DESCRIPTION

The present invention relates to a collector arranged to collect nasal secretion contained in the liquid used for performing a nasal wash in a repeatable manner without the support of healthcare providers . DESCRIPTION OF THE STATE OF THE ART

Nasal secretion taken from the nasal cavities , and more in particular from the nasopharyngeal or ol factory area, is normally used to perform examinations aimed at diagnosing the origin of upper respiratory tract infections . In most cases , samples of nasopharyngeal secretion are taken by using a normally flexible stick, provided with a sterile cotton swab at one free end, commonly referred to synthetically as a "nasal swab, " which gives the examination its name . Operationally, the end provided with the swab is inserted into a nasal cavity and pushed hori zontally to reach the nasal mucosa of the nasopharyngeal area or upwards to reach the nasal mucosa of the ol factory area until resistance is felt , which allows the identi fication of reaching the area where the secretion sample is to be taken . According to health protocols ( in Italy issued by the I stituto Superiore di Sanita (= Italian Healthcare Institute ) ) once the area to be sampled has been reached, the swab is swiped over this area and turned on itsel f for 15 seconds using the relative stick .

The use of the swab has some critical issues regarding the method, the risks and side ef fects listed below : the healthcare provider must implement all anticontamination procedures for him/hersel f and the patient ; - the healthcare provider must have an in-depth knowledge of the nasal cavities and the posterior wall of the nasopharynx, in particular, the swab must pass through : the vestibule and the nasal valve , the nasal cavity delimited laterally by the turbinates and medially by the nasal septum, whose irregularities , deviation or low septal crest , may be an obstacle to the passage of the swab to reach the posterior wall of the nasopharynx ;

- the mucous membrane , which covers and protects the inner wall of the nasal cavity, consisting of a respiratory epithelium in which most of the cells are ciliated and cilia, which are immersed in an aqueous fluid " sol" while on the surface there is a very thin layer of viscous mucus " gel" together form the "mucociliary system" .

- the "mucociliary system" is an extremely fragile and vulnerable barrier that can be easily damaged by rubbing as the swab passes inside the nasal cavity to reach the area where the secretion sample is taken and for the repair of which several weeks are required while , in the meantime , the entry of pathogens , including but not limited to microorganisms and pollutants , is facilitated .

Therefore , the frequent use of nasopharyngeal swabs results in side ef fects , including :

- permanent damage to the nasal mucosa, in particular of the mucociliary system with formation of fibrous tissue replacing respiratory tissue , with which acute pain is frequently associated;

- abnormalities of the nasal septum, in particular a low septal crest , may obstruct , even only partially, the passage of the swab through the nasal cavity preventing it from reaching the posterior wall of the nasopharynx or cause a blood ves sel to rupture resulting in hemorrhaging . In addition, once the sample has been taken, the swab must be placed in a test tube with flexible walls inside which there is a reagent ; the walls of the test tube are pressed against the swab so that any virus that may be present comes out of the swab, therefore the amount of virus that will come out depends on the type of swab and the healthcare provider .

When the healthcare provider is unable to reach the posterior wall of the nasopharynx or when the swabbing is performed by an inexperienced healthcare provider or when the healthcare provider leaves the patient the responsibility of performing the swab on him/hersel f , the risk of " false negatives" is obviously very high .

Therefore , the use of the swab has some critical issues and subj ective variables that reduce its reliabi lity and make it potentially harmful .

With regard to what has been described above , it would be useful to have a device that allows the taking :

- of nasal secretion samples not only without damaging the nasal mucosa, in particular the mucociliary system, but even improving its trophism;

- in a standardi zed and repeatable manner, in complete autonomy without the support of a healthcare provider, thus without burdening health care facilities ; and

- in children without traumati zing them .

In view of the situation described above , it would be desirable to have a device of practical use and limited cost that allows patients to independently and ef fectively collect biological material not only from their own nasopharyngeal and ol factory areas but from the mucosa lining all the anatomical structures present inside both nasal cavities and from all the lymphatic tissue present in the nasopharynx in a repeatable manner .

This would help to reduce false negatives and to perform very accurate monitoring in suf ficient numbers to provide up-to-date information on infection trends , without j eopardi zing the health of practitioners who would also benefit from the availability of more time to devote exclusively to the care of the most severe patients of other diseases as well .

