Review of new medical technologies

Review of new medical technologies: changing the landscape landscape

I. Diagnostics: from molecules to images with unprecedented accuracy

A. Genomic sequencing and personalized medicine

1. The next generation of sequencing (NGS): NGS revolutionizes diagnosis, allowing you to quickly and economically effectively seize whole genomes, exoma or targeted panels. This is of great importance for identifying genetic predispositions to diseases, diagnosing rare diseases, selecting optimal cancer therapy and pharmacogenomics.
   • The principle of work: NGS divides DNA into many fragments, which are then sequenced in parallel. Powerful algorithms level these fragments back to the reference genome, identifying variations and mutations.
   • Application in oncology: NGS helps to determine specific mutations in tumor cells, which allows you to choose targeted therapy, which blocks the activity of these mutated genes. For example, the identification of EGFR mutation for lung cancer allows you to use EGFR inhibitors.
   • Poutry diagnostics: Non -invasive prenatal testing (NIPT) based on NGS analyzes the fetal DNA circulating in the mother’s blood to detect chromosomal abnormalities such as Down syndrome.
   • Pharmacogenomy: NGS allows you to determine genetic variations that affect the metabolism of drugs, allowing doctors to select doses and drugs that will be most effective and safe for each patient. For example, CYP2C19 affects the metabolism of Clopidogen.
2. Liquid biopsy: A blood test for the identification of cancer cells, DNA or other biomarkers secreted by the tumor. Liquid biopsy allows you to monitor the progression of cancer, evaluate the effectiveness of treatment and detect relapses in the early stages.
   • Circulating tumor cells (CTCS): The release and analysis of CTCS allows you to study the characteristics of the tumor, including its genetic profile and sensitivity to drugs.
   • Circulating tumor DNA (CTDNA): CTDNA analysis allows you to identify mutations that cannot be detected by traditional biopsy methods. CTDNA can be used to monitor a minimum residual disease after treatment.
   • Exosome: Small extracellular vesicles secreted by cells contain information about their origin. Exosive analysis can provide valuable information about the state of the body and help in the diagnosis of various diseases.
3. Metabolomics: Analysis of small molecules (metabolites) in biological liquids or tissues to detect changes in metabolic pathways associated with diseases. Metabolomics can help in early diagnosis of diseases, monitor the effectiveness of treatment and develop new drugs.
   • Mass spectrometry: The main method of analysis of metabolites, which allows to identify and quantitatively determine thousands of metabolites in the sample.
   • Nuclear magnetic resonance (JAMR): Another method for analyzing metabolites, providing information about the structure and dynamics of molecules.
   • Application in cardiology: Metabolomics can help in the diagnosis and monitoring of heart failure, coronary heart disease and other cardiovascular diseases.
   • Application in diabetology: Metabolomics can help in the diagnosis and monitoring of diabetes, as well as in the development of new treatment methods.

B. improved visualization methods

1. 3D-printing organs and fabrics for modeling operations: 3D-porch allows you to create realistic models of organs and tissues based on computed tomography (CT) or magnetic resonance imaging (MRI). These models can be used to plan complex operations, training surgeons and develop new medical devices.
   • Preoperative planning: Surgeons can use 3D models to visualize the anatomical characteristics of the patient and plan the optimal surgical approach.
   • Surgeon training: 3D models allow surgeons to train on complex operations in a safe and controlled environment.
   • Development of medical devices: 3D models can be used to develop and test new medical devices, such as implants and prostheses.
2. Field tomography (Pat): The visualization method, combining optical and ultrasound technologies. Pat uses short laser pulses for heating tissues, which causes an expansion that generates ultrasound waves. These waves are detected and used to create images. PAT provides high contrast and resolution, and can also be used to visualize deeply located fabrics.
   • The principle of work: The laser impulse is absorbed by chromophores in the tissue (for example, hemoglobin), causing a thermoelastic expansion. This expansion generates ultrasonic waves that are detected by the sensor.
   • Application in oncology: PAT can be used to visualize tumors, angiogenesis and response to treatment.
   • Application in dermatology: PAT can be used to visualize the vessels of the skin, melanoma and other skin diseases.
3. Optical coherent tomography (OCT) of high resolution: The visualization method, using the interferometry of near infrared radiation to create images of microstructure of tissue with high resolution. OKT is widely used in ophthalmology, but also finds use in other areas of medicine, such as cardiology and dermatology.
   • The principle of work: Oct uses the light of the near infrared range to scan fabric. The reflected light interface with the reference beam, creating an interference picture that is used to create an image.
   • Application in ophthalmology: OKT is used to diagnose and monitor glaucoma, age macular degeneration and other retinal diseases.
   • Application in cardiology: OKT is used to visualize the coronary arteries and assess the state of atherosclerotic plaques.

