Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Biomedical Technology”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Epidemiology of syphilis in the United States, 1941--1993.

BACKGROUND AND OBJECTIVES: The distribution and trends of syphilis are influenced by biologic factors, sexual behaviors, biomedical technology, availability of and access to health care, public health efforts, changes in population dynamics, and sociocultural factors. The objective of this article is to review the epidemiology of syphilis in the United States during the period 1941-1993 in the context of some of these factors. STUDY DESIGN: Surveillance data on cases of syphilis and congenital syphilis reported by state and city health departments to the Centers for Disease Control and Prevention were analyzed to show distribution and trends by geographic location, racial and ethnic groups, gender, and age. RESULTS: Historically, syphilis was distributed widely throughout the country and declined rapidly after the introduction of penicillin therapy and broad-based public health programs, attaining its lowest levels in the 1950s. However, in recent years, the disease has returned and become focused in the southern region and in urban areas outside that region. Rates of syphilis have remained highest in black Americans, and the most recent national epidemic of syphilis primarily involved them. Rates in white men were at intermediate levels during the early 1980s but have declined to low rates in the 1990s, possibly because of changes in behavior in response to the AIDS epidemic. Rates in white women and other racial and ethnic groups have remained low throughout the 1980s and 1990s. CONCLUSIONS: Syphilis remains a significant problem in the United States, and its epidemiology is influenced by a complex combination of factors. To prevent and control syphilis effectively, public health practitioners must understand these factors and design programs and interventions that address the disease in the context of these factors.

Age Distribution↗
PubMed2006

Long-term results of ossiculoplasty: reasons for surgical failure.

OBJECTIVES: To present the value of a dedicated ear audit clinic, the overall long-term results of ossiculoplasty, and the reasons for surgical failure. STUDY DESIGN: Retrospective analysis was performed on ossiculoplasty cases in a county hospital. The information was extracted from a computer database. Individual patient case records were reviewed in all cases of surgical failure. METHODS: All patients who had ossiculoplasty were routinely followed-up in a dedicated ear audit clinic on a yearly basis. Between 1988 and 1999, the author performed 242 ossiculoplasties and their outcomes were monitored in the ear audit clinic. The 5-year results are presented. RESULTS: Even with the benefit of a dedicated audit clinic and a stable population, only 74.4% of ears had a known outcome at 5 years after ossiculoplasty. In the present series, 61.1% of partial and 37.6% of total ossicular reconstructions have an air-bone gap of 20 dB or better at 5 years. Of 83 identifiable late failures, 47 were caused by persistent or recurrent abnormalities within the middle ear and only 36 were thought to be caused by prosthesis-related or surgeon-related problems. CONCLUSION: The overall long-term results of ossiculoplasty have not dramatically improved in recent years, in spite of all the great advances in biomedical technologies. Unless there is a breakthrough in the understanding and management of the underlying otitis media, the long-term outcome of ossiculoplasty is unlikely to improve dramatically.

Adolescent↗
PubMed2001

Practical issues and concepts in vagus nerve stimulation: a nursing review.

Estimates of epilepsy incidence among the U.S. population range between 0.5% and 1%. The most common type of seizure in adult patients is partial onset. Approximately 20% of these patients are refractory to antiepileptic drug therapy and experience intolerable side effects such as confusion, dizziness, weight gain, lethargy, and ataxia. The ketogenic diet appears to be beneficial for children but is not considered a standard option for adults. Epilepsy surgery can be an option for many and may offer control or a reduction in seizures. However, many patients are opposed to cranial surgery or may not tolerate the ketogenic diet. Recent advances in biomedical technology and perfection in surgical techniques have shown vagus nerve stimulation (VNS) using the Neuro Cybernetic Prosthesis (NCP) system is an effective new treatment option in reducing seizure frequency. On July 16, 1997, the U.S. Food and Drug Administration (FDA) approved the use of the NCP for vagus nerve stimulation, as an adjunctive treatment for refractory partial onset seizures in adults and adolescents over 12 years of age. Murphy et al. and Wheless have reported similar results in children younger than 12 years. VNS represents the first therapy using a medical device approved by the FDA for the treatment of refractory seizures. An estimated 10,000 patients have been implanted with the device.

Adolescent↗
PubMed2005

Unpacking the concept of patient satisfaction: a feminist analysis.

