Nobody knows if innovation is infectious, or can be learnt.

But the year 2009 saw a wave of creative,

inspired approaches from the nation's medical fraternity. No, not big bang innovations, but more
the Tata Nano variety. With government expenditure on health as a percentage of total health
expenditure at 17.9 per cent, one hardly expects the Indian state to play a major role. Nor so much
the booming drug companies, who spend 12 to 15 per cent of their outlays on research and 30 per
cent on marketing. The true leaders of innovation this year have been the nation's surgeons.
Technology has been their driving force, minimally invasive the gold standard and precision the
mantra. And armed with new machines and new skills, surgeons have accessed parts of a patient's
body as never before, used tools and techniques in a whole new way, changed how some types of
surgery are performed, hastened the healing process for many and practically created new
milestones for the range of patients they can help.
"Modern surgery might not yet feature Star Trek-ian techniques and equipment, but in some
regards, they are on their way," says Dr Naresh Trehan, the cardiologist who pioneered robotic
surgery of the heart in the country. But that's not all. From discovering new drugs and genes, new
business models, new use of technology to designing hospital furniture keeping the Indian reality in
mind-simple innovations have been the flavour of the season. "The knowledge economy is an
innovation economy," they say. Our doctors and researchers this year have certainly provided a
roadmap for turning new ideas into long-term successes.
1. Sizing up the brain
Gene behind brain disorder found
This is what happens when the best brains come together to size up the brain. Geneticist Arun
Kumar of the Indian Institute of Science (IISC) and psychiatrist Satish Girimaji of the National
Institute of Mental Health and Neuro Sciences (NIMHANS) in Bangalore worked together for nine
years. The outcome? Finding a key gene that causes microcephaly-a disorder marked by smaller-
than-normal brain size and mental retardation. Until now only four genes were known to cause this
hereditary disorder that develops in the foetal stage. This is the first time a fifth gene, named STIL,
has been detected. The new gene is particularly valid for India, where one in every 50,000 to
1,00,000 live births ends up with microcephaly.
2. Beating cancer
Research and technology bring new hope
Medics link the HPV virus to cervical cancer, especially in sexually active women. In India, it kills
about 76,000 each year. This year, biochemists, microbiologists and gynaecologists at the All India
Institute of Medical Sciences sent a message of hope by detecting the most common HPV types that
cause havoc in India. More good news: the Apollo Speciality Cancer Hospital in Chennai launched
the CyberKnife technology, a first in India. A pocket-pincher, but it promises precise radiation to
cancer cells, avoiding healthy tissue. A noninvasive option that caters to the quality of life of a
cancer patient.
3. Gumming the eye
Using glue in eye surgery
For the first time, the entire front part of a patient's eye-cornea, sclera, iris, pupil and lens-was
transplanted at Dr Agarwal's Eye Hospital & Eye Research Centre, Chennai. It followed the
technique that was used here in 2007 to fix intraocular lens with fibrin glue (generally used to
arrest bleeding and seal tissues in surgery) in a patient's eye where lenses could not be implanted
by normal procedures. "Earlier, the treatment of damaged IOL was a challenge for ophthalmologists
and in most cases nothing could be done," says Agarwal. "With this glue technology, we can now
treat patients where intraocular lens capsules are missing."
4. Lend me a hand, robot
Milestone robotic surgeries of chest and stomach
It was the year of surgeons using third-generation robots to reach a range of organs. The first such
surgery on the thorax was done by Dr Arvind Kumar of AIIMS, Delhi, in June. Last month,Dr Jaydeep
Palep did the first stomach surgery at Care Hospital, Hyderabad."It's almost like shrinking one's
hands and putting them in places they would never fit,"says Kumar.
5. The sweet switch
A rare surgery for diabetes
Surgery for diabetes? That's exactly what Dr Surendra Ugale of Kirloskar Hospital in Hyderabad and
Dr Ramen Goel of Bombay Hospital tried out through the Ileal Transposition (or small intestinal
switch). The procedure shortens the intestinal tract between the stomach and terminal ileum, shifts
it into an upper area and puts it in line again. The fallout? A biochemical process that facilitates
insulin secretion in the presence of undigested food and controls Type II diabetes-a metabolic
disorder that is marked by the failure to absorb sugar and starch due to lack of the hormone insulin.
6. Sing a different tune
iPhone used to stave off blindness
Who would have thought that the pricey Apple iPhone could help India's rural masses? But doctors
at the Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, are doing
precisely that to diagnose vision loss in infants from remote areas. Over 8 per cent of India's 27
million infants each year weigh less than 2 kg and run the risk of Retinopathy of Prematurity. So
long just a handful of city doctors had the know-how. Now with the iPhone and a software
developed by the i2i TeleSolutions, the good doctors are busy saving lives across the country.
7. Business unusual
A low-cost luxury hospital
Free market mantra to tackle poverty? Think LifeSpring maternity hospital,Hyderabad. The no-frills
chain of small hospitals offering world-class care to low-income clients at 30-50 per cent of market
rates is winning kudos for its business model.Set up as a joint venture of Hindustan Latex Ltd and
Acumen,US, last year, six hospitals have rolled out, with 30 more on the cards by 2010. Success
mantra?With over 1,500 customers a month, optimising resources and leveraging economies of
scale.
8. Propped up in style
A homespun hospital bed addresses Indian needs
Between the hand-cranking metal beds and super-expensive motorised ones, Indian hospitals had
little choice. Then came Onio, the design firm in Pune set up by two ex-NID-ians, whose unique
design won them the Design Brilliance Award. "Indian beds imitated Western designs," says
Prakash Khanzode, who mentored the project. "We spoke to hundreds of doctors, nurses and
patients to come up with a design suitable for India." Plastic on all exposed surfaces, quick-shifting,
totally adjustable, the Vita Bed is ready for ICUs. Godrej is about to market it.
9. At your finger tips
Ancient medical skills online
Thousands of years of accumulated medical knowledge at the click of a mouse. Thanks to the
Council of Scientific & Industrial Research and the Department of AYUSH, Ministry of Health, the
world's first traditional knowledge digital library took shape this year. With over 200,000
ayurveda, siddha and unani formulations across 30 million pages in five international languages, it
will hopefully put an end to the rampant misappropriation of time-honoured medical knowledge
and practices-a growing concern.
10. Power-packed pill
A five-in-one capsule for the heart
Lifestyle moderation is the key to prevent chronic diseases. Yes, we all know that. But in this age of
lifestyle excesses, those who forget to look after their cardiovascular health, a preventive pill is
about to come handy. It's a five-in-one drug combo meant to keep blood singing through your veins
and simmer down raging cholesterol and blood pressure. Designed by a team of doctors from
Bangalore's St. John's Medical College and McMaster University, Canada, the polypill-a first in the
world-is likely to reduce coronary heart disease by 62 per cent and stroke by 48 per cent.
. DNA Modification For Treating Skin Disease
DNA modification research has led to the very successful treatment of a serious skin disease,
undertaken by the Children’s Hospital at Ruhr University in Germany, together with specialists
across Europe. A young Syrian boy named Hassan, suffering from a genetic disease called junctional
epidermolysis bullosa, was successfully treated with genetically modified skin.

