text:
|Numéro de publication
|Type de publication
|Numéro de demande
|Date de publication
|5 nov. 1996
|Date de dépôt
|17 avr. 1995
|Date de priorité
|11 oct. 1991
|État de paiement des frais
|Numéro de publication
|Jeffery G. Nile, Stanley J. Gromelski, Alan A. Brain, Steven T. Hardwick
|Cessionnaire d'origine
|Ansell Perry Inc.
|Exporter la citation
|BiBTeX, EndNote, RefMan
|Citations de brevets (7), Référencé par (33), Classifications (26), Événements juridiques (6)
|Liens externes: USPTO, Cession USPTO, Espacenet
[--CH2 --CH(OR)--] and [--CH(CO2 H)--CH(CO2 R1)--](I)
[--CH2 --CH(R4)--] and [--CH(CO2 H)--CH(CO2
[--CH2 --CH(OR)--] and [--CH(CO2 H)--CH(CO2 R1)--](I)
[--CH2 --CH(R4)--] and [--CH(CO2 H)--CH(CO2 R1)--](IA)
[--CH2 --CH(OCH3)--] and [CH(CO2 H)--CH(CO2 R1)--](II)
This is a continuation of our application Ser. No. 08/307,024, filed Sep. 14, 1994, now abandoned, which is a continuation of our application 07/957,983, filed Oct. 8, 1992, now abandoned, which is a continuation-in-part of our application Ser. No. 08/776,084, filed Oct. 11, 1991, now abandoned.
This invention relates to body contacting articles fabricated from natural or synthetic elastomeric materials e.g. natural or synthetic rubbers or polyurethanes. More particularly, the invention relates to medicinal gloves and especially to surgeon's gloves.
In order to improve the donning properties of gloves such as thin rubber or polyurethane gloves of the type used in medical examinations or surgical procedures, it has been customary to incorporate a donning aid at least at the hand contacting surface of the glove. Conventional donning aids have been powders such as talc or starch. However, the use of such particulate donning aids has the disadvantage that particles may drop off the glove into the wound possibly resulting in a granuloma. In order to avoid the use of donning powders other attempts to improve the donning properties of the glove have included the treatment of the hand contacting surface of the glove by halogenation or by lamination with another material having better donning properties than the base rubber. Other articles of natural or synthetic elastomeric materials also suffer problems associated with application due to the frictional resistance of the natural or synthetic elastomeric material employed in the manufacture of the article and the body portion with which it is to be contacted.
Delamination caused during stretching or flexing of the glove has been a problem associated with such laminated gloves particularly when the glove is donned when the hands are wet.
Attempts to improve resistance to delamination have included treatment of the natural or synthetic elastomeric base material surface for example by acid priming so that the laminated material keys well to the base material and remains adhered whilst the base material is stressed. In U.S. Pat. No. 4499154 there is disclosed a process for producing a flexible rubber article in which the formed rubber article is subjected to an acid priming step and a neutralising step prior to a polymer coating step.
The present invention seeks to mitigate the disadvantages of the prior art and to provide body contacting articles such as surgeon's gloves having good donning properties, by using polymers which can be applied directly to the natural or synthetic elastomeric surface without the necessity of pretreating that surface.
Thus the present invention provides a process which is simpler and more economical than those hitherto known.
FIG. 1 depicts the surface morphology of gloves according to the invention.
FIGS. 2-7 are photomicrographs of surfaces of gloves according to the invention.
According to the present invention there is provided a body contacting article which comprises a first layer of a natural or synthetic elastomer and thereon a layer of a polymer comprising repeating units of the formula:
[--CH2 --CH(OR)--] and [CH(CO2 H)--CH(CO2 R1)--](I)
[--CH2 --CH(R4)--] and [CH(CO2 H)--CH(CO2 R1)--](IA)
wherein R is a lower alkyl group and R1 is a lower alkyl group or a (lower) alkoxy (lower) alkyl group, and R4 is hydrogen or a phenyl group.
Aptly R is a lower alkyl group containing up to 4 carbon atoms. More suitably R is a methyl group. Aptly R1 is a lower alkyl group containing up to 9 carbon atoms (e.g. methyl, propyl, butyl, pentyl, hexyl, octyl or nonyl) more aptly up to 4 carbon atoms; or an alkoxy alkyl group having up to 4 carbon atoms in the alkoxy part and up to 4 carbon atoms in the alkyl part (eg. a propoxyethyl group). Suitably, when R is a methyl group, R1 is a propyl or butyl group. More suitably R1 is a --(CH2)3 CH3 group.
The natural or synthetic elastomer preferably comprises a natural rubber or a polychloroprene (e.g. Neoprene), a nitrile rubber, a styrene butadiene rubber or a polyurethane.
The polymers for use in the polymer layer favourably comprise or consist essentially of repeating units of formula (I) or (IA). Such polymers may be referred to as copolymers of a vinyl alkyl ether and a maleic ester (I), or of an alkylene and a maleic ester (IA).
