The impact of future technology on outpatient pharmacy.
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The long term clinical success of composite restoration depends upon appropriate curing light sources. This in-vitro comparative study investigates the influence of conventional halogen and light emitting diode curing sources on the surface hardness, depth of cure and polymerization shrinkage of composites specimens of 8 mm diameter and 10 mm in height were used to study the depth of cure. Specimens of dimension 8.6 mm in diameter and 2 mm in depth were used to measure the surface hardness and polymerization shrinkage. The results showed that in the long run LED's seem to have great potential to achieve a clinically consistent quality of composite cure.
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In this paper I examine some of the factors influencing technology development and attempt to explain whether CLIA '88 enhances the opportunities or exacerbates the problems for U.S.-based technology development. The viewpoint I express is concentrated on the clinical chemistry segment of the diagnostics arena.
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During its first year of operation (1988) the Swedish Council on Technology Assessment in Health Care focused on nine areas. Additional activities will be added as need requires and resources permit. Also, preparations for 1989 projects have begun. The nine areas include: identification of technologies needing assessment, including international comparisons; review and synthesis of the value of preoperative routines; review and synthesis of the value of gastroscopy for diagnosing stomach pain; assessment of different treatment methods for back pain; assessment of the value of vascular surgery for vascular spasms in the legs; organization of a strategy conference concerning medical technology assessment in Sweden; creation of a strategy that addresses an international review of medical technology, future technologies in health care, waiting lists for medical care--the importance of medical technology, resource utilization and organizational and educational aspects of introducing new technology in health care, and costs and medical technology; translation of foreign assessment studies, with comments; national and international cooperation. SCTA has discussed the need for assessing specific technology such as bone marrow transplantation and surgical treatment of epilepsy. SCTA's Scientific Advisory Committee has additionally considered the following subjects for future projects: medical, social, and economic consequences of alternative technologies screening for prostate, colorectal, breast, and cervical cancer; costs, indications, and medical benefit of surgery for varicose vains; and modern urology technologies, particularly those related to prostate care.
Enabling technologies for the future, whether exemplified by endoscopic, minimally invasive, or microdexterity systems or surgical and nonsurgical image-guided procedures, continue with an evolution so rapid that before one change has been accepted and perfected, another even more dramatic change promises to replace it. These information-based surgical and procedural interventions are just now becoming accepted standards of surgical, radiologic, and medical practice, and yet the promise of more advanced technologies blurs even these new boundaries, constantly redefining the concept of "surgery." It is essential that otolaryngologists, as part of the broader spectrum of physicians, understand these changes and prepare to adapt and improve each and every one of their technical and cognitive skills.
Future progress in healthcare and medicine depends on today's investment in research, development, and education. We cannot leave such urgent issues to determine themselves, but rather must actively collaborate to ensure a stable healthcare system. This chapter describes efforts made by leading experts in industry, government, and academia to better ascertain future healthcare management. Such collaboration has occurred during a series of Future Healthcare Technology Summits helping in planning investments in health technology. Deliberating and reviewing plans before taking action will accelerate progress as it will (1) save costs, (2) encourage compliance, (3) improve clinical outcomes, and (4) ensure greater patient satisfaction. What we must resolve is: How can we invest a couple billion dollars to save hundreds of billions and, most importantly, increase human health in the future. A new branch of science, Biomechatronics, with millions of Intelligent Caring Creatures- is the answer.
Hydrogenases provide an inspiration for future energy technologies. The active sites of these microbial enzymes contain Fe or Ni and Fe coordinated by CO and CN ligands: yet they have activities for hydrogen cycling that compare with Pt catalysts. Is there a future for enzymes in technological H2 cycling? There are obviously going to be disadvantages, perhaps overwhelming, as enzymes are notoriously fragile; yet what are the positive aspects and can we learn any chemistry that might be applied to produce the electrolytic and fuel cell catalysts of the future? We have developed a suite of novel electrochemical experiments to probe the chemistry of hydrogenases. The reactions are controlled and monitored at the surface of a small electrode, and characteristic catalytic properties are discernible from tiny amounts of sample material, so this approach can be used to search the microbial world for the best catalysts. Although electrochemistry does not provide structural information directly, it does give a "road map" by which to navigate the pathways and conditions that lead to particular states of the enzymes. This has prompted many interdisciplinary collaborations with other scientists who have provided microbiological, spectroscopic and structural contexts for this work. This article describes how these electrochemical experiments are set up, the data are analysed, and the results interpreted. We have determined mechanisms of catalysis, electron transfer, activation and inactivation, and defined important properties such as O2 tolerance and CO resistance in physical terms. Using an O2-tolerant hydrogenase, we have demonstrated a "proof of concept" miniature fuel cell that will run on a mixed H2/O2 feed in aqueous solution.
Focused ultrasound technology provides a noninvasive modality for tissue ablation. Although widely used for the treatment of benign prostatic hyperplasia, its application for the treatment of localized prostate cancer is controversial, and its use for the treatment of small renal masses remains experimental. This article outlines the underlying principles of thermal focused ultrasound technology and its limitations as evident in the current literature. The principles and technique of nonthermal cavitational ultrasound tissue ablation is described with a summary of preliminary experimental data.