On the other hand, it may be useful to point out that the particular shape of a device that can be used to take a sample of nasal secretion has nothing to do with the methods of diagnos is that are performed in a subsequent step on this sample and that could be performed on a sample taken from any other human or animal anatomical structure or cavity .

SUMMARY OF THE PRESENT INVENTION

The present invention relates to a collector arranged to collect nasal secretion contained in the liquid used for performing a nasal wash in a repeatable manner without the support of healthcare providers .

The above drawbacks are solved by the present invention according to at least one of the following claims .

According to some embodiments of the present invention, a collector for collecting a liquid used for performing a nasal wash is implemented, said collector comprising a concave body delimited laterally by two sides connected at the front by a first wall and at the rear by a second wall ; said concave body being divided in a fluid-tight manner into a first cavity and a second cavity by means of a septum arranged between said first wall and said second wall ; said first wall being shaped in an externally concave manner and delimited at the top by a first curved section that develops between two corner portions and has a respective concavity facing upwards ; said septum being arranged between said two corner portions and has a raised portion that extends over said curved section . According to an embodiment as described above , said septum is delimited at the top by a second section having an attachment portion attached to said second wall where said attachment portion is arranged in a lowered position compared to said raised portion .

According to an embodiment as described above , said second section has an upwardly inclined portion which is at least partially straight and connects said attachment portion to said raised portion .

According to an embodiment as described above , said second section is connected with said raised portion by means of a lowered portion delimited by a "U" -shaped edge .

According to an embodiment as described above , at least one said side is at least partially open and carries a support member shaped to house feeding members designed to administer liquid inside a nasal cavity between said first wall and the second wall .

According to an embodiment as described above , each said side is at least partially open and carries a support member shaped to house dispensing means designed to administer liquid inside a nasal cavity through a nasal dispenser between said first wall and the second wall . According to an embodiment as described above , said liquid dispensing means comprise a syringe that carries said nasal dispenser by means of an "L" -shaped fitting; said fitting having a first part shaped to couple with the spout of said syringe and a second part arranged to rest laterally and directly on said septum .

According to an embodiment as described above , said support member is transversely facing said septum or said "U" - shaped lowered portion .

According to an embodiment as described above , said fitting externally has a protrusion delimited by a profile curved similarly to said fitting to act as a stop for said septum and to distance said nasal dispenser from said septum by the amount necessary to allow correct positioning with respect to the nostril to be sprayed with said washing liquid .

According to an embodiment as described above , said profile is designed to interact by sliding with said septum when, in use , said syringe is removed by upward rotation from said support member .

According to an embodiment as described above , each said support member has a retaining element for retaining said syringe at the respective said side ; said retaining element comprising a circumferential proj ection at least partially cylindrical and arranged at the attachment of said support member to the respective said side .

According to an embodiment as described above , said concave body carries at the bottom a first duct in hydraulic communication with said first cavity by means of an inlet mouth and a second duct in hydraulic communication with said second cavity by means of an opening .

According to an embodiment as described above , at least one of said first duct and second duct is provided at the bottom with an outlet mouth or is alternatively provided with a closed bottom .

According to an embodiment as described above , said first duct or said second duct provided at the bottom with an outlet mouth has an annular seat for an opening part of a test tube , at least one axial abutment for said opening part , and radial retaining members for said opening part designed to define an annular meatus which, in use , allows said test tube to exchange air with the outside .

According to an embodiment as described above , said first duct and second duct are identical and each has an annular seat for an opening part of a test tube , at least one axial abutment for said opening part and radial retaining members for said opening part designed to define an annular meatus which, in use , al lows said test tube to exchange air with the outside .

According to an embodiment as described above , at least one of said first duct and second duct comprises filtering means .

According to an embodiment as described above , each said first duct and second duct has an inner shell ; said filtering means comprising a swab shaped to couple laterally in a matching manner to said shell .

According to an embodiment as described above , said filtering means comprise a screen member rigidly carried by said shell below the respective said inlet mouth to provide support for said swab .

