Abstract: In a sheath device for inserting a catheter into a patient's body, comprising a first sheath having a proximal end and a distal end, wherein when used as intended the distal end of the first sheath is provided for arrangement in the patient's body and the proximal end of the first sheath is provided for arrangement outside the patient's body, and wherein the first sheath comprises a tubular section and a sheath housing, which is disposed at the proximal end of the section and comprises a receiving channel for a catheter, according to the invention the tubular section is detachably held in a clamping element of the sheath housing in a non-positive manner so as to be able to easily shorten the tubular section.

Abstract: A medical catheter includes a deflectable and compressible catheter shaft; a pull ring near a distal end of the catheter shaft; a distal tip that includes a tip element and a mounting shaft; and an attachment apparatus for securely attaching the distal tip to the catheter shaft, the attachment apparatus including a compression ring which compresses the catheter shaft and the mounting shaft together. The compression ring can be located around the catheter shaft to compress the catheter shaft against an outer surface of the mounting shaft, or within the catheter shaft to compress the catheter shaft outwardly against an inner surface of the mounting shaft. The catheter can be a non-irrigated ablation catheter, with the tip element being a tip electrode, and it can be an irrigated ablation catheter, with the distal tip including a fluid manifold.

Abstract: A system by which resource information relating to an insertable medical device, such as an intravascular catheter, can be identified by its source so as to be accessed by a practitioner, caregiver, or patient, is disclosed. In particular, a resource information key is included at a predetermined key location on or proximate to the medical device, wherein the key indicates the source of the resource information. In one example embodiment, therefore, an insertable medical device for establishing intravascular access to a patient, such as a peripherally inserted central catheter (“PICC”), is disclosed and comprises: an internal portion configured for intravascular insertion into the patient, and a portion external to the patient. The exterior portion of the PICC includes a resource information key that is positioned at a predetermined key location. The resource information key indicates a website where a user can acquire the resource information relating to the medical device.

Abstract: An anchoring system secures a catheter to the body of a patient and arrests axial movement of the catheter without meaningfully impairing fluid flow through the catheter. The anchoring system includes an anchor pad that adheres to the patient's skin and supports a retainer. The retainer includes interengaging structure that moves the retainer between an open and a closed position. When in the open position, the retainer can receive a portion of the catheter and be subsequently moved to the closed position. Advantageously, the interengaging structure allows the retainer to receive catheters of various sizes. The retainer may further include one or more retention mechanisms to further inhibit axial movement of the catheter relative to the retainer when the catheter is secured therein. The anchoring system may include a mount that allows the retainer to rotate relative to the anchor pad.

Abstract: The present disclosure pertains to a fixing tool for holding a tubular catheter fixed in relation to the skin of a patient. This catheter fixing tool is equipped with a plate-shaped fixing tool main body and a securing member. The fixing tool main body has a retaining part, defining a catheter retaining slot, and a pair of wing pieces. The securing member can be interlocked with the fixing tool main body by rotating the securing member in a direction parallel to a principal surface of the fixing tool main body taking a virtual line perpendicular to the principal surface as the central axis C1. When securing member is rotationally interlocked with the fixing tool main body, the securing member presses the retaining part and the catheter securing slot is constricted. As a result, the catheter is held fixed by the securing member.

Abstract: The present invention discloses a catheter instrument 1000 comprising a needle tip shielding device 100, a catheter hub 200 and a needle unit 300, wherein the needle unit 300 is provided with connecting means 301 for connection to the catheter hub 200, and with connecting means 302 for connection to an external device.

Abstract: A guide is used for the selective catheterism of anatomic structures and for placing therapeutic instruments.

Abstract: Systems and methods are provided for performing a medical procedure within a patient's body that involves a thoracic duct including an ostium communicating with the patient's venous system. A distal end of a catheter is introduced through the patient's venous system into a body lumen adjacent the ostium of the thoracic duct. An expandable member on the distal end of the tubular may be expanded adjacent the ostium, e.g., within the body lumen or the thoracic duct itself, and used to isolate the thoracic duct from the body lumen, whereupon a medical procedure may be performed via the thoracic duct. For example, lymphatic fluid may be removed from the thoracic duct through a lumen of the tubular member and/or one or more agents may be introduced into the thoracic duct through the tubular member.

