Abstract: A monitoring device configured to be attached to the body of a subject includes an outer layer and an inner layer secured together. The inner layer includes light transmissive material and has inner and outer surfaces. A base is secured to at least one of the outer and inner layers and includes an optical emitter and optical detector. A layer of cladding material is positioned near the outer surface of the inner layer, and at least one window is formed in the layer of cladding material that serves as a light-guiding interface to the body of the subject. The light transmissive material delivers light from the optical emitter to the body of the subject along a first direction and collects light from the body of the subject and delivers the collected light in a second direction to the optical detector. The first and second directions are substantially parallel.

Abstract: An optical measurement device includes: a measurement light source unit that emits measurement light; measurement probe including an illumination fiber configured to radiate the measurement light to a living tissue, and a light-receiving fiber configured to receive return light of the measurement light reflected and/or scattered from the living tissue; a detection unit that detects the return light; an illumination control unit that causes the measurement light source unit to execute alternately emission and stoppage of the measurement light during the measurement and to emit the measurement light such that the emission time is longer than the stoppage time; and a computation unit that removes, from an intensity of return light of the measurement light detected by the detection unit, a detected intensity of return light of the observation light radiated by an endoscope and reflected from the living tissue.

Abstract: A pressure sensing medical device may include a guidewire including a tubular member having a lumen, the tubular member being translatable between a generally straightened position and a deflected position, and a pressure sensor attached at a distal end of a fiber optic extending within the lumen, the pressure sensor being disposed within a distal portion of the tubular member. The pressure sensor may include a pressure-sensitive membrane disposed on a distal end thereof. The pressure sensor may include one or more contact members capable of providing a contact point between the contact member and an inner surface of the tubular member when in the deflected position, the contact point being axially spaced apart from the membrane along a longitudinal axis of the pressure sensor.

Abstract: Disclosed is a system that includes a signal acquisition circuit to acquire a cuff pressure signal using an inflatable cuff, and to generate an oscillometric signal from the cuff pressure signal. The system also includes a user interface to enter one or more patient-specific detection threshold values, a memory to store the cuff pressure signal, the oscillometric signal, and the one or more patient-specific detection threshold values. The system also includes a microprocessor operatively coupled to the signal acquisition circuit, the user interface, and the memory. The microprocessor includes at least one algorithm to use the cuff pressure signal, the oscillometric signal, and the entered one or more patient-specific detection threshold values to calculate patient-specific readings of at least one of mean arterial pressure, systolic blood pressure and diastolic blood pressure. Related apparatus, systems, methods and/or articles are described.

Abstract: A cuff system includes a flexible substantially tubular sheath having a distal end, a proximal end, a central longitudinal axis, and a central channel extending along the longitudinal axis. The system also includes a first guide disposed at the proximal end of the sheath. The first guide is configured to control insertion of a cuff connector into the central channel in a first direction substantially parallel to the longitudinal axis. The system further includes an orifice proximate the distal end of the sheath. The orifice is configured to enable fluid connection between a portion of the cuff connector and an inflatable cuff while a remainder of the cuff connector is disposed within the central channel.

Abstract: An exemplary computer-implemented method is disclosed for detection of onset of depolarization on far-field electrograms (EGMs) or electrocardiogram (ECG)- or ECG-like signals. The method includes determining a baseline rhythm using a plurality of body-surface electrodes. The baseline rhythm includes an atrial marker and a ventricular marker. A pre-specified window is defined as being between the atrial marker and the ventricular marker. A low pass filter is applied to a signal within the window. A rectified slope of the signal within the window is determined. A determination is made as to whether a time point (t1) is present such that the rectified slope exceeds 10% of a maximum value of the rectified slope. A point of onset of a depolarization complex in the signal is determined. The point of onset occurs at a largest curvature in the signal within the window.

Abstract: Disclosed herein methods, devices, and systems for detecting and diagnosing a diabetic disease or disorder in a subject from a prime electrocardiogram which comprises calculating at least one distribution function of the prime electrocardiogram and determining whether the distribution function is indicative of the presence of absence of the diabetic disease or disorder.

Abstract: A medical device system performs a method determining presence of scar tissue. Torso-surface potential signals are received by a processor from multiple electrodes distributed on a torso of a patient. The processor extracts features of the potential signal from each electrode and stores values of the features in a non-transitory storage medium. The processor determines a scar indicator index for each of the electrodes from the stored features and identifies which ones of the electrodes have an affirmative scar indicator index. An overall scar burden index is determined as a proportion of the electrodes with an affirmative scar indicator index.