BRIEF DESCRIPTION OF THE FIGURES

Further characteristics and advantages of the collector according to the present invention will appear clearer from the following description, set forth with reference to the attached figures which illustrate a non-limiting embodiment example thereof . In particular :

- Figure 1 is a schematic perspective view of a first preferred embodiment of a collector for liquids according to the present invention;

- Figure 2 illustrates Figure 1 with parts removed for clarity;

- Figure 3 is a bottom view of Figure 1 ;

- Figure 4 is a schematic perspective view of Figure 2 integrated with some accessories ;

- Figure 5 is a schematic perspective view of a second preferred embodiment of Figure 1 ;

Figure 6 is a plan view of Figure 5 ; - Figure 7 is a plan view of the Figure 5 with parts removed for clarity;

- Figure 8 is a schematic perspective view of a third preferred embodiment of Figure 1 integrated with some accessories ;

- Figure 9 is a side view of Figure 8 with parts removed for clarity;

- Figure 10 is a cross-sectional view of Figure 9 ;

- Figure 11 shows one of the accessories from Figures 8- 10 in side elevation accompanied by a first embodiment of a dispenser fitting;

- Figure I la ) shows a second embodiment of the dispenser fitting of Figure 11 ;

- Figure 11b ) shows a third embodiment of the dispenser fitting of Figure 11 ; and

- Figure 12 is a front view of Figure 4 on an enlarged scale and with parts removed for clarity, in which the relative accessory is illustrated in a plurality of rotated positions .

DETAILED DESCRIPTION OF THE PRESENT INVENTION

Before describing in detail the preferred embodiments of the present invention or details thereof , it is useful to speci fy that the relative scope is not limited to the particular embodiments described below . The disclosure and description in the present document are illustrative and explanatory of one or more embodiments and variations currently preferred, and it will be clear to experts skilled in the art that various changes can be made in the design, in the organi zation, in the order of operation, in the means of operation, in the structures of the equipment and position, and in the methodology and use of mechanical equivalents without departing from the spirit of the invention . In addition, it should be understood that the attached figures have the purpose of clearly illustrating and disclosing currently preferred embodiments to an expert skilled in the art, but they are not drawings that illustrate how these embodiments should be executed in reality or real representations of final products; on the contrary, these figures can comprise conceptual views simplified to facilitate comprehension or allow for an easier and quicker explanation. In addition, the relative dimensions and arrangement of the components can differ from those shown and still function within the spirit of the invention.

On the other hand, various indications such as "upper", "lower", "left", "right", "front", "rear", "proximal", "distal" and so on refer only to the explanation in combination with the drawings and the components can be oriented differently, for example during transport and production, and during operation. Since many different and distinct embodiments can be produced within the scope of the concepts taught herein, and since multiple modifications can be made to the embodiments described herein, it must be understood that the details provided below must be interpreted as illustrative and non-limiting with regard to the spirit of the invention.

In Figure 1, the number 1 indicates, overall, a collector 1 for collecting a liquid used for performing a nasal wash. The collector 1 comprises a concave body 10 delimited laterally by two lateral sides 2100 and 2100' connected at the front by a first wall 120, which hereinafter may be qualified by the term "proximal, " and at the rear by a second wall 122, which hereinafter may be qualified by the term "distal, " wherein these walls are shaped symmetrically with respect to a first plane T, the outline of which can be seen in Figure 3 .

With particular reference to Figures 1 and 2 , the first proximal wall 120 is delimited at the top by a concave curved section 1200 that is shaped for shape coupling, in use , with an anatomic facial portion arranged between the upper lip and nose of a user . In addition, the second distal wall 122 extends higher in height than the first proximal wall 120 so as to cover the user ' s nose during washing, and the curved section 1200 is delimited laterally by two symmetrically shaped corner portions 1202 which, in use , are designed to laterally delimit the nostrils and, in particular to engage the nasolabial folds or nasogenian furrows . These corner portions 1202 are raised with respect to a central portion of the first proximal wall 120 and, preferably but not limitedly, cuspidate , although they could be rounded without thereby departing from the scope of the present invention .

With particular reference to Figures 1 , 2 and 4 , the concave body 10 is divided in a fluid-tight manner into two funnel-shaped cavities by a septum 30 arranged between the first wall 120 and the second wall 122 , which will be identi fied hereinafter with the expression " first cavity 210" and " second cavity 210 ' " . The septum 30 is flat and oriented as the f irst plane T and has a raised portion 32 which extends over the curved section 1200 . With particular reference to Figure 1 , the septum 30 is delimited at the top by a second section 34 that has an attachment portion 36 attached to the second distal wall 122 where the attachment portion 36 is arranged in a lowered position compared to the raised portion 32 . The second section 34 has an upwardly inclined portion 38 which is at least partially straight and connects the attachment portion 36 to the raised portion 32 . The first funnel-shaped cavity 210 terminates in a first cylindrical duct 212 open at the bottom, which develops between an inlet mouth 214 , placed on the bottom of the first funnel-shaped cavity 210 and visible in Figures 2 and 4 , and an outlet mouth 216 , placed precisely at the end of the first duct 212 . The latter is delimited internally by a shell 2124 and is provided with first coupling members defined by an annular seat 2160 for a test tube 2162 , where this seat is arranged to house a respective opening part known and not illustrated .