Abstract: A method for manufacturing a safety catheter includes a flexible, multi-lumen shaft having a drain lumen draining fluid adjacent a distal tip of the shaft out a proximal drain end of the shaft and an inflation lumen. A hollow balloon portion has an inflation port fluidically connecting the inflation lumen to the balloon interior to inflate the balloon outwardly larger than a diameter of the shaft. The drain lumen is fluidically connected to the balloon interior by a drainage port. A hollow stretch valve in the drain lumen prevents fluid from passing through the drainage port in a steady state and permits fluid to pass therethrough in a stretched state when the shaft is stretched. Distal of a proximal end of the stretch valve, the shaft has a stretching extent that is relatively more stretchable than at least a portion of the shaft that is proximal of the stretching extent.

Abstract: Devices and methods for treating heart disease by normalizing elevated blood pressure in the left and right atria of a heart of a mammal are disclosed. The devices are adapted to permit fluid flow across the membrane in which the device is implanted at first rate, and at a second rate, wherein a difference between the first rate and the second rate is not solely dependent upon variations in blood pressure differential across the membrane due to the heart's pumping cycle.

Abstract: Implantable shunt devices and methods for draining cerebrospinal fluid from a patient's subarachnoid space include a shunt having opposed first and second ends, the second end being constructed to penetrate a wall of a sigmoid, transverse, straight, or sagittal sinus of the patient, a one-way valve, a hollow passageway extending between the second end and the one-way valve such that cerebrospinal fluid can be drained through the second end and out through the valve, and a mechanism coupled to the shunt and configured to anchor the shunt at a desired location proximal to the subarachnoid space.

Abstract: The present invention relates to an external nasal dilator, more specifically to an improved external nasal dilator, which provides a focused and efficient spring force to the outer wall tissues of a first and second nasal passages.

Abstract: Systems and methods for administration of small volume sufentanil drug dosage forms to the sublingual mucosa of a subject using a device are disclosed. The dispensing device includes a lock-out feature and a means to retard or prevent saliva and/or moisture ingress such that the drug dosage forms in the device remain dry prior to administration.

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 invention is directed to airless storage and dispensing systems that include a pump or dispensing package pre-filled with a topical semi-solid imiquimod pharmaceutical formulation (“pump systems”) and methods for storing and dispensing from the pump systems a plurality of precisely measured and uniform unit doses of a topical semi-solid imiquimod pharmaceutical formulation, and more particularly to pump systems, pre-filled with a topical imiquimod pharmaceutical cream and methods for delivering multiple precisely measured unit doses of a topical imiquimod pharmaceutical cream, and methods for using a controlled delivery pump system to store and dispense a plurality of consistent and precisely measured unit doses of a topical imiquimod pharmaceutical cream for use in topically treating a dermal and mucosal-associated condition, such as, external genital warts and/or perianal warts (EGWs), actinic keratosis or actinic keratoses (AK or AKs) and superficial basal cell carcinoma (sBCC).

Abstract: Described here are brachytherapy applicators that comprise a modular support matrix. The modular support matrix may define the arrangement of radiation source lumens within the brachytherapy applicator. The modular support matrix can be adjusted to position the radiation sources to obtain a certain dose and dose profile. A series of modular support matrices may be operably connected according to patient anatomy or dosing requirements. Systems and methods for using such modular brachytherapy applicators are also described.

Abstract: Bubble presence within a region is monitored to determine if a predetermined condition is met such as whether the presence is of sufficient magnitude, the bubbles being subject to energizing (240). In some embodiments, the energizing only occurs when time- wise preceded by the determination (S508, S510). The determining can include measuring a grayscale value (104), or assessing the energy carried by a frequency component of the echo signal, in the region in real time. The energizing may occur region-by-region, automatically and without need for user intervention, in a treatment pass (S428) over the regions. The regions (232) in the pass might be subject to respective instances of the energizing without intervening monitoring, or, in another embodiment, to both the determining and the responsive energizing. The determining can be subject to, automatically and without need for user intervention, interruption (S408) and concurrent switching to a next region.

