Engineers Add New Updates to Medical Advances – 2019

  1. Pharmacogenomic Testing

Pharmacogenomic testing determines patients’ genetic makeup to tailor prescribed medical treatments based on individual drug metabolism. Pharmacogenomic testing, for example, can determine how patients will respond to opioid therapy, potentially decreasing opioid abuse. Outside clinical consensus on the benefits of pharmacogenomic testing is split, with some experts optimistic about the technology and others pessimistic. Clinicians have been slow to implement pharmacogenomics, despite technological advances in the field and greater access to genetic testing. Stakeholders in the United States and Europe are examining the clinical utility of pharmacogenomics and establishment of appropriate guidelines. 

  1. Artificial Intelligence

The Encyclopedia Britannica defines artificial intelligence (AI) as “the ability of a digital computer or computer-controlled robot to perform tasks commonly associated with intelligent beings. The term is frequently applied to the project of developing systems endowed with the intellectual processes characteristic of humans, such as the ability to reason, discover meaning, generalize, or learn from past experience. Although AI technologies have matched human performance of tasks, such as mathematical calculations or playing chess, they have yet to match human adeptness at covering wide domains of information. With respect to health care, AI can assist medical diagnosis and aid physicians in identifying pathology on diagnostic scans. Furthermore, AI can help interpret mounds of electronic health data.

  1. Treatment of Acute Stroke

2018 guidelines are an update to the 2013 guidelines, which were published prior to the six positive ‘early window’ mechanical thrombectomy trials.   In addition, in the last 3 months, two trials  showed a clear benefit of ‘extended window’ mechanical thrombectomy for certain patients with large vessel occlusion who could be treated out to 16-24 hours. When it comes to stroke intervention, a timely response is critical. Prolonged lack of blood flow following a stroke can cause irreversible destruction, often resulting in disability. In many cases of stroke, intervention methods can be deployed to save tissue. But until now, intervention of a stroke has only been recommended within a limited window of time. Released this past year, new guidelines suggest an expanded window for treatment. This lengthened timeframe is anticipated to lower the risk of disability and provide opportunity for recovery to an increased number of future stroke patients.

  1. Immunotherapy

Immunotherapy has revolutionized cancer treatment by leveraging the immune system to fight tumors. In particular, immune checkpoint inhibitors have demonstrated great potential in the treatment of solid-tumor types, such as melanoma and non-small cell lung cancer. The hope is that someday immunotherapy options will exist for all types of tumors.

  1. 3-D Printing

3-D printing allows the user to create health products specific to the patient, including prosthetics, implants, and airway stents. These customized creations enhance comfort and performance because they are modeled after the patient’s body measurements, while offering minimal risk of postoperative complications. 3-D printing also has applications in surgical planning, such as with heart surgery or even face transplant. Utilizing 3D printing technology, medical devices can now be matched to the exact specifications of a patient. Designed to be more compatible with an individual’s natural anatomy, devices modeled from patient-specific dimensions have shown greater acceptance by the body, increased comfort and improved performance outcomes. The versatility provided by 3D printing gives medical practitioners the ability to provide patients the most advanced care, while simultaneously minimizing the risk of complication in patients that meet specific medical requirements. Currently, the most significant work in this space includes external prosthetics, cranial/orthopedic implants, and customized airway stents for diseases narrowing the airway. Work in prosthetics and other bodily implants is also gaining speed with some cleared for the commercial market. The technology has also been found helpful in surgical planning. To date, the technology has been used for many complicated heart surgeries, and even the Cleveland Clinic’s most recent total face transplant. With its widening healthcare applications, 3D printing is increasing the attention to detail in patient care.    Prosthetics

  1. Stroke Visor

In 2018, the FDA cleared the Cerebrotech Visor, which is a noninvasive spectroscopy device that measures changes in the distribution of cerebral fluids and couples these findings with machine-learning to enhance algorithms and detect certain brain pathologies, such as stroke, trauma, and swelling. Though less common than ischemic strokes, hemorrhagic strokes – during which blood escapes from a ruptured blood vessel in the brain – are responsible for nearly 40 percent of stroke deaths. Rapid diagnosis is necessary for effective treatment, as uncontrolled bleeding can lead to swelling of, and damage to, the brain. Medical Device Development speed diagnosis, healthcare professionals are using new, advanced technologies such as the hemorrhage scanning visor, which can detect bleeding in the brain. An efficient diagnostic tool, the visor for prehospital hemorrhage scanning serves to speed up diagnosis and the ever-important time to treatment.  

  1. Virtual Reality/Mixed Reality – VR/MR

Virtual reality/mixed reality (VR/MR) applications have become popular in medical education. With its immersive approach, VR/MR is good for all kinds of learners: audio, visual, and kinesthetic. VR is a completely computer-generated version of the world and requires the use of VR goggles. MR, or augmented reality, superimposes computer-generated images or sounds onto real-world settings and needs only be displayed on a screen.  VR/MR permits medical students to experience and learn from life-and-death scenarios in a low-stakes environment. Other applications of VR/MR include surgical simulation and diagnostic imaging.

  1. Robotic Surgery

Robotic approaches to surgery are less invasive and faster, and are often associated with improved clinical outcomes, such as decreased recovery time and reduced pain. Robotic approaches to surgery also guide surgeons in the operating room. Currently, robotic surgery is used in a gamut of procedures from spine to endovascular.  Engineers Develop Personal Robots  For instance, the da Vinci Surgical System, which is probably the best-known robotic surgery platform, translates the surgeon’s hand movements to smaller movements made by the robot inside the body, all visualized via laparoscopy. The da Vinci System has been used on more than 3 million patients globally.  

  1. RNA Therapeutics

RNA therapeutics stymie RNA genetic abnormalities before these abnormalities are translated into functioning or nonfunctioning proteins. Examples of this technology include antisense nucleotides and RNA interference, and are applicable to rare genetic diseases, cancer, and neurologic illness.

   10.  Heart Surgery

Advances in technology now allow for the performance of heart surgery percutaneously. Replacement of the aortic, mitral, or tricuspid valves via catheter obviate the need for open-heart surgery and improves surgery results. Cardiac surgery today is less invasive and more routine and effective than its historic counterpart. Performed percutaneously – via a catheter through the skin – many cardiac procedures no longer require an open heart surgery approach. Two such procedures performed this way include replacements and repair of both the mitral and tricuspid valves. Hot on the trail of aortic valve percutaneous intervention, recent percutaneous mitral and tricuspid valve intervention has yielded significant positive outcomes while filling a void in the field of heart surgery. The exploration of this technology in a greater patient population is ongoing.   Exoskeleton for Babies and Children

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