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https://www.readbyqxmd.com/read/27898549/hypertensive-crisis-during-norepinephrine-syringe-exchange
#1
Roland A Snijder, Johannes T A Knape, Toine C G Egberts, Annemoon M D E Timmerman
A 67-year critically ill patient suffered from a hypertensive crisis (200 mm Hg) because of a norepinephrine overdose. The overdose occurred when the clinician exchanged an almost-empty syringe and the syringe pump repeatedly reported an error. We hypothesized that an object between the plunger and the syringe driver may have caused the exertion of too much force on the syringe. Testing this hypothesis in vitro showed significant peak dosing errors (up to +572%) but moderate overdose (0.07 mL, +225%) if a clamp was used on the intravenous infusion line and a large overdose (0...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27894230/factor-viii-delivery-devices-in-haemophilia-a-barriers-and-drivers-for-treatment-adherence
#2
Isabel Fernández-Arias, Hae Kyung Kim
INTRODUCTION AND OBJECTIVE: To capture the experience of haemophilia A patients with their devices for coagulation factor reconstitution, the barriers for treatment adherence; and to determine their preferences, presenting a new double-chamber syringe (DCS). METHOD: A cross-sectional research through a supervised survey and a DCS testing session. RESULTS: Seventy-four (74) patients participated, 50% of them on prophylaxis treatment, and 7 years (median) with their usual treatment (IQR 17...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27809609/evaluation-of-an-investigational-wearable-injector-in-healthy-human-volunteers
#3
Marc C Torjman, Robert Machnicki, Jennifer Lessin, Channy Loeum, Douglas Steinberger, Sarah Mycroft, Jeffrey I Joseph
OBJECTIVES: Introduction of a wearable device for subcutaneous delivery of larger volume bolus injections would encourage patient compliance and reduce the burden on healthcare services. With one such wearable device commercially available, this study examined the safety and functionality of an investigational device in volunteers. METHODS: Four devices were applied to the subject's abdomen: 1) Investigational Device, 2) Investigational Device: subject movement, 3) Control Device: FDA-cleared syringe driver with FDA-cleared infusion set, 4) Control Device: FDA-cleared syringe driver attached to investigational device...
November 4, 2016: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/27433097/towards-safe-injection-practices-for-prevention-of-hepatitis-c-transmission-in-south-asia-challenges-and-progress
#4
Naveed Zafar Janjua, Zahid Ahmad Butt, Bushra Mahmood, Arshad Altaf
AIM: To summarize the available information about injection use and its determinants in the South Asian region. METHODS: We searched published and unpublished literature on injection safety in South Asia published during 1995-2016 using the keywords "injection" "unsafe injection" and "immunization injection" and combined these with each of the countries and/or their respective states or provinces in South Asia. We used a standardized questionnaire to abstract the following data from the articles: the annual number of injections per capita, the proportion of injections administered with a reused syringe or needle, the distribution of injections with respect to prescribers and providers and determinants of injection use...
July 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27212656/a-cross-national-analysis-of-the-effects-of-methadone-maintenance-and-needle-and-syringe-program-implementation-on-incidence-rates-of-hiv-in-europe-from-1995-to-2011
#5
Phillip L Marotta, Charlotte A McCullagh
Although many studies have found an association between harm reduction interventions and reductions in incidence rates of Human Immunodeficiency Virus (HIV) infection, scant research explores the effects of harm reduction cross-nationally. This study used a year- and country-level fixed effects model to estimate the potential effects of needle-and-syringe programs (NSPs) and methadone maintenance therapy (MMT) on incidence rates of HIV in the general population and among people who inject drugs (PWID), in a sample of 28 European nations...
June 2016: International Journal on Drug Policy
https://www.readbyqxmd.com/read/26472335/reviewing-harm-reduction-for-people-who-inject-drugs-in-asia-the-necessity-for-growth
#6
REVIEW
Katie Alexandra Stone
BACKGROUND: There is an estimate of three to five million people who inject drugs living in Asia. Unsafe injecting drug use is a major driver of both the HIV and hepatitis C (HCV) epidemic in this region, and an increase in incidence among people who inject drugs continues. Although harm reduction is becoming increasingly accepted, a largely punitive policy remains firmly in place, undermining access to life-saving programmes. The aim of this study is to present an overview of key findings on harm reduction in Asia based on data collected for the Global State of Harm Reduction 2014...