Abstract: A wound care dressing is provided, including a hydrophobic base fabric, a plurality of electrode pairs, a plurality of hydrogel layers, and a waterproof thin film. The hydrophobic base fabric has a first surface and a second surface opposite to each other. The electrode pairs are arranged in an array and disposed on the first surface of the hydrophobic base fabric. The hydrogel layers are not in contact with one other, and each hydrogel layer covers a top surface and side walls of each electrode in the electrode pairs. After the hydrogel layers are in contact with a wound and absorb tissue fluid from the wound, the hydrogel layers form a restrictive electronic cycling channel with the electrode pairs to establish a plurality of bioelectric fields promoting wound healing on a surface of the wound. The waterproof thin film is disposed on the second surface of the hydrophobic base fabric.

Abstract: The present invention provides a flexible circuit electrode array adapted for neural stimulation, comprising: a polymer base layer; metal traces deposited on the polymer base layer, including electrodes suitable to stimulate neural tissue; a polymer top layer deposited on the polymer base layer and the metal traces at least one tack opening. The present invention provides further a method of making a flexible circuit electrode array comprising depositing a polymer base layer; depositing metal on the polymer base layer; patterning the metal to form metal traces; depositing a polymer top layer on the polymer base layer and the metal traces; and preparing at least one tack opening.

Abstract: Electrical neurostimulation leads for use in craniofacial peripheral nerve neurostimulation (e.g. occipital neurostimulation). Paddle leads, lead wires, lead wire anchors, tools, or other hardware can be designed for implantation in the craniofacial region. This can address problems of electrical neurostimulation in the craniofacial region such as lead migration, hardware breakage, patient discomfort, or other problems.

Abstract: The disclosure is directed to securing electrodes of a medical lead adjacent to a target tissue site. The medical lead may include at least one adhesive element disposed along a longitudinal outer surface of the lead body to adhere the adjacent tissue to the lead. Adhesive elements may be disposed proximal to, distal to, or in-between the electrodes of the lead. Each adhesive element may be inactive during lead implantation and activated by removing a covering sheath to expose the adhesive elements to moisture in the tissue or presenting an energy, e.g. ultraviolet light, to the adhesive elements. Once active, the adhesive elements secure the lead to surrounding tissue to prevent migration of the electrodes from the target tissue.

Abstract: Embodiments of the invention provide apparatus and methods for stimulating L cells in the intestinal tract to produce incretins for the treatment of conditions including diabetes and obesity. Many embodiments provide a method and apparatus for the treatment of diabetes by electrically stimulating L-cells to secrete incretins to stimulate or otherwise modulate the production of insulin. Particular embodiments provide a swallowable capsule for stimulating L-cells in the intestinal tract as the capsule moves through the tract. The capsule can include two or more electrodes for providing electrical stimulation to L-cells, a power source for powering one or more components of the capsule, a sensor for sensing the location of the capsule in the intestinal tract; a controller and a waveform generator for generating the electrical signals emitted by the electrodes to stimulate the L-cells to secrete incretins such as GLP-1 to stimulate insulin production for glucose regulation of diabetic conditions.

Abstract: In various embodiments, the invention disclosed herein provides systems, devices and methods for providing electrical stimulation to a patient. An electrical mechanical interconnection is provided to facilitate user friendly systems and devices. Exemplary therapeutic electrical stimulation devices include a shoe connected mechanically and electrically to a conductor that provides signals for electrical stimulation.

Abstract: An exemplary sound processor included in a cochlear implant system associated with a patient may 1) identify a loudness level of an audio signal presented to the patient, 2) determine that a stimulation pulse amplitude corresponding to the loudness level is greater than a maximum stimulation pulse amplitude allowed by a compliance voltage associated with a cochlear implant implanted within the patient, and 3) direct, in response to the determination that the stimulation pulse amplitude is greater than a maximum stimulation pulse amplitude allowed by the compliance voltage, the cochlear implant to represent the loudness level to the patient by directing the cochlear implant to generate and apply one or more stimulation pulses to the patient in accordance with at least one of a first encoding scheme that includes pulse density modulation and a second encoding scheme that includes a combination of pulse amplitude modulation and pulse width modulation.