Preferably the body contacting article is a surgeon's glove.
According to a further embodiment of the invention there is also provided a surgeon's glove which comprises a rubber glove which has on the hand contacting surface thereof a layer of a polymer comprising repeating units of the formula:
[--CH2 --CH(OCH3)--] and [--CH(CO2 H)--CH(CO2 R2)--] (II)
wherein R2 is lower alkyl group. Suitably R2 is an alkyl group containing up to 9 carbon atoms, more suitably up to 4 carbon atoms. Preferably R2 is a propyl or butyl group. More preferably R2 is an n-butyl or a --(CH2)3 CH3 group.
The preferred polymers for use in the polymer layer favourably comprise or consist essentially of repeating units of the formula II. Such polymers may be referred to as copolymers of vinyl methyl ether and a maleic ester.
Polymers having repeating units of formula I or II are commercially available and are sold under the trade name GANTREZ (available from GAF Corporation). Apt polymers are those of the GANTREZ ES series of resins and are described as alkyl monoesters of poly(methyl vinyl ether - maleic acid). Suitable resins of this series are the isoproply and n-butyl esters sold under the trade names ES-335, ES-425 and ES435.
Other polymers may however be suitable and these includes polymers of;
(i) the butyl half ester of poly(ethylene/maleic acid)--which is a rubbery material that laminates satisfactorily to rubber.
(ii) the butyl half ester of Scripset 520 (butyl half ester of poly (Styrene/maleic acid) which is a glassy material.
(iii) SMA 2625 (partly esterified poly(styrene/maleic acid))--which is a glassy material that laminates satisfactorily to rubber.
(Scripset 520 is a trade mark and relates to a substance obtainable from Monsanto).
The polymers having repeating units of formula I, IA or II may be applied directly to formed articles having a natural or synthetic elastomer surface.
Accordingly therefore there is also provided a method for producing a body contacting article comprising a first layer of a natural or synthetic elastomeric material, which method comprises applying to said first layer a layer of a polymer having repeating units of the formula I, IA or II as hereinabove defined.
The method of the present invention may be employed as part of the article manufacturing process. For example, where the article is a glove such as a surgeon's glove, the glove may be first formed by a conventional dipping procedure wherein a suitably shaped former is first dipped into a coagulant and thereafter into a latex solution comprising the natural or synthetic elastomer, e.g. natural rubber from which the article is to be formed. After withdrawal from the dipping bath the article may then be subjected to a conventional washing or leaching step prior to application of the polymer layer.
In a preferred aspect of the process of the present invention the formation of the polymer layer on the natural or synthetic elastomer surface takes place prior to final curing of the elastomer. Thus in a conventional glove dipping process, the process train may be modified by incorporating the process of the invention as an intermediate step between the leaching and curing steps.
Thus in accordance with an embodiment of the invention there is provided a process for the production of dipped articles in which a layer of a polymer having repeating units of formula (I), (IA) or (II) is applied to a natural or synthetic eastomer surface of the article prior to final curing of the rubber article.
Aptly, the polymer may be applied to the elastomer surface as a solution. Suitably the solution employed is an alcoholic solution. Preferred alcohols for forming the polymer solution include alkanols such as ethanol and isopropanol.
The polymer content in such solutions should not be more than 50% by weight of the solution, aptly up to about 15% by weight of the total solution, and preferably up to about 8% by weight. Generally, the polymer contact of the solution will be at least 2% by weight of polymer. Preferably polymer contents of from 4 to 6% by weight may be used.
The elastomers can be obtained as latices, which can then be dipped and coated. Cosolvents can be used in the preparation of the latices and the elastomer may be initially present in an emulsion, e.g. a polyurethane emulsion.
The polymer layer may be formed by conventional solution coating procedures but is aptly formed by dipping the article into a solution of the polymer.
The polymer solution may be employed at temperatures below the boiling range of the polymer solvent and may suitably be used at ambient temperatures.
Although the polymer may be used alone, additional hydroxyl containing compounds may be added to the polymer solution. Aptly such hydroxyl containing compounds may include water or polyhydroxy compounds such as polyethylene glycol.
Aptly water may be present in the polymer solution in amounts up to 50% by weight based upon the weight of the solution.
Preferred polyethylene glycols for inclusion with polymers having repeating units of formula (I), (IA) or (II) are those commercially available under the tradename CARBOWAX. Polyhydroxy compounds, as typified by the carbowaxes, may be present in amounts up to about 30% by weight of the polymer aptly in amounts up to 10%, possibly up to 5%, up to 1% or up to 0.5% by weight of the polymer.
After application of the polymer layer, the article may be dried and cured according to conventional procedures.
The article may thereafter be subjected to post-curing treatments such as halogenation in order to impart desired physical properties to the product.
