The Top 10 Medical Advances of the Decade

1. Medical Advances Dr.T.V.Rao MD Dr.T.V.Rao MD

2. What is new in the last decade • The first decade of the 21st Century brought a number of discoveries, mistakes, and medical advances that have influenced medicine from the patient's bedside to the medicine cabinet.

3. Mapping the Human genome advances medicine • Mapping the human genome had become a race of time and money in the 1990s, with two competitors at the forefront: the government-funded Human Genome Project, which completed its task in 15 years with more than $3 billion in taxpayer money, and a private company, Celera Genomics, which was financed with $100 million and took less than a decade.

4. Genomic science advances preventive medicine • " The biggest area of the future will be preventive medicine,". "By understanding the genetic causes and links to disease we can spend more and more attention on preventing disease."

5. A Craig Venter publishes the final draft • In 2003 a "final" draft was released by researchers, and in 2007 more updates to the genome were published by Craig Venter, PhD, chief scientist behind Celera Genomics.

6. Genetic association with prostatic cancer decoded • Doctors have developed a genetic test for a gene associated with prostate cancer, "and there's a drug available that greatly lowers the risk for prostate cancer in the future."

7. Information technology to patients and doctors • Doctors say the Internet and information technology has actually changed the way they practice medicine for the better. Even doctors need to look things up from time to time. • With a pad and pen, then sit in the waiting room while the nurse pulls their file.

8. The knowledge at you finger tips • In the past if you had a clinical question to research, I had to go to the library, pull out multiple years of the Index Medicus, look up the topic, write down the references, go to the stacks and pull the volumes of journals, find the article, read the article, go to the copy machine and make a copy& if I were lucky, I would have my answer in about four hours. • Now you have everything at your finger tips

9. Your iPod touch or ipad brings everything …. • Now You can be on rounds and in five minutes have more information on the topic than I need& on my iPod Touch or iPad I can look up a medication, check the formulary to see if it's covered, check for interactions with a patient's other meds and double-check details of the pharmacology of the med plus quickly review the problem I am treating, and You don't even have to go online

10. Information technology makes life safe • Information technology has also, to some degree, made life safer for the patient. Once admitted to a hospital, they get a bar code which matches their blood samples and their IVs.

11. Information technology should be supported by the hospitals ??? • But many physicians have been reluctant to go digital because there is a significant upfront investment, which is why several of the healthcare reform measures now before Congress include provisions to underwrite some of this cost. • The developing countries should go a long way ?

12. Anti-Smoking laws and Campaigns Reduce Public Smoking - yes • In a report issued last October, the Institute of Medicine said those public smoking bans have cut exposure to second-hand smoke, which, in turn, has contributed to a reduction in heart attacks and death from heart disease.

13. Antismoking laws have impact on smoking • Anti-smoking campaigns (at least in the U.S.), including banning of smoking in workplaces and public places, [have] enormous impact across socioeconomic classes on many diseases • In terms of the greatest good for the greatest number, there can be no doubt that the decline in smoking (through various means) has had the greatest impact

14. antismoking law reduces morbidity and mortality • It's probably the most important 'doable' public health measure for decreasing morbidity and mortality,

15. Heart Disease Deaths Drop by 40 Per cent • Those looking for dramatic improvements in public health need look no further than the world of heart disease. • A mere 25 years ago, when a patient came to a hospital with a heart attack, the best that could be done was to put the patient in a darkened room, give him or her morphine for pain and lidocaine, which doctors believed would prevent dangerous irregular heartbeats, and hope for the best.

16. Genetically engineered drugs for rescue in heart disease • Today treating a heart attack is all about speed: speed the patient to the hospital so that a clot that blocks the life-saving flow of blood can be "busted" with drugs like the genetically engineered tissue plasminogen activator or tPA.

17. New drugs changes the future of heart diseases • Moreover, drugs that didn't exist 25 years ago -- chiefly statins like simvastatin, Lipitor, mevacor, and Crestor -- are now routinely used to slow the progression of atherosclerosis,the medical term that describes the build-up of the hard, waxy substance called plaque that narrows arteries.

18. Preventive cardiology solves many issues on heart diseases • Research shows about half of the gains in heart disease came from new treatment interventions, the other half (up to 60 percent) are due to prevention.

19. Prompt screening greatly helped many patients • Importantly, what this means is that the community 'gets it.' Better control of blood pressure, pre-emptive lowering of blood cholesterol levels, better diets, and reduced smoking are resulting in fewer (cardiac) events,

20. Stem Cell Research: Laboratory Breakthroughs and Some Clinical Advances • Probably no area of research has so fired the public imagination and so ignited the fires of public controversy as that of stem cell research. In reality, this area has generated more political action than reproducible clinical advances

21. Genetic manipulations have cure for many critical diseases • European researchers genetically manipulated bone marrow cells taken from two 7-year-old boys and then transplanted the altered cells back into the boys and apparently arrested the progress of a fatal brain disease called adrenoleukodystropy

22. Now we can make stem cells to our needs • Now we can make embryonic-like stem cells directly from skin cells, which makes it possible to model a multitude of human diseases in the petri dish. New drugs based on stem cells are being developed, and the first human clinical trial based on products of human embryonic stem cells is expected

23. Targeted Therapies for Cancer Expand With New Drugs • Two blockbuster-targeted therapies burst on the cancer scene in late 1990s, and arguably changed forever the concept of cancer treatment, converting what was often a fatal disease into a chronic illness. The first, Herceptin, is a drug that targets a type of breast cancer that is characterized by a specific cancer gene -- an oncogene -- called HER-2.