Abstract: An implantable neurostimulator-implemented method for enhancing post-exercise recovery through vagus nerve stimulation is provided. An implantable neurostimulator, including a pulse generator configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (in both afferent and efferent directions) of action potentials within neuronal fibers including a patient's cervical vagus nerve. An operating mode is stored in the pulse generator. An enhanced dose of the electrical therapeutic stimulation is parametrically defined and tuned to prevent or disrupt tachyarrhythmia through continuously-cycling, intermittent and periodic electrical pulses. The patient's physiological state is monitored during physical exercise via at least one sensor included in the implantable neurostimulator, and upon sensing a condition indicative of cessation of the physical exercise, the enhanced dose is delivered for a period of time the enhanced dose to the vagus nerve.

Abstract: An implantable stimulation system comprises a stimulator for generating electrical stimulation and a conductive stimulation lead having a proximal end electrically coupled to the stimulator, wherein at least a first component of the impedance looking into the stimulator is substantially matched to the impedance of the stimulation lead. At least one distal stimulation electrode is positioned proximate the distal end of the stimulation lead.

Abstract: A method of delivering electrical stimulation energy includes receiving stimulation parameters such as a selection of one or more electrodes, a stimulation amplitude, and a stimulation frequency. The stimulation parameters define, at least in part, an electrical stimulation energy deliverable as a series of electrical pulses at the stimulation frequency. The method also includes receiving a duty cycle parameter that indicates a relative number of the electrical pulses to be suppressed; and delivering the electrical stimulation energy to patient tissue through the stimulation lead. A percentage of the electrical pulses are suppressed according to the duty cycle parameter. Optionally, a distribution parameter is received that indicates how suppressed electrical pulses are to be distributed among the electrical pulses. Optionally, a suppression level parameter is received that indicates a reduction of the stimulation amplitude for each electrical pulse that is to be suppressed.

Abstract: A patient suffering from congestive heart failure is at increased risk of cardiac arrhythmogenesis during sleep, particularly if experiencing central sleep apnea as a co-morbidity. Low intensity peripheral neurostimulation therapies that target imbalance of the autonomic nervous system have been shown to improve clinical outcomes. Thus, bi-directional autonomic regulation therapy is delivered to the cervical vagus nerve at an intensity that is insufficient to elicit pathological or acute physiological side effects and without the requirement of an enabling physiological feature or triggering physiological marker. The patient's physiology is monitored to identify periods of sleep. In one embodiment, upon sensing a condition indicative of tachyarrhythmia following a period of bradycardia, as naturally occurs during sleep, an enhanced “boost” dose of bi-directional neural stimulation intended to “break” the tachyarrhythmic condition is delivered.

Abstract: Devices and methods for detecting a physiological target event such as events indicative of HF decompensation status are described. An ambulatory medical device is configured to determine the presence and timing of a confounding event, segment a sensed physiological signal into at least two data segments, adjust the physiological signal by removing or lessening the impact of the confounding event on the physiological signal. The adjusted data can be presented to the user, and the ambulatory medical device can detect the target events using the adjusted physiologic signal. In some embodiments, the ambulatory medical device can be configured to detect an event indicative of HF decompensation using a physiological signal and the information of the detected confounding event.

Abstract: Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval. One manner described involves dynamically programming an AV interval in cardiac resynchronization therapy (CRT) device having a rate-adaptive AV (RAAV) feature in such a way that not less than a minimum AV interval is maintained. That is, the AV interval is not allowed to be reduced so much that the P-wave is truncated by the QRS complex. In this form of the invention, the AV interval is reduced by one millisecond per one bpm increase in heart rate (and vice versa for reducing heart rate) but maintained at a value calculated from the end of the P-wave (PWend) and the beginning of the QRS complex (QRSbeg) or delivery of a ventricular pacing stimulus or to the end of the end of the QRS complex (QRSend).

Abstract: A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings.

