Well it’s that time of year again… when we review the best medical stories of the past year. This year we broadened our aim to include more than just medical research. Take a look at the curated list of topics that have captured our attention.
1. Grow Your Own
I’m not talking about pot, though that came close to making this year’s list. I’m referring to the amazing work in regenerative medicine that has been quietly humming along for years.
Starting with bioscaffolds to create a “framework” for the final organ, researchers have coaxed pluripotent human stem cells to differentiate into simple organs like the main airway (trachea). More complex organs have been out of reach until now, when researchers managed to grow human intestinal tissue and successfully transplant it into a mouse model.
Regenerative medicine could revolutionize the field of transplant medicine — and bring some relief to the frustrating bottleneck for organs that leaves many patients on waiting lists for years.
2. Personalized Medicine
The concept of tailoring medical treatments to one’s unique genetics just may be the vitamin D of 2014, judging from the voluminous press coverage and expansive editorials that appeared recently. Genomic medicine (often referred to as personalized medicine), even had its own spot in the State of the Union Address.
Unlike all the fanfare for vitamin D, there’s good science behind this idea: that genetic differences are the reason a given treatment doesn’t work for everyone, whether we’re talking about high blood pressure pills or a particular form of cancer chemotherapy.
But while we’d love to see tumors vaporized with the same deadly accuracy as SEAL Team 6, genomic medicine is a lot more complicated than a double tap.
For starters, simply performing the research to elucidate treatments for specific disease subgroups will be expensive and time-consuming. Imagine running not one breast cancer trial for thousands of patients, but dozens of smaller sub-trials on various tumor types, each with its own protocols and drugs. Furthermore, such small numbers make it statistically more difficult to determine complications and adverse side effects of treatments.
3. Mobile Stroke Units
This is perhaps my favorite topic from 2014. Stroke kills nearly 130,000 people annually and is the leading cause of adult disability in the US. And unlike coronary heart disease (think heart attack) — another major killer with nearly 380,000 deaths annually — there are relatively few good treatments for stroke.
The best chance of recovery for someone with an embolic stroke (where an artery in the brain is blocked by clot or cholesterol debris) is to receive tPA, the “clot busting” drug that has become a widespread and successful treatment.
Trouble is, tPA must be initiated within four hours of the stroke. Wait any longer and adverse side effects of tPA (bleeding) present a greater risk than the stroke itself. Deciding quickly whom to treat is tricky, too; it requires specialized imaging (MRI or CT scan) and evaluation by a neurologist.
To reduce the delay between diagnosis and treatment, some municipalities and hospitals are deploying mobile units with everything needed to assess a possible stroke. While these specialized ambulances are very expensive — upwards of $1M to build, let alone staff — they hold the promise of making stroke a far less deadly disease. We should have data on how these units are performing within a year or two, so stay tuned.
4. Our Amazing Gut Microbiome
This year we discovered that maybe there was more to being fat than simply eating too much and exercising too little.
But the idea that people absorb and process calories differently based on the types of bacteria in their gut — and that those bacteria can be permanently altered by exposure to antibiotics early in life — well that’s a mind-blowing revelation.
The Feds are finally on the case with the PCAST (President’s Council of Advisors on Science and Technology) report detailing the dangers of antibiotic resistance (like an extra 23,000 deaths annually). That’s as many as die from flu each year.
It’s high enough on the White House agenda to have made it into the State of the Union Address of 2014 (but alas, not 2015). CDC then granted superbugs their own microscopic line item, with a piddling $30M allocation from the $3.9T (yes, that’s trillion) federal budget.
Based on the near-daily reports of new outbreaks, we think $30M was way, way too little. Case in point: the 2016 budget proposal from the White House now includes a $1.2B provision across all government agencies for fighting these frighteningly adaptable microorganisms.
6. The Future is Plastics
Forget those massive great white sharks. The greatest danger in the oceans these days is plastic trash — more than 250,000 tons of the stuff are floating around. From your basic water bottle down to the tiniest micro-shard, plastic is making its way up the food chain, bringing with it a host of endocrine disruptors, toxins and death to sea animals everywhere. Some even argue that plastic should be reclassified as a hazardous waste.
It’s a fact: Obamacare has been a tremendous success, judging from enrollment figures (10 million newly-insured Americans and counting). However, as more than one commentator has pointed out, the Affordable Care Act (ACA) does nothing to control costs in our rampantly inefficient, inflationary health care system.
And that just may make this landmark legislation a big liability for years to come. For an excellent summary of the economic shortcomings of ACA, take a look at this video from a recent episode of “60 Minutes.”
8. Food Chain Contamination
Superbugs don’t just hang out in the hospital, waiting to infect unsuspecting patients. Sometimes those bacteria are on our food.
Here’s how it works:
- Farmers feed antibiotics to their livestock both to prevent disease and to enhance growth. (Hmm… didn’t we talk about antibiotics and weight already?) In fact, 80% of antibiotic use is on the farm, not in the pharmacy.
- Those farm bacteria then become antibiotic-resistant.
- During butchering, farm animal carcasses get contaminated with the resistant bacteria, sickening consumers who may improperly prepare or handle the contaminated meat.
This cycle has been in operation for dozens of years, right under the noses of FDA, USDA, and all those acronyms that are supposed to protect us. How bad is it? In 2014 Consumer Reports found that 97% of all chicken parts were contaminated with potentially harmful bacteria. It’s enough to make a meat-eater cry fowl… I mean foul.
2015 should be an interesting year in the world of medicine and health policy. Stay tuned for updates on these topics!