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Subcutaneous open-loop insulin delivery for type 1 diabetes: Paradigm Real-Time System. 1型糖尿病皮下开环胰岛素输送:范式实时系统。
Issues in emerging health technologies Pub Date : 2007-10-01
S L Pohar
{"title":"Subcutaneous open-loop insulin delivery for type 1 diabetes: Paradigm Real-Time System.","authors":"S L Pohar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) An open-loop insulin delivery system combines an external insulin pump with continuous monitoring of glucose levels via a subcutaneous sensor. The sensor communicates glucose readings to the pump using a radio transmitter. (2) In four small, comparative studies, adults and children with poorly controlled type 1 diabetes who were randomized to use the Paradigm Real-Time System had clinically important improvements in A1c (a measure of average glycemic control over the previous three months) compared to baseline. (3) Some studies found greater improvements in A1c and less hypoglycemia with the Paradigm Real-Time System compared to multiple daily insulin injections or pump therapy combined with conventional glucometer readings. (4) Adverse events with the Paradigm Real- Time System include infection, itching, irritation, and redness at the site of the glucose sensor, and rare instances of insulin pump malfunction. (5) Based on the limited amount of research published to date, the impact of the Paradigm Real-Time System on long-term glycemic control, prevention of diabetic complications, or quality of life is unclear.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 105","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27062305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Capsule colonoscopy: PillCam Colon. 胶囊结肠镜检查:PillCam结肠。
Issues in emerging health technologies Pub Date : 2007-10-01
K Tran
{"title":"Capsule colonoscopy: PillCam Colon.","authors":"K Tran","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) The PillCam Colon capsule is an ingestible miniature camera that captures images of the colon's inner lining. (2) There is limited evidence on the use of this technology in imaging the colon. Two small, methodologically flawed pilot studies found that for patients with positive findings (i.e., abnormalities detected), the rates of detection with the PillCam Colon capsule were similar to those obtained with conventional colonoscopy. (3) No serious adverse events were reported in the pilot studies, although some patients had delayed excretion of the capsule. (4) A challenge for clinicians using this technology will be the time required to read the large quantity of video images produced. Further enhancements to the software system used to view the images may address this issue.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 106","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27065823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nicotine vaccines for smoking cessation. 戒烟用尼古丁疫苗。
Issues in emerging health technologies Pub Date : 2007-09-01
J Murtagh, V Foerster
{"title":"Nicotine vaccines for smoking cessation.","authors":"J Murtagh,&nbsp;V Foerster","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Cigarette smoking is the leading cause of preventable disease and death in the world. (2) Nicotine vaccines produce antibodies that bind nicotine, the chief addictive agent in cigarettes, and prevent it from entering the brain. (3) Early trials suggest nicotine vaccines are safe and well tolerated, but the duration of effect is unclear, and immunological response varies across recipients. (4) Nicotine vaccines have not yet been studied in phase 3 trials and the relative performance of different vaccines, alone or in combination with existing therapeutic options, is unknown.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 103","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40996447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Yttrium-90 microspheres (TheraSphere and SIR-Spheres) for the treatment of unresectable hepatocellular carcinoma. 钇-90微球(TheraSphere和SIR-Spheres)用于治疗不可切除的肝细胞癌。
Issues in emerging health technologies Pub Date : 2007-09-01
C Allison
{"title":"Yttrium-90 microspheres (TheraSphere and SIR-Spheres) for the treatment of unresectable hepatocellular carcinoma.","authors":"C Allison","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Microspheres containing radioactive yttrium-90 (90Y) are infused into the hepatic artery. These deliver high doses of ionizing radiation to inoperable hepatocellular carcinoma, the most common type of primary liver cancer. (2) Limited evidence from several case series indicates that palliative therapy with 90Y microspheres may reduce tumour size and increase survival time. (3) In some patients, 90Y treatment may result in enough tumour reduction to permit liver resection or transplantation. (4) While 90Y microsphere therapy is generally well tolerated, major complications and several treatment-related deaths have occurred. Improved patient selection criteria and technical changes to microsphere delivery have reduced the risks of complications and death. (5) Patient selection and the technical aspects of 90Y microsphere treatment are complex and require the coordinated expertise of a multidisciplinary team.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 102","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26999670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sipuleucel-T (Provenge): active cellular immunotherapy for advanced prostate cancer. Sipuleucel-T (Provenge):主动细胞免疫治疗晚期前列腺癌。