Abstract: A method of treating a patient and an external programmer for use with a neurostimulator. Electrical stimulation energy is conveyed into tissue of the patient via a specified combination of a plurality of electrodes, thereby creating one or more clinical effects. An influence of the specified electrode combination on the clinical effect(s) is determined. An anatomical region of interest is displayed in registration with a graphical representation of the plurality of electrodes. The displayed anatomical region of interest is modified based on the determined influence of the specified electrode combination on the clinical effect(s).

Abstract: Electrode voltage monitoring circuitry for an implantable neurostimulator system having a plurality of electrode-driver integrated circuits (ICs) in provided. Electrodes from either or both ICs can be chosen to provide stimulation, and one of the IC acts as the master while the other acts as the slave. Electrodes voltages on the slave IC are routed to the master IC, and thus the master IC can monitor both electrode voltages on the slave as well as electrode voltages on the master. Such voltages can be monitored for a variety of purposes, and in particular use of such voltage is disclosed for determining the resistance between electrodes and to set a compliance voltage for stimulation.

Abstract: A system and method for outputting historical stimulation information includes a processor configured to assign individual display regions, e.g., pixels or voxels, (or a larger region) a score based on those volumes of activations (VOA) in which the individual display region had been included and the scores assigned to those VOAs, and display in a display device a map of varying graphical indicia based on the different scores assigned to the elemental display regions.

Abstract: Methods, systems, and devices for dynamically adjusting a user interface provided by an external unit of a hearing device. In an example method, the external unit determines whether a state of the external unit is one of (i) a coupled state when the external unit and the stimulation unit are coupled or (ii) a decoupled state when the external and the stimulation unit are decoupled. The external unit then provides one of (i) a first user interface when the determined state is the coupled state or (ii) a second user interface when the determined state is the decoupled state. The second user interface provides access to a greater number of functions of the hearing device than first user interface provides.

Abstract: A system for providing alerts of neurological events occurring in a human subject is provided. The system includes: a monitoring module adapted to detect and sample a neurological signal; an event detection module coupled to the monitoring module for detecting one or more types of predetermined reportable events based on the detected neurological signal; and an alert module coupled to the event detection module, wherein upon the detection of a reportable event by the event detection module, said alert module selects a first alert contact from a plurality of contacts contained in a contact list, and generates a first alert communication to the first alert contact.

Abstract: Processes for manufacture and assembly of implantable medical devices are described. In particular, techniques are provided for nondestructive electrical isolation assessment of feedthrough assemblies of the implantable medical devices. The feedthrough assemblies may include an insulating structure, a plurality of terminal pins extending through the insulator and a ferrule having an inner lumen into which the insulating structure is disposed. One or more insulating seals may be disposed at the interface of the ferrule-to-insulating structure and/or the terminal pin-to-insulating structure. The electrical isolation assessments may be based on the dielectric properties of the components of the feedthrough assemblies, such as the insulating structure.

Abstract: A device includes a hermetically sealed case with electronic circuitry housed within. One surface of the hermetically sealed case includes a metallic plate and a co-fired ceramic electrical feedthrough with a number of vias. The co-fired ceramic electrical feedthrough is hermetically joined to the metallic plate and a hybrid circuit is connected to the feedthrough.

Abstract: A medical device control unit may include at least one processing device, a circuit electrically coupled to the at least one processing device, and a flexible housing configured to contain the at least one processing device and the circuit. The flexible housing may include at least one connection portion configured to engage a connector protruding from a flexible carrier, and at least one electrical contact electrically coupled to the circuit and configured to establish an electrical connection with an exposed electrical contact on the flexible carrier when the connection portion is engaged with the at least one connection portion.

Abstract: An external control device includes a human-computer interface, a first controller and a power transmitting unit. An implantable medical device includes a power receiving unit, a second controller and a second detector. A method for monitoring power supply comprises: producing a first magnetic field by the power transmitting unit; sensing the first magnetic field to produce a second magnetic field and converting it into a direct current by the power receiving unit; detecting a power value of the direct current by the second detector to output a detection signal to the second controller; outputting a status information to the external control device by the second controller according to the detection signal; and receiving the status information by the first controller. The first controller transmits an adjustment signal to the power transmitting unit if informed of the status information that the power value is not within a designate power range.