Abstract: A method of providing a graphical representation of sleep quality includes obtaining ECG data for a patient, obtaining a plurality of N-intervals from the ECG data, calculating a plurality of spectral densities based on the plurality of N-N intervals, wherein each spectral density is associated with one of a plurality of successive time windows and is calculated based on certain ones of the N-N intervals associated with the one of the plurality of successive time windows, and generating the graphical representation of sleep quality using the plurality of spectral densities.

Abstract: Systems and methods for quantifying the likelihood of the contribution of multiple possible forms of chronic disease to patient reported dyspnea can include the testing protocol having a flow/volume loop, performed at rest, flowed by the measurement of cardiopulmonary exercise gas exchange variables during rest, exercise and recovery as unique data sets. The data sets are analyzed using feature extraction steps to produce a pictorial image consisting of disease silos displaying the likelihood of the contribution of various chronic diseases to patient reported dyspnea. In some embodiments, the silos are split into subclass silos. In some embodiments, multiple chronic disease indexes are used to differentiate between sub-types of a particular chronic disease (e.g., differentiating WHO 1 PH from WHO 2 or WHO 3 PH). Test results are plotted serially to asses to provide feedback to the physician on the efficacy of therapy provided to the patient.

Abstract: A non-invasive monitoring apparatus for end-tidal gas concentrations, and a method of use thereof, is described for the detection of endogenous gas concentrations, including respiratory gases, in exhaled breath.

Abstract: The invention relates to an inhalation support apparatus and the use thereof and to a method for supporting the inhalation of an inhalation mixture that is to be inhaled. The invention further relates to a device for the control of pressure changes, their use in the medical and non-medical field and a method for detecting respiratory problems.

Abstract: A fatigue monitoring apparatus includes a fatigue detecting helmet. The fatigue detecting helmet includes a cap, a first electrode, a second electrode, a fatigue computation device and a power supply. The first electrode is disposed in the cap to contact a head, thereby obtaining a first physiological information. The second electrode is positioned out of the cap to contact the head, thereby obtaining a second physiological information. The fatigue computation device and the power supply are disposed on the cap. The fatigue computation device includes a brainwave computation module and a fatigue judgment module. The brainwave computation module is electrically connected to the first and second electrodes for obtaining a brainwave information based on the first and second physiological information. The fatigue judgment module is electrically connected to the brainwave computation module for obtaining a fatigue information based on the brainwave information.

Abstract: A surgical system kit is described. The surgical system kit includes a peripheral electrode, a surgical access instrument configured to be placed in a surgical target site, and a control unit. The surgical access instrument has a body with a proximal end, and a distal end, two or more electrodes on the distal end at fixed locations and spaced apart a known distance. The control unit is configured to send a signal to the peripheral electrode, receive information indicative of a neural response from at least one electrode of the surgical access instrument, and interpret the information according to a nerve conduction velocity modality to measure the nerve conduction velocity through the segment of the nerve.

Abstract: In general, the invention is directed to methods and devices for determining an ion concentration in the extracellular fluid of a patient. As examples, the ion may be one or more of potassium, sodium, chloride, or calcium. A system includes an electrode deployed in or near a tissue, such as a skeletal muscle, of the patient. A pulse generator supplies one or more stimulations to the tissue, and a sensor, such as an accelerometer, detects the response of the tissue to the stimulations. A processor determines a concentration of ions in the extracellular fluid as a function of the response. The system may detect an ion imbalance based upon the determined concentration of ions.

Abstract: An endoscope for removing tissue at a surgical site includes an elongated tubular body insertable within a mammalian cavity of a patient. An instrument channel extends between a first opening at a distal end and a second opening at a proximal end of the tubular body and is sized and configured to receive a surgical cutting assembly that includes an aspiration channel configured to remove material entering the endoscope via a distal end of the surgical cutting assembly. A torque generation component configured to generate torque is positioned within the distal end and configured to provide the generated torque to a coupling component. The coupling component is positioned at the distal end of the elongated tubular member and configured to actuate a cutting component of the surgical cutting assembly responsive to actuation of the torque generation component.

