10 resultados para Cardioverter-Defibrillators, Implantable

em CentAUR: Central Archive University of Reading - UK


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Long-chain n-3 polyunsaturated fatty acids are found in oily fish and in fish oils and similar preparations. Substantial evidence from epidemiological and case-control studies indicates that consumption of fish, oily fish and long-chain n-3 fatty acids reduces risk of cardiovascular mortality. Secondary prevention studies using long-chain n-3 fatty acids in patients post-myocardial infarction have shown a reduction in total and cardiovascular mortality with an especially potent effect on sudden death. Long-chain n-3 fatty acids have been shown to beneficially modify a range of cardiovascular risk factors, which may result in primary cardiovascular prevention. However, reduced non-fatal and fatal events and a reduction in sudden death probably involve other mechanisms. Reduced thrombosis following long-chain n-3 fatty acids may play a role. A decrease in arrhythmias is a favoured mechanism of action of long-chain n-3 fatty acids and is supported by cell culture and animal studies. However human trials using implantable cardiac defibrillators have produced inconsistent findings and a recent meta-analysis does not support this mechanism of action. An alternative mechanism of action may be stabilisation of atherosclerotic plaques by long-chain n-3 fatty acids. This is suggested by one published human study which showed that incorporation of long-chain n-3 fatty acids into plaques collected at carotid endarterectomy resulted in fewer macrophages in the plaque and a morphology indicative of increased stability. These findings are supported from observations in an animal model and suggest that the primary effect of long-chain n-3 fatty acids might be on macrophages within the plaque.

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In this article, an overview of some of the latest developments in the field of cerebral cortex to computer interfacing (CCCI) is given. This is posed in the more general context of Brain-Computer Interfaces in order to assess advantages and disadvantages. The emphasis is clearly placed on practical studies that have been undertaken and reported on, as opposed to those speculated, simulated or proposed as future projects. Related areas are discussed briefly only in the context of their contribution to the studies being undertaken. The area of focus is notably the use of invasive implant technology, where a connection is made directly with the cerebral cortex and/or nervous system. Tests and experimentation which do not involve human subjects are invariably carried out a priori to indicate the eventual possibilities before human subjects are themselves involved. Some of the more pertinent animal studies from this area are discussed. The paper goes on to describe human experimentation, in which neural implants have linked the human nervous system bidirectionally with technology and the internet. A view is taken as to the prospects for the future for CCCI, in terms of its broad therapeutic role.

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Hypothesis: The aim of this study was to measure the mass loading effect of an active middle-ear implant (the Vibrant Soundbridge) in cadaver temporal bones. Background: Implantable middle ear hearing devices such as Vibrant Soundbridge have been used as an alternative to conventional hearing aids for the rehabilitation of sensorineural hearing loss. Other than the obvious disadvantage of requiring implantation middle ear surgery, it also applies a direct weight on the ossicular chain which, in turn, may have an impact on residual hearing. Previous studies have shown that applying a mass directly on the ossicular chain has a damping effect on its response to sound. However, little has been done to investigate the magnitude and the frequency characteristics of the mass loading effect in devices such as the Vibrant Soundbridge. Methods: Five fresh cadaver temporal bones were used. The stapes displacement was measured using laser Doppler vibrometry before and after the placement of a Vibrant Sound-bridge floating mass transducer. The effects of mass and attachment site were compared with the unloaded response. Measurements were obtained at frequencies between 0.1 and 10 kHz and at acoustic input levels of 100 dB sound pressure level. Each temporal bone acted as its own control. Results: Placement of the floating mass transducer caused a reduction of the stapes displacement. There were variations between the bones. The change of the stapes displacement varied from 0 dB to 28 dB. The effect was more prominent at frequencies above 1,000 Hz. Placing the floating mass transducer close to the incudostapedial joint reduced the mass loading effect. Conclusion: The floating mass transducer produces a measurable reduction of the stapes displacement in the temporal bone model. The effect is more prominent at high frequencies.

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Is the human body a suitable place for a microchip? Such discussion is no longer hypothetical - in fact in reality it has not been so for some years. Restorative devices such as pacemakers and cochlear implants have become well established, yet these sophisticated devices form notably intimate links between technology and the body. More recent developments in engineering technologies have meant that the integration of silicon with biology is now reaching new levels - with devices which interact directly with the brain. As medical technologies continue to advance, their potential benefits for human enhancement will become increasingly attractive, and so we need to seriously consider where this may take us. In this paper, an attempt is made to demonstrate that, in the medical context, the foundations of more advanced implantable enhancement technologies are already notably progressed, and that they are becoming more science fact than is widely considered. A number of wider moral, ethical and legal issues stem from enhancement applications and it is difficult to foresee the social consequences, the fundamental changes on our very conception of self and the impact on our identity of adoption long term. As a result, it is necessary to acknowledge the possibilities and is timely to have debate to address the wider implications these possibilities may bring.