With particular reference to Figures 2-4 , the first duct 212 may have a filtering device for the liquid collected in the first cavity 210 that comprises a screen 221 carried by the shell 2124 between the inlet mouth 214 and the outlet mouth 216 that is selectively usable to provide support for a filter swab of the f iltering device and known from the application PCT/ IB2021 / 052608 and not illustrated for economy of text and figures ; the teachings of this application are considered incorporated herein for convenience . The swab is insertable inside the shell 2124 through the inlet mouth 214 . The purpose of the swab is to retain any pathogens contained in the washing liquid discharged into the first cavity of the concave body 10 .

The first duct 212 has on the top, inside the annular seat 2160 , at least an axial abutment 2164 and internal and/or external radial spacers 2166 made through longitudinal ribs , visible in Figure 3 and in a relative enlargement , whose function i s to radially retain the opening part of the test tube 2162 and to define a substantially annular meatus between the shell 2124 and the outer wall of the housed test tube 2162 to allow the latter to exchange air with the outside , in order to allow it to be filled with the washing liquid . With reference to Figures 1 and 2 , the concave body 10 carries at the bottom a second duct 212 ' in hydraulic communication with the second cavity 210 ' through an inlet opening 2120 ' that is visible in Figures 2 and 4 . The second duct 212 ' is delimited longitudinally by a closed bottom 2122 .

In any case , it may be useful to point out that each swab can be produced with any material that is capable of filtering the liquid resulting from nasal wash to retain, as much as possible , pathogens , compris ing viruses , that may be present in the nasal cavities and removed by the washing liquid . These materials must also have the characteristic of being compressible but tending to resume the original undeformed conformation by completely filling the space in which the swab was inserted under pressure , between the inlet mouth 214 and the screen 221 .

For convenience , but without limiting the scope of the present invention, each swab may be produced exclusively in one , or in combination of at least two , of the following materials : cotton, natural silk, arti ficial si lk, nonwoven fabric .

In addition, the swab may have any shape that allows the part of the first duct 212 that develops between the inlet mouth 214 and the screen 221 to be fully engaged in order to prevent liquid leakage .

With particular reference to Figures 1-4 , the side 2100 ' of the second cavity 210 ' is provided with a support member 1240 ' which is semi-cylindrical and elongated according to a longitudinal direction D that cuts transversely through the first transverse plane T . The support member 1240 ' is cut in hal f by a second plane M that geometrically contains the direction D and the outline thereof , visible in Figure 3 ; the support member 1240 ' is arranged to house the dispensing members 40 designed to administer liquid inside a nasal cavity through a nasal dispenser 42 between the first proximal wall 120 and the second distal wall 122 on opposite side of the outlet mouth 216 .

With particular reference to Figures 1 and 2 , the support member 1240 ' has a retaining element 1242 of the syringe 44 at its side 2100 ' ; the retaining element 1242 comprises an at least partially cylindrical circumferential proj ection the angular width of which is equal to the angular width of the respective support member 1240 ' ( always greater than 180 ° ) and arranged at the attachment of the support member 1240 ' to the respective side 2100 ' , the purpose of which is to locally deform the shaft of the syringe 44 to improve the stability of its coupling with the collector 1 .

With particular reference to Figure 4 , and in more detail to Figures 11 , I la ) and 11b ) , the liquid dispensing members 40 comprise a syringe 44 that carries the nasal dispenser 42 through an "L" -shaped fitting 46 . The fitting 46 has a first part 46 ' shaped to couple with a spout of the syringe 44 and a second part 46 ' ' arranged to carry the nasal dispenser 42 . On the other hand, the fitting 46 may have a protrusion 460 delimited by an "L" -shaped profile 462 curved similarly to the fitting 46 where this protrusion is carried partially by the first part 46 ' and the second part 46 ' ' or even only by the second part 46 ' ' and is provided to rest on the septum 30 laterally . Therefore , the function of the protrusion 460 is to act as a stop for the septum 30 and to distance the nasal dispenser 42 from the septum 30 by the amount necessary to allow correct positioning of the dispenser 42 with respect to the nasal vestibule through which the washing liquid is introduced . As can be seen in Figures 11 and 11b ) , the protrusion 460 can take di f ferent shapes , or may even be absent as in Figure I la ) according to the respective design speci fications ; in this case , by moving the syringe 44 forward or backward, the correct position of the dispenser 42 can be found inside the nasal vestibule . The absence of the protrusion 460 allows the syringe 44 to be moved longitudinally until the outer wall of the dispenser 42 contacts the corresponding face of the septum 30 .