C. Biosensor and wearable devices

1. Continuous glucose monitoring (CGM): Devices that continuously measure the level of glucose in the interstitial fluid and transmit data to a smartphone or other device. CGM helps people with diabetes better control the level of blood glucose, prevent hypo- and hyperglycemia and improve the quality of life.
   • The principle of work: A small sensor is inserted under the skin and measures the level of glucose in the interstitial fluid. The transmitter transfers data to the receiver or smartphone.
   • Advantages: Continuous glucose monitoring, the ability to track trends and receive notifications of high or low glucose levels, the ability to adjust the dose of insulin in real time.
   • Predictive CGM: Some CGM use algorithms to predict glucose levels in the future, which allows people with diabetes to take preventive measures to prevent hypo- or hyperglycemia.
2. Wearable sensors for monitoring vital indicators: Devices that monitor the frequency of heart contractions, blood pressure, oxygen level in the blood, body temperature, activity and sleep. These data can be used to monitor the health status, identify early signs of diseases and improve physical form.
   • Application in sports medicine: Wearable sensors are used to track training loads, optimize the training process and prevent injuries.
   • Application in geriatrics: Wearable sensors are used to monitor the health status of older people, identify falls and other incidents, as well as to provide remote medical care.
   • Application in cardiology: Wearable sensors are used to monitor the heart rhythm, detect arrhythmias and assess the effectiveness of the treatment of cardiovascular diseases.
3. Microfluid diagnostic devices (Lab-on-A-Chip): Miniature devices that combine several laboratory functions on one chip. They allow you to conduct a quick, cheap and portable analysis of biological samples.
   • The principle of work: Microfluid channels and chambers allow you to accurately control the movement of liquids and conduct chemical reactions in small volumes.
   • Application in the diagnosis of infectious diseases: Lab-on-a-chip devices can be used to quickly detect pathogens, such as bacteria, viruses and fungi.
   • Application in monitoring health status: Lab-on-a-chip devices can be used to monitor the level of glucose, cholesterol and other biomarkers.

II. Therapy: innovative methods of treatment and restoration

A. General therapy

1. CRISPR-CAS9: Genoma editing technology that allows you to accurately and effectively modify DNA. CRISPR-CAS9 has a potential for the treatment of genetic diseases, cancer and infectious diseases.
   • The principle of work: The CRISPR-CAS9 system consists of CAS9 protein, which acts as “molecular scissors”, and the RNA guide (GRNA), which directs CAS9 to a certain DNA section. CAS9 cuts DNA in this place, and the cell tries to restore the gap. During this process, you can insert a new gene or remove a defective gene.
   • Application in the treatment of genetic diseases: CRISPR-CAS9 is used to treat genetic diseases such as sickle cell anemia, cystic fibrosis and spinal muscle atrophy.
   • Application in oncology: CRISPR-CAS9 is used to develop cancer immunotherapy, in which immune cells are modified for more efficient recognition and destruction of cancer cells.
   • Ethically questions: The use of CRISPR-CAS9 causes ethical issues related to security, justice and the possibility of changing the embryo line (DNA change that is transmitted to descendants).
2. Vector delivery of genes: The use of viruses (adenoassed viruses (AAV), lendiviruses) or other carriers to deliver genes to cells. Vector delivery of genes is an important method of gene therapy.
   • Adenoassed viruses (AAV): Nepatogenic viruses that are well suited for genes to various types of cells.
   • Lentviruses: Viruses that can integrate their genetic material in the genome of the host cell, providing the long-term expression of the gene.
   • Nevirus vectors: Liposomes, nanoparticles and other non -viral media that can be used to deliver genes to cells.
3. Car-T cell therapy: Cancer immunotherapy, in which the patient T-cells are modified for recognition and destruction of cancer cells. Car-T-cell therapy was effective in the treatment of certain types of blood cancer.
   • The principle of work: The patients of the patient are taken and genetically modified to express a chimary antigenic receptor (CAR), which recognizes a certain antigen on the surface of cancer cells. Modified T cells breed and introduced back to the patient, where they attack and destroy cancer cells.
   • Side effects: Car-T-cell therapy can cause serious side effects, such as cytokine release syndrome (SVC) and neurotoxicity.

