Archives for category: healthcare

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Diabetes is a chronic disease of the body’s inability to control blood sugar leading to, among other issues, amputations, vision loss, cardiovascular problems and nerve damage. Those with Type I diabetes often are born with the disease, and are diagnosed because of uncontrolled glucose levels and the inability of the pancreas to produce insulin, which is a hormone that helps to pull sugar out of the bloodstream and convert it to usable energy. The pancreas also produces the hormone glucagon, which works conversely of insulin and increases glucose levels in the body.

Those with type I diabetes must constantly monitor their body’s blood sugar and regulate it by sticking a needle into their body to deliver insulin. This old method is thankfully being upgraded according to a bionic pancreas whose effectiveness was confirmed in a study recently published in The New England Journal of Medicine, carried out by researchers at Boston University and Massachusetts General Hospital.

In two similar studies performed, adolescents and adults (over 21) were given a bihormonal (insulin and glucagon) pancreas to test which required only an iPhone and small subcutaneous device to deliver injections. Over 5 days, subjects were encouraged to eat and drink as normal while the device monitored their body’s response to meals. The device itself involved an iPhone which ran an algorithm which monitored glucose levels, and commanded the hardware interface to deliver specific levels of insulin or glucagon as needed through subcutaneous injection. Amazingly, this system updates every five minutes and adjusts hormone level as needed.

While this system is not for home sale yet, with such positive outcomes it will hopefully be on the consumer market soon.

Being permanently confined to a wheelchair not only limits you for health reasons, but wheelchairs are also a huge physical barrier to traveling between locations. Even if a target destination is coined ADA accessible, logistically getting to and from a location can have so many barriers that it may not be worth the trip. Constantly relying on others for assistance, not being able to speak at eye level, the physical impact of constantly sitting are some of the problems those that are confined to a wheelchair must experience.

Developed a couple of years ago but finally being released for sale on the market sometime this year, Tek Robotics has developed a robotic mobilization device that allows an individual to independently stand, and then mobilize them to a location that may not be wheelchair accessible. Each device supports a person from behind and gently pulls them into standing position, all without the assistance of a second individual. Instead of throwing the body forward as needed to heave someone out of a wheelchair, this battery-operated devices uses a gas spring to help suspend a person in a standing position. The dimensions are thin enough to fit through a regular doorway (it occupies one third the width of a wheelchair, states the website) but also designed for balance even with the narrower base.

Reservations are now being taken for shipment sometime this year. Each unit will cost approximately $15,000. See the video below for more explanation:

 

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Most emergency medical training involves lifeless torsos, videos, and noninvasive simulated work on a live partner in which you haphazardly  practice what you would actually have to do in an emergency situation. From my personal experience of many CPR classes as well as a course of emergency medical training, I can attest none of this prepares you very well for what you would actually have to act out in a life threatening situation. No, you can never fully prepare for having to rescue someone, but what gives you the confidence to do it is practicing something similar prior to having to act on the spot.

Kernerworks has developed a realistic robotic mannequin that breathes, bleeds, and responds to procedures to give feedback if they have been performed correctly.This company in San Rafael, CA includes a team of former special effects artists that used to work for film studios. The mannequins were molded from real people, given realistic features, and have an internal computer system that includes sensors which respond to procedures.

Used for military training for trauma response, one of the products is a double amputee mannequin which allows trainees to practice relieving pnueumothorax with a needle (sensors respond if done correctly). One of the features is also a well developed throat which features air differential sensors. Medics can practice placing a laryngoscope into the throat which has a camera so you can see the placement of a tube for breathing. An endotracheal tube can be placed in the throat for use of an Ambu bag, if done correctly this shows the chest rising. If it is done incorrectly and the tube is accidentally placed into the esophagus, the chest will not rise. Unlike most practice torsos, these are sensors responding to these procedures, which are much more precise. Watch the video above for a tour Tested shared which explains more about the company and the incredible work behind the mannequins.