AIM: The aim of this paper is to present a feminist critique of the concept of patient satisfaction. BACKGROUND: Fiscal restraint, health care restructuring, shifting demographics, biomedical technological advances, and a significant shortage of health care professionals are stretching health care systems across North America to the breaking point. A simultaneous focus on consumerism and health service accountability is placing additional pressure on the system. The concept of patient satisfaction, with roots in the consumer movement of the 1960s, has both practical and political relevance in the current health care system and is commonly used to guide research related to consumer experiences of health care. Because the quality of health care encounters may lead to treatment-seeking delays, patient satisfaction research may be an effective vehicle for addressing this public health issue. However, there is wide agreement that patient satisfaction is an under-theorized concept. Using current conceptualizations of patient satisfaction, we end up all too often producing a checklist approach to 'achieving' patient satisfaction, rather than developing an understanding of the larger issues underlying individual experiences of health care. We focus on the symptoms rather than the problems. DISCUSSION: Without further theoretical refinement, the results of research into patient satisfaction are of limited use. To push forward theoretical development we might apply a variety of theoretical lenses to the analysis of both the concept and the results of patient satisfaction research. Feminism, in particular, offers a perspective that may provoke further refinement of patient satisfaction as a concept. CONCLUSIONS: Without a deeper understanding of the values and beliefs (or the worldview) that informs our approaches to researching patient satisfaction, researchers will be reacting to the most obvious indicators and failing to address the underlying issues related to individual experiences of health care.

Appointments and Schedules↗
PubMed2000

Health care savings from microbiological caries risk screening of toddlers: a cost estimation model.

OBJECTIVES: Modeling new biomedical technologies and determining their expected cost is necessary before initiating formal clinical trials. This paper estimates an economic model for the potential cost impact of microbiological screening of toddlers for caries risk compared to the traditional method of managing pediatric caries. METHODS: Potential cost savings were calculated based on screening test properties (sensitivity and specificity) derived from a population of 1,180 children aged 1 to 3 years with a caries prevalence of 15 percent. An algorithm was then developed to allocate prevalent and anticipate incident caries, treatment effectiveness assumptions, and existing regional treatment costs. RESULTS: The cost analysis model conservatively predicts savings of 7.3 percent from screening and early intervention. Cumulative dental treatment costs for a child at age 4 years are $367.90 if the child has been screened and $396.70 otherwise. The model further predicts that cost savings increase significantly as caries prevalence increases. CONCLUSIONS: Microbiologic risk assessment for pediatric caries may be an example of a preventive public health screening technique that results in both clinical benefits and cost savings. If the model is validated by randomized clinical trials, microbiologic screening could be used by pediatric primary care providers to identify toddlers who require early referral to dentists for further risk assessment and early caries management.

Algorithms↗
PubMed2005

High capacity implantable data recorders: system design and experience in canines and Denning black bears.

BACKGROUND: Implantable medical devices have increasingly large capacities for storing patient data as a diagnostic aid and to allow patient monitoring. Although these devices can store a significant amount of data, an increased ability for data storage was required for chronic monitoring in recent physiological studies. METHOD OF APPROACH: Novel high capacity implantable data recorders were designed for use in advanced physiological studies of canines and free-ranging black bears. These hermitically sealed titanium encased recorders were chronically implanted and programmed to record intrabody broadband electrical activity to monitor electrocardiograms and electromyograms, and single-axis acceleration to document relative activities. RESULTS: Changes in cardiac T-wave morphology were characterized in the canines over a 6 month period, providing new physiological data for the design of algorithms and filtering schemes that could be employed to avoid inappropriate implantable defibrillator shocks. Unique characteristics of bear hibernation physiology were successfully identified in the black bears, including: heart rate, respiratory rate, gross body movement, and shiver An unanticipated high rejection rate of these devices occurred in the bears, with five of six being externalized during the overwintering period, including two devices implanted in the peritoneal cavity. CONCLUSIONS: High capacity implantable data recorders were designed and utilized for the collection of long-term physiological data in both laboratory and extreme field environments. The devices described were programmable to accommodate the diverse research protocols. Additionally, we have described substantial differences in the response of two species to a common device. Variations in the foreign body response of different mammals must be identified and taken into consideration when choosing tissue-contacting materials in the application of biomedical technology to physiologic research.

Acceleration↗
PubMed1986

Pathobiology of platelet-activating factors.