We have found that further improvements in the hand donning properties may be obtained by treatment with an agent such as a surfactant. An apt surfactant for use with the invention is cetyl pyridinium chloride (CPC). Although this surfactant may be employed alone, it may suitably be employed as a complex with a long chain acid, more suitably with a fatty acid. Preferred fatty acids include stearic acid. Lauric acid is especially preferred. CPC in admixture with fatty acid derivatives such as lauryl sulphonate may also be used but these mixtures are less preferred.
Suitable complexes may be formed by adding each of the constituents to water and applying the aqueous complex to the article. A preferred complex may be formed by admixing CPC and lauric acid in water and heating such that each constituent is present in amounts of about 2% by weight of the aqueous complex.
The complex may be applied either by spraying it onto the elastomer surface of the article or by immersing the article in the aqueous complex. Suitably the complex is applied at elevated temperature. Spraying is preferred. In a preferred embodiment the spraying is carried out at elevated temperature, aptly at about 130° F. Dipping applications may be carried out at temperatures of about 100° F.
Other donning aids such as silicones used either along or in combination wit the CPC containing complexes may also be used with advantage.
Thereafter the treated article is dried.
Examination of the elastomer surface and the polymer layer thereon, for example by a Scanning Electron Microscope (SEM) shows the polymer to be distributed over the whole of the rubber surface.
The articles of the invention may have flat polymer coatings. However, in preferred form of the invention, the polymer layer, whilst being continuous has raised areas (domains) which are thicker than the surrounding polymer layer. In these preferred forms of the invention the thickness of the raised domains may be up to 25 μm thicker than that of the remaining areas, favourably up to about 7 μm thicker. The remaining areas may be less than about 8 μm thickness, aptly between 6 and 7 μm, more aptly less than 1 μm
The occurrence of raised domain architecture of the polymer surface depends mainly upon the condition of the elastomer surface to which the polymer is applied.
We have found that if the elastomer surface contains moisture, for example after the leaching stage in a conventional dipping process train, a raised domain architecture will occur when the polymer is applied. Thus it is preferred to apply the polymer between the leaching and curing stages when the articles are produced by a dipping process.
Further improvements in the donning preparation of articles such as gloves when produced in accordance with the invention have been determined when a polymer has repeating units of the formula
[--CH2 --CH(C6 H5)--] and [--CH(CO2 H)CH(CO2 R3)--] III
where R3 is an alkyl group. Aptly R3 is a lower alkyl group, more aptly R3 is an alkyl group, containing up to 4 carbon atoms. Suitable polymers having repeating units of formula (III) are sold under the trade name SCRIPSETS (available from Monsanto). Preferred grades are those sold under the designations SCRIPSETS 540 and SCRIPSETS 550.
Other similar and suitable polymers may be those sold under the trade name SMA resin (available for Atochem) e.g. the polymer sold under the trade name SMA 2625, which is effective in combination with the polymers having repeating units of formula I and II.
Polymers having repeating units of formula (III) may be incorporated directly into the solution of the polymer having repeating units of formula (I), (IA) or (II). Aptly polymer (III) may present in the polymer (II) solution in an amount of greater than about 5% by weight of the total solids content of the solution. Preferably the concentration of polymer III will be about 20% by weight or less of the solution solids. In favoured form the solution for forming the polymer layer on the article will comprise or consist essentially of 94% by weight of ethanol, 4.8% by weight of a polymer having repeating units of formula (I) or (IA) and 1.2% be weight of a polymer having repeating units of formula (III).
The surface morphology of articles having the above described modified polymer layer shows that the raised areas have further raised areas thereon.
Gloves produced with said modified layers have good donning properties especially wet hand donning properties.
In addition to having the modified polymer layer thereon, the donning properties body contact articles may further improve by the use of donning aids, for example as hereinbefore described.
The invention will now be illustrated by the following examples.
An alcoholic coagulant solution was prepared according to the formulation:
______________________________________Industrial Methylated Spirits 3469 lbsCalcium Nitrate 71 gals (US)Triton X-100 1.153 KgCarbowax 600 17.7 lbsCalcium Carbonate 250 lbsSurfynol TG (An acetylenic 450.2 gmsurfactant)______________________________________
Glove formers, for moulding a surgeon's glove, were immersed in the coagulant solution for 1 minute. The temperature of the coagulated solution was maintained at 110° F.
The coagulant treated former was then dipped into a latex solution for 1 minute. The temperature of the latex was ambient temperature and the solution had the following composition:
______________________________________Water 3600 lbsNatural rubber Latex 9750 lbsModicol 3 lbs(elemental sulphur dispersion)DPTT1 Dispersion 210 lbsZMBT2 Dispersion 46 lbsMZ3 Dispersion 30 lbsLowinox4 Dispersion 148 lbs______________________________________ 1 Dipentylmethylene thiuram tetrasulphide 2 Zinc Mercaptobenzathiazole 3 Methyl Zimate 4 a hindered phenol antioxidant.
The final solids content of the latex solution was reduced by the addition of a further 800 lbs of water.
Upon removal from the latex solution the coated formers are then immersed in a leaching bath, maintained at 160° F., for 2 minutes.
