medstories

TOP 11 MEDICAL STORIES OF THE CENTURY: 

TOP 11 MEDICAL STORIES OF THE CENTURY Presented by: The AAPA’s Clinical and Scientific Affairs Council

Top 11 Medical Stories of the Century: 

Top 11 Medical Stories of the Century Council Members: Richard Davis, Chair Richard Donnelly Sharon Girard Richard Muma James Taft Sarah Toth

Top 11 Medical Stories of the Century: 

Top 11 Medical Stories of the Century Objectives: 1) Identify 11 of the top medical stories of the century. 2) Describe the impact of these events on public health, medical technology and disease diagnosis and treatment.

Number 11- Discovery of DNA: 

Number 11- Discovery of DNA Drs. Watson and Crick described structure of double helix Suggested “copying mechanism” for genetic material Watson JD and Crick FHC. Molecular Structure of Nucleic Acids. Nature. April 25, 1953, p.737.

Number 11 – Discovery of DNA: 

Number 11 – Discovery of DNA Timeline: 1861, Virchow: cells arise from other cells 1866,Haeckel: nucleus contains hereditary factors 1889,Altman: isolated nucleic acids 1953,Watson&Crick: structure of DNA 1999, NIH’s Human Genome Project

Number 10 – Development of CT/MRI: 

Number 10 – Development of CT/MRI CT: -Godfrey Hounsfield, introduced CT, 1972 (Nobel prize with Allen Cormack, 1979) -CT measures the attenuation of X-Rays in tissue from hundreds of angles, image re-constructed by computer -Greater sensitivity than 2-D Radiography -Allows visualization of soft tissues Hounsfield GN. Computed medical imaging: Nobel lecture, 12/8/79. J Comput Assist Tomogr, 4:665-674, 1980.

Number 10 – Development of CT/MRI: 

Number 10 – Development of CT/MRI

Number 10 – Development of CT/MRI: 

Number 10 – Development of CT/MRI MRI -Nuclear Magnetic Resonance in bulk matter -Felix Block & Edward Purcell [1952 Nobel Prize] -Raymand Damadian, 1971 (relaxation constants of water [T1 and T2] longer in malignant rat tissue -Paul Lauterbur, 1973 (resolution and spatial discrimination determined by magnetic field) -Richard Ernst, (mathematics of Fourier transforms allow imaging of data from 2 dimensions) -1982, MRI becomes exam of choice for CNS -1990’s functional (fast) MRI research tool

Number 10 – Development of CT/MRI: 

Number 10 – Development of CT/MRI

Number 9 – Eradication of Smallpox: 

Number 9 – Eradication of Smallpox Disease -Variola virus: Two forms: major (>20% victims killed) and minor (1% victims killed) -Illness: Flu-like with chills, high fever, nausea and aches. After 2-3 days, characteristic rash (unsightly, painful swollen pustules) -Incubation period: 12 days

Number 9 – Eradication of Smallpox: 

Number 9 – Eradication of Smallpox History -Present for at least 12 millennia -Emerged with agriculture ~12,000 years ago -1157B.C.: Pharaoh Ramses V died from smallpox -Early 1500’s: Spanish conquistadors bring smallpox to Central America -1520-1522: Death of 3.5 million Aztecs from smallpox -17th-18th century: In Europe, one million deaths/year due to smallpox -18th century: Five reigning European monarchs died from smallpox

Number 9 – Eradication of Smallpox: 

Number 9 – Eradication of Smallpox Experiment -In 1796, Dr. Edward Jenner, an English physician, observes that milkmaids with cowpox rarely get smallpox -Inoculated a boy with fluid from pustular cowpox lesion. Six weeks later no response to inoculation from pustular smallpox -Introduced inoculation of smallpox at end of 18th century

Number 9 – Eradication of Smallpox: 

Number 9 – Eradication of Smallpox Eradication -1967: World Health Organization initiates campaign to eradicate smallpox (10-15 million cases/year worldwide) -1977: Last case of naturally occurring smallpox in Somalia (Ali Maow Maalin) -1980: World Health Assembly declares global eradication -1980: U.S. stopped routine vaccination of smallpox -First time a disease vanquished -One of the greatest triumphs in history of medicine

Number 8 – Discovery of the Polio Vaccine: 

Number 8 – Discovery of the Polio Vaccine Disease -Poliomyelitis: acute infectious disease, in severe form, affects the central nervous system with destruction of lower motor neurons in spinal cord resulting in flaccid paralysis -Poliovirus is an enterovirus 

Number 8 – Discovery of the Polio Vaccine: 

Number 8 – Discovery of the Polio Vaccine History -Beginning of 20th century: few people had heard of polio -Summer of 1916: epidemic struck New York City -27,000 people paralyzed -9,000 people dead -Epidemic every summer until vaccination initiated in 1955

Number 8 – Discovery of the Polio Vaccine: 

Number 8 – Discovery of the Polio Vaccine Vaccine -Jonas Salk , an American research scientist, develops vaccine from inactivated poliovirus grown in monkey kidney tissue -April 1954: Massive field trial of Salk vaccine -Children (grades 1-5) inoculated in U.S., Canada and Finland -Treated 440,000 with vaccine and 210,000 received placebo -April 12, 1955: Announcement of successful field trials -April 1955: Five million children vaccinated with Salk vaccine

Number 8 – Discovery of the Polio Vaccine: 

Number 8 – Discovery of the Polio Vaccine Results -End of “nightmare summers of quarantine and contagion” -Dramatic decline in incidence of polio in U.S. -Salk vaccine hailed as a milestone in medical history

Number 7 - Surgeon General’s Report On Smoking: 

Number 7 - Surgeon General’s Report On Smoking Timeline   1905: In exchange for tobacco-state support of the 1st federal Food and Drug Act, tobacco was removed from the US Pharmocopeia, and thus from FDA regulation   1957: American Cancer Society followed 200,000 people for 44 months. Smokers had a 68% increased mortality. Of the 448 lung cancers, all but 15 smoked.  

