Last Year in Medicine – 2024 Recap

Curated by Lavanya Patnala, M.B.B.S.

And with that, the 2024 season has officially come to an end. Before we officially step into 2025, let’s take a moment to reflect on this year filled with groundbreaking advancements and pivotal challenges in the field of medicine.

Advancements in Stroke Treatment (1-3)

As someone deeply passionate about stroke care, it’s hard not to begin with the exciting progress made in stroke treatment this year. 2024 saw significant advancements, with promising findings emerging from clinical trials that could reshape how we approach stroke management and recovery.

The 2024 annual International Stroke Conference (ISC), took place in Phoenix, Arizona, in February of this year showcased pivotal trials. The EMBOLIZE, MAGIC-MT, and STEM trials showed that MMA embolization is a safe adjunct therapy in addition to standard management for chronic subdural hemorrhage. The ZODIAC trial provided evidence that zero-degree head positioning is safe and may improve outcomes in patients with large vessel occlusion who are candidates for thrombectomy compared to the traditional recommendation of 30° head positioning. The TIMELESS and CHABLIS-T II trials showed that the use of TNK in select patients is safe in an extended late window of 4.5-24 h with increased reperfusion. The STOP-CAD study retrospectively compared risk of recurrent stroke in patients treated with antiplatelet or anticoagulation agents following spontaneous cervical artery dissection. Finally, 1-year outcomes of the SELECT2 trial showed improved functional outcome in patients who underwent endovascular thrombectomy plus medical care compared to medical care alone.

Trials exploring tenecteplase’s role in ischemic stroke, in both minor and non-minor strokes, particularly beyond the traditional 4.5-hour treatment window were discussed at the European Stroke Organisation Conference (ESOC) 2024. The TRACE-III study conducted in China further validated tenecteplase for treating moderate-to-severe acute ischemic stroke due to large-vessel occlusion where thrombectomy is unavailable.

GRASSROOT (Gravity Stent-Retriever System for Reperfusion of Large Vessel Occlusion Stroke Trial) was launched on Aug 15 2024 representing a major milestone in stroke advancement in India. The trial evaluates the safety and efficacy of a new advanced stent-retriever and has been developed specifically to address distinctive characteristics of stroke clots in the Indian Population. AIIMS Delhi is the leading centre for this trial among 7 other centres across India.

Violence Against Healthcare Professionals: A Growing Crisis (4-8)

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No recap of 2024 would be complete without addressing the growing issue of violence against healthcare workers (VAHCW), which has become a major concern, especially in India.

Over 75% of doctors in India have faced violence while on duty, as per the Indian Medical Association. This includes both physical attacks and daily verbal abuse, highlighting a grim reality for healthcare workers.

In August this year, a junior doctor from the state-run R.G. Kar Medical College & Hospital in Kolkata was tragically raped and murdered, sparking outrage across the medical community and beyond. Doctors are upset that the CBI failed to file charges against Sandip Ghosh, the former principal, and Abhijit Mondal, the ex-officer-in-charge of Tala police station, within the required 90-day period, leading to their release on bail. Joint Platform of Doctors (JPD) and Abhaya Mancha, a citizens’ platform, are demanding justice for the victim and planning a prolonged protest.

In November, a Tamil Nadu government doctor was stabbed seven times at a hospital in Chennai by a young man whose mother had been treated for cancer by the same doctor six months earlier. The attacker, who was also a patient attender at the hospital, targeted the doctor in the outpatient department (OPD) of Kalaignar Centenary Hospital in Guindy. The assault occurred after the accused suspected the doctor had prescribed incorrect medication for his mother’s cancer treatment.

These incidents are just two of the cases that made headlines in 2024. Many similar attacks on HCWs occur but do not come to light. The surge in violence against HCWs underscores the urgent need for zero-tolerance policies and stricter enforcement of existing laws.

The Medicare Service Persons and Medicare Service Institutions (Prevention of Violence and Damage or Loss to Property) Act was implemented in 2008. Most states and UTs have adopted different versions of this Act with varying levels of stringency However, inconsistent enforcement and limited police awareness undermine its effectiveness.