Junctional epidermolysis bullosa leaves the skin as thin and fragile as paper, because of faulty DNA
programming. The treatment entailed removing a patch of the boy’s healthy skin that contained
faulty DNA, and repairing it with a customised virus in the laboratory. Thereafter, the modified skin
was grafted back onto the patient’s body over the course of several operations, where it grew back
successfully.

Two years later, Hassan enjoys fully functioning, healthy skin. According to Dr Michele de Luca, who
led the team, his skin is currently stable and robust, without blistering or itching.

2. Liquid Biopsies To Locate Tumor DNA In Medical World

According to the US National Centre of Biotechnology Information, “liquid biopsies” can uncover
cell-free circulating tumor DNA, or ctDNA, which is proven to be more than 100 times more
abundant in the blood than tumor cells, and sheds from a tumor into the bloodstream.

This medical method has been proven to be a non-invasive and rapid manner of detecting cancer
early. In addition, routine cancer check-ups will soon become easier and more effective, and cancer
care will be more personalized.

3. Cellular Immunotherapy To Treat Leukaemia And Lymphomas

Blood-cancer patients can soon expect a new, more efficient treatment. Called chimeric antigen
receptor T-cell therapies, it entails removing a patient’s immune system T-cells and genetically
reprogramming them to seek and destroy tumor cells.

Dr Renier Brentjens of the Memorial Sloan Kettering Cancer Centre in the US explains that it is
possible for these CAR T-cells to remain in the body, thereby guarding against cancer recurrence, so
the therapy frequently results in long-term remissions. Blood-cancer patients who have been
treated with this new therapy have reported a remission rate of 90%. It is expected this treatment
will soon be presented to the FDA for treatment of acute lymphoblastic leukaemia (ALL), and, if it is
successful, in the future cellular immunotherapy can possibly replace chemotherapy, thereby doing
away with many of the side-effects. Click here to find out more about immunotherapy.

4. Warm Perfusion For Cardiac Transplantation

The University of Minnesota in the US is in the process of developing what is known as the
TransMedics Organ Care System (OCS), or, more colloquially, the “heart in the box”.

For nearly half a century, organs for transplantation were packed and placed in saline and ice
before the medical operation, but injuries were a risk. With the OCS device, which stands at waist
level and rolls around on a cart, the heart is allowed to keep beating and circulating the donor’s
warm, oxygenated, nutrient-laden blood until it is disconnected and implanted into the recipient.

The advantages lie in the fact that blood has an excellent capacity for oxygen delivery, and is a
potent antioxidant, free-radical scavenger and an efficient buffer, while also reducing injury.
Click here to find out more about this.

5. 3D Visualization And Augmented Reality For Surgery

According to Duke University in the US, new innovations in technology, called HoloLens goggles,
can help surgeons visualize regions of the body they cannot see, and thus change the way doctors
operate. The goggles augment the surgical reality by projecting 3D images onto the real objects.

Duke neurosurgery residents Andrew Cutler and Shervin Rahimpour are responsible for this
innovation, which will be particularly helpful for “blind” surgeries, such as extraventricular drain
(EVD) placement. Instead of having to rely on static CT scans and physical “landmarks”, medical
doctors will now be able to place a three-dimensional image of a brain onto a head, and watch a
virtual projection of the catheter as it pierces the brain.

2017 has seen its fair share of medical breakthroughs and pioneering research.

This has paved the way for several new advances we can expect in 2018.

1. Drones to distribute medicine to isolated areas

With improved technology, remote treatment and better distribution of medical services and
medicine is rapidly becoming a reality.

In 2016, it was reported that a start-up company made use of drones to deliver medicine to
Rwanda. This practice has since become routine and it is estimated that even more areas will
benefit through this method.

2. Curing diseases through gene editing (CRISPR technology).

This method holds potential for the treatment of many diseases, including retinaldegenerative
disease and inherited diseases, such as cystic fibrosis and haemophilia.

It was reported in November 2017 that the FDA is set to approve a gene therapy for inherited
retinal diseases. Many experts believe that this could pave the way to treatment for even more
diseases.
3. ASL patients will be able to communicate with their thoughts

Earlier this year, CNN reported on a new technology that could help decode the thoughts of those
with functional brain activity in a completely paralysed body, brought on by a stroke, traumatic
injury or amyotrophic lateral sclerosis (ALS).