Throughout the evolution of knowledge about inflammation, a primary goal has been to understand this important biological response in sufficient depth to prevent the unwanted tissue injury that may spontaneously occur or that may coevolve to produce disease. That is, although the host defense systems normally function in a protective manner, excessive activation or alterations of the homeostatic regulation of the inflammatory responses often results in overt tissue injury and organ dysfunction. Thus, significant attention has been focused upon precise definition of the interactions of the myriad of involved cells and mediators so that interventions may be developed to block these events to prevent and control inflammatory tissue injury. PAF, as a relative newcomer to the investigative eye of experimental pathologists, is a potent proinflammatory mediator of many aspects of the complex host defense system. No doubt, its role in the initiation and maintenance of tissue injury or disease will be conclusively documented with additional research and forthcoming advances in biomedical technology. At present, however, we must be content to accept the conclusion that, while it is tempting to speculate that this unique phospholipid is involved in many different disease processes, unequivocal details to this end are lacking. Nonetheless, the spectrum of antagonists of PAF action which are currently evolving [cf. 95-100] will undoubtedly permit assessment of the putative contributions of PAF to many biological conditions associated with disease. At that time, meaningful conclusions as to the biological role of PAF in human tissue injury and disease may be provided.

Animals↗
PubMed2003

Both hPTH(1-34) and bFGF increase trabecular bone mass in osteopenic rats but they have different effects on trabecular bone architecture.

UNLABELLED: Osteoporosis is a syndrome of excessive skeletal fragility that results from both the loss of trabecular bone mass and trabecular bone connectivity. Recently, bFGF has been found to increase trabecular bone mass in osteoporotic rats. The purpose of this study was to compare how trabecular bone architecture, bone cell activity, and strength are altered by two different bone anabolic agents, bFGF and hPTH(1-34), in an osteopenic rat model. MATERIALS AND METHODS: Six-month-old female Sprague-Dawley rats (n = 74) were ovariectomized (OVX) or sham-operated (sham) and maintained untreated for 2 months. Then OVX rats were subcutaneously injected with basic fibroblast factor (bFGF; 1 mg/kg, 5 days/week), human parathyroid hormone [hPTH(1-34); 40 microg/kg, 5 days/week], or vehicle for 60 days (days 60-120). Sham-operated and one group of OVX animals were injected with vehicle. Biochemical markers of bone turnover (urinary deoxypyridinoline cross-links; Quidel Corp., San Diego, CA, USA) and serum osteocalcin (Biomedical Technologies, Stroughton, MA, USA) were obtained at study days 0, 60, 90, and 120 and analyzed by ELISA. At death, the right proximal tibial metaphysis was removed, and microcomputed tomography was performed for trabecular bone structure and processed for histomorphometry to assess bone cell activity. The left proximal tibia was used for nanoindentation/mechanical testing of individual trabeculae. The data were analyzed with Kruskal Wallis and post hoc testing as needed. RESULTS: Ovariectomy at day 60 resulted in about a 50% loss of trabecular bone volume compared with sham-treated animals. By day 120 post-OVX, OVX + vehicle treated animals had decreased trabecular bone volume, connectivity, number, and high bone turnover compared with sham-operated animals [p < 0.05 from sham-, hPTH(1-34)-, and bFGF-treated groups]. Treatment of OVX animals with bFGF and hPTH(1-34) both increased trabecular bone mass, but hPTH(1-34) increased trabecular thickness and bFGF increased trabecular number and connectivity. Histomorphometry revealed increased mineralizing surface and bone formation rate in both bFGF and hPTH(1-34) animals. However, osteoid volume was greater in bFGF-treated animals compared with both the hPTH(1-34) and OVX + vehicle animals (p < 0.05). Nanoindentation by atomic force microscope was performed on approximately 20 individual trabeculae per animal (three animals per group) and demonstrated that elastic modulus and hardness of the trabeculae in bFGF-treated animals were similar to that of the hPTH-treated and sham + vehicle-treated animals. CONCLUSION: Both hPTH(1-34) and bFGF are anabolic agents in the osteopenic female rat. However, hPTH(1-34) increases trabecular bone volume primarily by thickening existing trabeculae, whereas bFGF adds trabecular bone mass through increasing trabecular number and trabecular connectivity. These results suggest the possibility of sequential treatment paradigms for severe osteoporosis.

Anabolic Agents↗
PubMed1993

[Development of a lower limb model for the study of accident sequelae of vehicle-pedestrian collisions].

