ABSTRACT
OBJECTIVE: To determine whether a device designed to provide low-intensity, low-frequency mechanical stimulation improves healing time of acute wounds. DESIGN: Repeated measures using mechanical stimulation on one side of a rat and sham stimulation on the contralateral side. SETTING: Academic animal facility. PARTICIPANTS: Six male Sprague-Dawley rats, approximately 400 g. INTERVENTION: Mechanical stimulation of 4-mm biopsy wounds in rats was produced through the use of permanent magnets cyclically attracted and repelled by activation of an electromagnet by a square wave generator at a frequency of 1 Hz and a force equivalent to 64 mm Hg pressure. MAIN OUTCOME MEASURE: Days to complete closure of 4-mm biopsy punch wounds. MAIN RESULTS: This form of stimulation reduced time to close the biopsy wounds by nearly 50%. Mechanically stimulated wounds closed in 3.8 +/- 1.6 days (mean +/- SD) compared with 6.8 +/- 1.9 days for sham-stimulated wounds (P = .0002). CONCLUSION: Production of a mechanical stimulation device with a miniaturized controller and power source and trials on humans are needed to determine the efficacy and potential cost savings of such a device in the management of wounds.
Subject(s)
Biopsy/adverse effects , Disease Models, Animal , Electromagnetic Phenomena/methods , Magnetics/therapeutic use , Wound Healing/physiology , Wounds, Penetrating/therapy , Acute Disease , Animals , Cell Movement , Cost Savings , Electromagnetic Phenomena/economics , Electromagnetic Phenomena/instrumentation , Equipment Design , Inflammation , Magnetics/instrumentation , Male , Miniaturization , Organogenesis , Rats , Rats, Sprague-Dawley , Stress, Mechanical , Time Factors , Wounds, Penetrating/etiologySubject(s)
Electric Stimulation Therapy/economics , Home Care Services/economics , Insurance, Health, Reimbursement , Medicaid/economics , Medicare/economics , Skin Ulcer/therapy , Wound Healing , Centers for Medicare and Medicaid Services, U.S. , Electric Stimulation Therapy/methods , Electromagnetic Phenomena/economics , Humans , Medicaid/organization & administration , Medicare/organization & administration , Skin Ulcer/economics , Transcutaneous Electric Nerve Stimulation/economics , United StatesSubject(s)
Electric Stimulation Therapy/economics , Electromagnetic Phenomena/economics , Insurance Coverage/economics , Medicaid/economics , Medicare/economics , Chronic Disease , Current Procedural Terminology , Electric Stimulation Therapy/instrumentation , Electromagnetic Phenomena/instrumentation , Humans , Organizational Policy , Patient Selection , Skin Ulcer/therapy , United States , Wound HealingABSTRACT
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is a new treatment with promise for resistant depression. OBJECTIVE: We tested the economic feasibility of this new method compared with electroconvulsive therapy (ECT). METHOD: An economic decision analysis was used to compare the costs of three different treatment strategies for nonpsychotic severe depression. The strategies were: ECT alone; rTMS alone; and rTMS followed by ECT for nonresponders (rTMS-to-ECT). We calculated 12-month costs and quality adjusted life years (QALYs) for the three treatment options for all nonpsychotic, severely depressed United States patients who would have otherwise undergone ECT. A sensitivity analysis was performed to test the degree of change in outcome with various parameter changes. RESULTS: The additional cost of using ECT alone compared with rTMS alone was 460,031 US dollars per quality adjusted year of life gained. For ECT versus rTMS-to-ECT, there was both an increased cost and a loss of 1,538 QALYs with ECT alone. The sensitivity analysis revealed the model to be robust with various parameter changes. CONCLUSION: If rTMS were to be made widely available clinically in the US, it would offer a substantial economic benefit over ECT in treating resistant depression. Using rTMS-to-ECT offers not only an economic advantage but also an increase in QALYs. This analysis suggests that rTMS would be a cost-effective treatment for depression compared with the current option of ECT alone.
Subject(s)
Decision Making , Depressive Disorder, Major/economics , Depressive Disorder, Major/therapy , Electroconvulsive Therapy/economics , Electromagnetic Phenomena/economics , Cost-Benefit Analysis , Depressive Disorder, Major/epidemiology , Electroconvulsive Therapy/instrumentation , Electroconvulsive Therapy/statistics & numerical data , Electromagnetic Phenomena/instrumentation , Electromagnetic Phenomena/statistics & numerical data , Humans , Periodicity , Severity of Illness IndexABSTRACT
Biomagnetic measurement performed outside a magnetically shielded room is subject to distortion by strong magnetic fields. Reducing such disturbances can enhance and stabilize biomagnetic measurement conditions in the absence of passive shielding. We have developed an active magnetic shielding system that produces both homogeneous and spatial gradient magnetic fields. The system is composed of anisotropic magnetoresistive sensors, a digital signal processor controller and two different coil systems. In order to improve the measurement environment for a first-order gradient coil SQUID system, the disturbing vertical magnetic fields and vertical field gradients are reduced, thus achieving a shielding factor of approximately 6 at 100 Hz. Our system provides a more flexible and less costly alternative to magnetically shielded rooms.