The Epidemic Diseases Act Ordinance 2020 was temporarily amended during the COVID-19 pandemic to include provisions addressing violence against healthcare workers. MoHFW later proposed a central bill titled ‘The Healthcare Service Personnel and Clinical Establishments (Prohibition of violence and damage to property) Bill (2019)’ with a clear definition of violence against healthcare personnel, health workplace, and health workforce, which was ill-defined in the Epidemic Diseases Act. However, it was rejected by the Ministry of Home Affairs stating that passing the Bill would set an improper precedent for other fraternities to demand exclusive protections based on their profession.

The Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill, 2022, also referred to as the Central Protection Act for Doctors, was introduced in the Lok Sabha with the aim of curbing violence against medical professionals and healthcare institutions. The National Task Force (NTF), constituted by the Supreme Court recommended using existing provisions to address violence against healthcare professionals in states without specific laws and concluded that a separate central law for such offenses is unnecessary.

Outbreaks And Infectious Crises (9-15)

2024 witnessed several new outbreaks, and with the lingering effects of the COVID-19 pandemic, each new infectious crisis understandably sparks anxiety and concern.

Mpox is caused by the monkeypox virus of the Orthopoxvirus genus in The global outbreak of clade IIb began in 2022 and continues to this day, including in some African countries and has grown beyond. As of August 2024, the Swedish authorities a confirmed case of mpox due to clade Ib.

Oropouche virus is mainly found in South America and the Caribbean, with over 10,000 cases reported in 2024. It causes a febrile illness similar to dengue and chikungunya, and the cause of infection is often misdiagnosed. No specific treatments or vaccines are yet available.

Chandipura virus (CHPV) endemic in India has caused the largest outbreak in 20 years, with 245 cases and 82 deaths in 2024. However, the current outbreak is the largest in the past 20 years. CHPV causes acute encephalitis with fever, altered mental status, and seizures. It is transmitted by vectors such as sandflies, mosquitoes and ticks. The case-fatality ratio from CHPV infection is high and there is no specific treatment or vaccine available.

As of December, Rwanda reported an outbreak of Marburg virus disease (MVD), a highly virulent illness similar to Ebola. Initial infections often stem from exposure to fruit bat habitats, with human transmission occurs through contaminated bodily fluids. MVD presents with sudden onset of high fever, severe headache, and malaise, followed by watery diarrhea, abdominal pain, nausea, and vomiting by the third day. Hemorrhagic symptoms may appear by days eight to nine in fatal cases. There is currently no approved treatment or vaccine for MVD.

A new virus, identified as ‘Dinga Dinga,’ (meaning ‘shaking like dancing’) in the Bandibugyo district, Uganda, where approximately 300 cases among women and teenage girls have been reported.

AI in Health Care (16-19)

Top 6 AI Trends in Healthcare for 2023 and Beyond - KnowHow

In 2024, the role of artificial intelligence (AI) in healthcare saw significant growth, with numerous institutions worldwide launching new initiatives aimed at enhancing healthcare models, sparking excitement and optimism within the medical community.

Researchers at Tsinghua University in China recently created the “Agent Hospital” 1st AI hospital town to treat patients in virtual world, where all doctors, nurses, and patients are controlled by intelligent agents powered by large language models (LLMs) that can interact autonomously.

An Australian biotechnology company is building what could be the first AI-driven , MedArmor AI Hospital in Vietnam, which will pursue a preventive healthcare model, emphasising early disease detection and timely interventions.

Chi Mei Medical Center in Taiwan has rolled out multiple AI copilots to lighten workloads for doctors, nurses and pharmacists.

In India, Apollo Cancer Centre has launched India’s first AI-Precision Oncology Centre (POC) in Bengaluru. Australia’s Monash University and Apollo Hospitals have tied up to train AI algorithms to identify and diagnose diseases such as cancer, heart disease and diabetes.