The initial research was published in the journal PLOS Biology. While the research was only in the
beginning stages at the time, it holds great promise for 2018.

4. An artificial pancreas for diabetics

Diabetes is caused by the insufficient production of insulin by the pancreas. It was reported in May
2017 that the first artificial pancreas systems were beginning to infiltrate the market to help
diabetics regulate their insulin levels.

As of December 2017, these are still not widely distributed, but we can expect artificial pancreas
systems to become more prominent in 2018 and further.

The Hybrid Close-Loop Insulin Delivery System in the first automated artificial pancreas system.

5. Reduction of LDL cholesterol

When powerful cholesterol drugs known as PCSK9 inhibitors were approved by the FDA in 2015,
many experts hailed it as an enormous breakthrough. The study findings were reassuring, but more
studies were needed to see whether this would pave the way for a medication with fewer side-
effects than statins.

But new studies have reported good news – earlier in 2017, a 20% reduction in LDL was reported
in a study group of 25 982 patients. We can expect this drug to be used more frequently in 2018.

6.Enhanced post-surgery recovery

We know the drill when it comes to surgeries – no eating and drinking beforehand, feeling a bit
groggy afterwards and being prescribed pain medication to help with the recovery. But
readmissions after surgery remain a problem, not to mention the opioid problem caused by
painkiller prescriptions.
New research has been looking at the Enhanced Recovery After Surgery (ERAS) protocol that
accounts for various methods to speed up recovery after surgery. This includes post-operative
nutrition plans and alternative methods to pain medication to speed up the recovery process.

In 2018, more hospitals will be looking to use the ERAS protocol.

7. More targeted, precise breast cancer therapies

Breast cancer is a disease that will affect one in 26 South African women in their lifetime. We rely
on treatments such as chemotherapy to fight the cancer cells, but these do not always have the
success rate we hope for.

In 2018 we could expect to see more targeted treatments for breast cancer that is designed to
target the specific characteristics of the cancer cells, such as the protein that allows the cells to
grow in a malignant way, according to Breastcancer.org.

8. Improved treatments for sleep apnoea

Sleep apnoea is a potentially dangerous condition and treatment for moderate to severe sleep
apnoea is often evasive and uncomfortable, involving the Continuous Positive Airway Pressure
machine (CPAP). This machines blows air into your nose via a nose mask, keeping the airway open
and unobstructed.

But a less invasive method was approved by the US FDA in October 2017. The Remede sleep
system, an implanted device that treats central sleep apnoea by activating a nerve that sends
signals to the diaphragm to stimulate breathing, has been approved by the US Food and Drug
Administration.

Following successful trial studies, this could be a treatment that we see more frequently in 2018.

9. Next-generation vaccines

Developing vaccines for emerging diseases are pricey and time-consuming. It is important to keep
abreast of vaccine technology and develop new ways of vaccination manufacturing to keep
epidemics under control.
Luckily, innovators will be upgrading the vaccination manufacturing process in 2018. This includes
freeze-drying so that vaccinations can be transported to remote areas more effectively. Companies
are also investigating faster ways to manufacture vaccinations to make them more readily
available.

10. The first human head transplant

The jury is still out on this one, but deserves a mention. In 2017, Sergio Canavero, a neurosurgeon
from Italy, was set to perform the first head transplant. Up to now, there has been no success in
animal experiments.

This lengthy 36-hour long procedure will allow the head to be removed and be reattached to a new
body, with all the nerve ends and blood vessels reattached and the spinal cord glued with a special
bio-compatible glue.

1. Growing organs in a petri dish to help treat cystic fibrosis

Els van der Heijden has cystic fibrosis but the 53-year-old was not benefiting from the expensive
medication she was taking. Doctors did not want to try a new, more expensive drug because it had
not been proven to work in people with the rare type of cystic fibrosis that Van der Heijden had.

Instead, they scraped a few cells from Van der Heijden and grew a mini version of her
large intestine in a petri dish. When Van der Heijden's "mini gut" responded to treatment, doctors
knew it would help her too.

This experiment was conducted to help people with rare forms of cystic fibrosis. So far, doctors
have grown mini guts – just the size of a pencil point – for 450 of the Netherlands' roughly 1 500
cystic fibrosis patients.

2. Lab-grown skin saves boy dying from rare genetic disease

A seven-year-old boy from Germany had a rare genetic disease called epidermolysis bullosa and
was on the brink of death. This disease makes the skin extremely fragile and thin, and had
destroyed nearly 60% of his skin. As a result, he was suffering from fatal sepsis.
Doctors intervened by using stem cells and gene therapy to engineer a fully functional skin for the
boy. He was the first person in the world to receive a skin transplant of this magnitude, and this
operation holds potential for more research.

3. Lymph-node transplant surgery in South Africa a success

On local soil, a man suffering from advanced skin cancer and lymphoedema has received successful
reconstructive surgery.

Surgeons at Life Vincent Pallotti Hospital successfully performed a novel vascularised lymph node
transfer, a procedure done on small blood vessels to treat lymphoedema.

Lymphoedema is a painful side effect of cancer and cancer treatment. This procedure is believed to
be the first in South Africa.

4. Boy born with HIV remains stable for eight years, without using drugs

A South African child born with the Aids virus has kept the infection suppressed for more than eight
years after stopping anti-HIV medicines – more evidence that early treatment can occasionally
cause a long remission that, if it lasts, could be a form of cure.

The case was revealed during July 2017 at an Aids conference in Paris, where researchers also gave
encouraging results from tests of shots every month or two instead of daily pills to treat HIV. This is
a very promising reason why people should stay on their treatments, according to researchers.