Abstract: A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described, as well as alternative systems for tissue preservation and transport. The cutting device includes an outer cannula in which a reciprocating inner cannula is disposed. A tissue collector is also provided and is in fluid communication with the lumen of the inner cannula. A temperature control sleeve may be disposed around the tissue collector to control the temperature of the tissue samples. A preservation system may be supplied that is configured to deliver fluids to tissue samples in the tissue collector. A fluid supply sleeve may be disposed about the outer cannula and is selectively positionable along the length of the outer cannula.

Abstract: This invention relates to a device (10) for taking at least one sample of soft tissue from an organ, said device comprising a body (11) and a needle (12) formed by a stylet (13) and a cannula (14) coaxial with said stylet, said device comprising a mechanism for arming the needle, designed for sequentially moving the cannula (14) and then the stylet (13) from a rest position wherein the stylet and the cannula are extended towards the outside of the body, to a shooting position wherein the stylet and the cannula are retracted towards the rear of the body, and a triggering mechanism designed to release the stylet then the cannula and to allow their displacement from the shooting position to the rest position, the cannula being coupled kinematically to a cannula slider (24) comprising at least one retaining element (26) for maintaining the cannula slider in a shooting position, the stylet being coupled kinematically to a stylet slider (30) comprising at least one retaining element (32) for maintaining the stylet

Abstract: This invention relates to medical guidewire having multiple electrically conductive pathways extending from substantially their distal ends to substantially their proximal ends.

Abstract: Methods and systems for treating an airway disorder and delivering an implant to airway tissue are provided. A method includes partially inserting at least a first and second wire into airway forming tissue, wherein the first and second wires' axes define implant positions for a first and second implant, respectively. A wire guide can be used to maintain an orientation of the first and second axis relative to each other.

Abstract: A physiological monitor is provided for determining a physiological parameter of a medical patient with a multi-stage sensor assembly. The monitor includes a signal processor configured to receive a signal indicative of a physiological parameter of a medical patient from a multi-stage sensor assembly. The multi-stage sensor assembly is configured to be attached to the physiological monitor and the medical patient. The monitor of certain embodiments also includes an information element query module configured to obtain calibration information from an information element provided in a plurality of stages of the multi-stage sensor assembly. In some embodiments, the signal processor is configured to determine the physiological parameter of the medical patient based upon said signal and said calibration information.

Abstract: The present invention relates to the diagnosis and treatment of pelvic floor prolapse. The diagnosis and treatment may involve the use of a multiple sensor-enabled device for vaginal insertion capable of providing real-time data regarding the patient's physiology, the position and movement of the urethra, and the muscular strength of the patient's vagina and pelvic floor. The methods and devices of the invention may also be useful to addressing other medical issues, including urinary incontinence, sexual health, and fecal incontinence, as well as facilitate patient home wellness activities.

Abstract: A method and apparatus for measuring a volume of a wound are described, the method comprising the steps of: applying a dressing over a wound, the volume of which is to be measured, the dressing including at least a sealing drape over the wound so as to create a sealed wound cavity; creating a vacuum in said wound cavity by vacuum pump means so as to produce a predetermined vacuum in the wound cavity; measuring a volume of air extracted from said wound cavity in producing said predetermined vacuum; and, calculating a volume of said wound.

Abstract: The transvaginal tactile probe is configured to obtain a high resolution mapping of pressures and strains within the vagina of a pregnant woman prior to birth. The device provides real-time data visualization, analysis tools and information. This data may be used to assist with clinical decisions regarding selecting a preferred method of prevention of severe childbirth injury or altering delivery management, e.g. early induction at term, elective caesarean section in patients with a history of obstetric anal sphincter injury, water-birth, warm compresses to the perineum. The device is intended for use by medically trained personnel who counsels patients regarding risk of severe trauma at childbirth (such as urogynecologists and obstetricians) and regarding the effect of perineal massage and childbirth training device (such as physical therapists).

Abstract: Methods for operating a processing system to generate accurate information representative of movement of a body from activity sensors such as tri-axial accelerometers. The system uses wavelet analysis and/or adaptive thresholds to provide quantitative measurements of a person's posture and/or activity, including low-speed activity, during daily living.

Abstract: A wireless motion sensor platform comprising MEMS inertial sensors and accompanying software for classification of diverse motion characteristics and kinematics of patient anatomy at high resolution. The sensor platform comprises a low-cost, compact, and low-weight device that can be applied to a patient's upper and/or lower leg during a knee examination to measure acceleration along three axes as well as rotations about these axes.