B. Robotized surgery

1. System da Vinci: The most famous system of robotic surgery, which allows surgeons to conduct complex operations with greater accuracy and less invasiveness.
   • Advantages: Improved visualization, increased maneuverability of instruments, reduction of the tremor of the surgeon’s hands, reducing the restoration time of the patient.
   • Application: Urology (prostatectomy), gynecology (hysterectomy), cardiac surgery (mitral valve plastic), general surgery (colon resection).
   • Surgeon training: Special training and certification for working with the DA Vinci system are required.
2. Other surgical robots: Other surgical robots intended for various surgical procedures are developed and used.
   • Robots for neurosurgery: Provide high accuracy during complex operations on the brain and spinal cord.
   • Robots for orthopedics: Help surgeons to carry out the exact installation of implants when replacing the joints.
   • Microbots: Miniature robots that can be introduced into the body for minimally invasive procedures.
3. Artificial intelligence in robotic surgery: AI is used to improve the accuracy and efficiency of robotic surgery.
   • Assisted decision -making: AI can analyze the data during the operation and provide surgeons with information that helps them make more reasonable decisions.
   • Automation of tasks: AI can automate some tasks such as the imposition of sutures, freeing surgeons for more complex aspects of the operation.
   • Operation planning: AI can use CT and MRI data to create 3D models of organs and fabrics, which helps surgeons plan operations with greater accuracy.

C. Target therapy

1. Inhibitor tyrosinekinase (ITC): Medicines that block the activity of tirosinkinase enzymes, which play a role in the growth and reproduction of cells. ITK are used to treat various types of cancer.
   • The mechanism of action: ITK bind to the active center of tyrosinkinase and block its activity. This leads to a stop of growth and propagation of cancer cells.
   • Examples: Imatinib (leukemia), Gephitinib (lung cancer), Sunitinib (kidney cancer).
   • Resistance: Cancer cells can develop ITK resistance, which requires the development of new drugs.
2. Monoclonal antibodies: Antibodies that are associated with a certain antigen on the surface of cancer cells. Monoclonal antibodies can block the growth of cancer cells, attract immune cells to cancer cells, or deliver drugs directly to cancer cells.
   • The mechanism of action: Various monoclonal antibodies have different action mechanisms. Some block the signaling paths necessary for the growth of cancer cells. Others attract immune cells to cancer cells, causing their destruction. Still others deliver drugs directly to cancer cells.
   • Examples: Trastuzumab (breast cancer), rituximab (lymphoma), Bevacizumab (colon cancer).
3. Inhibitors of immune control points: Medicines that block proteins that prevent the attack of the immune system on cancer cells. Inhibitors of immune control points allow the immune system to recognize and destroy cancer cells.
   • The mechanism of action: Cancer cells often express proteins that bind to proteins on the surface of immune cells, preventing their activation. Inhibitors of immune control points block these interactions, allowing immune cells to attack cancer cells.
   • Examples: Pembrolyzumab (lung cancer, melanoma), nivolumab (lung cancer, melanoma), ipylimumab (melanoma).
   • Side effects: Inhibitors of immune control points can cause autoimmune reactions, as they activate the immune system.

D. Regenerative medicine

1. Cell therapy: The use of cells to restore damaged tissues and organs. Cell therapy has the potential for the treatment of a wide range of diseases, such as heart failure, diabetes and Parkinson’s disease.
   • Types of cells: Stem cells (embryonic stem cells, induced pluripotent stem cells, mesenchymal stem cells), mature cells (cardiomyocytes, pancreatic beta cells, neurons).
   • The mechanism of action: Cells can replace damaged cells, stimulate tissue regeneration or distinguish growth factors that contribute to tissue restoration.
   • Cell delivery: Cells can be introduced directly into the damaged tissue or organ, or they can be delivered through the bloodstream.
2. Tissue engineering: The creation of artificial tissues and organs in the laboratory to replace damaged or sick tissues and organs. Tissue engineering includes the use of cells, coffee and growth factors.
   • SCapple: Three -dimensional structures that provide support for cells and allow them to organize in the tissue. Scaffolds can be made of various materials, such as collagen, hyaluronic acid and polymers.
   • Growth factors: Proteins that stimulate the growth and differentiation of cells.
   • Examples: Artificial leather, cartilage, bone and blood vessels.
3. 3D biopting: The use of 3D printers to create three-dimensional tissues and organs from cells, biomaterials and growth factors.
   • BioChernila: Materials used for 3D biopriet that contain cells, biomaterials and growth factors.
   • Advantages: The possibility of creating complex three -dimensional structures, control over the location of cells and biomaterials, personalized tissues and organs.
   • Application: Creating tissues for testing drugs, creating implants, creating artificial organs for transplantation.