5. HIV eliminated from mice

Another important breakthrough was made with regards to HIV. Scientists discovered that they
could successfully cut out the HIV virus from mouse cells making use of CRISPR (gene editing)
therapy. The study was first published in the journal Molecular Therapy.

While this study is still in its infancy, the HIV virus was eliminated by only one round of treatment –
with more research, this technology can have far-reaching consequences for HIV.
6. The Nobel Peace Prize awarded for breakthrough research on the circadian rhythm

This year the Nobel Prize for Medicine was awarded for insights into our internal biological clock.
The Nobel Prize for Medicine was presented to three Americans for discoveries about the
body's daily rhythms.

Circadian rhythms adapt one's physiology to different phases of the day, influencing sleep,
behaviour, hormone levels, body temperature and metabolism. Groundbreaking research into our
circadian rhythm can produce even more groundbreaking research on health.

7. Landmark gene therapy for leukaemia approved

US health officials have approved a breakthrough treatment that genetically engineers patients'
own blood cells into an army of assassins to seek and destroy childhood leukaemia.

CAR-T treatment uses gene therapy techniques to turbocharge T-cells, which are the immune
system soldiers that cancer too often evades. Researchers filter those cells from a patient's blood,
reprogram them to harbour a "chimeric antigen receptor", or CAR, that zeroes in on cancer, and
grow hundreds of millions of copies.
When this cell is returned to the cancer patient, it can continue multiplying and help fight the
disease for months or even years after.

8. Bio-engineering for penises

Scientists have made a new breakthrough in bio-engineering technology by

successfully growingfunctional male penises in a US laboratory. This could be a potential solution
for men who have lost their penis to injury or disease.

According to Mashable, the process of bio-engineering a penis involves using donor penis as a base.
The penis is soaked in a solution for two weeks to remove the donor’s DNA. This prevents the
recipient’s body from rejecting the penis once it is attached. Cells taken from the patient are
cultivated in the lab for six weeks before they are placed onto the base.

9. The first robot-assisted super-microsurgery

Using robots during surgery is the way forward – especially when it comes to dangerous, delicate
procedures. It seems like another robot-assisted surgery breakthrough has been achieved.

Surgeons from the Maastricht University Medical Centre in the Netherlands performed the first
robot-assisted super-microsurgery. The robot sutured vessels as small as 0.3 mm to treat
lymphoedema in a patient. It’s a delicate procedure but the robotic assistance made it go without a
hitch.

10. New gene discovered that causes heart disease

And finally, a huge breakthrough by South African researchers – the identification of a new gene
called CDH2. This gene is responsible for causing arrhythmogenic right ventricle cardiomyopathy
(ARVC), a genetic disorder of the heart that causes cardiac arrest.

Researchers at the University of Cape Town’s Hatter institute for Cardiovascular Research in Africa
(HICRA), with global collaboration, have identified a new gene that is a major cause of sudden death
among young people. Although everyone has the CDH2 gene, a mutation of it causes the genetic
disorder that leads to ARVC.
hings move fast in the world of modern medicine, but if expert predictions about what to expect in

2018 prove true, they might move at a quicker speed than anyone anticipated.

It could also see technology companies start to become as important a player in the health-care

world as pharmaceutical companies. Breakthroughs in everything from patient monitoring to

sleep apnea are coming from Silicon Valley and could dramatically shift the current paradigm.

The Cleveland Clinic, for the past 10 years, has put together an annual list of expected medical

innovations for the coming year. In that time, says Chief Wellness Officer Dr. Michael Roizen, who

leads the initiative, the group has truly missed only one prediction. While the group has

occasionally been a bit premature in some of its estimates, he says, the predictions have ultimately

come true.

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To make the predictions, the group interviews more than 150 physicians, 30 to 40 venture

capitalists and a handful of media who cover the medical industry across the country to get their

collective thoughts on what's imminent. That list is then honed, eliminating long-shot candidates,

and goes through a double-elimination vote among physicians and venture capitalists. Nominees

are thoroughly vetted, and the groups eliminate candidates throughout the process.

Here's some of what the group expects to see this year.

Gene therapy for inherited retinal diseases

David Paul Morris | Bloomberg | Getty Images
A researcher tests gene therapy in Point Richmond, California.

In a historic move, the FDA has approved gene therapy for inherited retinal diseases. The approval

signals a new era for gene therapy, which suffered setbacks for years but is now pressing forward.

Patients that have a defective gene called RPE65 — which is responsible for producing a protein

that makes light receptors in the eye — suffer from leber congenital amaurosis and retinitis

pigmentosa, yet now have hope.

The treatment made by Spark Therapeutics is called Luxturna. It is injected into the eye and uses a

benign virus to deliver healthy copies of the gene to the retina.

While not a cure, it can improve eyesight substantially, according to researchers. But it comes with

a whopping price tag: $850,000 per onetime treatment.

Spark gene therapy drug priced less than expected at $850,000 10:34 AM ET Wed, 3 Jan
2018 | 01:45

This breakthrough can be a big first step in medicine. "If you look at cancer, we know the majority

of cancer starts with a DNA defect," Dr. Roizen says. "And that DNA defect can be corrected or

ameliorated. Say you have a family who has in vitro fertilization; they will examine the genes of the

embryo before it gets implanted to see if it has any problems — and if so, can we intervene and

change that problem? … This has a huge potential that is just going to start to break through."

The Cleveland Clinic's not the only group that's bullish on gene therapy. Health24 listed it as one of

the 10 advancements to expect this year as well.

Big reductions in LDL cholesterol

Maurizio De Angelis | Science Photo Library | Getty Images
Computer illustration of low-density lipoprotein (LDL), or bad cholesterol, molecules.

