and feasibility of PRP injections in treating androgenic alopecia were assessed. Eleven patients suffering from hair loss due to androgenic alopecia and not responding to 6 months treatment with minoxidil and finasteride were included in this study. The hair pull test was performed before every treatment session. A total volume of 2-3 cc PRP was injected in the scalp by using an insulin syringe. The treatment was repeated every two weeks, for a total of four times. The outcome was assessed after 3 months by clinical examination, macroscopic photos, hair pull test and patient's overall satisfaction.Results:A significant reduction in hair loss was observed between first and fourth injection. Hair count increased from average number of 71 hair follicular units to 93 hair follicular units. Therefore, average mean gain is 22.09 follicular units per cm2. After the fourth session, the pull test was negative in 9 patients.Conclusion:PRP injection is a simple, cost effective and feasible treatment option for androgenic alopecia, with high overall patient satisfaction.