A year in medicine: review of 2014

Looking back on 2014, perhaps two medical stories stick most in the memory - one because of its popularity in social media, the other because of its newsworthiness. Both stories have involved charitable action against devastating illness, but each has had very different connotations.

2014 was a year of medical innovations, but the ALS Ice Bucket Challenge and the Ebola epidemic dominated news feeds.

We refer, of course, to the year of the Ice Bucket Challenge, a summer craze that broke out in support of a medical research charity and went viral across social media. And it has also been the year of Ebola, which produced its largest epidemic in history, creating a public health disaster in West Africa and threatening to cross further international borders.

Earlier this week, Google released their Year in Search 2014 results, revealing that both Ebola and the Ice Bucket Challenge were among the top five most searched topics.

As an example, there is some infoamtion on amyotrophic lateral sclerosis (ALS) - updated to include coverage of the Ice Bucket Challenge and how the campaign swelled funds for what was a relatively small medical charity helping the search for a curative treatment.

Major medical developments in 2014 share some developments with stem cells, which again represent the biggest breakthroughs, coincidentally including one that helps the Ice Bucket cause.

We hope you enjoy this summary of the past year, which comes with all our best wishes for the holidays and the new year ahead.

Highlights from 2014 covered by topic in this article include:

• Breakthroughs in medicine
• Dementia and Alzheimer's disease
• Diet
• Ebola
• E-cigarettes
• Exposure to chemicals
• Drugs
• Health policy
• Heart health
• HIV
• Innovative technology
• Paralysis
• Personal health tracking.

Breakthroughs in medicine - stem cells

All but one of this year's major breakthroughs involved stem cells. The exception was a pioneering success against female infertility: World first - baby born after womb transplantation.

A flurry of developments in 2014 involved stem cells.

In stem cell research, this past year has added another flurry of breakthroughs. Developments have been accelerated in recent years after the problem of using embryos to harvest stem cells was partially overcome by the discovery, late in the last decade, that adult cells could be returned to an almost embryo-equivalent state.

Adult cells can now be turned, in scientific terms, into an "undifferentiated, pluripotent stem cell state," meaning that researchers have been able to use stem cells that possess the potential to grow into a number of different cell types. This has offered the hope in the field of regenerative medicine of creating new tissues or even whole organs.

However, that major development - to produce induced pluripotent stem (iPS) cells - has been limited in the breadth of cell types that iPS cells can become.

In January of 2014, though, a researcher claimed that a new finding could mean a full embryonic equivalent may be possible that would not be limited in this way. "It may not be necessary to create an embryo to acquire embryonic stem cells," the researcher said. Read more on this news that scientists may be able to create embryonic stem cells without embryos.

In other breakthroughs involving stem cells, the origin of Lou Gehrig's disease may have been discovered. Also known as amyotrophic lateral sclerosis (ALS), this disease received wider recognition in the summer of 2014 - thanks to the Ice Bucket Challenge. Earlier in the year, iPS cells had been used to grow a model of ALS nerve cells, leading to potential clues about how the condition originates.

Two further remarkable developments in 2014 were also owing to stem cell research:

• Scientists convert human skin cells directly into brain cells
• Human lungs successfully grown in a lab for the first time.

That is not the end of this spotlight on stem cells - they also make an appearance in this next section about developments against cognitive decline, as well as in the sections on heart health and paralysis.

Dementia and Alzheimer's disease

Impairments to memory, communication and thinking - cognitive decline - describe dementia, of which Alzheimer's disease is the best known and most common form.

Current dementia tests

When does cognitive decline result in a dementia diagnosis? Scoring six or under against a 10-question quiz is one part of typical testing, with questions such as:

• What is your age?
• What year are we in?
• Count backward from 20 to 1.

The huge burden of the disease among populations continues to make it a priority, and 2014 produced two developments that could result in improved, earlier detection:

• New blood test predicts Alzheimer's. This was a development using 10 biomarkers of Alzheimer's disease and dementia. It raises the prospect of preparing for dementia conditions earlier, and in medical research, of exploring treatments that target earlier stages of disease processes.
• Alzheimer's blood test breakthrough. Another prospect for treatment resulting from a better understanding of the disease at an earlier stage, this was a test that could confirm detection after mild cognitive decline begins but before full-blown Alzheimer's sets in.

