Traumatic brain injury (TBI) is a common disorder with high morbidity and mortality, accounting for one in every three deaths due to injury. Older adults are especially vulnerable. They have the highest rates of TBI‐related hospitalization and death. There are about 2.5 to 6.5 million US citizens living with TBI‐related disabilities. The cost of care is very high. Aside from prevention, little can be done for the initial primary injury of neurotrauma. The tissue damage incurred directly from the inciting event, for example, a blow to the head or bullet penetration, is largely complete by the time medical care can be instituted. However, this event will give rise to secondary injury, which consists of a cascade of changes on a cellular and molecular level, including cellular swelling, loss of membrane gradients, influx of immune and inflammatory mediators, excitotoxic transmitter release, and changes in calcium dynamics. Clinicians can intercede with interventions to improve outcome in the mitigating secondary injury. The fundamental concepts in critical care management of moderate and severe TBI focus on alleviating intracranial pressure and avoiding hypotension and hypoxia. In addition to these important considerations, mechanical ventilation, appropriate transfusion of blood products, management of paroxysmal sympathetic hyperactivity, using nutrition as a therapy, and, of course, venous thromboembolism and seizure prevention are all essential in the management of moderate to severe TBI patients. These concepts will be reviewed using the recent 2016 Brain Trauma Foundation Guidelines to discuss best practices and identify future research priorities.
Aerial drone technology is now in use to improve medical care, especially blood delivery. The use of aerial drones is broader than just this and includes aerial photography, express shipping and delivery, disaster management, search and rescue operations, crop monitoring, weather tracking, law enforcement, and structural assessment. This wide use promises to accelerate and, ideally, reduce the cost of technological advances of drones. By doing so, drone use offers the opportunity of improving health care, particularly in remote and/or underserved environments by decreasing lab testing turnaround times, enabling just‐in‐time lifesaving medical supply/device delivery, and reducing costs of routine prescription care in rural areas.
Diabetes management involves constant care and rigorous compliance. Glucose control is often difficult to maintain and onset of complications further compound health care needs. Status can be further hampered by geographic isolation from immediate medical infrasiructures. The Home Care Interactive Patient Management System is an experimental telemedicine program that could improve chronic illness management through Internetbased applications. The goal of the system is to provide a customized, integrated approach to diabetes management to supplement and coordinate physician protocol while supporting routine patient activity, by supplying a set of customized automated services including health data collection, transmission, analysis and decision support. This experimental approach is intended to deliver high-level monitoring and treatment capabilities for diabetic patients in remote areas, enable early identification and treatment of disease complications, develop a comprehensive data base for research and development, and increase patient quality of life. There are three main components to the Home Care Interactive Patient Management System: Remote Monitoring, Education, and Communication. The Remote Monitoring aspect allows patients to input general health data into a sophisticated web site. Data analysis conducted by the computer system in conjunction with a physician monitors compliance and medical course, allowing for immediate modification of treatment regimens. Patients can access information regarding disease management, treatment options, and general health education via the Education section. The Communication link enables patients to post questions for the physician, as well as interact with other patients through a virtual support group. The Home Care Interactive Patient Management System is expected to improve patient care, compliance and resource utilization while simultaneously reducing healthcare treatment costs. Program applications will help establish methods and tools for diabetes management. This test bed will provide the means to conduct an aggregate analysis in order to correlate social indicators with healthcare needs to ascertain new treatment modalities and focus methods. It is intended to facilitate treatment decisions, provide improved means of communication between patients and health care providers and apply a standardized means of healthcare to all patients regardless of residence.
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