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El. knyga: Safety Evaluation in the Development of Medical Devices and Combination Products

(Gad Consulting Services, Cary, North Carolina, USA), (North Carolina State University, Raleigh, USA)
  • Formatas: 504 pages
  • Išleidimo metai: 20-Oct-2008
  • Leidėjas: CRC Press Inc
  • Kalba: eng
  • ISBN-13: 9781040168813
  • Formatas: 504 pages
  • Išleidimo metai: 20-Oct-2008
  • Leidėjas: CRC Press Inc
  • Kalba: eng
  • ISBN-13: 9781040168813

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Capturing the growth of the global medical device market in recent years, this practical new guide is essential for all who are responsible for ensuring safety in the use and manufacture of medical devices. It has been extensively updated to reflect significant advances, incorporating combination products and helpful case examples of current real-life problems in the field.

The Third Edition explores these key current trends:













global device markets continually advancing technology the increasing harmonization of device safety regulation worldwide









Each aspect of safety evaluation is considered in terms of International Standards Organization (ISO), US Food and Drug Administration (FDA), European Union (EU), and Japanese Ministry of Health and Welfare (MHW) perspectives. In addition, the book reflects the role of the continuing growth of technology in the incorporation of science, particularly in the areas of immunotoxicology and toxicokinetics.

Recenzijos

....Discuss[ es]...highly relevant case histories...the quantity of practical information...makes this book very worthwhile. Instrumentation Science and Technology (prior edition)