Number 7 - Surgeon General’s Report On Smoking: 

Number 7 - Surgeon General’s Report On Smoking 1960: American Cancer Society, American Heart Association and the National Tuberculosis and Respiratory Disease Association urged President Kennedy to appoint a commission to determine if smoking was a health hazard.   1961: Surgeon General Luther Terry appointed an “expert commission” to undertake a comprehensive review of all the data on smoking.

Number 7 - Surgeon General’s Report On Smoking: 

Number 7 - Surgeon General’s Report On Smoking 1963: Phillip Morris hired lobbyist Abe Fortas to speak with President Johnson on behalf of tobacco.   1964: Surgeon General Terry presented the results of the first US Government Review of The Effects of Smoking. A 387 page book entitled “Smoking and Health-Report of the Advisory Committee to the Surgeon General of the Public Health” contained 7,000 scientific articles and studies.      

Number 7 - Surgeon General’s Report On Smoking: 

Number 7 - Surgeon General’s Report On Smoking 1965: The FTC required tobacco companies to place warning labels on cigarette packages and on ads 6 months later.

Number 6 – Oral Contraceptives: 

Number 6 – Oral Contraceptives Key Events in the Development of contraceptive agents: 1950: Drs. Katherine McCormick and Margaret Sanger collaborate to promote development of a physiologic contraceptive for women.

Number 6 – Oral Contraceptives: 

Number 6 – Oral Contraceptives 1954: First administration of synthetic progestins to women 1955: Announced findings at International Planned Parenthood meeting in Tokyo

Number 6 – Oral Contraceptives: 

Number 6 – Oral Contraceptives 1956: Discovery that mestranol contaminants in progestins help provide greater cycle control and efficacy, establishing the principle of combined oral contraceptives

Number 6 – Oral Contraceptives: 

Number 6 – Oral Contraceptives 1958: Searle applies for FDA approval for contraceptive indication 1959: FDA approves Enovid, the first oral contraceptive  

Number 5 – Organ Transplantation : 

Number 5 – Organ Transplantation World War I: Allografts for skin transplantation 1946: The first adrenal gland transplant 1954: The first renal transplant on monozygotic twins 1960: The first corneal transplant 1962: The first limb replantation

Number 5 – Organ Transplantation: 

Number 5 – Organ Transplantation 1967: The first allogenic heart transplant 1968: The first allogenic liver transplant 1978: The first allogenic bone marrow

Number 4 - HIV: 

Number 4 - HIV 1981: June, Pneumocystis pneumonia outbreak in Los Angeles July, Pneumocystis pneumonia and Kaposi’s sarcoma in New York City December, CDC reports infant develops a deficiency after a blood transfusion

Number 4 - HIV: 

Number 4 - HIV 1982 May, immune system disorder is spreading 1983 May, Detection of HTLV III , a retrovirus is found as the causative agent 1984 January, Transmission of the disease can occur before patient has symptoms October, Dr Gallo finds genetic variations

Number 4 - HIV: 

Number 4 - HIV 1985 January, CDC recommends to screen blood supply July, T4 helper cells are found defective October, US Public Health Service launches plan to decrease the spread 1987 AZT is released

Number 4 -HIV: 

Number 4 -HIV 1988 January, HIV-II found in the US 1988 - Many drugs available; disease managed as a chronic disease with improved survival; improved diagnostic/therapeutic tests (ie, viral load); tremendous cost

Number 3 – Discovery of Insulin: 

Number 3 – Discovery of Insulin Drs. Banting and Best discovered insulin in the summer of 1921

Number 3 – Discovery of Insulin: 

Number 3 – Discovery of Insulin J.B. Collip Made the first clinical application of the extract of insulin in January 1922

Number 3 – Discovery of Insulin: 

Number 3 – Discovery of Insulin Insulin changed the live of millions of people In the pre-insulin period diabetes was a wasting disease coupled with starvation treatment

Number 3 – Discovery of Insulin: 

Number 3 – Discovery of Insulin Gave us a better understanding of diabetes Meant life or death for patients with insulin -dependent diabetes Today accepted and used routinely

Number 2 – Discovery of Penicillin: 

Number 2 – Discovery of Penicillin Alexander Fleming 1928

Number 2 – Discovery of Penicillin: 

Number 2 – Discovery of Penicillin Drs. Howard Florey and Ernst Chain purified penicillin 1940

Number 2 - Discovery of Penicillin: 

Number 2 - Discovery of Penicillin World War II Accelerated development and increased widespread use of penicillin while saving lives

Number 2 – Discovery of Penicillin: 

Number 2 – Discovery of Penicillin Set the framework for development of other antibiotics Opened the era for therapeutic use of antibiotics Changed the way medicine was practiced

Number 1 – Development of the PA Profession: 

Number 1 – Development of the PA Profession