E. Neurotechnology

1. Interfaces “Brain Computer” (IMK): Devices that allow you to directly connect between the brain and the external device, such as a computer or prosthesis. IMK have a potential for restoring motor and sensory functions in people with paralysis or other neurological disorders.
   • Types of IMK: Invasive (electrodes are implanted directly into the brain), non -invasive (electrodes are placed on the surface of the head).
   • Application: Management of prostheses, restoration of motor functions, treatment of epilepsy, recovery of speech.
   • Ethical questions: The use of IMCs causes ethical issues related to confidentiality, safety and control.
2. Neurostimulation: The use of electric or magnetic pulses to stimulate the brain. Neurostimulation is used to treat depression, Parkinson’s disease, epilepsy and chronic pain.
   • Types of neurostimulation: Transcranial magnetic stimulation (TMS), transcranial stimulation with direct current (TSPT), deep brain stimulation (fuel and lubricants).
   • The mechanism of action: Neurostimulation can change the activity of neurons, influence neurotransmissions and stimulate neuroplasticity.
   • Safety: Neurostimulation is usually considered safe, but can cause side effects, such as headache and convulsions.
3. Neurorebalization using virtual reality (BP): The use of BP to create immersive environments that allow patients to train motor and cognitive skills. VR-neurorebilization can be more effective than traditional rehabilitation, since it provides a more motivating and interactive environment.
   • Application: Restoration after a stroke, brain injuries, spinal injuries, Parkinson’s disease.
   • Advantages: The motivating and interactive environment, the ability to train complex movements in a safe and controlled environment, the ability to track the progress of the patient.

III. Digital healthcare: transforming accessibility and effectiveness

A. Telemedicine

1. Virtual consultations: Conducting medical consultations with a doctor through video communication. Virtual consultations allow patients to receive medical care from home, which is especially useful for people living in remote areas or having limited mobility.
   • Advantages: Convenience, availability, reduction in transport costs, reduction of waiting time.
   • Application: Primary medical care, consultations of specialists, psychiatry, dermatology.
   • Normative aspects: It is necessary to comply with regulatory requirements regarding the confidentiality and protection of patients of patients.
2. Remote patient monitoring: Using sensors and devices to track the health status of patients at home. Remote monitoring of patients allows doctors to identify early signs of deterioration and take preventive measures.
   • Types of devices: Wearable sensors, blood pressure monitors, glucose levels, cardiomonitors.
   • Application: Chronic diseases (heart failure, diabetes, COPD), postoperative observation, geriatrics.
   • Data security: It is necessary to ensure the safety and confidentiality of patients of patients.
3. Telereabilitation: Conducting rehabilitation classes with a physiotherapist or other specialist through video communication. Telebalization allows patients to receive rehabilitation assistance from home, which is especially useful for people living in remote areas or having limited mobility.
   • Advantages: Convenience, availability, reduction in transport costs, the ability to engage in a comfortable environment.
   • Application: Recovery after a stroke, injuries, operations, chronic pain.
   • The need for individualization: Telebalization programs should be individualized for each patient.