2015: Harm Reduction Journal
https://www.readbyqxmd.com/read/26260350/a-police-education-programme-to-integrate-occupational-safety-and-hiv-prevention-protocol-for-a-modified-stepped-wedge-study-design-with-parallel-prospective-cohorts-to-assess-behavioural-outcomes
#7
Steffanie A Strathdee, Jaime Arredondo, Teresita Rocha, Daniela Abramovitz, Maria Luisa Rolon, Efrain Patiño Mandujano, Maria Gudelia Rangel, Horcasitas Omar Olivarria, Tommi Gaines, Thomas L Patterson, Leo Beletsky
INTRODUCTION: Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and HIV prevention. PEPs incorporating HIV prevention (including harm reduction programmes like syringe exchange) have been successfully piloted in several countries but were limited to brief pre-post assessments; the impact of PEPs on policing behaviours and occupational safety is unknown...
2015: BMJ Open
https://www.readbyqxmd.com/read/26032673/high-prevalence-of-syringe-lending-among-hiv-positive-people-who-inject-drugs-in-bangkok-thailand
#8
Pauline Voon, Kanna Hayashi, Lianping Ti, Karyn Kaplan, Paisan Suwannawong, Evan Wood, Thomas Kerr
BACKGROUND: Syringe sharing continues to be a major driver of the HIV pandemic. In light of efforts to enhance access to sterile syringes and promote secondary prevention among HIV-positive individuals, we sought to identify the prevalence and correlates of used syringe lending among self-reported HIV-positive people who inject drugs (PWID) in Bangkok, Thailand. FINDINGS: We used bivariable statistics to examine factors associated with self-reported syringe lending among self-reported HIV-positive PWID participating in the Mitsampan Community Research Project, a serial cross-sectional study of PWID in Bangkok, between June 2009 and October 2011...
2015: Harm Reduction Journal
https://www.readbyqxmd.com/read/25964040/hyperbaric-intensive-care-technology-and-equipment
#9
REVIEW
Ian L Millar
In an emergency, life support can be provided during recompression or hyperbaric oxygen therapy using very basic equipment, provided the equipment is hyperbaric-compatible and the clinicians have appropriate experience. For hyperbaric critical care to be provided safely on a routine basis, however, a great deal of preparation and specific equipment is needed, and relatively few facilities have optimal capabilities at present. The type, size and location of the chamber are very influential factors. Although monoplace chamber critical care is possible, it involves special adaptations and inherent limitations that make it inappropriate for all but specifically experienced teams...
March 2015: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/25921096/the-efficacy-and-safety-of-epidural-filter-catheters-when-used-for-post-operative-intra-articular-anaesthesia
#10
S C Reston, P Basanagoudar, A D McNair, A H Deakin, A W G Kinninmonth
UNLABELLED: There are concerns about the risk of iatrogenic infection when employing local anaesthetic techniques with post-operative intra-articular infusions in total knee arthroplasty. This study aimed to determine the efficacy of intact epidural filters in preventing transit of bacteria and to develop a technique of administration which would prevent membrane rupture. Filter efficacy was assessed using a standardised test suspension of Pseudomonas aeruginosa. Twenty millilitres of suspension was injected through isolated epidural filters (n=10) or filters with 40cm of catheter tubing attached (n=30)...
January 2016: Knee
https://www.readbyqxmd.com/read/25743437/out-of-hours-palliative-care-what-are-the-educational-needs-and-preferences-of-general-practitioners
#11
Claire Magee, Jonathan Koffman
OBJECTIVES: Offering genuine choice to patients over place of care and death requires the provision of high-quality palliative care 24/7. This study examines the confidence of out-of-hours general practitioners (GPs) in symptom control and end of life prescribing, and identifies their educational needs and preferences in order to inform recommendations for future education. METHODS: A self-completion postal survey was designed and sent to 1005 GPs working for an independent provider of out-of-hours services across England...
September 2016: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/25715160/continuous-subcutaneous-infusion-in-palliative-care-a-review-of-current-practice
#12
REVIEW
Tabitha Thomas, Stephen Barclay
Syringe drivers are widely used in palliative care, and this article reviews the challenges and outstanding questions associated with their use. Misperceptions among the lay public and some health professionals can be addressed by sensitive communication with patients and families and clear thinking in clinical teams concerning the drugs and doses used, particularly in non-malignant disease. Good levels of knowledge concerning syringe driver use has been found among GPs and community nurses, although this is not the case in some nursing home teams...
February 2015: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/25715105/high-hiv-burden-among-people-who-inject-drugs-in-15-indian-cities
#13
Gregory M Lucas, Sunil S Solomon, Aylur K Srikrishnan, Alok Agrawal, Syed Iqbal, Oliver Laeyendecker, Allison M McFall, Muniratnam S Kumar, Elizabeth L Ogburn, David D Celentano, Suniti Solomon, Shruti H Mehta
BACKGROUND: Injecting drug use has historically been the principal driver of the HIV epidemic in the northeast states of India. However, recent data indicate growing numbers of people who inject drugs (PWIDs) in north and central Indian cities. METHODS: We conducted face-to-face surveys among PWIDs in seven northeast and eight north/central Indian cities using respondent-driven sampling. We used a rapid HIV-testing protocol to identify seropositive individuals and multiassay algorithm to identify those with recent infection...