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In this paper an attempt has been made to take a look at. how the use of implant and electrode technology can now be employed to create biological brains for robots, to enable human enhancement and to diminish the effects of certain neural illnesses. In all cases the end result is to increase the range of abilities of the recipients. An indication is given of a number of areas in which such technology has already had a profound effect, a key element being the need for a clear interface linking the human brain directly with a computer. An overview of some of the latest developments in the field of Brain to Computer Interfacing is also given in order to assess advantages and disadvantages. The emphasis is clearly placed on practical studies that have been and are being undertaken and reported on, as opposed to those speculated, simulated or proposed as future projects. Related areas are discussed briefly only in the context of their contribution to the studies being undertaken. The area of focus is notably the use of invasive implant technology, where a connection is made directly with the cerebral cortex and/or nervous system. Tests and experimentation which do not involve human subjects are invariably carried out a priori to indicate the eventual possibilities before human subjects are themselves involved. Some of the more pertinent animal studies from this area are discussed including our own involving neural growth. The paper goes on to describe human experimentation, in which neural implants have linked the human nervous system bi-directionally with technology and the internet. A view is taken as to the prospects for the future for this implantable computing in terms of both therapy and enhancement.

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In this paper an attempt has been made to take a look at how the use of implant and electrode technology can now be employed to create biological brains for robots, to enable human enhancement and to diminish the effects of certain neural illnesses. In all cases the end result is to increase the range of abilities of the recipients. An indication is given of a number of areas in which such technology has already had a profound effect, a key element being the need for a clear interface linking the human brain directly with a computer. An overview of some of the latest developments in the field of Brain to Computer Interfacing is also given in order to assess advantages and disadvantages. The emphasis is clearly placed on practical studies that have been and are being undertaken and reported on, as opposed to those speculated, simulated or proposed as future projects. Related areas are discussed briefly only in the context of their contribution to the studies being undertaken. The area of focus is notably the use of invasive implant technology, where a connection is made directly with the cerebral cortex and/or nervous system. Tests and experimentation which do not involve human subjects are invariably carried out a priori to indicate the eventual possibilities before human subjects are themselves involved. Some of the more pertinent animal studies from this area are discussed including our own involving neural growth. The paper goes on to describe human experimentation, in which neural implants have linked the human nervous system bi-directionally with technology and the internet. A view is taken as to the prospects for the future for this implantable computing in terms of both therapy and enhancement.

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Experiments demonstrating human enhancement through the implantation of technology in healthy humans have been performed for over a decade by some academic research groups. More recently, technology enthusiasts have begun to realize the potential of implantable technology such as glass capsule RFID transponders. In this paper it is argued that implantable RFID devices have evolved to the point whereby we should consider the devices themselves as simple computers. Presented here is the infection with a computer virus of an RFID device implanted in a human. Coupled with our developing concept of what constitutes the human body and its boundaries, it is argued that this study has given rise to the world’s first human infected with a computer virus. It has taken the wider academic community some time to agree that meaningful discourse on the topic of implantable technology is of value. As developments in medical technologies point to greater possibilities for enhancement, this shift in thinking is not too soon in coming.

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This communication examines the suitability of a photo-patternable polydimethylsiloxane (PP-PDMS) elastomer as an insulating material for implantable microelectrodes. PP-PDMS is produced by mixing a photoinitiator (2-hydroxy-2-methylpropiophenone) with the PDMS base and curing agent. Subsequent exposure to UV radiation and development of the elastomeric “photo-resist” allows for the definition of well-defined openings within the PP-PDMS film. The dielectric constants of PP-PDMS and PDMS are similar (ε ≈ 2.6, f <;1MHz). Gold film microelectrodes patterned on glass or a PDMS substrate are encapsulated with PP-PDMS, while recording sites as small as 104 μm2 can be obtained in the PP-PDMS layer. The cytotoxicity of the PP-PDMS was preliminary tested in vitro by culturing 3T3 fibroblasts in PP-PDMS extracts. No adverse effects were observed in cultures exposed to PP-PDMS films initially leached in isopropanol solvent for 48h.

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Various strategies for ocular drug delivery are considered; from basic formulation techniques for improving availability of drugs; viscosity enhancers and mucoadhesives aid drug retention and penetration enhancers promote drug transport into the eye. The use of drug loaded contact lenses and ocular inserts allows drugs to be better placed where they are needed for more direct delivery. Developments in ocular implants gives a means to overcome the physical barriers that traditionally prevented effective treatment. Implant technologies are under development allowing long term drug delivery from a single procedure, these devices allow posterior chamber diseases to be effectively treated. Future developments could bring artificial corneas to eliminate the need for donor tissue and one-off implantable drug depots lasting the patient’s lifetime.