B. Mobile health applications (MHEaltH)

1. Health monitoring applications: Applications that allow users to track their vital indicators, activity, nutrition and sleep. These applications can help users better understand their health and make healthier decisions.
   • Functions: Tracking activity, sleep monitoring, food accounting, arterial pressure measurement, glucose measurement, cardiac rhythm monitoring.
   • Advantages: Convenience, accessibility, the ability to track progress, motivation for a healthy lifestyle.
   • Quality and reliability: It is important to choose applications that have a scientific justification and comply with high quality standards.
2. Diseases Management applications: Applications that help users manage chronic diseases such as diabetes, asthma and heart failure. These applications can provide information about the disease, remind you of taking drugs, help to track the symptoms and contact your doctor.
   • Functions: Reminders of medication, tracking symptoms, information about the disease, communication with a doctor, community support.
   • Advantages: Improving control over the disease, reducing the frequency of hospitalizations, improving the quality of life.
   • The need for integration with healthcare systems: It is important to integrate applications for managing diseases with healthcare systems so that doctors can access patient data.
3. Mental health applications: Applications that provide users with tools and resources to improve mental health, such as meditation, exercises for awareness and cognitive-behavioral therapy. These applications can be useful for people with depression, anxiety and other mental disorders.
   • Functions: Meditation, awareness exercises, cognitive-behavioral therapy, monitoring of mood, connection with therapist.
   • Advantages: Convenience, accessibility, decrease in stigma, the ability to receive help anonymously.
   • The need for professional assessment: Applications for mental health should not replace professional assessment and treatment.

C. Big data analysis and artificial intelligence (AI)

1. AI -based diagnostics: The use of AI for the analysis of medical images, laboratory data and other sources of information to make a diagnosis. AI can help doctors quickly and more accurately diagnose diseases, especially in the early stages.
   • Application: Recognition of cancer in x -rays and CT, diagnosis of retinal diseases on the images of OKT, identification of arrhythmias on the ECG.
   • Advantages: Increasing the accuracy of diagnosis, reduction of diagnosis time, reduction in the load on doctors.
   • The need for validation and testing: AI models must be carefully validated and tested before they are used in clinical practice.
2. Personalized medicine based on AI: The use of AI to analyze genetic data, data on the state of health and lifestyle of patients to develop personalized treatment plans. AI can help doctors choose the most effective and safe therapy for each patient.
   • Application: The selection of cancer target therapy, the choice of dose of drugs based on pharmacogenomy, the development of individual nutrition and physical activity plans.
   • Advantages: Increasing the effectiveness of treatment, reducing side effects, improving treatment results.
   • Ethically questions: It is necessary to take into account ethical issues related to the confidentiality and protection of patients of patients.
3. Prediction and prevention of diseases based on AI: The use of AI to analyze large data to predict the risk of developing diseases and develop preventive measures. AI can help identify people at risk and offer them personalized prevention strategies.
   • Application: Prediction of the risk of developing cardiovascular diseases, diabetes, stroke, cancer.
   • Advantages: Reducing incidence, reduction of mortality, improving public health.
   • The importance of accurate and reliable data: For accurate forecasting, it is necessary to use accurate and reliable data.

D. Blockchain in healthcare

1. Safe storage and exchange of medical data: The use of blockchain to create a safe and transparent storage system and exchange of medical data. Blockchain can help protect patients from unauthorized access and ensure their integrity.
   • Advantages: Safety, transparency, decentralization, control of patients over their data.
   • Application: Storage of electronic medical cards (EMK), exchange of medical data between doctors and patients, management of clinical testing data.
   • Compatibility with existing systems: It is necessary to ensure compatibility of blockchain systems with existing healthcare systems.
2. Management of the supply chain: Using a blockchain to track the movement of medicines from the manufacturer to the patient. Blockchain can help prevent fake drugs and ensure their safety.
   • Advantages: Transparency, trackability, safety.
   • Application: Tracking the movement of drugs, checking the authenticity of drugs, identifying fake drugs.
   • Cooperation between interested parties: For effective management of the supply chain, cooperation between manufacturers, distributors, pharmacies and regulatory authorities is necessary.
3. Simplification of insurance payments: Using blockchain to automate the insurance payments process. Blockchain can help reduce the time of processing claims and reduce administrative expenses.
   • Advantages: Automation, transparency, cost reduction.
   • Application: Automatic verification of compliance of services to the insurance coating, automatic processing of claims, prevention of fraud.
   • The need for data standardization: For the effective use of blockchain, it is necessary to standardize medical data and insurance codes.

This comprehensive overview highlights the transformative potential of new medical technologies across diagnostics, therapeutics, and digital health. Continuous research, development, and ethical considerations are crucial to harnessing these technologies for the benefit of patients and the advancement of healthcare. Further exploration into specific sub-areas within these broad categories would reveal even more nuanced advancements and applications.