March 13, 2015: AIDS
https://www.readbyqxmd.com/read/25256259/managing-end-of-life-medications-at-home-accounts-of-bereaved-family-carers-a-qualitative-interview-study
#14
Sheila Payne, Mary Turner, David Seamark, Carol Thomas, Sarah Brearley, Xu Wang, Susan Blake, Christine Milligan
OBJECTIVE: To explore how bereaved family members recall managing end of life medications when delivering care to a patient dying at home in England. DESIGN: Qualitative study. SETTING: Domestic homes in two contrasting areas in England. PARTICIPANTS: 59 bereaved family carers who have delivered care to a patient who spent a minimum of 2 weeks at home prior to their death from cancer or other non-malignant condition...
June 2015: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/25245939/prevention-treatment-and-care-of-hepatitis-c-virus-infection-among-people-who-inject-drugs
#15
Philip Bruggmann, Jason Grebely
People who inject drugs (PWID) represent the core of the hepatitis C virus (HCV) epidemic in many countries. HCV transmission continues among PWID, despite evidence demonstrating that high coverage of combined harm reduction strategies, such as needle syringe programs (NSP) and opioid substitution treatment (OST), can be effective in reducing the risk of HCV transmission. Among infected individuals, HCV-related morbidity and mortality continues to grow and is accompanied by major public health, social and economic burdens...
February 2015: International Journal on Drug Policy
https://www.readbyqxmd.com/read/25164380/measurement-of-compliance-of-infusion-device-consumable-elements-using-an-analytical-weighing-balance
#16
Douglas McG Clarkson, Romain Barbosa
The value of compliance of disposable elements such as infusion lines and syringes can significantly affect the performance characteristics of infusion devices. In a technique used to determine the compliance of infusion lines, the item under test is placed in a semi sealed water filled enclosure and the volume of fluid displaced is measured on an analytical weighing balance as set pressures are applied to the test item. Thermal drift of the measurement chamber was minimised by inclusion of discs of Invar alloy...
November 2014: Medical Engineering & Physics
https://www.readbyqxmd.com/read/24967761/syringe-drivers-incorrect-selection-of-syringe-type-from-the-syringe-menu-may-result-in-significant-errors-in-drug-delivery
#17
L J Tooke, L Howell
There have been many reported adverse incidents due to syringe driver use, most of which have been attributable to human error. In this paper we present a previously unreported, but potentially widespread practice which may result in significant over or under-delivery of medication. Even with the naked eye it is evident that syringes of equal volume have different dimensions and to quantify this we sectioned a range of syringes and measured the inner and outer dimensions. Extensive menus for syringe brand and volumes are available on syringe drivers, offering users greater flexibility...
July 2014: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/24652411/the-hiv-epidemic-in-eastern-europe-and-central-asia
#18
Jack DeHovitz, Anneli Uuskula, Nabila El-Bassel
Eastern Europe and Central Asia represent one of the few regions globally where there is a continued increase in the incidence of HIV infection. For example, in Eastern Europe the rate of diagnosed cases of HIV infection per 100 000 population has increased from 11.7 in 2004 to 22.5 in 2011. Initially propelled by injection drug use, heterosexual transmission has now become a major driver of new infections in the region. Nonetheless substance use remains an important factor, with its control limited by challenges in scaling up harm reduction efforts...
June 2014: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/24577209/the-use-of-syringe-drivers-in-the-community-considerations-for-palliative-care-providers
#19
Cathy West
'Caring for him at home was such a sad, challenging but rewarding and special time ... we wouldn't have wanted him to die anywhere else ... things improved after the syringe driver was started as he seemed more at ease and was not suffering anymore ... the twinkle returned to his eyes for a while ... it made such a positive difference and allowed us to carry on at home until the end.' These words from the family of a dying patient recently cared for by the author remind us of how special the care given at the end of life is...
February 2014: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/24526788/caregivers-experiences-of-managing-medications-for-palliative-care-patients-at-the-end-of-life-a-qualitative-study
#20
Barbara Sheehy-Skeffington, Sarah McLean, Michael Bramwell, Norma O'Leary, Aisling O'Gorman
Informal caregivers are important in enabling palliative care patients to die at home, including their role in managing medications. Often these patients are taking multiple medications, imposing an unnecessary burden on those who are already struggling with oral intake. A literature review revealed that, while there are a number of qualitative studies published examining the experience of caregivers looking after patients at the end of life, there is a dearth of published studies specifically examining the impact of managing medications on caregivers...
March 2014: American Journal of Hospice & Palliative Care
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