Issues in emerging health technologies Pub Date : 2007-09-01
I McKarney
{"title":"Sipuleucel-T (Provenge): active cellular immunotherapy for advanced prostate cancer.","authors":"I McKarney","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Sipuleucel-T (Provenge) is an active cellular immunotherapy (therapeutic vaccine) that is designed to stimulate the patient's T-cells to recognize and attack prostate cancer cells that express prostatic acid phosphatase (PAP) antigen. (2) Sipuleucel-T demonstrated a survival benefit in men with advanced androgen-independent prostate cancer (AIPC), although this preliminary finding requires confirmation in larger trials. (3) Mild to moderate myalgia, chills, fever, and tremor are the most commonly reported adverse events for patients receiving sipuleucel-T. These events generally resolve quickly. (4) More studies are needed to evaluate sipuleucel-T in the earlier stages of prostate cancer and in combination with conventional therapies.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 101","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2007-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26944885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ranolazine (Ranexa) for chronic stable angina. 雷诺嗪(Ranexa)治疗慢性稳定型心绞痛。
Issues in emerging health technologies Pub Date : 2007-06-01
S Ndegwa
{"title":"Ranolazine (Ranexa) for chronic stable angina.","authors":"S Ndegwa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Ranolazine-- an adjunctive treatment to beta-blockers, calcium channel blockers, or long-acting nitrates-- is indicated for patients with chronic stable angina who have not responded to standard anti-anginal therapy. (2) In three randomized controlled trials (RCTs), ranolazine, in combination with standard anti-anginal medications, led to modest but statistically significant improvements in exercise duration, and reductions in the frequency of angina episodes and nitroglycerin consumption, when compared to standard anti-anginal medications only. The clinical significance of these improvements is unknown. Most of the participants in studies were male and Caucasian. Thus, there are questions about the drug's efficacy in other populations. (3) One RCT suggests that the addition of ranolazine to standard treatment is ineffective in reducing major cardiovascular events that are associated with acute coronary syndromes. (4) The adverse effects reported with ranolazine include dizziness, nausea, asthenia (weakness), constipation, and headache. Long-term data from one trial indicate that there is no significant increase in the incidence of death or arrhythmia among those taking ranolazine. More clinical trials of ranolazine are needed to confirm its long-term safety, its optimal dosing, its efficacy in combination with full dose beta-blockers with or without calcium channel blockers, and its potential role in the treatment of other cardiovascular conditions.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 99","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26799865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nuchal translucency measurement in first trimester Down syndrome screening. 孕早期唐氏综合征筛查中的颈部透明度测量。
Issues in emerging health technologies Pub Date : 2007-06-01
A Scott
{"title":"Nuchal translucency measurement in first trimester Down syndrome screening.","authors":"A Scott","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Approximately three in every four fetuses with Down syndrome have increased nuchal translucency (NT), which is a larger than normal build-up of fluid at the back of the neck. (2) The ultrasound measurement of NT between 11 and 14 weeks' gestation, in combination with the mother's age and the levels of placental biochemical markers in her blood, can be used to detect approximately 84% of fetuses with Down syndrome. (3) The accuracy of NT measurement is affected by fetal position, measurement technique, the type of risk-calculation software used, and the sonographer's experience and technical expertise. (4) A rigorous standardization and quality assurance system for NT measurement is needed before any test using NT ultrasound is offered universally. The cost of establishing such a program is unknown.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 100","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26799748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intra-articular hyaluronic acid (viscosupplementation) for hip osteoarthritis. 关节内透明质酸(粘胶补充)治疗髋关节骨关节炎。