The leached coated formers were immersed in a polymer bath, maintained at ambient temperature before passage to a curing oven where they were dried at 240° F. for 20 minutes.
The polymer solution was prepared by diluting an ethanolic solution of GANTREZ ES-425 copolymer to 4% by weight solids content with industrial methylated spirits. GANTREZ ES-425 has repeating units of Formula (II) in which R2 is a (CH2)3 CH3 group. To the 4% resin solution was added a polyethylene glycol (Carbowax 600) in an amount of 20% by weight based on the weight of the resin.
After curing all the gloves were removed from the formers and subjected to a conventional halogenation procedure and then sprayed with a donning aid consisting of:
______________________________________Cetyl Pyridinium Chloride 2% by weightLauric Acid 2% by weightWater qs 100%______________________________________
The temperature of the spraying solution was 100° F. The gloves were then dried at 140° F. for 5 minutes.
The thus produced gloves exhibit good hand donning properties.
Example 1 was repeated except that the polymer solution consisted essentially of a 4% solution of GANTREZ ES 425 in industrial methylated spritis. The thus treated polymer gloves were subjected to the post treatments summarised in the following table.
______________________________________Example No Halogenation CPC/Lauric Acid______________________________________2 Yes No3 Yes Yes4 No No5 No Yes______________________________________
The thus produced gloves exhibit good hand donning properties.
Examples 2-5 were repeated except that the polymer solution consisted of:
______________________________________GANTREZ 425 4.8% by weightSCRIPTSET 550 1.2% by weightIndustrial Methylated Spirit 94% by weight______________________________________
The gloves thus produced exhibited good wet and dry hand donning properties.
The surface morphology of gloves produced in accordance with Examples 3 and 6 was examined together with that of a control sample which is a conventional halogenated glove having no polymer treatment in accordance with the invention.
Surface roughness measurements and surface traces were obtained by surface profilometry using a Rank Taylor-Hobson TALLYSURF 10 profilometer.
Glove samples were taken from the middle finger of each glove for the control samples and the glove of Example 3 the amplification (Vv) was ×5000 whereas (because of the increase in difference between the lowest and highest points of the probe) that for the glove for Example 6 was Vv =X1000. The Vh setting was 0.8 mm (cut-off) in each case.
The surface roughness (averaged in three readings) was
______________________________________ Example 3 0.55 μm Example 6 2.92 μm Control 0.49 μm______________________________________
FIG. 1 in the accompanying drawing depicts the surface trace for each glove over a length of 3 cm (Vh - ×10 and Vv - ×1000).
The synthetic latices shown in table 1 below, were coagulation dipped, as described below, and coated with a solution (an industrial Methylated Spirits) of 2.8% by weight GANTREZ ES-425, 1.2% by weight SCRIPSET 540 and 0.8% by weight CARBOWAX 600 (referred to as 70/30 blend of Gantrez ES-425 and Scripset 540).
TABLE 1______________________________________SampleNo. Polymer Brand Name Manufacturer______________________________________1 Polychloroprene Neoprene 671 Du Pont2 Styrene Revinex 26W10 Doverstrand butadiene Rubber3 Nitrile rubber Revinex 99G41 Doverstrand4 Polyurethane BIP L9009 BIP5 Polyurethane Cydrothane Cyanamid HP5035______________________________________
Preheated (to 115° C.) ceramic glove formers were used to prepare coated latex gloves using the steps shown in Table 2. All the dipping operations were carried out by hand.
TABLE 2______________________________________Process Details Temperature Time______________________________________Dip into coagulant1 60° C. Zero dwellAir Dry Room 1 minDip into latex2 Room 10 sec dwellAir dry Room 1 min 30 secDip into leach3 70° C. 2 min dwellAir dry Room 1 minDip into coating4 room zero dwellAir dry Room 1 minOven dry 115° C. 30 min______________________________________ 1 the coagulant consisted of calcium nitrate, calcium carbonate powder and distilled water 2 the latices were used in their as supplied form 3 the leach consisted of distilled water 4 the coating solution consisted of a 70/30 blend of Gantrez ES425 and Scripset 540 dissolved in a 80/20 blend of Industrial Methylated Spirits (IMS) and Isopropyl alcohol (IPA). Samples were dipped only half way in the coating solutions.
Both the coated and uncoated latex surfaces were examined using optical microscopy. This revealed that roughened coatings were present on the synthetic latices. These roughened coatings, give rise to good damp hand donning performances.
The polymers listed below were applied onto coagulation dipped natural rubber latex surfaces.
1. Gantrez ES 225 (Acid primed latex)
2. Isopropyl half ester of Gantrez AN169
3. Propoxyethyl half ester of Gantrez AN169
4. n-Hexyl half ester of Gantrez AN169
5. n-Nonyl half ester of Gantrez AN169
6. n-Butyl half ester of polyethylene/maleic acid
Preheated (to 115° C.) ceramic glove former were used to prepare samples using the procedure set out in Table 3 below. The dipping operations were carried out on the Cotswold Dipping Machine and Glove Coating Rig.