In particular, the profile 462 is designed to act as a sliding support for the same fitting 46 on the septum 30 when, in use , the syringe 44 is removed upward from the corresponding support member 1240 ' by performing a rotary movement that develops in the second plane M, as seen in Figure 12 in which the syringe 44 is illustrated in 4 successive positions .

The use of the collector 1 is easily understood in light of what has been described above and requires no further explanation . On the other hand, it may be useful to point out that , because of the way it is constructed, and in particular because of the presence of the second wall 122 , which defines a barrier that prevents , in use , the spread of spray into the environment , the collector 1 is usable for performing nasal washes by preventing the dispersion of the liquid used both in the dispensing and in the discharge step from any nasal cavity .

To perform the wash, the collector 1 must be equipped with a syringe 44 containing the washing liquid and provided with the nasal dispenser 42 through the fitting 46 . In particular, the syringe 44 will be housed with its respective shaft inside the support member 1240 ' , corresponding to the second cavity 210 ' . In order to collect the liquid dispensed for washing in the first cavity 210 the first coupling members 2160 of the first outlet mouth 216 will house a test tube 2162 through the respective opening part , visible in Figure 2 .

At this point the collector 1 can be moved closer by the user oriented with the first plane T substantially vertical , with the curved section 1200 of the first proximal wall 120 in contact with its facial portion arranged between the upper lip and the nasal pyramid, the two corner portions 1202 engaging the nasolabial folds , the raised portion 32 in the nasolabial corner, in the center of the philtrum, delimited at the sides by two vertical lines , and the inclined portion 38 of the second section 34 of the septum 30 below the columella, so that the septum 30 is ideally the continuation of the nasal septum and each of the first and second cavities 210/210 ' is the continuation of the respective nasal cavity . In this way, the collector 1 is arranged in the ideal position to perform the washing .

Next , the longitudinal position of the syringe 44 along the direction D can be adj usted so that the nasal dispenser 42 engages the nasal vestibule arranged on the side of the support member 1240 ' facing the second cavity 210 ' . Once the nasal dispenser 42 has been inserted inside the nasal vestibule , one will have to bend the head forward so that the washing liquid will propagate inside all the areas of the two nasal cavities comprising the ol factory areas and the nasopharyngeal area, by keeping the collector 1 with the first duct 212 and the second duct 212 ' substantially vertical it is certain that the discharge liquid will not be dispersed into the surrounding environment . At this point , the piston of the syringe 44 can be operated to dispense the liquid inside the nasal cavity through the nasal vestibule engaged by the nasal dispenser 42 , which can be referred to synthetically as the " inlet nasal cavity . " Once the liquid has flooded the nasal cavity corresponding to this nasal vestibule , the liquid will begin to flood the nasopharynx and, subsequently, the other nasal cavity, which may be referred to as the "discharge nasal cavity, " through which the liquid mixed with nasal secretion will exit outward to percolate into the corresponding first cavity 210 below, and, through the duct 212 , flow into the test tube 2162 .

In the event that the screen 221 and the relative swab are provided, the part of the liquid that will have soaked the swab itsel f can always be recovered inside the test tube 2162 by exerting pressure on the swab against the screen 221 .

Once the washing liquid has been completely discharged from the discharge nasal cavity, the inlet nasal vestibule can be released from the nasal dispenser 42 and, to do so , it can be rotated downwards by rotating the syringe 44 upwards while keeping the second part 46 ' ' of the fitting or the "L" -shaped curved profile 462 of the protrusion 460 of the fitting 46 , or the outer wall of the dispenser 42 in contact with the septum 30 , as in Figure 12 , depending on the actual shape of the fitting 46 .