Bad cholesterol, known as low-density lipoprotein (LDL), is a major factor in heart disease. And

certain new drug combinations can lower LDL levels by 75 percent. PCSK9 inhibitors, along with

statins, have proved especially powerful at reducing bad cholesterol numbers. That, says Roizen,

could also help people truly change their lifestyles to focus more on healthy living.

A number of trials are testing this theory now to see just how low LDL levels should go. Doctors

now have the tools and research to help reduce cardiovascular death.

A new kind of patient monitoring

Hero Images | Getty Images

Part of the reason an intensive care unit is so chaotic is because alarms are constantly going off —

and they're not always critical. (One study, says Roizen, found that 80 percent of hospital alarms

were deemed unnecessary.)

Big data is starting to inch its way into the hospital and this year could be a turning point, as

"mission control" operations monitor those alarms and alert staff when things require

intervention. Those stations can spot trends that harried health-care employees can't as they rush

from crisis to crisis. And using artificial intelligence algorithms, they can predict which patients

will get in trouble and let doctors and nurses intervene, ideally before it becomes critical.

Similarly, hospitals are discharging patients quicker than ever these days. But follow-up

appointments with doctors can be challenging — and are certainly inconvenient, since the patient

has to drive (or be driven) to the doctor's office for what often amounts to a five-minute

appointment.
"Well over 80 percent of our post-op patients now see their surgeon every day via … an app on the

iPhone, where they can show the wound and talk to the doctor," says Roizen. "It's an ease of

convenience so the patient doesn't have to come in for the one-week checkup. Instead, they can be

seen every day."

A better night's sleep

Juanmonino | Getty Images

Man sleeping, using a mask for apnea sleep disorder treatment.

Sleep apnea affects 22 million people and can lead to high blood pressure, heart disease and

stroke. Popular treatments, like a CPAP machine, might be effective, but they still make sleeping

difficult for people with sleep apnea. That's why it is estimated that more than 40 percent of sleep

apnea patients refuse to wear the device.

Neuromodulation is a new way to treat apnea. Think of it as a pacemaker for poor sleepers. The

implant is controlled by a wearable patch that is worn during sleep that stimulates the patient and

ensures key airwaves are kept open during sleep. Clinical tests have been encouraging, and they're

certainly more comfortable for patients than a CPAP device.

"It's really in its infancy, but this will replace CPAP in 50 to 70 percent of patients eventually,"

predicts Roizen. "It will bring partners together again, as opposed to them sleeping in other

rooms."

An artificial pancreas
Frederucj Florin | AFP | Getty Images
A woman wears an early prototype of a bio-artificial pancreas (BAP) at the European Center for the
Study of Diabetes on July 3, 2014, in Strasbourg, eastern France.

Diabetes kills more Americans every year than AIDS and breast cancer combined, according to the

American Diabetes Association. Now the 1.25 million Americans who suffer from Type 1

diabetes might have a ray of hope on the horizon: A hybrid close-loop insulin delivery system that

began rolling out last May.

The technology, essentially an artificial pancreas, is expected to become more widespread this

year as more patients demand the technology and more insurers reimburse the system. It uses

computer algorithms to automatically and continuously deliver an adequate supply of insulin to

the body. Approved by the FDA, it enables direct communication between a glucose monitoring

device and an insulin pump to stabilize a person's blood glucose level.

Ultimately, that could be good news for people with Type 2 diabetes, which is much more common.

"This will be of great use to people with Type 1 diabetes, but we think it will spread quickly to the

millions of people with Type 2 as well," says Roizen.

. Tricorders

On the original Star Trek, Dr. McCoy (a.k.a. “Bones”) carried a sensory device called a tricorder to
record and relay medical information. Soon, thanks to Qualcomm’s $10 million XPrize competition,
that neat fictional gadget could become a health care reality.

Over the last five years, teams from the U.S., the U.K., Canada, India, and Taiwan have competed to
develop their own functional tricorders—portable tools able to diagnose health conditions and take
real-time vital signs like blood pressure. The winning design will be announced in early 2017, with
 the hope that, eventually, individuals will be able to use it at home, “to assess and manage their
health independent of a hospital or doctor’s office.” Live long and prosper, indeed.

2. (CAR) T-cell Immunotherapies

There have been such tremendous advancements in treatments for blood cancers like leukemia and
lymphoma, that the five-year survival rate for children with Acute lymphocytic leukemia (ALL) is
now over 85 percent. And starting in 2017, those kinds of numbers may leap even higher.

For the first time, pending FDA approval, chimeric antigen receptor (CAR) T-cell therapy will be
made available to “high-end” cancer centers around the country. In this kind of cellular
immunotherapy, white blood cells called T-cells are extracted from a patient, treated at a special
laboratory, and then returned to the patient to fight cancer cells. Trials on kids with ALL have
proven very successful, with high rates of complete remission. The Leukemia & Lymphoma Society
notes that studies of CAR T-cell therapy on multiple myeloma,chronic lymphocytic leukemia (CLL),
and some types of non-Hodgkin lymphoma (NHL) have also been “very promising,” as well.

3. Augmented Reality

When Pokémon Go burst onto the scene this past July, millions of everyday Americans got their first
taste of augmented reality (AR), in which a computer digitally enhances the sights and sounds of
real-life environments. While some AR tools have already made inroads into health care—like
AccuVein, which maps out patients’ veins for phlebotomists and nurses—the incredible technology
will become even more widespread in 2017, as it:

 teaches doctors and medical students how to do certain surgeries, procedures, and dissections

 helps patients envision their own conditions, treatments, surgeries, and recoveries

 maps out the locations of health care providers and life-saving equipment (like defibrillators) for

the public in case of emergency

 It’ll be years before they’re a reality, but AR implants for the eyes and ears are coming down the

pike, too. Google and Samsung have already filed patents for lens implants intended to monitor

glaucoma and deliver medicines.