TABLE 3______________________________________Process Details Temperature Time______________________________________Dip into coagulant1 60 zero dwellAir dry Room 1 MinDip into latex2 Room 12 secAir dry Room 1 min 30 secDip into leach3 70 2 MinAir dry Room 1 MinDip into coating4 Room 30 SecAir dry Room 1 MinOven dry 115 30 Min______________________________________ 1 the coagulant consisted of calcium nitrate, calcium carbonate powder and distilled water. 2 the latex used was as supplied Perry Style 42 or Dermaguard latex. 3 the leach consisted of distilled water. 4 the coating solutions used consisted of 4 to 6% polymer solids dissolved in Industrial Methylated Spirits.
Satisfactory hand donning characteristic results were obtained with the isopropyl half ester of Gantrez AN169 and with the n-butyl half ester of polyethylene/maleic acid. The other materials gave even better results
A glove former for moulding a surgeon's glove was dipped into Witco #A 127-71 polyurethane without coagulant. The resulting film was dried for 5 mins at 130° F. and then overdipped with an overdip formulation, comprising:
2.8% Gantrez ES-425
1.2% Scripset 540
0.8% Carbowax 600
Examination of the Gantrez-Scripset surface by Scanning electron microscope was carried out and the results are shown in FIGS. 2 (40 ×magnification) and 3 (100 ×magnification), from which is can be seen that domains were formed. The glove was found to exhibit good hand donning properties.
The process described in Example 9 was repeated, but using Du Pont Neoprene 571 latex instead of polyurethane and including an extra step of dipping the glove former in coagulant and drying it before dipping into the Neoprene latex.
Examination of the Gantrez-Scripset surface by Scanning electron microscope was carried out and the results are shown in FIGS. 4 (150 ×magnification) and 5 (500 ×magnification), from which is can be seen that domains were formed. The glove was found to exhibit good hand donning properties.
The process described in Example 9 was repeated but using Reichhold Nitrile (TYLAC 68-060-00) latex instead of polyurethane and using 12 dips into the latex instead of 1. A further difference was that after drying the nitrile coating and before overdipping the sample was leached at 160° F. for 2 mins.
Examination of the Gantrez-Scripset surface by Scanning electron microscope was carried out and the results are shown in FIGS. 6 (150 ×magnification) and 7 (500 ×magnification), from which is can be seen that domains were formed. The glove was found to exhibit good hand donning properties.
Additional detail of some of the abovementioned coating polymers is given below:
Gantrez ES-225 and Half Esters of Gantrez AN169 are believed to contain repeating units of the formula: ##STR1##
n-Butyl Half Ester of Poly/ethylene/maleic acid is believed to contain repeating units of the formula: ##STR2##
Scripset 540 and 550 and Butylated Scripset 520 are believed to contain repeating units of the formula: ##STR3## where R=n-butyl (for Scripset 540)
R=ethyl/n-butyl mixture (for Scripset 550)
R=n-butyl (for Butylated Scripset 520)
for Butylated Scripset 520 the ratio of the number of the first units to the number of the second units is 1:1, Scripsets 540 and 550 the ratio is 1:<1.
is believed to be ##STR4## where m=1 to 3
where R is a low alkyl group.
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|Classification aux États-Unis
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|Classification internationale
|Classification coopérative
|Classification européenne
|24 mai 1996
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|20 nov. 1998
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|4 mai 2000
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text:
A news story – it's not labeled as an editorial or as an advertisement – on a New Jersey news website bemoaned how "doctors will soon be forced to scale back or discontinue medical imaging services, due to the major reimbursement cuts recently released in the Centers for Medicare & Medicaid Services' (CMS) 2010 Physician Fee Schedule."
The story went on to quote four sources who promoted the need for imaging support – but it quoted no one who talked about questions of overuse of, and overspending on, medical imaging.
So a reader weighed in on the online comment section, writing:
"Is this a press release or a news story? Are you paid by the imaging lobby?
The part about "stifling innovation" and "delivering better outcomes with less radiation" is downright disturbing, particularly in light of a a recent National Cancer Institute report that said 29,000 cancers – and 14,500 deaths – related to radiation exposure from CT tests will occur in people who were scanned just in the year 2007.
You should know your reporting could be hurting people. How about an article detailing the risks of CT scans to provide some balance to your readers? Imaging can help but medical researchers are quickly discovering it's vastly overused, particularly for heart disease and musculoskeletal disorders. Not only can the radiation harm you, it can lead people to get unnecessary surgeries that carry the risk of harming them for life."
Thank goodness the "news website" posts comments. In this case, it made the page look smarter and more balanced.
We Welcome Comments. But please note: We will delete comments that include personal attacks, unfounded allegations, unverified facts, product pitches, profanity or any from anyone who doesn't list what appears to be an actual email address. We will also end any thread of repetitive comments. We don't give medical advice so we won't respond to questions asking for it. Please see more on our comments policy.