Notable findings were also made in early-stage research to find treatments for Alzheimer's disease - two relating to brain cell regeneration, and a third focusing on the protein plaques in the brain that mark the condition:

• Promising drug candidate for Alzheimer's found in turmeric compound. Here, researchers found that a curry spice could promote the proliferation of brain stem cells, making aromatic turmerone a potential drug candidate in regenerative medicine.
• Memory and learning deficits restored in Alzheimer's mouse models. Another development in attempts at cellular regeneration to reverse the brain cell death that happens in dementia, this study found that brain function in mice used as models of Alzheimer's could be boosted by the implantation of special cells, and even that some faculties lost through the disease could be restored.
• Researchers 'reverse symptoms of Alzheimer's' in mice with novel compound. Another finding of brain function restoration - again in mice - this time not as a result of cellular regeneration, but instead brought by the action of a potential drug against amyloid plaque formation.

Diet

First, the good news - going by the latest findings this year, the sort of diet that could be particularly good for us:

It may come as no surprise that fruits and vegetables are still hailed for their health benefits, but a new study suggested we should eat seven - not five - portions a day.

• 'Eat seven portions of fruit and veg a day' to lower death risk. Just when you thought five a day would be enough, this study of data from 65,000 people found fewer deaths among those who had eaten a further two portions a day.
• Mediterranean diet 'better than low-fat diet' for cardiovascular risk. The researchers behind this news story found that a focus on what to includein the diet was as important as what to exclude.

There was also a small study that linked green tea consumption with subsequent boosts in brain activity: Green tea may boost our working memory.

Now, the bad news - for fans of burgers and barbecues, at least:

• Eating grilled meat 'increases risk of Alzheimer's and diabetes'
• Eating processed red meat 'linked to heart failure.'

Ebola

As introduced at the beginning of this article, one of the biggest medical news stories of the year has been the Ebola crisis in West Africa, but it has not been all bad news:

• Ebola vaccine set for human trials. Immunization against Ebola was given the go-ahead for testing in early-stage clinical trials, after protection had been achieved in monkeys.

As the following three stories show, there have been high fears of the virus becoming a greater threat in the US:

• CDC confirm first case of Ebola in the US. A traveler from Liberia to Dallas, TX, in September - Thomas Duncan - made the first reality of fears about the infection reaching America. He did not survive his illness.
• Are the CDC doing enough to stop Ebola in the US? Failure to fully contain Thomas Duncan's infection raised questions about the health care response.
• CDC ramp up Ebola screening at five US airports. Tighter controls were established in response to events.

E-cigarettes

Against the backdrop of US cities banning vaping in public, and the failure of a full scientific understanding of the risks and benefits to keep pace with the growing popularity of e-cigarettes, their controversy has featured widely in the news this year. 

The topic of e-cigarettes was a controversial one in 2014.

The studies behind the following two news stories question whether e-cigarettes are effective at reducing tobacco smoking, and even whether they are encouraging it:

• E-cigarettes 'do not reduce use of conventional cigarettes'
• Are e-cigarettes encouraging conventional cigarette smoking in adolescents?

On the other hand, a survey of thousands of smokers in the UK suggested that the electronic alternatives could be helping to reduce tobacco use: 'E-cigarettes help smokers quit,' new study says. But while there may be benefit, the question of regulation has also been important:

• E-cigarettes 'should not be marketed as smoking cessation aids'
• FDA announce proposal to regulate e-cigarettes.

Exposure to chemicals

Of course, as well as the chemicals in tobacco smoke or those in nicotine vapor, lots of others are potential toxins, as these five stories reported:

• Industrial chemicals 'may cause global neurodevelopmental epidemic'
• Food packaging chemicals 'may be harmful to human health'
• Exposure to environmental toxins linked to autism incidence rates
• Scientists identify 'high-priority' chemicals that may cause breast cancer
• Toothpaste, sunscreen chemicals 'interfere with sperm function'.

Drugs

From drugs that were once totally illicit but have been legalized, through illegal party drugs that potentially have beneficial use, to pharmaceutical products that are being misused, here is a selection of headlines:

Marijuana

• Medical marijuana - where does the debate stand now?
• Marijuana use linked to cardiovascular complications and death
• 'Casual marijuana use changes the brain,' researchers say

Ketamine

• 'Remarkable but brief antidepressant effect' from party drug ketamine
• Ketamine shows 'game-changing' effect on suicide prevention

Prescription painkillers

• Regulations over opioid prescriptions 'too permissive,' say experts
• Deaths from prescribed painkillers 'higher than from heroin and cocaine combined'.

Health policy

• Crowd funding is all the rage, but can it work for medical research?
• Americans struggling to afford food are also skipping medications
• "Obamacare" means 'better public health' through prevention
• Organ donation: is an opt-in or opt-out system better?

Heart health

Cardiovascular risk is still one of the biggest threats to health, so developments against heart disease continue to be pursued. Notable this year was a range of ways to stand in for (or replicate in research) damaged cardiac or vascular tissue using lab-grown, animal-grown or mechanical options:

The beating heart

The tiny heart developed by stem cell scientists produced 30 beats a minute. But what exactly is heart rate, and what is a typical beat per minute in humans?