4. Synthetic Blood

From prosthetic limbs to artificial hearts, pacemakers to ear implants, we’ve figured out how to
replace darn near every part of the human body. But until fairly recently, blood was a bit of a pipe
dream. Not so anymore.

In 2017, England’s National Health Service (NHS) will conduct early safety trials, in which about 20
people are given small amounts of synthetic blood made from stem cells. The short-term goal is to
create red blood cells to treat specific conditions and illnesses, like sickle cell anemia. The long-term
goal? NHS scientists hope to make enough for transfusions for people with rarer blood types.

5. Mobile Stroke Treatment Units

When a stroke hits, every second counts; it’s estimated you lose about two million neurons each
minute after the event, and the longer you go untreated, the worse the damage to your brain. That’s
why a Mobile Stroke Treatment Unit (MSTU or MSU) could be a lifesaver.

Usually staffed by paramedics, a nurse, and a medical imaging specialist, among other emergency
personnel, an MSTU is essentially an ambulance dedicated to the fast diagnosis and treatment of
strokes. When a dispatcher calls in a stroke, the MSTU is mobilized to the patient’s home. Once it
arrives, the team is able to determine whether a stroke is caused by a blood clot, administer a drug
to dissolve that clot, and then bring the patient to an appropriate hospital.

Early studies of response time are promising, and there are currently units in Cleveland, New York,
Houston, and Denver, with more coming every day. In fact, one source reports that by late 2017, an
MSTU will be available to more than 40 percent of major-city emergency rooms.

6. Interoperability

If there’s one advancement medical experts and the press seem most excited about, it’s
interoperability, or, the ability of health care information technologies—like a hospital’s digital
systems—to communicate with each other. For those who have wondered why the billing
department can’t get on the same page as your doctor, this is the breakthrough for you.
Set to debut in 2017, Fast Healthcare Interoperability Resources (FHIR) is a kind of tool dedicated
to saving money and lives by improving the speed and efficiency of health data transferal.
Essentially, instead of transferring entire documents, which causes a backup, FHIR transfers
specific bits of health care information—a word, a code—from one place (ex: your doctor) to
another (ex: billing). This means health care workers don’t have to go through tons of extraneous
information to get the data they want, making your experience faster and your records, more
accurate.

On a more personal level, the technology will make it easier to create health apps, as well, which
could filter down to patients in years to come.

7. Ultrasound Therapy for Alzheimer’s Disease

According to the Alzheimer’s Association, 1 in 3 current seniors will die with the condition or
another dementia. And while we’re still a long way from a cure, there’s one encouraging treatment
set to begin human trials in 2017: ultrasound therapy on amyloid plaques, which clump around
neurons and are believed to contribute to Alzheimer’s.

Back in 2015, Australian researchers found the sound waves generated by ultrasounds cleared
amyloid plaques (pictured) in mice, 75 percent of which performed better on memory tests
afterward. There was no damage to the surrounding tissue, and the treatment could be much
cheaper than drugs that perform similar functions, reports The Wall Street Journal. Of course,
duplicating the results in humans is a much harder endeavor, thanks to our thicker skulls and more
sophisticated brains. Still, researchers are optimistic about the long road ahead.
 PETER DAZELEY / GETTY

96573859

1. Blind people can see again

One week before Christmas, the FDA approved a gene therapy for the first time ever, paving the

way for the technique's broader use in solving the most dire medical issues of today that stem from
genetic mutations. Luxturna got an enthusiastic go-ahead from the FDA for people suffering from an

inherited conditions like retinal dystrophy and Leber congenital amaurosis (LCA), which slowly

degrades vision to the point of blindness for some patients. Luxturna targets the RPE65 gene that

these patients can't produce correctly by inserting DNA for the protein directly into the eye via a

harmless virus. The virus funnels itself into the retina, enters cells, and re-programs them by

"infecting" them so begin the proper production of RPE65 and correcting the retina's faulty

mechanism. While Luxturna isn't a complete cure for blindness—it allows LCA patients to discern

shapes and light—it provides a sense of independence and freedom to explore the world that is

often taken for granted by sighted individuals. The therapy offers hope for people like 17-year-old

Christian Guardino, who competed on America's Got Talent and was treated for the disorder at just

13. Guardino told The Daily Beast that before Luxturna, he couldn't see the moon traipsing across

the night sky. Now, "I can see the stars."

 REUTERS / PAULO WHITAKER
Doctors wrap a child's burnt skin with sterilized tilapia fish skin at Dr. Jose Frota Institute in the
northeastern costal city of Fortaleza, Brazil, May 3, 2017.

2. Burns can be soothed with fish scales

Burn victims face a critical time and medical need when skin is scorched: If they're not covered to

prevent infection, patients can die. In developing countries like Brazil, options that are used in

places like the United States—human skin, pig skin, and artificially grown lab alternatives—aren't

widely available. In the small coastal town of Fortazela, however, doctors have come up with an

ingenious, effective, and cheap fix: sterilized tilapia scales. Tilapia scales have the unique ability to

protect burned skin and stay on thanks to a collagen proteins that are abundant in tilapia skin that

promote healing and reduce scarring in humans. It also helps that tilapia scales retain moisture and

are resistant, allowing them to be a strong but tender barrier for delicate, burned people.

Refrigerated and sterilized, the tilapia skin stays fresh and usable for a couple years. Add to this the

fact that tilapia scales speed healing time, require far fewer changes, and make the healing process

less painful, and tilapia scales come across as practically a miracle. Tilapia scales are not going to

arrive in the United States any time soon for burn victims—other alternatives are plentiful, and

preserving tilapia scales actually can be more costly here—but for developing countries that don't

have access to these options, can sterilize the scales, and where tilapia are plentiful, the tilapia scale

burn hack is nothing short of awesome.