Abstract: Post-scar formation reduction apparatus comprises a biocompatible scar interface layer, a compressible pressure chamber overlying the scar interface layer, and an at least substantially uniformly compressible pressure element in the pressure chamber which extends over the scar interface layer. The pressure element has a bulk modulus enabling a predetermined uniform or substantially uniform compression of the pressure element in at least a direction perpendicular or substantially perpendicular to the scar interface layer on application of a specific pressure. Evacuator is also provided which at least partially evacuates the pressure chamber, whereby the pressure element is uniformly or substantially uniformly compressed in the direction of the scar interface layer and the pressure chamber positively urges the compressed pressure element towards the scar interface layer.

Abstract: An electronic vibrating compression glove which simultaneously provides compression and vibration therapy to arthritic hands.

Abstract: A vehicle seat includes a seat cushion S1 and a seat back S2. The seat back S2 includes a seat back frame F2 constituting a framework thereof, a pressure-receiving member 30 located in the seat back frame F2 and configured to support an upper body of an occupant, elastically supporting members 26, 27 elastically supporting the pressure-receiving member 30 in the seat back frame F2, and a cover material covering the seat back frame F2 and the pressure-receiving member 30. The seat back is configured such that when a backward movement load is applied from the upper body of the occupant seated on the seat cushion S1 to the seat back S2, the pressure-receiving member 30 moves backward to allow the upper body of the occupant to sink into the seat back S2. A vibrating unit 50 is attached to the pressure-receiving member 30.

Abstract: Provided herein are muscle compression devices and self-actuated muscle compression devices. The devices generally comprise at least one encompassing member with an inner surface substantially contacting a muscle perimeter in at least one location on the subject's skin, at least one compression member disposed on the inner surface and at least one actuator disposed on the encompassing member in a tightening relationship therewith. The components of the device may be arranged as single clasping loops around the subject or as a vest or harness worn by the subject. Also provided is a method for compressing a muscle in which the device is positioned on the subject and the actuators are self-actuated to tighten the encompassing members. Tightening results in the compression members contacting the muscle target site with increasing compressive force.

Abstract: A method of selecting and using a compression garment is disclosed. The method may include selecting a garment comprising a compression sleeve including a proximal end and a distal end. The compression sleeve may comprise material having one of short-stretch function and inelastic function. The method may include donning the garment by inserting a limb of an animal or human through an opening in the proximal end and positioning the compression sleeve such that the material extends over at least a portion of a muscle mass of the limb. When the muscle mass is activated, the compression sleeve may augment the venous muscle return produced by the muscle mass.

Abstract: A garment-based system, construction and method controls knee brace displacement relative to a brace-outfitted lower extremity. The garment-based system includes or is cooperable with a knee brace, a waist-encircling anchor structure, an anchor-to-brace tether structure, and certain tether-to-brace attachment structures. The waist-encircling anchor structure is receivable about a user's waist and fixable in a transverse anchor plane. The inelastic anchor-to-brace tether structure is fastened to the waist-encircling anchor structure and extends in a first direction orthogonal to the transverse anchor plane. The tether-to-brace attachment structure(s) fasten the knee brace to the anchor-to-brace tether structure, and are immovable in the first direction.

Abstract: An orthopedic device has at least one flexible or rigid frame member contoured to generally correspond to an anatomical limb. The device also includes a tightening system having a dial tensioning device and at least one cable and/or strap connected to the dial tensioning device. The dial tensioning device has a rotary ratchet permitting incremental adjustment of the cable and/or strap. Adjustment of the dial tensioner in a first direction secures the frame member to the limb.

Abstract: Provided is a resin acid ester-based tackifier having a good compatibility with a synthetic rubber elastomer, being capable of reducing the melt viscosity of the elastomer, and being capable of imparting excellent adhesive properties and/or pressure-sensitive adhesive properties to the elastomer. The tackifier is composed of an ester composition characterized by (i) the ester composition comprising 70% by weight or more of a resin acid ester represented by the general formula (1): and (ii) the S?NMR/SNMR ratio of the ester composition being at least 6% in the 1H-NMR spectrum of the ester composition, wherein S?NMR is the total integral value of the proton signal(s) appearing in the region of 6 to 8 ppm and SNMR is the total integral value of all the proton signals appearing over the entire range of the 1H-NMR spectrum.