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Surgery has come a long way with many facilities now using robotics to either assist or replace human tasks. Delicate procedures that require a lot of precision, repetition, and endurance can benefit from the use of such technology. A few years ago, CardioARM was developed for minimally invasive heart surgery. This device resembles a snake, which can travel to the target areas through insertion beneath the sternum and perform ablations of heart tissue that is disturbing heart rhythm. Ablation, meaning the target area of heart is burned away. This procedure replaces the more invasive task of opening the chest cavity and cutting away into your vitals. For anyone who has ever visualized the inside of a body, it is amazing that a device is not only able to navigate but reach a specific area of the heart and perform an ablation on target tissue.

CardioARM features 50 links which are connected by cables and can move in a combination of 105 different movements. The device can move forward and reverse, and is headed with a camera and light guide to allow for visualization. Once the CardioARM enters under the xyphoid process (bottom of the sternum), it is directed toward the specific region of troublesome heart tissue. Once it reaches its target, it delivers a “dot to dot” procedure for the ablation. Each lesion is delivered 30 watts of power for 30 seconds.

In 2011, this device was first successfully tested in human clinical trials. As it takes a long time for such devices to actually enter hospitals, this will hopefully become an option soon for surgeons dealing with life threatening arrhythmias.

For those that prefer independent living but require assistance with dally tasks such as eating, Swedish company Bestic has developed a robotic arm that assists with eating. It can be programmed for height, speed, and type of food, and allows the user to eat alongside others without requiring the assistance of another person. For those with musculoskeletal and neurological injuries and diseases that render their upper body muscles weak or with tremor such as Polio, MS, Parkinson’s or Ataxia, this allows for some normalcy at mealtime.

Those that are interested in trying the device can contact the makers through their website.

Watch the video below:

As an adult, you are expected to enter situations with a certain composure. Hyperventilating or crying while getting your blood drawn is frowned upon, though many of us naturally have this reaction as someone is prodding our blood vessels, looking to extract the blood our body works so hard to make.

Veebot looks to make this a more efficient, accurate process for predictability and efficiency, which may possible quell the young and not so young when going in for a common blood drawing procedure. According to their website , 20-25% of phlebotomy procedures fail to draw blood on the first stick. That’s 20-25 out of every 100 procedures. Not very efficient.

Veebot’s team has developed a robotic devices with a viewing system that identifies and selects the best insertion site. Using lighting and ultrasound viewing techniques, once selected the machine can insert the needle. According to sources, the process takes about a minute.  A technician must still be present to oversee the procedure, so to assuage some fears  it will not just be you and a needle-sticking robot alone in a room together.

RP-7i Remote Presence Robot

As a physical therapist, being required to be physically present for your career can be both a burden and a relief. I can breathe a little easier (for now) knowing that my job probably won’t be outsourced any time soon, as it requires physical touch and presence. I also look forward to the day, however, when I am feeling under the weather, or when life’s circumstances keep me from going into work that I can still, at least partially, do my job from home.

Interestingly enough, there are now telepresence robots which allow doctors to advise patients by telecommuting. While this may be in the further future for PT’s,  There are 5 different models listed on the InTouch Health website.

These products are described as remote presence devices, they allow clinicians to interact with patients in real time. In life threatening situations, these can be vital in saving time so that a physician in a hospital can consult patients or support staff to guide treatment without wasting wait time. In less immediate situations, they can just add convenience to healthcare without patients losing work time with travel. Many people simply let medical conditions fester to the point of immediate concern because of the time and effort it takes to get to a medical appointment, and we could potentially save so much in healthcare costs by allowing people the gift of time and convenience to address medical concerns before they require increased tests and procedures.

I hope that as a PT I can soon provide consults to patients requiring less manual treatment and more instruction and guidance without the inconvenience and costs required to physically attend a medical appointment.

photo above: http://www.intouchhealth.com/images/rp-7i-big.png