 CASE WESTERN RESERVE UNIVERSITY

3. Brain implants can help quadriplegics move with thought

Paralysis used to be an end-all for people with spinal cord injuries: Damage to the fragile cord that

runs messages from the brain to the body's nervous system about movement—jerk your hand off

the hot iron, flick your head this way, shimmy around the table corner, step back from the
oncoming car—meant a lifetime of being unable to move independently. The tragedy of spinal cord

injuries and paralysis ranged from those who couldn't move a limb to others who were

quadriplegic, unable to move any part of their body from the neck down. But in March at Case

Western Reserve University, quadriplegic patient Bill Kochevar was able think about actions and

actually perform them for the first time in eight years. This was thanks to BrainGate2, a system of a

pair of electrodes implanted in Kochevar's brain that communicated with another set of electrodes

embedded in Kochevar's arm muscles. The results are "amazing," he said in a video: Kochevar can

extend his arm and grab objects, an action that seems simple but requires a complex set of

instructions from his brain to his arm that was impossible without BrainGate2. "I thought about

moving my arm and it did," Kochevar said. "I can move it in and out, up and down." For a man who

couldn't use his arms at all last year, that's truly amazing.
 MELETIOS VERRAS / GETTY

4. CAR T-cell therapy can cure incurable cancers

In mid-December, in a televised moment that warmed hearts, former Vice President Joe Biden

clutched hands with Meghan McCain, whose father, Arizona Sen. John McCain, is battling brain

cancer—the same disease that killed Biden's son, Beau. Biden cited the groundbreaking research

being done at the University of Pennsylvania that holds hope for people battling the terminal

cancer. The chimeric antigen receptor (CAR) T-cell could augment the first line of defense of a cell's

immune response to an invader, whether that be cancer or the flu. Researchers are working on

genetically re-engineering these T-cells with the CAR molecule on their surfaces so they target

tumor cells with an army of similar CAR T-cell copies and destroy cancerous cells. For brain cancer

patients, this could at the very least prolong life, and at the very optimistic end, get rid of brain

cancer tumors, which are unusually aggressive and latch onto organs, making them difficult to saw

off. The FDA has already given the go-ahead to two CAR T-cell therapies: Kymriah, for patients

below 25 battling acute lymphoblastic leukemia, and Yescarta, for non-Hodgkin's lymphoma

patients. It might take a while for these treatments to trickle down to brain cancer patients, but the

astounding results "borders on miraculous," one doctor told The Daily Beast.
AP / ERIC RISBERG
 Brian Madeux sits with his girlfriend Marcie Humphrey while waiting to receive the first human
gene editing therapy at the UCSF Benioff Children's Hospital in Oakland, Calif. Madeux, who has
Hunter syndrome, received the treatment on Monday, Nov. 13.

5. Genes can be directly edited in a living, breathing person

Gene editing technology like CRISPR has captured the imagination of scientists and futurists,

launching ethical debates about designer babies and questions about the accuracy of chopping off

blocks of DNA or squeezing in bits to "perfect" the human genome. But until November of this year,

gene editing was limited to the petri dish sort: Isolated chains carefully edited using tools outside

the human body. In November, however, that changed for the first time ever. Brian Madeaux, who

suffers from Hunter syndrome (a condition that prevents Madeaux from properly breaking

carbohydrates down due to an enzymatic malfunction), had a non-infectious virus carrying two zinc

finger proteins injected into him. In other words, the gene editing was occurring right in his body,

not outside of it, which pushed the boundaries of this research forward into new frontiers.

Madeux’s proteins carried instructions for cells to fix the enzyme issue, which was then copied to

the liver. That's huge: The very mechanism that Madeux had suffered from for his entire life was

getting corrected right at the base with precision. "We cut your DNA, open it up, insert a gene, stitch

it back up. Invisible mending," a doctor told the AP. Madeux is still under constant supervision but

he's "nervous and excited" to see what this gene therapy could do, and what it might mean for the

millions of people dealing with errors in their genetic code

The news that comes out of research universities and hospitals often sounds too hopeful: Here's a
gene that maybe, could potentially end obesity. This newly discovered protein pathway might sort-
of, some day cure cancer.

Do any of the thousands of studies published each year really result in a meaningful change in
someone's life?
Here's your answer: For the eighth consecutive year, the Cleveland Clinic has selected 10
technologies and discoveries that are already making an impact.

“We look for innovations that are somewhat disruptive, so a new medication isn't just a little better,
it's substantially better,” says Michael Roizen, M.D., who headed the panel of 30 medical
professionals that selected this year's finalists. Check out the technology of the future that's already
on our doorstep.

2 of 11

The Bionic Eye

The “Argus II” takes a video signal from a camera built into sunglasses and wirelessly transmits that
image to implants in the retinas of people who have lost their vision. Though it’s been available in
Europe since 2011, the U.S. Food and Drug Administration (FDA) only approved the eye earlier this
year.

“This really is like Star Trek technology,” Dr. Roizen says.

The system isn't perfect. It lets a blind person regain basic functions like walking on a sidewalk
without stepping off a curb, and distinguishing black from white socks, but only lets you read one
giant-sized word at a time on a Kindle.

Plus, as the retina itself heals over the implant, the quality of vision decreases. The Argus II is
currently only approved for people who have lost their sight from retinal pigmentosis—which
affects 1 in 4,000 Americans.

But the technology could soon help the more than 1.75 million people who suffer from macular
degeneration.

3 of 11

The Cancer Gene Fingerprint

Not all cancers are equally lethal—cancer in your prostate means a longer survival rate than a
malignancy in your brain, for example.

But even prostate cancer comes in multiple flavors ranging from manageable to very bad. By
analyzing the mutated genome of a tumor, doctors can now pinpoint whether a cancer is sensitive
to a certain chemotherapy, or one that doesn’t respond at all to current treatments.

