COVID-19 has always been consumable. In the past two years, the world has been paying attention to the vaccine competition, the pressure faced by suppliers, the best testing solutions and ensuring safety.

COVID-19 has also slowed down some research efforts, but scientists are still trying to solve many other pressing problems — Alzheimer's disease, maternal mortality, and prostate cancer — that have plagued patients for decades.

The following eight medical advances may not have caught your attention, but they may ultimately improve the lives of millions of people.

Assessing a stroke requires a quick, life-and-death assessment: is the culprit a clot (need to thin the blood) or cerebral hemorrhage (needs surgery)? Now, portable MRI equipment can assist in the evaluation at the patient's bedside, and the time required is much shorter than the time required to travel to a standard machine.

Swoop MRI was created with input from Yale School of Medicine in New Haven, Connecticut. It was approved by the Food and Drug Administration (FDA) in August 2020 and has been put into use in several hospitals in the United States.

Kevin Sheth, MD, a neuroscientist at Yale University, said that this new portable machine has many advantages over its larger counterparts.

"The very powerful magnets in conventional MRI present a lot of challenges," he explained. "You need intensive power and cooling, preventive measures like shielded rooms, and a lot of training. If you use weaker magnets, all these problems will be solved."

According to a study in August 2021, weaker magnets are effective, and the study requires clinicians to use Swoop images to identify various brain lesions. "Our goal is not to be as good as high-magnetic MRI, but to be sufficient for clinical decision-making," said Sheth, who is a co-author of the study but has no financial interest in Hyperfine, the Connecticut-based company that makes machines.

The size of the Swoop-it is smaller than some refrigerators-eliminates the need to move weak patients to the hospital corridors. More importantly, its cost—approximately US$100,000, while a larger machine requires US$1 million—makes it within hospitals and districts with fewer resources. "This basically democratizes brain imaging," Sheth believes.

One in eight American men has prostate cancer, and it is estimated that more than 34,000 people will die of prostate cancer this year alone. When it metastasizes, the disease is almost always incurable, allowing doctors to focus only on delaying death and improving the lives of patients.

A promising new approach has succeeded in both of these goals-and it has succeeded in men with advanced disease, who have worsened despite receiving standard treatment.

In fact, according to a paper published in September, it more than doubled the time patients can survive without cancer progression. The study conducted a follow-up survey of 831 men in 10 countries with a median time of 20 months, and compared patients who continued to receive standard treatment with patients who received new treatment.

The name of the therapy is complicated: lutetium-177-PSMA-617. But its method is simple: drive the radiation directly into the cancer cells while preserving the surrounding healthy tissue.

The method uses a compound called PSMA-617 to hone a protein that is almost exclusively found in prostate cancer cells, explains Oliver Sartor, MD, co-lead researcher and medical director of the Tulane Cancer Center in New Orleans. Then, the radioactive particles carried by the compound will explode the cancer cells wherever they are.

"It's like a little smart bomb," Sartor said.

According to Novartis, the drug manufacturer that funded the study, in September, the FDA granted treatment priority review status. It is expected to receive a response in the first half of 2022.

Sartre felt hopeful. "I have been engaged in prostate cancer research for more than 30 years. This is the biggest progress I have made."

For more than 5,000 years, sickle cell disease (SCD) has caused unspeakable suffering to people of African descent. In patients with hereditary diseases, red blood cells are not round but crescent-shaped-like a sickle-and can block blood vessels, deprive the body of oxygen and cause great pain. For a long time, the only treatment was bone marrow transplantation, but now new gene editing techniques may provide a safe and effective alternative.

According to a study in January 2021, in a study conducted at Boston Children's Hospital, scientists used a virus to turn off the gene that triggers sickling of cells. The patient then produced healthy red blood cells—almost everyone was able to stop the blood transfusion that SCD often requires.