A major goal of the development and associated experimental investigation of car bumpers is the minimization of injuries in car-to-pedestrian collisions. Because the lower leg is particularly prone to injuries in a collision between a vehicle and a pedestrian, a lower leg model has been developed that makes it possible to simulate most of the processes occurring during an injury. In cooperation with the Institut für Biomedizinische Technik (Institute for Biomedical Technology) of the University of Stuttgart and the Kunststofflabor des Fachbereiches für Produktionstechnik (Institute for Production Methods) of the Fachhochschule für Technik (Polytech) Esslingen, a muscle tissue model has been designed that makes it possible to simulate in a first approximation the mechanical behaviour of biological tissue under accident-specific pressure, or in the case of a crush injury. Initial prototypes were built with bone models of the tibia and fibula and with a skin model whose relevant material parameters were taken from the literature.

Accidents, Traffic↗
PubMed2001

The tempering of medical anthropology: troubling natural categories.

This article reviews an approach in medical anthropology that commenced in the early 1980s and that continues to the present day in which biomedical knowledge and practices are systematically incorporated into anthropological analyses. Discussion then focuses on contributions made by feminists and medical anthropologists to the literature on medicalization and resistance, illustrating how the ethnographic approach has been crucial in critically reconceptualizing and situating these concepts historically and cross-culturally. The concept of local biologies is introduced in the third section of the article in creating the argument that the coproduction of biologies and cultures contributes to embodied experience, which, in turn, shapes discourse about the body. Subjective reporting at menopause provides an illustrative case study of local biologies in action. The final part of the article takes up the question of the moral economy of scientific knowledge. Comparative ethnographic work in intensive care units in Japan and North America reveals how a moral economy is put into practice in connection with brain-dead bodies and the procurement of organs from them. Medical anthropological contributions to policy making about biomedical technologies is briefly considered in closing.

Anthropology, Cultural↗
PubMed2006

Gender expectations: natural bodies and natural births in the new midwifery in Canada.

In this article, I examine the meaning of natural bodies and natural births in contemporary midwifery in Canada and explore the impact of these central concepts on the embodied experiences of pregnant and birthing women. The ideal of a natural birth has been used as a successful rhetorical strategy in scholarly and popular feminist works on childbirth to counter and critique the predominant biomedical or "technocratic" model of the pregnant and birthing body as inherently problematic and potentially dangerous to the fetus. Contemporary Canadian midwifery--which only as recently as 1994 made a historic transition from a grassroots social movement to a full profession within the public health care system--continues to work discursively through the idiom of nature to affect women's knowledge and experience of their bodies and selves in pregnancy and birth. However, my key finding in this ethnographic study, which focused primarily on midwifery in the province of Ontario in the years following professionalization, is that natural birth is being redefined by the personal, political, and pragmatic choices of midwives and their clients. I argue that the construction, negotiation, and experience of natural birth in contemporary midwifery both reflects and promotes a fundamental shift away from essentialized understandings as it makes room for biomedical technology and hospital spaces, underpinned by the midwifery logics of caring and choice. Natural birth in this context also carries important cultural messages--gender expectations--that posit women as persons and bodies as naturally competent and knowing.

Anthropology, Cultural↗
PubMed2003

The CCN3 (NOV) cell growth regulator: a new tool for molecular medicine.

The CCN genes encode secreted signaling proteins that participate in fundamental processes including cell adhesion, proliferation and differentiation, embryogenesis, tissue remodeling and patterning. Abnormal expression of CCN proteins is associated with several pathological conditions, including vascular diseases, fibrosis and cancer. Understanding the structural and functional basis for the variety of biological properties attributed to CCN proteins is an important challenge. It will help the understanding of their roles in the control of cellular proliferation, differentiation and death, thereby allowing their use for early diagnosis and therapy. In an attempt to evaluate the relevance of CCN3 as a useful tool in modern biomedical technologies, the biological properties of the CCN proteins and the data that established their potential usefulness will briefly be reviewed.

Animals↗
PubMed2005

[Present status of regenerative medical therapy and its potential in dentistry].

