Medicine just for you

In this article, the author explores a new field of medical study – personalized medicine, which is tailor made to the patient’s needs. It takes into account the patient’s medical history, genetic history and sometimes even as much as the sequence of the patient’s genome. Medical professionals seek advice from patients, bioethicists, civil libertarians in order to find the best way to fulfill this while taking care of the matter of privacy. The author fears that the advent of this new technology would lead to a significant rise in healthcare costs. In a country where a simple illness can often be a death sentence due to the exorbitant cost of treatment, this does not bode well. Yet, the author feels that the pros outweigh the cons, and that such research should be expedited at any rate.

Read an excerpt of the article written by the Editorial Board:

President Obama’s new budget contains a farsighted proposal that could ultimately transform the practice of American medicine. The proposal seeks to design treatments for the individual, which are sometimes called ‘‘personalized medicine’’ or ‘‘precision medicine’’ to distinguish them from the one-size-tries-to-fit-all approach. For example, about 4 percent of all cystic fibrosis cases are caused by a particular mutation in one gene. The disease clogs the lungs with thick mucus; a drug that targets the mutation lets patients breathe easily. Drugs have also been used to treat a number of cancers that stem from genetic defects, including an aggressive form of breast cancer. This new way of looking at diseases is not limited to genes but examines environmental factors as well. Federal officials say researchers plan to collect data on a person’s diet, exercise, smoking history, exposure to toxins and populations of micro-organisms in and on the body. They will be seeking medical records, laboratory test results, medication histories and even physiological monitoring by mobile phones. The White House will seek advice from patients, bioethicists, civil libertarians and others on how to do this while preserving patient privacy. ... read more

3-D printers are transforming medical care

Are 3-D printers transforming medical care? Karen Weintraub writes that they offer doctors the huge advantage of practicing operations beforehand. Such 3-D-printed models are transforming medical care, giving surgeons new perspectives and opportunities to practice, and patients and their families a deeper understanding of complex procedures. Though there has been little research so far into the benefits of 3-D printing or surgical simulations, Department of Veterans Affairs researchers have shown that teamwork exercises in operating rooms reduced patient deaths or injuries by as much as 18 percent. ‘‘Solve one problem, remove one error, identify one latent safety threat, save one life,’’ and it will reduce both personal and financial costs, Dr. Weinstock said.

Read an excerpt of the article written by KAREN WEINTRAUB:

The surgeon held a translucent white plastic eye socket in each hand. Gently moving them away from each other, Dr. John Meara showed the distance between Violet Pietrok’s eyes at birth. He slid the sockets closer to demonstrate their positions 19 months later, after he had operated on her. Violet, now nearly 2, was born with a rare defect called a Tessier facial cleft. Her dark brown eyes were set so far apart, her mother says, that her vision was more like a bird of prey’s than a person’s. A large growth bloomed over her left eye. She had no cartilage in her nose. The bones that normally join to form the fetal face had not fused properly. Her parents, Alicia Taylor and Matt Pietrok, sought out Dr. Meara at Boston Children’s Hospital, thousands of miles from their home in Oregon, because the plastic surgeon had performed four similar operations in the previous three years. Before he operated on Violet, Dr. Meara wanted a more precise understanding of her bone structure than he could get from an image on a screen. So he asked his colleague Dr. Peter Weinstock to print him a three-dimensional model of Violet’s skull, based on magnetic resonance imaging. That first model helped him to decide what might need to be done and to discuss his treatment plan with her family. Three more 3-D printouts closer to the surgery allowed Dr. Meara to rotate the model skull in directions he could not manage with a picture and would not attempt with a patient on the operating table. Then he was able to cut and manipulate the plastic model to determine the best way to push her eye sockets more than an inch closer together. Such 3-D-printed models are transforming medical care, giving surgeons new perspectives and opportunities to practice, and patients and their families a deeper understanding of complex procedures. Hospitals are also printing training tools and personalized surgical equipment. Someday doctors hope to print replacement body parts. ‘‘There’s no doubt that 3-D printing is going to be disruptive medicine,’’ said Dr. Frank Rybicki, chief of medical imaging at the Ottawa Hospital and chairman and professor of radiology at the University of Ottawa. He is the former director of the applied imaging science lab at Brigham and Women’s Hospital, a few blocks from Boston Children’s. ‘‘It makes procedures shorter, it improves your accuracy,’’ said Dr. Rybicki, who uses 3-D printing in his work with face transplants. ‘‘When bioprinting actually hits, it will change everything.’’ For now, the printer extrudes a layer of liquid plastic instead of ink. It adds a second layer, and then another, and a skull or rib cage — or whatever the surgeon dials up — slowly emerges. The same process can also print layers of human cells. So far, researchers have also printed blood vessels, simple organs and bits of bone. A Utah boy’s life was saved last year by a 3-D-printed plastic splint that propped open his windpipe. Dr. Weinstock, director of the Pediatric Simulator Program at Boston Children’s, sees 3-D models as part of a larger program to improve surgical craft. more