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But doctor, it's my hip!: the fate of failed medical devices.

It is difficult to study failed medical devices because of a lack of data. Routine device retrieval and analysis (DRA) is essential to performance evaluation, which, in turn, is essential to good patient care. We argue for the development of a national DRA program and medical device database and discuss the major ethical and policy issues associated with this proposal.

Consumer Product Safety↗

Effects of electrical muscle stimulation combined with voluntary contractions after knee ligament surgery.

The aim of the present study is to compare the effect of electrical muscle stimulation combined with voluntary muscle contractions with a program only with voluntary muscle contractions during immobilization in casts after anterior cruciate ligament surgery. Twenty-three patients, 7 women and 16 men with a mean age of 28 yr, were randomized into two groups: an experimental group (13 patients) and a control group (10 patients). Post-operatively, the patients were immobilized for 3 wk in a full leg cast with the knee flexed at an angle of 20 degrees to 30 degrees and then in a knee cast for another 3 wk. All patients had a standard program with quadriceps muscle contractions. In addition, the experimental group received electrical stimulation of the quadriceps muscle 4 X 10 min, 3 times.wk-1, at a frequency of 30 Hz. During each stimulation, the patients were requested to contract the quadriceps muscle voluntarily as well. When pre-operative measurements were compared with those at the end of the immobilization period (6 wk after the operation), a significantly larger reduction in the knee extension isometric muscle strength was found for the control group than for the experimental group. In comparisons of the data of the male subjects only, this difference was still seen to be significant. The cross-sectional area of the quadriceps muscle measured with computed tomography was significantly less reduced during the immobilization period in the experimental group than in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Ethical problems raised by anti-HIV vaccination.

At present questions are being asked world-wide about the risk of the AIDS epidemic. The discovery of an anti-HIV vaccine has become an urgent priority, but it also raises a number of sensitive questions. Ethical problems in this field are particularly delicate, since the perspectives of individual health and public health do not seem to coincide. Our research team conducted a review of more than 400 articles on the ethical problems raised by AIDS. We concentrated particularly on the ethical and legal issues raised by research on anti-HIV vaccine. These problems fall into three main categories: therapeutic assays, which must be controlled by a strict agreement defined by international norms; manufacture of the future vaccine, raising legal difficulties which must be faced and solved now; distribution of the vaccine to the population, which should be conducted on a general basis, i.e. it should be offered to all individuals and not only to risk groups.

Animal Experimentation↗