"A participant used to have a blood transfusion every month, but he did not need a blood transfusion for three years," said David Williams, MD, director of the Department of Hematology/Oncology at Boston Children's Hospital and head of the research team. "This completely changed his life."

The study followed 6 patients for a median of 18 months and found that the treatment completely stopped the more severe symptoms of the disease.

"I am very happy for my sickle cell patient. This is a terrible disease," Williams pointed out.

Williams' next step is a trial with 25 patients. At the same time, SCD researchers elsewhere are working on other gene editing technologies. "All these methods look promising, and we need more research to determine which one is better," Williams said.

"This is a very exciting time. In the past, we didn't have any particularly good treatments, and now we have several possibilities," he added.

When a woman's uterus fails to contract after childbirth, it will cause a lot of blood loss, which may lead to emergency hysterectomy or even death. In fact, postpartum hemorrhage affects 3% to 10% of all births in the United States and causes more than one-third of birth-related maternal deaths worldwide.

Treatment options include medications that are not always effective and inserting a balloon to apply pressure to the uterus—just like applying pressure to an incision—which is risky and must be maintained for a day.

But suppliers now have another option.

A new vacuum device helps with natural postpartum contraction, putting pressure on leaking blood vessels. After research in 12 locations, the FDA approved the device-Jada vacuum tamponade in September 2020.

"The vacuum method is very logical because it's like what the body should do," said Dena Goffman, MD, principal investigator at Columbia University Irvine Medical Center in Manhattan. In addition, the use time of the vacuum is shorter than that of the balloon-about two or three hours. "For moms, this is very important because it makes it easier to breastfeed, get up and connect with their children," she added.

According to the study funded by the device manufacturer Alydia Health, the vacuum controlled bleeding within three minutes and successfully treated 94% of the participants. In contrast, other studies believe that the effectiveness of balloons is 87%.

"When the patient has postpartum hemorrhage and you are the doctor at the bedside, it is scary, because you know how fast the condition is getting worse," Goffman said. "With this device, when you see that the bleeding rate slows down quickly and you can feel the uterus contracting, it's incredible."

Tearing the anterior cruciate ligament (ACL)-the flexible band inside the knee that helps stabilize the knee-can upend sports careers and weekend athletes. In the United States, 100,000 to 200,000 ACL tears occur every year.

The most effective repair option is to remove the broken ACL, remove the graft from the tibia or elsewhere, suture the tissue into the knee, and hope that both surgical sites will heal well.

In December 2020, the FDA approved a simpler and more natural method: Bridge-Enhanced ACL Repair (BEAR).

"We basically repaired my ACL by stimulating it," said Martha Murray, MD, director of plastic surgery at Boston Children's Hospital and founder of BEAR.

The method involves placing a protein sponge between the ends of the torn ACL, prepared with some of the patient's own blood. Murray explained that the blood facilitates the connection of the two ACL components to the sponge, and ultimately connects to each other.

So far, the method has been tested on more than 100 patients. In a study in May 2020, patients and doctors reported that BEAR performed as well as standard repairs — and there were no transplants that could cause persistent pain or weakness in the donor site. Miach Orthopaedics has an exclusive global license for the BEAR implant and has begun to provide the product through plastic surgeons in the United States.

For Murray, this experience highlights the value of being a doctor and researcher. "When you are facing a patient with a problem and the current solution is not perfect, it is great to be able to say,'We are working on a better solution.' It's really gratifying."

Since 2014, a new obesity drug has been on the market for the first time, bringing hope to 78 million Americans at risk of being overweight: cancer, heart disease, diabetes, and COVID-19 complications.

According to the research that helped it get FDA approval in June, this new drug—semaglutide, also known as Wegovy—is more powerful than its predecessors.

"Compared with other drugs, we found that the weight loss is 1.5 to 2 times that of other drugs," said Robert Kushner, a researcher at Northwestern University's Feinberg School of Medicine and leader of the semaglutide research. "This is a leap forward."

