East Surrey Hospital is a National Health Service hospital in the Whitebushes area to the south of Redhill, in Surrey, England. It is managed by the Surrey and Sussex Healthcare NHS Trust.
Armed conflicts such as those in Gaza and Ukraine highlight the urgent need for innovative solu- tions to deliver emergency medical and surgical support in inaccessible and high-risk environ- ments. Traditional supply chains often fail in war zones due to blockades, damaged infrastructure and safety concerns for healthcare personnel. Unmanned Aerial Vehicles (UAV), commonly refer- red to as drones, have emerged as a promising tool to bridge these critical gaps. This narrative re- view explores the role of drones in delivering medical supplies, supporting casualty triage and en- hancing emergency response in conflict settings. A structured literature search of MEDLINE and Embase (2000-2025) identified relevant studies assessing drone applications in healthcare, with particular focus on their deployment in war and disaster zones. Evidence demonstrates drones can significantly reduce delivery times for blood products, automated external defibrillators and essen- tial medicines, while providing reconnaissance to locate casualties and assess hazards. Advantag- es include improved timeliness, reduced risk to rescuers and enhanced situational awareness. However, challenges remain, including limited payload and range, vulnerability to adverse weather and electronic interference, regulatory and legal barriers, and civilian mistrust linked to military drone use. Future integration of artificial intelligence, secure communication systems and harmon- ised regulatory frameworks may expand drone utility, ultimately transforming emergency medical care in conflict zones.
People with acquired brain injury, including stroke and traumatic brain injury, are at increased risk of developing oral health problems, which can occur at any stage from acute admission through rehabilitation and longer-term care. Contributing factors include dysphagia, cognitive impairment, reduced awareness, reliance on others for oral care, altered salivation and oro-motor impairments such as limited mouth opening. Individuals are susceptible to oral disease, including fungal infections, caries and periodontal disease, which can cause pain, infection and reduced quality of life. Poor oral hygiene is also associated with healthcare-associated pneumonia, a significant risk following acquired brain injury. Oral health should remain a clinical priority for neurologists and healthcare teams across rehabilitation and community settings. Oral health management is, therefore, a shared multidisciplinary responsibility to promote recovery and rehabilitation. We provide practical guidance on assessing oral health risks, supporting daily mouth care, managing common oral problems and ensuring timely referral to dental services.
Abstract Background The clinical benefit and safety of drug-coated devices in chronic limb-threatening ischemia remain debated, particularly after recent randomized evidence questioning paclitaxel-coated technologies. We evaluated wound healing, limb outcomes, and mortality after infrainguinal endovascular therapy with uncoated, paclitaxel-coated, and sirolimus-coated devices. Methods Consecutive patients with chronic limb-threatening ischemia undergoing successful infrainguinal endovascular therapy in a prospective single-center service evaluation were analyzed. The primary exposure was use of any drug-coated device during the index procedure. Inverse probability of treatment weighting and multivariable Cox models were used to adjust for baseline differences. Exploratory analyses compared paclitaxel-coated, sirolimus-coated, and uncoated devices. Results Among 341 patients, 244 (71.6%) received at least one drug-coated device. After weighting, drug-coated device use was associated with more frequent wound healing, whereas major amputation, clinically driven target lesion revascularization, major adverse limb events, and death did not differ significantly between groups. In weighted multivariable models, drug-coated device use remained associated with wound healing (HR, 1.86; 95% CI, 1.14–3.02), but not with mortality or major limb events. Exploratory drug-specific analyses suggested the highest wound-healing rates among patients treated with sirolimus-coated devices, while mortality was comparable between paclitaxel-coated and uncoated devices. Conclusion In this real-world cohort of patients with chronic limb-threatening ischemia undergoing infrainguinal endovascular therapy, drug-coated device use was not associated with increased adjusted 1-year mortality and was associated with improved wound healing. Exploratory analyses suggested favourable wound-healing outcomes with sirolimus-coated balloons, with a lower observed mortality signal that warrants confirmation in larger comparative studies. What is Known Drug-coated devices are widely used in endovascular therapy to prevent restenosis, but their clinical benefit in patients with chronic limb-threatening ischemia remains uncertain. Recent randomized evidence has questioned the effectiveness of paclitaxel-coated devices in chronic limb-threatening ischemia and has raised ongoing concerns regarding long-term mortality. What the Study Adds In a real-world cohort of patients with chronic limb-threatening ischemia undergoing infrainguinal endovascular therapy, drug-coated device use was not associated with increased adjusted 1-year mortality and was associated with improved wound healing. Wound healing may be a clinically sensitive, patient-relevant endpoint for evaluating endovascular strategies in CLTI. Exploratory drug-specific analyses suggested favourable outcomes with sirolimus-coated devices, supporting dedicated comparative studies of limus-based technologies in CLTI.