• Lab-grown mini beating human hearts 'may lead to a cure for heart disease'. Stem cells found yet another potential benefit when they were used to create beating organs - 1 mm in diameter and contracting at about 30 beats a minute, they could be used to model heart disease.
• 'Mini heart' may help people with blood flow problems. This was also a stem cell-enabled mini heart creation, this time to help at specific peripheral locations to push blood back along damaged veins.
• Heart failure: transplantation of animal organs into human patients 'more viable'. The genetic manipulation of piglet hearts brought them closer to the human counterparts they may one day be able to replace in the otherwise limited supply of organs for transplantation.
• Novel, implantable device 'could slow, reverse heart failure'. This was a mechanical approach to heart disease, a cuff that compensated for heart failure by adding a synched pulse around the aorta.

HIV

HIV returned to the US news agenda in 2014, which tracked the Mississippi baby. First reported in 2013, this had been the first case of a "functional cure" for a baby born with HIV - antiretroviral drugs given within 30 hours of birth had succeeded in removing all trace of the virus, taking away the need for further therapy. Until, that is, the child's story took a twist this year:

• HIV found again in child believed to have been cured. This bad news broke in July.
• HIV cure failure in Mississippi baby 'the beginning of a new chapter'. The researchers in the case said the news did not mean "the end of the story, but the beginning of a new chapter."
• HIV rebounds in second baby thought to have been cured with early treatment. The Mississippi baby turned out not to be the only such case - a similar story would emerge from Italy.

In other 2014 developments about HIV, there was promise for an HIV vaccine, as researchers found a way to make "neutralizing" HIV antibodies. And scientists took a new approach that they believed identified the original source of the HIV pandemic.

Innovative medical technologies

Google Glass is the best known example of spectacle-mounted camera tech for consumers, but a similar approach is tackling partial blindness.

An area of growth in technology generally is 3D printing, and it is producing developments in medicine, too:

• Motorbike crash victim's face repaired with 3D printing
• 3D-printed implants restore baby's breathing
• 3D printing may make individualized medicine more affordable.

Other recent technological advances have been crossing from different fields into medicine, including the 'smart glasses' for the near-blind, which started trials in public spaces.

Developed specifically for medicine, but no less innovative, was new technology in renal dialysis: Success for world's first newborn kidney dialysis machine.

In breast cancer, meanwhile, hope for powerful early-detection technology comes in the shape of an imaging development, a thin-film tactile device: 'Electronic skin' could revolutionize breast cancer detection.

Paralysis

Stem cells have made the broadest contribution to medical developments in 2014, and scientists in the field have brought cell regeneration findings to the potential benefit of paralyzed patients: Paralyzed man walks again after nose cells repair his spinal cord.

The estimated 6 million people living in the US with paralysis would be interested in these other two news stories from the year:

• Paralyzed men move legs following spinal shock treatment. An implanted device delivered an electrical current to the lower spinal cords of four young men, enabling them to move their legs again.
• Monkey controls limb movements of 'avatar' using its mind. This story was another reason for optimism about the possibility of returning lost control over limbs.

The following video shows how participants in the first of those two studies enjoyed the remarkable effects of their stimulator devices in regaining limb control:

https://www.youtube.com/watch?v=mL7aeQfolko#action=share

Personal health tracking and monitoring

Last year we saw wearable and smartphone-enabled tech really come of age as a powerful means of tracking health and managing chronic disease.

Teddy the Guardian's paws pick up heart rate, oxygen saturation and temperature.

The market continued to develop in 2014, along with concerns about the real value and benefit, including: search here an article titled "Health apps: do they do more harm than good?"

"Wearable" may become "integrated" if developments continue along the lines of the following two stories, where monitoring technology is brought even closer to the body:

• Forget wristbands, the future of health tracking is skin-mounted, say scientists
• Wearable, skin-like device 'monitors cardiovascular, skin health 24/7'.

Advances are not confined to personal self-monitoring for adults - applications are also aiming to improve the care of babies and children:

• Wearable 'smart' baby monitor provides parents with insight. "Monitor, learn and predict your baby's sleep habits and optimal sleep conditions."
• Wired Health: how do we harness self-monitored health data? Among a number of answers to that question addressed at a 2014 summit was Teddy the Guardian - a cuddly toy solution to child health monitoring.

And finally

As a final note for this medical news article review of 2014, here is a nod to the leading researchers who received the year's highest honor for scientific contributions to medicine:

• Scientists win Nobel prize for discovering brain's 'inner GPS'. Three scientists were rewarded for their work on "place cells and grid cells" in our brains, which they found help us to map our location and navigate.

References:

Compilation of stories from my Blog - www.emersonblognews.blogspot.com