Issues in emerging health technologies Pub Date : 2007-05-01
S Dagenais
{"title":"Intra-articular hyaluronic acid (viscosupplementation) for hip osteoarthritis.","authors":"S Dagenais","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In viscosupplementation, a glycosaminoglycan called hyaluronic acid (HA) is administered via intra-articular injection to patients with osteoarthritis (OA). Two systematic reviews found that HA for hip OA may relieve pain and improve function. Randomized controlled trials had differing results. Uncontrolled studies suggest that there are moderate improvements regarding pain and function for three to six months after HA injection. There is no evidence regarding the cost-effectiveness of this therapy. No serious adverse events have been reported after intra-articular injection of HA for hip OA. The best available evidence suggests that HA may offer symptomatic relief in patients with mild to moderate hip OA for whom other conservative therapies are contraindicated or have failed. Currently, there is insufficient good quality evidence to determine this conclusively.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 98","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2007-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26738636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Extracorporeal shock wave treatment for chronic rotator cuff tendonitis (shoulder pain). 体外冲击波治疗慢性肩袖肌腱炎(肩痛)。
Issues in emerging health technologies Pub Date : 2007-01-01
C Ho
{"title":"Extracorporeal shock wave treatment for chronic rotator cuff tendonitis (shoulder pain).","authors":"C Ho","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Electrohydraulic, electromagnetic, or piezoelectric devices are used to translate energy into acoustic waves during extracorporeal shock wave treatment (ESWT) for chronic rotator cuff tendonitis (shoulder pain). The acoustic waves may help to accelerate the healing process of chronic rotator cuff tendonitis via an unknown mechanism. (2) ESWT, which is performed as an outpatient procedure, is intended to alleviate the pain due to chronic rotator cuff tendonitis. (3) Limited evidence from a German study indicates that the cost of ESWT for rotator cuff tendonitis is one-fifth to one-seventh the cost of surgical treatment, with longer recovery time and time off work in the surgical treatment group accounting for about two-thirds of the overall cost. (4) The evidence reviewed for this bulletin supports the use of high-energy ESWT for chronic calcific rotator cuff tendonitis, but not for non-calcific rotator cuff tendonitis. High-quality RCTs with larger sample sizes are needed to provide stronger evidence.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 96 (part 3)","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26554490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Obstructive sleep apnea: a palatable treatment option? 阻塞性睡眠呼吸暂停:一种令人满意的治疗选择?
Issues in emerging health technologies Pub Date : 2007-01-01
C Allison
{"title":"Obstructive sleep apnea: a palatable treatment option?","authors":"C Allison","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) The Pillar(R) Palatal Implant System consists of three polyester threads that are permanently implanted in the palate (the roof of the mouth) to reduce airway obstruction in individuals with mild to moderate obstructive sleep apnea (OSA) and snoring. (2) Three small, non-randomized uncontrolled trials reported a moderate reduction in the number of breathing interruptions during sleep, three to six months following palatal implant insertion. Statistically significant improvements in daytime sleepiness and snoring intensity were also reported. (3) The minimally invasive surgical procedure causes mild, transient discomfort. A potential complication is partial extrusion of the implant, requiring removal and replacement. (4) Currently, there is insufficient published evidence to determine whether palatal implants are an effective treatment option for patients with mild to moderate OSA due to palatal obstruction. (5) Larger, randomized controlled studies are needed to determine the long-term safety and efficacy of the implants in a more diverse patient population, including those who are obese or those with comorbid medical conditions. Comparisons with existing treatments for OSA are also needed.</p>","PeriodicalId":83756,"journal":{"name":"Issues in emerging health technologies","volume":" 97","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26610742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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