Knowing the subtype might mean jumping directly to a clinical trial that could save your life.

4 of 11

The Seizure Stopper

For the 840,000 epileptics suffering from sudden, uncontrollable seizures, the NeuroPace is like “a
defibrillator for your brain,” Dr. Roizen says.
The system includes sensors implanted in the brain that can spot the first tremors of an oncoming
seizure. Then it sends electrical pulses that counteract the brain's own haywire signals, stopping
the seizure in its tracks.

Even more impressive: The NeuroPace can be fine-tuned by doctors based on its performance. In
the first year it was available, seizure episodes were reduced by an average of 40 percent—but 2
years later, they dropped by 53 percent.

5 of 11

The Hepatitis Cure

Until recently, treatment for hepatitis C fell into the good-but-not-great category, with only around
70 percent of patients being cured.

And that was after as much as 48 weeks of a strict anti-viral drug regimen, including injections of
interferon—which causes a number of debilitating side effects.

But the new drug Sofosbuvir is a much more potent killer of hep C, with success in as many as 95
percent of patients. Even more, the medication only has to be administered for 12 weeks, sans
interferon injections.

6 of 11

The Anesthesiologist's iPad

Surgeons may get more glory, but anesthesiologists probably play the most vital role in keeping you
alive during surgery. They're the last face you see before you're put into a medicated sleep so deep
you don't even notice that your body is being peeled open.

Between keeping track of your heart rate, breathing, and brain functions, an anesthesiologist also
needs to be familiar with the ins and outs of the procedure so they can adjust sedatives and
painkillers—without causing complications.

The new “perioperative information management systems” include software on touchscreen-

enabled computers that can warn doctors if things are going south, keep track of the surgeon's
workflows, and document every step of the procedure. All are essential when surgeries last up to 16
hours and docs need to pass the reins to a fresh pair of eyes.

7 of 11

The Fecal Transplant

The idea of taking someone else's poop and giving it a new home in your own colon may sound
repulsive, but the treatment has proven remarkably effective in curing infections of C. difficile—a
nasty bacteria that kills 15,000 people each year.

Take heart: The digested food waste in feces isn't itself the cure. You're simply gaining some of the
helpful bacteria living in the donor's gut—like a farmer choosing the hardiest crops to seed next
year's fields.
“The bacteria produce proteins that are involved in a lot more diseases than we realized,” says Dr.
Roizen. Still grossed out? Researchers in Canada have developed a method to deliver just the
bacteria—no feces—via an oral pill, skipping the need for a poo enema.

8 of 11

The Heart-Saving Hormone

Around 1 in 4 people who are hospitalized for heart failure don't last much longer than a year.

But a new drug called Serelaxin has upped the odds of survival by as much as 37 percent, according
to a University of California, San Francisco study. It's a synthetic version of the hormone relaxin,
which is produced by pregnant women to help with the increased stress carrying a fetus places on
the heart.

“It not only opens up your blood vessels to supply your organs oxygen, but it has anti-inflammatory
properties,” Dr. Roizen says. Serelaxin's life-saving potential is profound enough that in June, the
FDA dubbed it a “breakthrough therapy,” putting it on a faster track for approval in hospitals.

9 of 11

The Robot Doctor

If you're undergoing a colonoscopy, you'll want something to take the edge off (for obvious
reasons).

But even a light sedative to help you snooze while doctors spelunk your butt requires the presence
of an anesthesiologist—which translates to $1 billion in additional medical expenses, according to a
study in the Journal of the American Medical Association.

Enter the Sedasys: a computer with an attachment on the IV that meters out the correct amount of
sedative and monitors vitals.

It even includes an earpiece to wake patients up if necessary. That allows docs to administer “light
to moderate” sedation on their own, with a single anesthesiologist supervising multiple patients.

“If Michael Jackson's doctor had this and knew how to use it, then Michael Jackson would still be
alive today,” says Dr. Roizen.

10 of 11

The Better Heart-Attack Risk Test

Today you get a cholesterol test to assess your risk of heart attack, but soon you'll be more worried
about your trimethylamine N-oxide (TMAO) levels.

Why? People with the highest levels of TMAO in their blood have 2.5 times the risk of a heart attack
compared to those with the lowest levels, according to a recent study in the New England Journal of
Medicine.
TMAO is a compound produced by intestine bacteria—yep, the same ones involved in fecal
transplants—after you eat choline, which is found in eggs, red meat, and dairy.

Once in your bloodstream, TMAO accelerates the process of cholesterol forming into plaques in
your arteries.

“We're learning why red meat is hazardous, and what could be done to avoid that hazard,” Dr.
Roizen says. Beyond simply avoiding red meat, preventive steps could include probiotics or
medications that pinch off TMAO-producing pathways.

11 of 11

The Precision-Guided Cancer Treatment

The difficult goal in any cancer treatment is to kill the tumor while leaving healthy cells alone.

Recently, a better understanding of what makes cancer cells tick has allowed scientists to develop a
class of drugs that pinpoint a weakness in cancer's uncontrolled growth.

For example, in lymphomas and leukemias, scientists have determined that the growth is controlled
by a protein called Bruton's tyrosine kinase (BTK). After years of experimentation, doctors
developed a new drug called Ibrutinib that blocks BTK.

A pair of studies in the New England Journal of Medicine this summer found that the oral pill helped
71 percent of chronic leukemia patients and 68 percent of patients with a type of non-Hodgkins
lymphoma. Most importantly, Ibrutinib killed off the lymphoma while leaving the rest of the
immune system alone.

“Hopefully this will lead to a whole new class of drugs that will be cancer cell-specific,” says Dr.
Roizen.