These are just a few of the advances; the scope of AI in healthcare is poised for exponential growth in 2025, as technologies evolve and integrate more deeply into various aspects of medical practice.

Ozempic Craze (20-22)

GLP-1 agonists like Semaglutide has captured attention as many celebrities have undergone significant weight loss transformations, with gossip columns often speculating that Ozempic is the secret behind their success. Here’s the scoop on this trending medication.

Obesity in the US is declining for the first time in a decade, with Ozempic playing a key role in this shift. The medication, originally designed for type 2 diabetes, has become widely popular for weight loss. However, a recent study published by Harvard University found that Novo Nordisk’s Ozempic is linked to an increased risk of NAION, a rare form of vision loss, with users being more than twice as likely to develop the condition compared to those using other diabetes medications.

The FDA has also received reports of adverse events linked to unapproved versions of GLP-1 receptor agonists like semaglutide and tirzepatide. Counterfeit Ozempic products have surfaced, posing risks to patients due to incorrect ingredients and dosages. The FDA is actively addressing these issues, issuing warning letters to halt the sale of fraudulent drugs.

Booming Industry: Wearable Tech (23,24)

Wearable devices: Useful medical insights or just more data?

This year witnessed a significant rise in wearable tech, including smart rings, watches, and continuous glucose monitoring (CGM) patches, which have become more accessible and widely used.

The wearable technology industry is witnessing a rapid surge, driven by advancements in health monitoring and personalized care. Innovations such as devices for cardiovascular monitoring, like phonocardiograms (PCG) and seismocardiograms (SCG), have enhanced non-invasive diagnostics by providing comprehensive heart assessments through sound and vibration analysis. Meanwhile, wearable tech for chronic kidney disease (CKD) management and potential expansion to other conditions like liver dysfunction underscores its growing market potential, reflecting the increasing demand for precision medicine. Despite challenges in durability for long-term use, advancements in flexible sensors and green biomaterials point to a sustainable and efficient future for wearable devices.

While wearables offer transformative possibilities, concerns remain regarding their psychological and systemic impacts. A new research from University of North Carolina shows that devices wearable devices, such as smart watches, can significantly amplify anxiety and increase healthcare use in patients with Afib, signaling a need for further studies on their broader implications.

With continuous innovation, use of sustainable materials, and thoughtful integration into healthcare, wearable technology can redefine patient care and monitoring, making it a cornerstone of future medical advancements.

New Promising Avenues For Neurodegenerative Disorders (25,26)

Among the NIH research highlights of the year described, the most promising advancements this year lies in diagnostic testing, particularly in the potential use of blood tests to detect tauopathies and synucleopathies. These breakthroughs could revolutionize the management of Neurodegenerative disorders, offering hope for earlier detection and more effective treatments in the near future.

A study by Drs. Sebastian Palmqvist and Oskar Hansson from Lund University evaluated the blood test PrecivityAD2, which measures amyloid beta ratios and p-tau217. Compared to spinal fluid tests and PET scans, it predicted Alzheimer’s disease with 88%-92% accuracy, significantly outperforming traditional clinical evaluations. “We see this as a major step towards global clinical implementation of an Alzheimer’s blood test,” Hansson says. “The next steps include establishing clear guidelines for how an Alzheimer’s blood test can be used in clinical practice, preferably by implementing these tests first in specialist care and then in primary care. This work is currently ongoing.”

Dr. Christopher Gibbons’ team at the Beth Israel Deaconess Medical Center showed that detecting phosphorylated α-synuclein (P-SYN) in skin biopsies could identify neurodegenerative disorders like Parkinson’s disease, multiple system atrophy, and dementia with Lewy bodies with over 90% accuracy. The minimally invasive test correlated with disease severity and was well-tolerated. Gibbons says. “With a simple, minimally invasive skin biopsy test, this study demonstrated how we can more objectively identify the underlying pathology of synucleinopathies and offer better diagnostic answers and care for patients.”