Once the inlet nasal cavity has discharged all the liquid contained in the respective nasal cavity into the second cavity 210 ' , and therefore the second duct 212 ' has been filled, one can proceed to move the collector 1 from the position described above and be able to remove the test tube 2162 and subsequently discharge the collector 1 of the liquid contained in the second closed-bottom duct 212 ' . The exact positioning relative to the human face re ference points mentioned above allows the test to be repeated any number of times being certain to replicate identically the conditions under which the test was performed . This is so , both because this position is repeatable being associated with so-called " reference points" of the human face (precisely the two nasolabial folds , the nasolabial corner and the columella ) , and because the "mucociliary" system is not at all damaged by washing without having to involve any healthcare provider, and al so because when the collector 1 is positioned as described above the particular shape of the septum 30 makes it the arti ficial continuation of the nasal septum inside the collector 1 and, therefore , allows to be certain that the liquid reaching a given nasal cavity is discharged exclusively into the corresponding first cavity 210 or second cavity 210 ' , depending on which of the two is facing said nasal cavity . The discharge of the washing liquid contained in the nasal cavity facing the second cavity 210 ' and engaged by the dispenser 42 naturally follows the removal of the dispenser 42 from the corresponding nostril . Therefore , i f the particular shape of the septum 30 makes it an arti ficial continuation of the nasal septum inside the collector 1 , the first cavity 210 and the second cavity 210 ' are extensions of the relative nasal cavities .

In other words , having designed the collector 1 in such a manner that it can be used in thi s way prevents mixing of the fractions of liquid di scharged into the first and second ducts 212 /212 ' , therefore that the washing liquid flowing into the test tube 2162 is diluted by the washing liquid remaining inside the nasal cavity through which it was administered .

Finally, it is clear that modi fications and variations can be made to the collector 1 described and illustrated herein without thereby departing from the scope of the present invention .

In particular, the concave body 10 can be modi fied as in Figures 5-7 , where each side 2100/2100 ' carries a support member 1240/ 1240 ' and the second duct 212 ' is identical to the first duct 212 ( as represented and described with reference to Figure 2 ) to carry the two test tubes 2162 . In this way, it is possible to use the collector 1 to indi f ferently dispense washing liquid through the right nasal vestibule or through the left nasal vestibule and to collect in separate test tubes the fraction of liquid that will be discharged from the inlet nasal cavity and the fraction of liquid that , passing through the nasopharynx, will be discharged from the di scharge nasal cavity, without the two discharged fractions of liquid mixing inside the concave body 10 due to the presence and the particular shape of the septum 30 .

With reference to Figures 8- 10 , a collector 1 is proposed modi fied with respect to the previously described versions , in which the second section 34 is substantially hori zontal and centrally has a lowered portion 340 delimited by a "U" -shaped edge 342 which reconnects to the raised portion 32 from the side of the first proximal wall 120 .

Of course , the septum 30 described herein (with reference to Figures 8- 10 ) has been illustrated in combination with the version of the collector 1 with two support members 1240 and 1240 ' of Figures 5-7 , although it can be used to equip a collector 1 which carries only one support member 1240 ' , such as the one described with reference to Figures 1-4 .

In such a case , the second part 46 ' ' of the fitting 46 is , with the syringe 44 inside any one of the support members 1240 or 1240 ' , at a height in which it can rest laterally and directly on the septum 30 .

It is considered useful to point out that the presence of the screen 221 in the first duct 212 or in the second duct 212 ' is optional , since everything described above is valid whether said screen 221 is present or absent . And the same is also true for the case in which the use of the swab is preferred to be avoided .

In the claims , any reference sign in brackets should not be interpreted as a limitation to the claim . The words " that comprises" does not exclude the presence of other elements or steps in addition to those listed in a claim . Furthermore , the term "one" , as used in this context , is defined as one or more than one . Furthermore , the use of introductory expressions such as " at least one" and "one or more" in the claims should not be interpreted in the sense that the introduction of another claim element identi fied by using the indefinite article "a" or "an" limits any particular claim in which that claim element appears individually, even when the same claim comprises introductory expressions "one or more" or " at least one" and indefinite articles such as "a" or "an" . The same applies to the use of definite articles . Unless established otherwise , terms such as " first" and " second" are used to arbitrarily distinguish the elements that these terms describe . Therefore , these terms are not necessarily intended to indicate the temporal priority or other type of priority of these elements . The simple fact that some measures are set forth in mutually di f ferent claims does not indicate that a combination of these measures cannot be used to advantage .