Abstract: An implantable pacemaker detects delivery of an anti-tachyarrhythmia shock by another device. The implantable pacemaker delivers cardiac stimulation therapy within a patient. The implantable pacemaker senses, via the electrode pair, an electrical signal. The implantable pacemaker detects the anti-tachyarrhythmia shock based on the sensed electrical signal by detecting DC voltage polarization across the electrode pair within the patient. The implantable pacemaker alters the cardiac stimulation therapy based on the detected anti-tachyarrhythmia shock.

Abstract: An implantable medical device includes a low-power circuit and a multi-cell power source. The cells of the power source are coupled to a transformer in a parallel configuration. The transformer includes multiple secondary windings and each of the windings is coupled to a capacitor that stores energy for delivery of a therapy to a patient. In accordance with embodiments of this disclosure, the low power circuit is configured to control simultaneous delivery of energy from each of the cells to a plurality of capacitors through the transformer.

Abstract: The invention relates to a method for cosmetic skin smoothening wherein two magnetic fields are generated perpendicular to each other and wherein the field strength of a quasi-static magnetic field or the frequency of an alternating magnetic field is modulated.

Abstract: A waveguide neural interface device including: a neural device implantable in tissue and including an array of electrode sites that electrically communicate with their surroundings, in which the array of electrode sites includes at least one recording electrode site; and a waveguide, coupled to the neural device, that carries light along a longitudinal axis and includes a light directing element that redirects the carried light from the waveguide to illuminate selectively targeted tissue, in which at least a portion of the redirected light is directed laterally away from the longitudinal axis and the recording electrode site is configured to sample illuminated tissue. A method for assembling a waveguide neural interface device is also described.

Abstract: A radiotherapy apparatus includes a source of radiation, a patient support for locating a patient in the field of the source of radiation, a position detector for determining a position of a patient relative to the radiotherapy apparatus, a comparator for comparing the output of the position detector with a predetermined position, and a feedback system for informing the patient of the output of the comparator.

Abstract: Dosimetrical end-to-end quality assurance devices, systems, and methods for radiation devices using X-ray imaging, optical surface imaging, and electromagnetic navigational systems to position the quality assurance device either absolute or relative in space.

Abstract: The invention disclosed a high-intensity focused ultrasound thermal ablation apparatus having integrated temperature estimation and elastography for thermal lesion determination and the method thereof, using the different power to burn by the same focused ultrasound transducer, and then using the apparatus to measure the temperature and elasticity estimating by the relevant analysis method.

Abstract: The present invention relates to polygalactomannan compositions, and more particularly cationic guar gum compositions, which, when crosslinked with glyoxal, from discrete guar particles which are capable of being easily dispersed in water which permits subsequent processing of the guar, such as washing. The guar and its derivatives are desirable for use in applications such as personal care, household care products and the like.

Abstract: Dehydroascorbic acid and polymeric/monomeric derivatives and isomers thereof are useful for artificially coloring the skin and more particularly as a skin self-tanning agent; the dehydroascorbic acid may be formed “in situ” from ascorbic acid or a derivative or salt thereof via chemical oxidation and/or via enzymatic oxidation, and a two-component agent thereof includes a) a first component (B) containing, in a physiologically acceptable medium, at least ascorbic acid or a derivative or salt thereof; b) a second component (C) containing, in a physiologically acceptable medium, at least one chemical oxidizing agent and/or one enzymatic oxidizing agent; components (B) and (C) being stored separately.

Abstract: Nonwoven safety garments include, in some embodiments, features of the stitching which limit the number of particulates emitted from seams between cut edges. Attachments features may be included on the garments to enable secure, external attachment of measuring equipment. Doffing features, such as loops, are provided to help the wearer safely remove the garment, either by helping her pull off part or all of the garment or by starting to separate closure devices, while avoiding contact between the wearer's hands and head, neck or body. In some embodiments, a re-positionable elastic closure on a neck flap covers the neck up to the bottom of a face mask or respirator, and a grasping tab helps the wearer safely open the re-positionable closure and the neck flap without contacting his or her neck or the interior of the garment, thereby avoiding a personal contamination event.