It is disturbing how easy it seems to be to get the "news" media to present as news what are actually highly biased points of view. As this "news" story of medical imaging illustrates, these points of view are often of questionable accuracy at best, and at worst risks harming the health of readers. It seems some news organizations are willing to present an unresearched press release as news.
Another example of this phenomenon is discussed in a post by Dr. Eric Widera which details media reporting suggesting morphine promotes cancer growth, inspite of no evidence for this contention. The reporting seems to have emanated from an effort to promote a very expensive drug which blocks the actions of morphine.

subset: commoncrawl


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Key things you need to know aboutDr. Burns:
Phone & Address
Check insurance plans, locations and make an appointment
Accepting new patients?
- Yes
Dr. Burns' Offices
- CHI St. Vincent Surgery Clinic - Little Rock
- St. Vincent General and Colorectal Surgery
- 701 N University Ave Ste 203
- Little Rock, AR 72205
(501) 313-0425
- (501) 664-2434
- Directions
7 Tips to Prepare for Your Appointment
The key to a successful appointment is communication. To get the most out of your visit, prepare ahead of time so you can lead the conversation with your doctor. These 7 tips will get you ready
Dr. Burns' Experience
Research training, expertise and qualifications
Dr. Burns' Specialties
- Colon & Rectal Surgery
Procedures Dr. Burns Performs
- Anoscopy With Removal of Anal Tumor
- Appendectomy, Laparoscopic
- See all 24 procedures
More About Dr. Burns' Background
Hospital Quality
The right hospital is as important as the right doctor
- CHI St. Vincent Infirmary
- 2 Saint Vincent Cir
- Little Rock, AR 72205
- Baptist Health Medical Center - Little Rock
- 9601 Baptist Health Drive
- Little Rock, AR 72205
9 Facts About Hospital Quality
Patients' risk of dying during a hospital stay for heart bypass surgery could be 87.4% lower, on average, at a hospital rated 5 stars compared to a hospital rated 1 star for that procedure. Choosing the right hospital is critical to your health. View Slideshow
Patient Satisfaction
Patients' feedback on their experience with Dr. Burns
Likelihood of recommending Dr. Burns to family and friends is 4.6 out of 5 5 1 36
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"Lifou....Loyalty Isalnds" Lifou by Norm-NZ
Lifou Travel Guide: 24 reviews and 80 photos
The waters of Lifou are crystal clear warm water. Absolutely positively fantastic diving.... The coral colours together with the fish are beautiful. Get a mask, snorkel, and flippers and enter another World so spectacular and so beautiful.
- In a nutshell:More than just palm trees, a fantastic experiance....
Reviews (7)
As the ship Pacific Sky sailed away from Lifou Island towards our next island stop I wished I had more time, more days... more travel advice
There are several swimming pools on board the cruise ship Pacific Sky. A great place to relax in the sun or the shade by... more travel advice
The ship's air-conditioned cabin I stayed in was nice but basic. Nice place to rest from all the on board activities,... more travel advice
On the cruise ship Pacific Sky there are many night clubs or night spot to enjoy and have fun... And I mean have fun, as... more travel advice
Travelogues (1)
- 1
Comments (4)
Not exactly a useful tip about Lifou - to know that the food is good on a ship which probably won't be there.
OK, stop with the beaches, you will make me cry!
Lifou looks great for snorkelling!! Best wishes nada
Nice start Norm! Wow, pretty nice boat you went on. The south Pacific is the perfect place for a cruise ship.
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Mama L. is married to husband Felix and has three children, Franki, 18, Godwini, 17, and Dicsoni, 15. She hopes to increase her profits so that she can continue to support her family.
About SELFINA
SELFINA is engaged in economic empowerment of women in Tanzania through a leasing and leaseback arrangement as a practical way to achieve economic and social emancipation.
SELFINA has taken a lead role as a pioneer of micro-credit in Tanzania through Micro Leasing. Customs and traditions in Tanzania normally make it difficult for women to own land and assets, and they are therefore termed not-creditworthy by financial institutions as they lack tangible collateral assets. This leads to poor financial support and poor access to basic needs and services for women with low incomes.
SELFINA buys and leases equipment to women. Where a client needs working capital, SELFINA buys equipment from the said client, extending a loan to her, and then leases back the same equipment – a process called "sale and leaseback".
About Tanzania
24View loans »
Success!! The loan was 100% repaid
- Repayment Term
- 14 months (Additional Information)
- Repayment Schedule
- Monthly
- Disbursed:
- Dec 22, 2007
- Listed
- Dec 8, 2007
- Currency Exchange Loss:
- Covered
- Ended:
- Jan 15, 2009


text:
Motorcyclist injured in wreck on U.S. 17
Published: Wednesday, September 4, 2013 at 10:41 a.m.
Last Modified: Wednesday, September 4, 2013 at 10:41 a.m.
Southbound traffic was shut down Wednesday morning on U.S. 17 near Bolivia for an accident involving a motorcycle and a vehicle.
