The Heart: One in four heart patients is back in the hospital within 30 days. Help is on the way
Alarm systems for the heart
Some five million Americans suffer from heart failure. About a million of them are discharged from hospitals every year -- and 1 in 4 is back within 30 days. That's bad for patients and hugely expensive for the health care system: The cost of caring for patients with heart failure is expected to top $37 billion in 2009, and hospital admissions will account for 80 percent of that sum. Silicon Valley start-up Corventis aims to head off a lot of those readmissions with a system that lets physicians track patients' cardiac health remotely during the high-risk period following hospital discharge. The company's AVIVO system, which became commercially available last spring, equips the patient -- say, someone who has suffered an acute heart attack -- with a disposable sensor that attaches to the chest like a large bandage. It monitors the patient's heart rate, respiration, and fluid status and activity and wirelessly transmits the data to Corventis's Web server. Cardiologists can check in from work, home, and even their smartphones. The goal is to detect irregularities early and treat them proactively -- and less expensively. Plus, the AVIVO system comes relatively cheap: Its current price is $400 to $700 per week.
Cardiac Concepts, in Minnetonka, Minnesota, uses a different kind of monitoring to help the more than 50 percent of heart-failure patients who suffer from sleep apnea, or disrupted nighttime breathing, which can aggravate heart failure. The company is focused on the problem of central sleep apnea, in which the resting brain fails to regulate the body's balance of carbon dioxide and oxygen. People with the condition pass the night swinging between hyperventilation and dangerously shallow breathing, their panicky hearts working hard when they should be resting. Cardiac Concepts's solution: an implanted device that uses an algorithm to sense changes in respiration and stimulates the body to respond -- the mechanical equivalent of a "keep quiet" nudge from a snorer's bedmate. Trials of the device are under way in Europe, China, and the U.S., says CEO Bonnie Labosky. "The regulatory agencies look for safety and efficacy," she says. "Reimbursement people will care about the same thing."
The Spine: Relief for the 260,000 Americans who suffer from spinal cord injury
Invivo's spinal cord treatment
After being severely injured in a car crash 17 years ago, Frank Reynolds, founder and CEO of InVivo Therapeutics, spent years training his body to walk again -- as well as thinking about how to help the 260,000 Americans living with spinal cord injury, or SCI. With innovative technology developed by MIT medical-gadget guru Robert Langer, Reynolds is now tantalizingly close to a solution that will help victims of even the most severe injuries recover bodily functioning -- whether that means breathing on their own or walking again. Already successful in primate experiments, InVivo's spinal cord treatment uses a biodegradable polymer that is injected or implanted into the spinal cord to form a "scaffold" that reduces cell death and scar formation and promotes the survival of neural stem cells, which repair the injured spinal cord. If the technique works in humans, it will be the first effective therapy for SCI, and Reynolds foresees the platform being used in the immediate aftermath of traumatic SCI as well as in cases of chronic paralysis. Given that the lifetime cost of caring for quadriplegics and paraplegics is estimated at about $700,000 to more than $3 million per individual, the potential savings are enormous.
The Bladder: The tiny device floats in the bladder, steadily releasing local anesthetic
Precision pain relief
If you haven't heard of interstitial cystitis (or IC, also known as painful bladder syndrome), consider yourself lucky. At least a million women in the United States have the condition. Though it is not life threatening, the condition can drastically affect quality of life. Symptoms such as frequent urination and chronic pain sometimes result in job loss and depression; indeed, the suicide rate among IC sufferers is more than five times the national average. One of the most common treatments for IC requires a visit to a doctor's office to flood the bladder with a drug as frequently as three times a week -- and the results are often lackluster. Taris Biomedical, in Lexington, Massachusetts, is developing a technology that the company's co-founder, Christine Bunt, says will radically alter treatment. Taris's solution: a tiny "pretzel" made of semipermeable silicone tubing that floats in the bladder, steadily releasing the local anesthetic lidocaine in response to osmotic pressure. Initially, the device would have to be removed after a few weeks, but the company -- which raised $15 million in June -- has patents covering a biodegradable version as well. Taris hopes to begin human trials in early 2010.
The Hips: The device, inspired by silicon chips, looks like an Oreo coated in titanium
Therapy for brittle, fracture-prone bones
Some 10 million Americans suffer from osteoporosis, and an estimated 34 million more are at risk because of low bone mass. Eighty percent of those with the disease are women, and the condition makes them susceptible to fractures of the hip, spine, and other bones. Those injuries cost $19 billion in 2005, according to the National Osteoporosis Foundation, a sum that is expected to exceed $25 billion by 2025. One of the most effective treatments for the most severe cases is injections of the parathyroid hormone, which stimulates new bone growth. The problem: The hormone must be injected daily for up to two years to be effective, a regimen that most patients find too demanding to follow. The solution proposed by Bedford, Massachusetts–based MicroCHIPS is to automate the process using an implantable device that is designed to deliver the drug precisely and without fail, day in and day out. Looking something like an Oreo coated in titanium, the device was inspired by the silicon chips used in computing and developed by the company's CEO and president, John Santini, along with MIT professors Robert Langer and Michael Cima. The MicroCHIPS device -- which is implanted under the skin in the abdominal area -- is programmed to administer a dose once a day and will store as much as a year's worth of the drug in powdered form in tiny reservoirs built into the chip. The company, which employs 19 and has funding from a consortium of venture funds as well as medical-device industry giant Medtronic, expects to begin human trials within a year. The market for osteoporosis treatment is expected to be $8 billion to $10 billion by 2010. But Santini envisions future applications of the company's technology that will include implantable "rescue" devices, such as one for diabetics, that would sense low glucose levels and automatically dispense an antidote -- and make a 911 call.