Abstract: A renal failure blood therapy system includes a renal failure blood therapy machine, a test including multiple blood samples taken at multiple times during a test therapy to determine concentration levels for each of a first solute and a second solute at each of the multiple times, and a device programmed to (i) estimate at least one first patient parameter using the determined concentration levels for the first solute, (ii) estimate at least one second patient parameter using the determined concentration levels for the second solute, (iii) determine a first plurality of acceptable treatments using the at least one first patient parameter, (iv) determine a second plurality of acceptable treatments using the at least one second patient parameter, and (v) merge the first plurality of acceptable treatments with the second plurality of acceptable treatments to determine a plurality of clinically acceptable treatments for both the first solute and the second solute.

Abstract: Methods and compositions to controllably regulate cells at a target site. A quantum dot-targeting agent complex is administered to a patient in need of therapy, and the complex is stimulated using an implanted fiber optic system. In embodiments, the system includes an electrical sensor that detects and monitors electrical activity of the stimulated controllably regulated cells, and relays this information to a controller that can regulate further stimulation.

Abstract: The present invention describes Photolabile Compounds methods for use of the compounds. The Photolabile Compounds have a photoreleasable ligand, which can be biologically active, and which is photoreleased from the compound upon exposure to light. In some embodiments, the Photolabile Compounds comprise a light antenna, such as a labeling molecule or an active derivative thereof. In one embodiment, the light is visible light, which is not detrimental to the viability of biological samples, such as cells and tissues, in which the released organic molecule is bioactive and can have a therapeutic effect. In another embodiment, the photoreleasable ligand can be a labeling molecule, such as a fluorescent molecule.

Abstract: A method of performing a medical procedure is disclosed. The method includes: positioning an energy delivery device configured to deliver energy adjacent uric acid (UA) crystals having a resonance frequency; applying energy to tissue through the energy delivery device at a predetermined frequency thereby resonating the UA crystals; debulking at least a portion of the UA crystals; and removing at least a portion of the debulked UA crystals.

Abstract: According to some embodiments, a microdermabrasion device for treating skin comprises a handpiece assembly having a distal end and a proximal end. The handpiece assembly includes at least one delivery conduit and at least one waste conduit. The microdermabrasion device additionally comprises a tip configured to be positioned along the distal end of the handpiece assembly, wherein the tip is adapted to contact skin surface. In several embodiments, the tip comprises a lip, a first opening in fluid communication with the fluid delivery conduit and a second opening in fluid communication with the waste conduit. In one embodiment, the device includes one or more abrasive elements positioned along a distal end of the tip, wherein the abrasive elements are configured to selectively remove skin as the tip is moved relative to a skin surface.

Abstract: The present application discloses a handle configured to receive a catheter. The handle comprises a port that communicates with a lumen of the catheter and a mechanism is provided that moves the end of the catheter for positioning. The guide wire traverses a reservoir located in the handle. In particular, the handle comprises an enclosure with a conduit and a reservoir, where the conduit extends through the enclosure from the left side to the right side and the reservoir space has a curved or concave base. The bottom side and top side of the handle converge into a tapered point on the left side.

Abstract: The embodiments disclosed herein relate to balloon catheter assemblies. The balloon catheter assemblies can include a plurality of ports, a junction hub, an elongated member, and an inflation balloon. The balloon catheter assemblies can also include a reinforced tubular shaft extending through the inflation balloon. The balloon catheter assemblies can also include a retaining mechanism that can be removably attached to the junction hub.

Abstract: The present invention relates to a medical delivery apparatus which comprises a hollow container (2) filled with a liquid drug (3). The container (2) is closed at its distal end by a pierceable membrane (4) and provided with a plunger at its proximal open. Whenever a piston rod (20) moves the plunger (5) forward inside the container, a pressure is build up in the liquid drug (3) contained in the container (2). Further, a resilient element (33),such as a spring, is provided. This resilient element (33) can be activated to operate from a relaxed state to a tensed state upon activation of a dose injection mechanism during injection. The resilient element (33) is operated to its tensed state when during injection, the pressure is build up in the liquid drug (3) and secured in its tensed state as long as the pressure inside the container (2) is above a predetermined threshold value.