The motorcyclist was injured.
According to Brunswick County 911 dispatch, all southbound traffic was stopped for the wreck, which was reported about 10:30 a.m. near Mill Creek Road.
Check back later for more on this developing story.
-- F.T. Norton
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.


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Salex is a company that has long had a tradition of giving back to the community it serves. When Salex decided, 3 years ago, to open an office in South West OntMore
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We live in a split-level zero lot line home. We just had the waste pipe coming from our upstairs bathroom repaired. It runs down through the wall between our garage and downstairs family room. The pipe had cracked when the house "settled" and the stud that it passes through put pressure on it. The pipe is fixed, but the drywall is missing on the garage side of the wall where the plumber accessed the pipe. The new section of pipe sticks out a bit ****her than the old pipe, so drywall will not fit flush over the opening. To complicate things, the section of wall the waste pipe runs down through is also our cold air return (originating from a vent on the baseboard of the family room side). The air return is approx. 32" wide with a stud down the center and the waste pipe running through one half. Right now I can see through the air return vent to the garage. I have plastic sheeting covering the opening temporarily. My questions are: Can I cover the garage-side opening with plywood instead of drywall? What about insulation? The wall is insulated except for this section since it is the cold air return. My concerns are keeping the cold garage air (it was 5 below zero last night) away from the pipe so it won't "freeze", and also sealing the cold air return effectively. Any suggestions would be greatly appreciated!
No you can't use plywood to cover the hole as it is not allowed by code.You will most likely have to hire a carpenter to bump out the area around the pipe,insulate and finish as needed.
Cold air return location and space requirement
Cold Air Return Noise
Cold Air Return
Old cold air return ducts
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DIPLOMACY is a minefield, and Mitt Romney spent the last week blowing up his foreign policy credentials to be president. He raised doubts about his capacity to deal with global crises, and we were left hoping that if that 3 a.m. call ever went to him, he'd have set up call forwarding.
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Thread: Face pain (TN?) help
11-27-2011, 03:51 PM #1starry1 Guest
Face pain (TN?) help
So for the last few days I've had horrible pain in all down the right side of my face from my temple to my ear and through the upper and lower jaw. I've had hints of this pain in the past, but never the whole side of my face at once.
Gabapentin and tylenol help a little bit, but neither heat nor ice do anything. Do you have any tips for managing this?
11-27-2011, 04:19 PM #2Registered Member
- Join Date
- Aug 2005
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- st. Louis
- Posts
- 47
I started with TN about a year ago and my PCP dx it and sent me to my MS doc. He gave me Tegraltol which does work most of the time, however, I did end up in the ER once with the pain again really bad. After that he gave me lyrica to use as needed. If I were you I would go to the ER if you can not get a hold of your doctors. I waited out the pain way to many times and should have been in the ER.
art girl and starry1:
Firstly I am so so so sorry you both have this pain!!
I have it too and have some questions. Maybe sometime (of course, starry1 when you are feeling better) can we talk about it? I have so many question about TN (experiential questions rather than medical). Maybe we can meet in the chat room or a separate thread or something. Just an idea if anyone feels like it.
(FYI I am on neurontin/gabapentin 900 mgs daily, since middle of august. Tried to get off of it but I can't seem to manage the pain without. Currently I still have a large amount of breakthrough pain at this dose but I can still function. The side affects make it hard though...)
I hope you are pain-free soon!!
Lynne*undiagnosed and just hangin' in there somehow*
11-27-2011, 07:42 PM #4starry1 Guest
Well the on-call doctor called me back and said it sounds like classic TN to her. She increased my gabapentin and told me to see my neuro but to go to the nearest ER if I need to.
In looking up TN I saw its called the suicide disease and I can see how people can get to that point. This pain is way beyond childbirth on the 1-10 scale. I'm so sorry some of you know what this feels like.
tn pain
i have had tn for 12 years, it is the most horrid pain i could ever imagine. when it flares i get heavy pain meds and ride it out. when it first started it was manageable with advil and vicodin and neurontin, but now that doesn't touch the pain. the dentist tends to set mine off. cold drinks are bad too. i think putting ice on it only makes it worse.
I went to neurosurgeon after the last attack which ended up lasting 18 days, because oxycodone#10 did nothing. you can have the nerves repadded or cut depending on the condition. once you have it you learn to watch what tends to set it off. i have had all 12 back teeth cut out because i thought the pain was from my teeth before being diagnosed. it wears on a person and one should have a good support group of friends/family when it does flare. i personally think this is the worst part of my ms! once one has this pain, they will never forget it and fear it coming on again! there is a great neurosurgeon in cincinnati ohio
11-27-2011, 08:50 PM #6She increased my gabapentin and told me to see my neuro but to go to the nearest ER if I need to.
If things do get rough go to the ER because the neurontin is probably not gonna pull you out of that hole fast enough.
I hope you feel better soon!!
pumpkin32: wow, 12 years. How awful. yuck.