A new medical therapy that clinically treats disease by making use of the potential of cells for proliferation and differentiation has been tried. To realize this medical therapy of cell-based tissue regeneration, or so-called regenerative medical therapy, it is indispensable to develop a biomedical technology or methodology of tissue engineering that enables cells to enhance their proliferation and differentiation, leading to induction of tissue regeneration. This paper overviews this tissue engineering (TE) and the present status of TE-based regenerative medical therapy. There are four fundamental technologies in TE: 1) the scaffolding for cell proliferation and differentiation, 2) the isolation and culturing of cells, 3) the drug delivery system (DDS) of growth factor, and 4) the maintenance of space to induce tissue regeneration. The TE technologies are briefly explained and concrete examples of in vitro and in vivo tissue regeneration induction are introduced. The collagen sponges of cell scaffold and gelatin hydrogels incorporating various growth factors for controlled release enabled the regeneration induction of various tissues. Tissue engineering of cell scaffolding and DDS technologies that provide cells with a local environment suitable to induce tissue regeneration, is important to realize regenerative medical therapy.

Drug Delivery Systems↗
PubMedDate not supplied

Integrated software system for improving medical equipment management.

The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much emphasis has been given to patient safety. Through its Medical Device Directives, the European Union has required all member nations to use a vigilance system to prevent the reoccurrence of adverse events that could lead to injuries or death of patients or personnel as a result of equipment malfunction or improper use. The World Health Organization also has made this issue a high priority and has prepared a number of actions and recommendations. In the present workplace, a new integrated, Windows-oriented system is proposed, addressing all tasks of CEDs but also offering a global approach to their management needs, including vigilance. The system architecture is based on a star model, consisting of a central core module and peripheral units. Its development has been based on the integration of 3 software modules, each one addressing specific predefined tasks. The main features of this system include equipment acquisition and replacement management, inventory archiving and monitoring, follow up on scheduled maintenance, corrective maintenance, user training, data analysis, and reports. It also incorporates vigilance monitoring and information exchange for adverse events, together with a specific application for quality-control procedures. The system offers clinical engineers the ability to monitor and evaluate the quality and cost-effectiveness of the service provided by means of quality and cost indicators. Particular emphasis has been placed on the use of harmonized standards with regard to medical device nomenclature and classification. The system's practical applications have been demonstrated through a pilot evaluation trial.

Database Management Systems↗
PubMed2004

A review of neurophysiological testing.

The rapid advances in the technology of, and accumulation of pertinent data in, electrophysiological testing has increased exponentially in the past decade. This is attributable to continued advances in computer technology, biomedical engineering, and now the coregistration of the electrophysiological data with neuroimaging results. Knowledge of normal function and electrophysiological response at rest or on stimulation of the central and peripheral nervous systems is important to the neurosurgeon. Only by a basic understanding of normal and abnormal recordings may diagnoses and localizations be achieved. Intraspinal and intracranial surgical procedures are predicated on nontrauma to the neuraxis. This can be accomplished by performing electrophysiological testing to monitor the function of the spinal and cranial nerves, spinal cord, brainstem, basal ganglia, and cerebrum. If the surgeon cannot delineate critical cortex or pathways, he or she will be unable to avoid these areas in the patient.

Basal Ganglia↗
PubMed1994

The history of euthanasia debates in the United States and Britain.

Debates about the ethics of euthanasia and physician-assisted suicide date from ancient Greece and Rome. After the development of ether, physicians began advocating the use of anesthetics to relieve the pains of death. In 1870, Samuel Williams first proposed using anesthetics and morphine to intentionally end a patient's life. Over the next 35 years, debates about the ethics of euthanasia raged in the United States and Britain, culminating in 1906 in an Ohio bill to legalize euthanasia, a bill that was ultimately defeated. The arguments propounded for and against euthanasia in the 19th century are identical to contemporary arguments. Such similarities suggest four conclusions: Public interest in euthanasia 1) is not linked with advances in biomedical technology; 2) it flourishes in times of economic recession, in which individualism and social Darwinism are invoked to justify public policy; 3) it arises when physician authority over medical decision making is challenged; and 4) it occurs when terminating life-sustaining medical interventions become standard medical practice and interest develops in extending such practices to include euthanasia.

Beneficence↗
PubMed1992

The removal of well-fixed porous ingrown femoral components.

It is now evident that some biologically well-fixed hip prostheses may require removal and/or revision much earlier than originally anticipated. The relatively atraumatic removal of porous ingrown but clinically unacceptable femoral components, while difficult, has become increasingly feasible because of accumulated clinical experience and advances in biomedical technology. Preoperative planning, adequate instrument armamentarium, and intraoperative patience are important keys to the successful removal of these implants.

Adult↗