In fact, according to a study of nearly 2,000 patients, semaglutide recipients lost an average of nearly 15% of their body weight—compared to 2.4% in the control group.

Semaglutide-an injectable drug-is not entirely new. A synthetic version of a natural hormone that suppresses appetite, it has been used to treat type 2 diabetes. But the obesity trial paid by Novo Nordisk used a higher dose.

Kushner, a paid consultant for Novo Nordisk, points out that studies on high doses are not long enough to determine long-term side effects. However, recent studies have reported mild to moderate gastrointestinal problems that have eased over time.

Now Kushner hopes that semaglutide will help stimulate people's interest in obesity drugs.

"More than 40% of American adults suffer from obesity, while fewer than 3% receive medication," he said. "Part of the challenge is to educate primary care providers to provide evidence-based obesity care including consideration of medication."

Randall Bateman, MD, a neurologist at Washington University School of Medicine in St. Louis (WUSTL), is pleased to be able to contribute to the first blood test for Alzheimer’s disease-Alzheimer’s disease is a type of A devastating disease that affects as many as 5.8 million Americans.

However, as early as 2017, when Bateman was ready to share the findings that made the test possible, he was worried about the reaction of his peers. After all, scientists are convinced that the blood markers he studied cannot predict disease.

But the WUSTL method is more sensitive and direct than the previous method. The resulting test-called PrecivityAD-effectively detects amyloid plaques, a hallmark of Alzheimer's disease, and has been shown to be compatible with the previously used spinal tap or positron emission tomography (PET) scan The tools are equally accurate, the latter is more costly and more complex.

The test was developed by a company called C2N Diagnostics co-founded by Bateman and has been available to doctors since it was approved by the Federal Laboratory Accreditation Program in October 2020. It is now awaiting additional approval from the FDA.

"For more than 20 years, we have been hoping for a test to diagnose Alzheimer's disease," said Charles F. and Joanne Knight Distinguished Neurology Professor Bateman of WUSTL. "Currently, as many as half of Alzheimer's patients are misdiagnosed."

He added that the road to scientific success was paved by hard work and great uncertainty. "This is a real gamble. You put your life in this work, and you hope it will have a positive impact. Then it's like,'Wow, it worked!'"

Anger, fear, recurring nightmares and strong flashbacks are many symptoms that may strike patients with post-traumatic stress disorder (PTSD). This disease affects approximately 15 million American adults within a year and is extremely difficult to treat.

A potentially groundbreaking treatment for PTSD now comes from a seemingly unlikely source: Ecstasy, better known as the illegal drugs Ecstasy and Molly, which have fueled an all-night binge and caused potentially fatal side effects.

In June of this year, a study in "Natural Medicine" reported that patients with severe post-traumatic stress disorder-veterans, first responders, victims of sexual assaults and mass shootings, etc.-get from ecstasy Obtained significant relief.

In fact, after two months of treatment, 67% of subjects who received MDMA and talk therapy no longer met the diagnostic criteria for PTSD. "I saw this amazing shift in patients," said Dr. Jennifer Mitchell, the lead author of the study and professor of neurology at the University of California, San Francisco School of Medicine.

Treatment consists of three and eight-hour sessions per month, during which the patient takes ecstasy pills and deals with painful memories and emotions during conversation therapy.

Mitchell explained that ecstasy releases powerful serotonin and stimulates hormones related to emotional bonds. "Our idea is that it can help patients open up so that they can establish a good connection with the therapist and solve their problems faster."

Before the drug is approved by the FDA to treat PTSD, researchers will need to complete a clinical trial. Even if it succeeds, Mitchell knows that ecstasy is still stigmatized for its image of a party drug.

"I hope people can look at the data with an open mind," which includes that the MDMA used in the research has no possibility of abuse or other serious side effects. "We are talking about use under controlled treatment conditions," she said. "Recreational drug use is totally different. Otherwise, people will come back from [art and community activities] Burning Man to heal their psychological problems."

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