Lynne*undiagnosed and just hangin' in there somehow*
face pain
Sorry you are having this pain. I am having similar symptoms. My neurologist thinks it is caused from a chipped tooth and suggested a root canal but the pain goes way beyond that. It covers the entire right side of my face. I have been tempted to go to the ER. Also, it always starts hurting in the late afternoon and goes into the evening. The only thing that has helped was increasing my dose of beta blockers. My neuro said to keep an eye on my BP and HR. Good luck.
11-28-2011, 06:20 PM #8starry1 Guest
If the neuro wants you to go the dentist to rule out dental problems, I'd just do it; then he can't blow it off as not his problem anymore.
12-01-2011, 06:00 PM #9starry1 Guest
So how long do your episodes generally last?
I ask because I'm still having some breakthrough pain, even though I've been slowly increasing my gaba all week. Today the pain is worse than usual (I think because its cold and snowing), but its still nowhere near the peak pain I got over the weekend. I can't really go ask for pain pills because I can't work on them, I fall asleep immediately.


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: [Pokémon+]
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September 2nd, 2012 (12:10 PM).
Really wants shiny Porygon Z:3
Silver Tier
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Mark shrugged. Maybe he did have to train Able a bit more. Maybe it was just something this particular kind of Ninjask did. Maybe it was a girl thing? Who knows. Whatever the case, Mark went over to the elevator heading upstairs so he could catch up with the others.
"Well, I guess I can ask the teacher about her after class. I got alot of questions." Mark said. Assuming Lucia followed him, Mark pressed the button on the elevator and headed up to Battlefield 7. Meanwhile Snype was getting irritated by Roberto. At this point he wish he could just fight the guy and get him off of his back. He could only hope.
Mark ended up at the battlefield. It was designed alot like a forest. It was bound to give Bug types and Grass types a home field advantage.
Trainer Academy RP Pokemon
Snype (Sableye)- Lv. 52- Detect, Shadow Sneak, Will-o-wisp, Low Sweep, Foul Play, Taunt (Ability: Keen Eye)
Commodore (Porygon-Z)- Lv. 55 -Signal beam, Conversion 2, Recover, Tri Attack, Ice Beam, Trick Room (Ability: Trace)
Len (Poliwraith)- Lv. 53- Bubblebeam, Brick Break, Body Slam, Belly Drum, Sleep Talk, Rest (Ability: Water Absorb)
Able (Ninjask)- Lv. 46 - X-Scissor, Slash, Double Team, Protect, Baton Pass, Swords Dance (Ability: Speed Boost)
Kara (Gligar) Lv. 35 Acrobatics, Substitute, Fury Cutter, Knock Off, Slash,Toxic (Ability: Poison Heal)
Xerox (Ditto) Lv. 35 Transform (Ability: Imposter)
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Shedinja- Lv. 35 Fury Swipes, Confuse Ray, Sand attack, Leech Life, Mind Reader, Scratch (Ability: Wonder Guard)
Omanyte- Lv. 35 Brine, Mud Shot, Rollout, Ice Beam, Protect, Bite
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"Nameless City, The." Short story (5,070 words); probably written in mid- to late January 1921. First published in the Wolverine (November 1921); rpt Fanciful Tales (Fall 1936) and WT (November 1938); first collected in O; corrected text in D.
An archaeologist seeks to explore the nameless city, which lies "remote in the desert of Araby." It was of this place that Abdul Alhazred "the mad poet" dreamed the night before he wrote his "unexplainable couplet":
That is not dead which can eternal lie,
And with strange aeons even death may die.
The narrator burrows into the sand-choked apertures that lead into some of the larger structures of the city. He is disturbed by the odd proportions of a temple into which he crawls, for the ceiling is very low to the ground and he can scarcely kneel upright in it. He descends an immense staircase that leads down into the bowels of the earth, where he finds a large but still very low-built hall with odd cases lining the walls and frescoes covering the walls and ceiling. The creatures in the cases are very peculiar—apparently reptilian, but in size approximating a small man. Even though it is these anomalous entities who are portrayed in the frescoes, the narrator convinces himself that they are mere totem-animals for the human beings who must have built the city and that the historical tableaux depicted in the frescoes are metaphors for the actual (human) history of the place. But this delusion is shattered when the narrator perceives a gust of cold wind emerging from the end of the hallway, where a great bronze gate lies open and from which a strange phosphorescence emerges. He then sees in the luminous abyss the entities themselves rushing in a stream before him. Somehow he manages to escape and tell his story.
HPL admits (SL 1.122) that it was largely inspired by a dream, which in turn was triggered by a suggestive phrase in Dunsany's Book of Wonder, "The un-


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Product Description
Standard Style Gas Cap for all 1966 Mustangs.Replace your missing or unattractive, original gas cap with this factory style reproduction. Features a high quality chrome finish and the same twist on style as the original. The cap also features a security cable on the back to prevent theft.
*This gas cap is for the standard Mustang model, but will fit the GT.
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