24. New drugs are effective in chemotherapy failures • Women whose cancers express HER-2, which is estimated to be about 25 percept of women with breast cancer, will respond to Herceptin even when other powerful chemotherapy drugs have failed.

25. New drugs changes the solutions to cancer • The introduction/approval of trastuzumab (Herceptin) and lapatinib (TyKerb) in breast cancer will prevent many women's breast cancers from recurring and have significantly improved survival for many women faced with breast cancer. More important, these drugs represent highly effective agents that target the cancer, not the patient

26. New drugs target genetic mutations • Other drug, a cancer pill called Gleevec, targets genetic mutation called bcr-abl (b.c.r. able) that causes cancer cells to grow and multiply in patients with a variety of cancers, including chronic myeloid leukemia or with a stomach cancer called GIST.

27. Combination Drug Therapy Extends HIV Survival • Since the introduction of highly active antiretroviral therapy, or HAART, as this combination therapy approach is called, HIV/AIDS has evolved into a serious, but chronic disease with survival stretching into decades. • Moreover, this "cocktail" approach to treatment where drugs are combined in different ways or different sequences has become a model for treating other diseases ranging from lung cancer to heart disease.

28. Better approaches in hiv infections • The drop in death rates from HIV in the developed world (is) due to improved medications, "There was the 10 per cent drop in deaths due to HIV in the US between 2006 and 2007. • In Africa, where the HIV/AIDS crisis hits hardest today, doctors are slowly making progress-and in some cases real gains, which is the case with the use of antiretroviral drugs to block mother-to-infant HIV transmission.

29. Developing world too show progress in reduction of vertical transmission • Advances are being made in the developing world, with Botswana leading the way not with a 3% vertical transmission rate. It was the first and still is the most effective prevention strategy

30. Minimally Invasive and Robotic Techniques Revolutionize Surgery • Robotic surgery increased the ability of cancer surgeons to get clean margins as well due to the magnification of the structures • he greatest benefit of tiny openings into the body rather than large incisions made by traditional surgery, may -- believers say -- be shorter and less painful recovery time.

31. Study Finds Heart, Cancer Risk with Hormone Replacement Therapy • Until July 2002 most doctors treating middle-age women believed that giving their patients hormones -- either oestrogen alone or oestrogen combined with progestin -- would protect their hearts from the ravages of age that seemed to attack women after menopause. • Hormone replace therapy, or HRT, was also thought to be good for the bones, the brain, the skin, the figure, and the libido, and was considered the best treatment to control the annoying and sometimes disabling symptoms of menopause such as hot flashes, depression, and sleep disturbances • However research proves otherwise. >

32. Hormone treatments can increase heart disease risks • And then the world changed, the National Heart Lung and Blood Institute, which was sponsoring a placebo-controlled trial of hormone replacement therapy in more than 161,000 healthy women, announced that it was shutting down the study because HRT increased the risk of heart attack, stroke, blood clots, and breast cancer.

33. Hormone replacement treatment leads to increased risk of cancer • Two biggest advances in breast cancer this decade was the targeted-breast cancer treatment with Herceptin and "the finding that postmenopausal hormone replacement is associated with a huge increase in the risk of breast cancer."

34. Scientists Peer Into Mind With Functional MRI • Mind-reading has moved from carnival attraction to the halls of medicine with what is known as a functional MRI. • The medical mind-readers are not trying to identify a card randomly selected from a deck -- they are using sophisticated imaging techniques to map the way the mind works.

35. A greater understanding with MRI • The process, often called fMRI, traces the working of neurons -- brain cells -- by tracking changes in the oxygen levels and blood flow to the brain. The more brain activity in one area, the more oxygen will be used and the more blood will flow to that area. The patient lies awake inside an MRI scanner. He or she is asked to perform a simple task, like identifying a colour or solving a math problem.

36. Fmri tracts real-time events on functionality of brain • As the patient answers the question, the fMRI tracks the areas of the brain that are activated by tracing the speed at which the cells metabolize the sugar, or glucose. • First developed in the early 1990s, fMRI began to shape research at the beginning of the decade

37. Better understanding of several diseases with f-MRIusage • Using this fMRI technique, researchers are learning valuable information about disease such as depression, brain cancer, autism, memory disorders, and even conditions such as the skin disorder psoriasis.