Preface v
Table of contents
vii
Introduction
1(6)
Biocompatibility
1(1)
Scope of Devices and the Medical Device Market
2(1)
History
3(1)
Nonspecific Regulatory Considerations
4(1)
Organizations Regulating Drug and Device Safety in the United States
5(1)
References
6(1)
Regulatory Aspects and Strategy in Medical Device and Bio Materials Safety Evaluation
7(20)
Regulatory Basis
7(4)
Toxicity Testing: Medical Devices
11(15)
References
26(1)
Road Map to Test Selections
27(22)
Key Concepts
27(1)
condition of Use
27(1)
Materials, Components, and Products
27(1)
Chemical and Physical Property Considerations
27(3)
Specific Material Considerations
30(7)
Physical Properties of Polymers, Elastomers, and Silicones
37(1)
Biologically Derived Materials
38(1)
Factors Influencing Test Selection
38(2)
Prior Knowledge
40(1)
Miscellaneous Reference Sources
41(1)
Search Procedure
42(1)
Monitoring Published Literature and Other Research in Progress
42(1)
New Sources
42(1)
Kinds of Information
43(2)
Types and Uses of Tests
45(1)
Reasonable Man
45(1)
Qualifications Versus Proces Control
45(1)
Tiers of Concern: Consumers, Health Care Providers, and Manufacturing Employees
45(1)
Sterilization and cleanliness
45(1)
References
46(3)
Materials in Medical Device Design
49(14)
Introduction
49(1)
Metals
49(2)
Ceramics
51(1)
Polymers
52(2)
Elastomers
54(5)
Tissue Engineering Scaffolds
59(1)
Nanomaterials
59(1)
References
60(3)
What to Test: Sampling and Sample Preparation
63(6)
Sampling
63(1)
Randomization
64(1)
Sample Preparation
64(3)
Reference Materials
67(1)
Conclusions
67(1)
References
68(1)
Cytotoxicity Testing
69(6)
Background
69(1)
Crystal Violet Staining
70(1)
Silicone Microphysiometer
70(1)
Microtox Test
70(1)
Neutral Red Uptake Assay
70(2)
Agar Diffusion Test
72(1)
Direct Contact Test
72(1)
Elution Test
73(1)
Correlation with in vivo Results
73(1)
Conclusion
73(1)
References
73(2)
Hemocompatibility
75(8)
Non-Contact Devices
75(1)
External Communicating Devices
75(1)
Implant Devices
76(1)
Standard Tests
77(4)
Platelets
81(1)
Conclusion
82(1)
References
82(1)
Local Tissue Tolerance
83(16)
Dermal Irritation
83(3)
Ocular Irritation Testing
86(3)
Other Nonparenteral Route Irritation Tests
89(1)
Parenteral Routes
89(2)
Intracutaneous Irritation
91(4)
Factors Affecting Irritation Responses and Test Outcome
95(1)
References
96(3)
Immunotoxicology
99(34)
Overview of the Immune System
100(2)
Immunotoxic Effects
102(1)
Immunosuppression
103(1)
Immunostimulation
103(1)
Hypersensitivity
104(3)
Evaluation of the Immune System
107(1)
Immunopathologic Assessments
108(16)
Local Lymph Node Assay (LLNA)
124(2)
Approaches
126(1)
Problems and Future Directions
127(1)
References
128(5)
Implantation Biology and Studies
133(10)
USP Implantation Test
133(1)
British Pharmacopoeia
133(1)
ISO 10993 Implantation Test
134(2)
Test Method for Implantation in Subcutaneous Tissue
136(1)
Test Method for Implantation in Muscle
137(1)
Test Method for Implantation in Bone
137(1)
Control Materials
138(1)
Long-Term Implant Studies
138(3)
Considerations
141(1)
References
142(1)
Acute Systemic Toxicity Testing Device Safety Evaluation
143(8)
Introduction
143(1)
Acute Systemic Toxicity Characterization
143(6)
References
149(2)
Genotoxicity
151(30)
DNA Structure
151(7)
Cytogenetics
158(5)
Plate Incorportion Assay
163(8)
In Vitro cytogenetic Assays
171(3)
In vivo cytogenetic Assays
174(2)
References
176(5)
Subchronic and Chronic Toxicity and Reproductive and Developmental Toxicity
181(16)
Objectives
181(1)
Regulatory Considerations
181(1)
Study Design and Conduct
182(1)
Parameters to Measure
182(2)
Histopathology
184(2)
Study Interpretation and Reporting
186(1)
Reproductive and Developmental Toxicity
186(2)
Dose and Sample Preparation
188(1)
Methodological Issues
188(1)
Gravid Uterine Weights
189(1)
Implant Counts and Determination of Pregnancy
189(1)
Developmental signs
190(1)
Data Interpretation
191(3)
References
194(3)
Carcinogenicity
197(6)
Animal Model
197(1)
Dose Selection
198(3)
Interpretation of Results
201(1)
References
201(2)
Degradation Products and Impurities
203(20)
Introduction
203(1)
Metals
203(3)
Ceramics and Glasses
206(2)
Polymers
208(3)
Effects of Sterilization
211(4)
Heavy Metals
215(1)
Appendix A: Extractables Study
216(4)
References
220(3)
Combination Products
223(8)
Historical Background
223(1)
Future Trends
223(6)
References
229(2)
Clinical Studies for Medical Devices
231(12)
Design Considerations
231(6)
Epidemiology
237(3)
Conclusion
240(1)
References
241(2)
Special Studies
243(12)
Cardiovascular Devices and Prostheses
243(2)
Tampons
245(1)
Contact Lenses and Their Solution
245(1)
Specific Tests
245(5)
21-Day Eye Irritation Study in Rabbits
250(1)
Systemic Injection Test
251(1)
Production of Toxic Shock Syndrome Toxin-1 (TSST-1)
251(1)
In Vitro Evaluation of the Effects of Potential Tampon Materials on pH and Growth of Vaginal Microflora
252(1)
Inflammatory Responses to Biomaterials
252(1)
References
253(2)
Toxicokinetics in Biomaterial and Device Safety Evaluation
255(20)
Introduction
255(1)
Regulations
256(1)
Principles
256(9)
Laboratory Methods
265(7)
Physiologically-based Pharmacokinetic (PBK) Modeling
272(1)
Biologically Derived Materials
273(1)
References
273(2)
Case Histories and Problem Resolution
275(14)
Phthalate and Other Residuals Leaching from Devices
275(1)
Dalkon Shield
276(1)
Talc on Gloves and Condoms
277(1)
Toxic Shock Syndrome
277(2)
Latex Allergy
279(1)
Silicones in Devices
280(2)
Problem Solving
282(1)
Risk Assessments
283(1)
Case Studies
284(2)
Conclusions
286(1)
References
286(3)
Appendix A: Selected Regulatory and Toxicological Acronyms and Abbreviations 289(2)
Appendix B: Contract Testing Laboratories 291(2)
Appendix C: Notable International Regulatory Internet Addresses 293(2)
Appendix D: Non-U.S. Medical Device Regulators 295(2)
Index 297
SHAYNE C. GAD is the principal of Gad Consulting Services, Cary, North Carolina, USA. Gad Consulting Services is a 15-year-old consulting firm serving more than 350 clients (including 120 pharmaceutical companies in the US and 35 overseas). Dr. Gad received his B.S. in chemistry and biology from Whittier College, Whittier, California, and his Ph.D. in pharmacology and toxicology from the University of Texas at Austin, Austin, Texas, USA. He has published 39 books and more than 350 chapters, articles, and abstracts in the fields of toxicology, statistics, pharmacology, drug development, and safety assessment. Dr. Gad has more than 30 years of broad-based experience in toxicology, drug and device development, statistics, and risk assessment with specific expertise in neurotoxicology, in vitro methods, cardiovascular toxicology, inhalation toxicology, immunotoxicology, and genotoxicology. He was the past president of the American College of Toxicology and the Roundtable of Toxicology Consultants. Dr. Gad has consulted for the US Food and Drug Administration, Environmental Protection Agency, and the National Institutes of Health.

MARIAN G. MCCORD is Associate Professor with appointments in the Department of Textile Engineering, Chemistry, and Science at North Carolina State University, Raleigh, NC, USA, the Joint UNC/NCSU Department of Biomedical Engineering in Raleigh and Chapel Hill, NC, USA, and an Adjunct Associate Professor of Medicine at the University of North Carolina at Chapel Hill. She serves as co-Director of the Atmospheric Plasma Laboratory at the College of Textiles at NCSU, and is a leader in development of Advanced Medical Technology at NCSU (www.ncsu.edu/amt). Dr. McCord received her M.S. in Bioengineering and Ph.D. in Textiles and Polymer Science from Clemson University, Clemson, South Carolina, USA. She has been active in several professional organizations, including the AAMI Protective Barriers Committee, ASTM F23, the Biomedical Engineering Society, the American Society for Engineering Education, and the Society for Biomaterials. Dr. McCord is the recipient of the 2007 Richard Felder Award for Outstanding Service in Teaching and Learning. She has been an invited lecturer and presenter at numerous consortia, meetings, and conferences, and has been a valued mentor and advisor for her students.