Abstract: Embodiments of the present invention provide a vent arrangement integrated with a refill port disposed on the outer shell of an implantable drug-delivery device. The vent arrangement may utilize a tiered structure with two septums in a space-efficient configuration that facilitates both venting of pressure and refill of the drug reservoir.

Abstract: An electronic medical system is described. The system comprises an external RF power transmitter configured to emit a first power signal via an electromagnetic coupling, said RF power transmitter being configured to emit said first energy signal with a power no greater than 1W. The system further comprises an implantable medical device comprising: at least one receiver antenna configured to receive said first energy signal via an electromagnetic coupling; an RF power receiver module configured to extract a second energy signal having a power of at least 1 mW and to be powered by said second energy signal; a power actuator module, operatively connected to the RF power receiver module, powered by said second energy signal. The power actuator module is configured to deliver a medical treatment to at least a target tissue of a patient on the basis of a control signal generated by the RF power receiver module.

Abstract: Titration schemes are carried out by medical infusion devices, such as ambulatory or implantable infusion devices. The titration schemes carried out by infusion systems and devices may take into account patient side effects in controlling the rate at which a medicament is delivered from the devices of systems.

Abstract: A piston pump is described for pumping a fluid, comprising at least two cylinders each having a piston which is movable inside the associated cylinder along the longitudinal axis of the cylinder by means of a drive, wherein cylinders are attached to a common pump flange. In each cylinder a chamber is formed having a volume that changes when the associated piston is moved in the cylinder. The pump flange extends along the direction of motion of the pistons, and at least one inlet port and one outlet port are attached to the pump flange, whose longitudinal axes run along the pump flange. A central valve plate is attached to the side of the pump flange facing away from the cylinders that bear on the pump flange and continuously rotates transversely to the pump flange during pumping operation of the piston pump. Respective passages are introduced to the pump flange in the region of each inlet and outlet port, and cylinder openings are introduced to the pump flange in the region of each cylinder.

Abstract: A device is described for supplying and metering a fluid for medical purposes, at least comprising one pump for pumping the fluid and at least one element through which the fluid is conveyed. At least one recess is provided in the element, which is tightly covered by a sensor component composed of a pressure sensitive material, wherein the material of the element is harder than that of the sensor component. The apparatus also has a force sensor with which pressure-induced changes of the sensor component in the region of the recess can be measured.

Abstract: An introducer is configured to distinguish an introducer provided with a sheath tube whose wall thickness is reduced, from an introducer provided with a sheath tube whose wall thickness is not reduced, and to recognize the relationship between the inner diameter and the outer diameter for the sheath tube in which the wall thickness is reduced. The introducer includes an introducer sheath which includes an elongated hollow sheath tube and a sheath hub at the proximal side of the sheath tube and provided with a dilator insertion port. A first information piece having an inner diameter dimension of the sheath tube as an index is shown on at least one of the sheath tube and the sheath hub. Furthermore, a second information piece having an outer diameter dimension of the sheath tube as an index is shown on at least one of the sheath tube and the sheath hub.

Abstract: The application relates to a two-part overlapping dressing for securing a cannula during intravenous catheterization on the skin surface of a patient. The dressing comprises a first flexible adhesive sheet (10) provided with an opening (16) spaced from all its peripheral edges; and a second flexible adhesive sheet (12). The opening (16) in the first sheet comprises a slit (18), one end of which terminates in an enlarged aperture (20). The second sheet (12) is dimensioned such that, when it is aligned with and adhered against the first sheet (10) in use, it is capable of overlapping the full length of the slit (18) so as to reduce the opening (16) to the size of the enlarged aperture (20). The apparatus allows for a more secure fitting of the cannula whilst minimising the risk of infection.

Abstract: The present invention relates to a safety pen needle device comprising a generally tubular hub having a proximal and a distal end, said hub comprising attachment means arranged at its distal end for attaching the safety pen needle device to a medicament container assembly, and a coaxially arranged needle attachment member; an injection needle having an injection end and a non injection end, said injection needle being attached inside said hub and extending through the needle attachment member; wherein said device further comprises a generally tubular rotatable sleeve rotatable arranged on said hub, said rotatable sleeve comprising on its outer circumferential surface at least one guide track comprising flexible means; a generally tubular needle shield slidably arranged on said rotatable sleeve, said needle shield comprising at least one guide protrusion on its inner circumferential surface, wherein said at least one protrusion is arranged to interact with said at least one guide track and with said flexible m