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Innovations and Changes in the field of Medicine Michael Nirenstein, MD 1 As both providers and educators in the field of Health Care, we are extremely fortunate to be involved in a profession that has seen so many technological advances, in such a short period of time. In fact, it seems as if each new day brings us amazing, high tech advances in the areas of Disease Diagnosis Disease Treatment Patient Care 2 Let’s take a closer look at some of the more recent innovations in the field of Medicine 3 Advances in Disease Diagnosis • • • • MRI Neurography High Tech Cardiac Cath Labs Test to detect Alzheimer’s Risk Do you have breast cancer? Maybe your dentist will be the first to know! 4 MRI Neurography Innovations in medical technology now enable physicians to view the peripheral nerves with precision. 5 MRI Neurography With standard MRI’s it is difficult to distinguish between peripheral nerves and the surrounding soft tissue. With MRI Neurography, peripheral nerves are clearly identifiable from soft tissue, and damaged nerves are distinct from healthy nerves. 6 MRI Neurography Significance: -Faster, more accurate diagnosis of peripheral nerve diseases and disorders. -Less reliance on painful neurologic testing such as EMG’s and Nerve Conduction Studies. 7 High Tech Cardiac Cath Labs Two recent advances in the diagnosis of heart disease: Software that combines information from two imaging technologies And An Optical Catheter that can reveal the composition of Coronary Plaques 8 High Tech Cardiac Cath Labs Software that combines information from Single Photon Emission Computed Tomography (SPECT) and Cardiac Computed Angiography allows for a more accurate diagnosis of Coronary Artery Disease. SPECT provides three-dimensional images of blood flow to the heart muscle, while CT Angiography provides detailed images of coronary arteries. 9 High Tech Cardiac Cath Labs vPredict Optical Catheter System A spectroscopy-based catheter that can analyze the composition of a plaque, differentiating between cholesterol, cholesterol esthers, triglycerides, proteins, and blood. This will enable Interventional Cardiologists to provide optimal therapy for each individual patient. 10 Innovations in Alzheimer’s Risk Detection The latest medications can delay the onset of Alzheimer’s Disease, but none are able to reverse the devastating effects. This limitation makes early detection the key to these patients maintaining a good quality of life! 11 Alzheimer’s Risk Detection The Detect device, developed by Georgia Tech and Emory University gives a 10 minute, inexpensive test, that in a clinical study has shown higher accuracy than the 90 minute “Gold Standard” pen and paper test. 12 Saliva Test for Breast Cancer The University of Texas Health Science Center Dental Branch recently discovered that the appearance of breast cancer changes the mix of proteins secreted by the salivary glands. A person with breast cancer secretes a different profile of proteins compared to a person without breast cancer. 13 Saliva Test for Breast Cancer This discovery is now being applied to technology that opens up the possibility that in the near future, a dental practice or other health care facility, will be able to carry out a diagnostic test that detects the presence of breast cancer before the tumor forms. 14 Advances in Disease Treatment • Genetic Coding • Stem Cell Research Mad Scientist – Doc Brown 15 Genetic Coding A growing number of medical researchers say our bacteria-killing zealotry is misguided. Instead of fighting bugs, we can change the genetic code of bacteria to make them do our bidding. 16 Genetic Coding The painful ulcers of Crohn’s disease occurs when the body’s immune system attacks the normal bacteria found in the gut. Now, scientists can use microbes to fight back 17 Genetic Coding Scientists insert a gene that produces interleukin-10 (IL-10) An immune-calming molecule, into the L. Lactis bacteria 18 Genetic Coding The new gene replaces the gene that produces thymide, an essential nutrient, so the modified bacteria can live for only a few days. 19 Genetic Coding A Crohn’s disease patient swallows the modified bacteria, delivering the IL-10 payload straight into the intestines. 20 Genetic Coding The bacteria (A) colonize the gut and begin producing IL-10 (B). This compound suppresses the patient’s overactive immune response (C). 21 Genetic Coding As long as the patient keeps ingesting the modified L. lactis bacteria, the bacteria will produce enough IL-10 to stop the immune system from attacking the intestines, giving the ulcers time to heal. 22 Genetic Coding The Future of Genetic Coding: Salmonella bacteria thrives inside malignant tumors. By modifying these bacteria to produce a toxic enzyme, researchers hope to produce a targeted cancer killer. 23 Stem Cell Research On January 18, 2008, scientists in California successfully cloned a human embryo, theoretically capable of yielding stem cells. This is a major step forward toward the goal of creating lines of “true” embryonic stem cells. 24 Stem Cell Research A blastocyst is an embryo approximately 5 days old, that contains 50-200 cells. This is the stage at which stem cells – capable of forming any of the body’s 220 cell types, including blood, bone, and nerve tissue – can be harvested for research or therapy. 25 High Tech Patient Care • High Tech Imaging • Paperless/Wireless Medicine • High Tech Mixing Machine • ER’s of the Future 26 High Tech Imaging Gone are the days when radiology technicians used films for imaging studies. Digital imaging is one of the most important advancements in medicine today. 27 28 High Tech Imaging Advantages of Digital Imaging: • Lower costs to the hospital. No films, no developer or chemicals, and no storage facility needed. • Images can be produced instantly, and can be electronically sent to the radiologist, surgeon, or ER physician. • Images taken in rural facilities can be sent via the internet to a radiologist at another location for review. • Unlike plain films, images can be modified (contrast enhancements, magnified) to optimize quality. 29 Paperless/Wireless Medicine Imagine, an 81-year-old woman arrives by ambulance to the local hospital’s emergency department after falling in her home. The ER physician meets her at the entrance and immediately inputs data on his tablet PC. Within four minutes, an x-ray tech arrives with a portable x-ray machine, as a result of the doctor’s wireless order. In the ER, doctors and nurses wear small, voice-activated wireless devices around their necks to communicate with each other. Supply cabinets are opened with biometric thumbprint reading. This is the future of Paperless/Wireless Medicine, and the future is here! 30 Paperless/Wireless Medicine In 2004, President Bush signed an executive order (13335), titled “Incentives for the use of health information technology and establishing the position of the National Health Information Technology Coordinator”. This order mandates that all Americans will have electronic medical records by the year 2014. The US Department of Health and Human Services (HHS) is required to facilitate the development of a nationwide exchangeable health-data system that will allow the sharing of patient’s personal health information electronically (EMR). 31 Paperless/Wireless Medicine Advances in Paperless Information Technology include: • Bar-code technology that matches medicines to patient wristbands • Electronic prescription writing and filling • Wireless physician orders (labs, radiology) 32 Paperless/Wireless Medicine Paperless/Wireless Technology has been proven to: • Save hospitals money • Reduce medical errors • Improve health outcomes Hospital CEO 33 High Tech Device to Cut Medical Errors A tabletop device (Valimed) is now in use at the Children’s Hospital in the University of Michigan, which tests patients drugs compounded in the hospital pharmacy. The device uses enhanced photoemission spectroscopy to determine if drug compounds are correct. Five potentially serious medication errors were detected during the hospital’s testing of the device. 34 High Tech ER Offers Luxury Changes coming soon to an ER lobby near you: • • • • Flat Screen TV’s Gourmet Coffee X-Box Video Games Paperless sign-in using a tablet PC that stores patient data for future visits • Online scheduling of ER appointments 35 Innovations in the Field of Medicine Innovations in Medicine in our future? "My god, man! Drilling holes in his head's not the answer! The artery must be repaired! Now put away your butcher knives and let me save this patient before it's too late!" Dr. McCoy (Star Trek) 36