Rising Awareness and Hope: Amyotrophic Lateral Sclerosis Research (27-29)

Since the ALS Ice Bucket Challenge in 2014, awareness of ALS has grown significantly, along with its increasing prevalence over the last decade. As the global prevalence of amyotrophic lateral sclerosis (ALS) is projected to rise by 69% by 2040, the importance of advancing our understanding and treatment of this condition has never been more urgent.

A groundbreaking brain-computer interface developed at UC Davis that accurately decodes speech from neural signals. They tested the system in a 45-year-old man with ALS by implanting microelectrodes along the left precentral gyrus. Researcher David Brandman says. “I hope that this transformative technology will help future patients speak with their family and friends.”

FDA granted accelerated approval for QALSODY® (tofersen), targeting SOD1 gene mutations to reduce neurofilament light chain levels. The European Commission also granted marketing authorization under exceptional circumstances and orphan designation.

In Japan, Rozebalamin, a ultra-high dose mecobalamin therapy, has shown to slow disease progression by 45%, particularly when combined with standard treatments like riluzole, based on data from a Phase 3 clinical trial called JETALS. There was also a significant decrease in the blood levels of homocysteine, a molecule that causes damage to motor neurons and other cells in the brain and spinal cord, in treated ALS patients

PrimeC, is a novel extended-release oral formulation composed of a unique fixed-dose combination of ciprofloxacin and celecoxib. Phase 2b of PARADIGM trial demonstrated a 43% reduction in disease progression in pre-specified high-risk ALS patients. The drug synergistically targets several key mechanisms of ALS that contribute to motor neuron degeneration, inflammation, iron accumulation and impaired RNA regulation to potentially inhibit the progression of ALS, highlighting its potential to redefine ALS care.

The Future of Healing: Breakthroughs in Molecular Medicine (26)

Molecular medicine is paving the way for transformative and personalized healthcare, and several noteworthy advancements were brought to light by the 2024 NIH Research highlights.

A novel tool called CHARM, designed by Drs. Sonia Vallabh and Jonathan Weissman, offers a way to safely suppress prion protein production in the brain. In mice injected with CHARM, prion protein levels dropped by 80% within six weeks, showing promise for treating prion diseases like Creutzfeldt-Jakob disease and possibly other neurodegenerative disorders caused by toxic protein buildups, such as Huntington’s.

In another study, scientists studying the 13-lined ground squirrel discovered how cataracts that form during hibernation disappear when normal body temperature returns. They identified a protein, RNF114, that triggers the breakdown of CRYAA, a lens protein linked to cataracts. Human cells engineered to produce RNF114 showed similar effects, opening potential pathways for cataract treatments. “Understanding the molecular drivers of this reversible cataract phenomenon might point us in a direction toward a potential treatment strategy,” says Dr. Wei Li from NIH’s National Eye Institute, who helped lead the study.

A research team led by Dr. Zheng-Yi Chen at Mass Eye and Ear in Boston used CRISPR-Cas9 gene editing system and created a mouse model with a specific mutation in the microRNA-96 (MIR96) gene which causes a rare type of genetic hearing loss called autosomal dominant deafness-50 (DFNA50). People born with DFNA50 tend to have progressive hearing loss beginning in their teens. Delivered via a harmless virus, the treatment improved long-term hearing and protected inner ear hair cells, with earlier intervention yielding better results. Chen says. “Now, we have these results that show new possibilities for genome editing. These advances are bringing in a new era of treatments for people who have genetic deafness.”

As we close out 2024 and look ahead to 2025, the momentum of these breakthroughs promise even more exciting developments. I hope that the medical community continues to push boundaries, and with it, the potential to reshape how we understand, treat, and prevent a wide range of health conditions.

Wishing you all a happy new year.

Cheers!

Sources:

Advances in neurovascular research: Scientific highlights from the 2024 international stroke conference. Geraghty, Joseph R. et al. Journal of Stroke and Cerebrovascular Diseases, Volume 33, Issue 5, 107671
https://www.hindustantimes.com/cities/delhi-news/aiims-delhi-treats-first-patient-in-stroke-trial-under-new-tech-101730137729744-amp.html