TEDxMaastricht
Daniel Kraft: Medicine's future? There's an app for that
Daniel Kraft: Prihodnost medicine? Za to obstaja aplikacija
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Na TEDxMaastricht Daniel Kraft ponuja hitropotezen pogled na inovacije v naslednjih nekaj letih na področju medicine, ki so okrepljene z novimi orodji, testi in aplikacijami in prinašajo diagnostične informacije prav do bolnikove postelje.
Daniel Kraft - Physician scientist
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine. Full bio
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine. Full bio
Double-click the English transcript below to play the video.
00:15
A couple of years ago
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Pred nekaj leti,
na TED konferenci v Long Beachu,
na TED konferenci v Long Beachu,
00:17
when I was attending the TED Conference in Long Beach,
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00:19
I met Harriet.
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sem spoznal Harriet.
00:21
We'd actually met online before --
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Dejansko sva se srečala prej na spletu -
ne tako, kot si mislite.
ne tako, kot si mislite.
00:23
not the way you're thinking.
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00:25
We were actually introduced because we both knew Linda Avey,
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Oba sva poznala Lindo Avey,
00:27
one of the founders of the first online personal genomic companies.
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ki je ena od ustanoviteljev prve
spletne osebne genomske družbe.
spletne osebne genomske družbe.
00:30
And because we shared our genetic information with Linda,
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In ker sva najine
genetske informacije delila z Lindo,
genetske informacije delila z Lindo,
00:33
she could see that Harriet and I
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je ona lahko videla, da si s Harriet
deliva zelo redek tip mitohondrijske DNK -
deliva zelo redek tip mitohondrijske DNK -
00:35
shared a very rare type of mitochondrial DNA --
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00:37
Haplotype K1a1b1a --
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Haplotip K1a1b1a - kar je pomenilo,
da sva v daljnem sorodu.
da sva v daljnem sorodu.
00:39
which meant that we were distantly related.
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00:41
We actually share the same genealogy with Ozzie the iceman.
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Dejansko deliva isto rodoslovje
z Oetzijem, ledenim človekom.
z Oetzijem, ledenim človekom.
00:44
So Ozzie, Harriet and me.
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Torej Oetzi, Harriet in jaz.
00:46
And being the current day, of course, we started our own Facebook group.
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Ustanovila sva skupino na Facebook-u.
Vsi ste dobrodošli, da se pridružite.
Vsi ste dobrodošli, da se pridružite.
00:48
You're all welcome to join.
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00:50
And when I met Harriet in person the next year at the TED Conference,
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Ko sem naslednje leto srečal Harriet
osebno na konferenci TED,
osebno na konferenci TED,
00:53
she'd gone online and ordered our own happy Haplotype T-shirts.
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nama je naročila srečne Haplotip majice.
00:55
(Laughter)
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(Smeh)
00:57
Now why am I telling you this story,
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Zakaj vam pripovedujem to zgodbo
in kaj ima to s prihodnostjo zdravja?
in kaj ima to s prihodnostjo zdravja?
00:59
and what does this have to do with the future of health?
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01:01
Well the way I met Harriet is actually an example
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Kako sem spoznal Harriet, je primer,
01:03
of how leveraging cross-disciplinary,
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kako interdisciplinarno dopolnjevane,
skokovito rastoče tehnologije
skokovito rastoče tehnologije
01:05
exponentially-growing technologies
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01:07
is affecting our future of health and wellness --
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vplivajo na prihodnost
zdravja in počutja -
zdravja in počutja -
01:09
from low-cost gene analysis
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od nizkocenovnih genskih analiz
do priložnosti v zmogljivi bioinformatiki
do priložnosti v zmogljivi bioinformatiki
01:11
to the ability to do powerful bio-informatics
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01:13
to the connection of the Internet and social networking.
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in do internetne povezave
in socialnih mreženj.
in socialnih mreženj.
01:16
What I'd like to talk about today
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Danes bi rad govoril o
razumevanju teh eksponentnih tehnologij.
razumevanju teh eksponentnih tehnologij.
01:18
is understanding these exponential technologies.
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01:20
We often think linearly.
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Pogosto mislimo linearno.
01:22
But if you think about it, if you have a lily pad
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Ampak, če imate plavajoč lokvanjev list,
ki se razdeli vsak dan -
ki se razdeli vsak dan -
01:24
and it just divided every single day --
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01:26
two, four, eight, 16 --
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dva, štiri, osem, 16 -
v 15 dneh jih imate 32.000.
v 15 dneh jih imate 32.000.
01:28
in 15 days you have 32,000.
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01:30
What do you think you have in a month? We're at a billion.
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Koliko mislite, da jih bo v enem mesecu?
Prišli smo do milijarde.
Prišli smo do milijarde.
01:33
So if we start to think exponentially,
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Če začnemo misliti eksponentno,
01:35
we can see how this is starting to affect all the technologies around us.
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vidimo, kako to začenja
vplivati na vse tehnologije okoli nas.
vplivati na vse tehnologije okoli nas.
01:38
And many of these technologies -- speaking as a physician and innovator --
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In veliko teh tehnologij -
govorim kot zdravnik in inovator -
govorim kot zdravnik in inovator -
01:41
we can really start to leverage
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res lahko začnemo izkoriščati,
da vplivamo na prihodnost lastnega
zdravja in zdravstvenega varstva
zdravja in zdravstvenega varstva
01:43
to impact the future of our own health and of health care,
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01:45
and to address many of the major challenges that we have in health care today,
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in da se lotimo glavnih izzivov,
ki jih imamo v zdravstvu danes,
ki jih imamo v zdravstvu danes,
01:48
ranging from the really exponential costs
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od res skokovitih stroškov,
do staranja prebivalstva,
do staranja prebivalstva,
01:50
to the aging population,
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01:52
the way we really don't use information very well today,
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slabega načina uporabe informacij,
01:54
the fragmentation of care
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razdrobljenosti oskrbe,
01:56
and often the very difficult course
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in pogosto veliko težav
v sprejemanju inovacij.
v sprejemanju inovacij.
01:58
of adoption of innovation.
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02:00
And one of the major things we can do we've talked a bit about here today
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Kar lahko naredimo,
o čemer smo danes nekaj govorili,
o čemer smo danes nekaj govorili,
02:02
is moving the curve to the left.
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je premik krivulje v levo.
02:04
We spend most of our money on the last 20 percent of life.
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Večino denarja porabimo
na zadnjih 20 % življenja.
na zadnjih 20 % življenja.
02:06
What if we could spend and incentivize positions
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Kaj če bi lahko porabili in
spodbujali pozicije
spodbujali pozicije
02:08
in the health care system and our own self
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v sistemu zdravstvenega
varstva in nas samih
varstva in nas samih
02:10
to move the curve to the left and improve our health,
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za premik krivulje v levo
in izboljšanje zdravja,
in izboljšanje zdravja,
02:12
leveraging technology as well?
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tudi z izkoriščanjem tehnologije?
02:14
Now my favorite technology, example of exponential technology,
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Mojo najljubšo tehnologijo, primer
eksponentne tehnologije, imamo vsi v žepu.
eksponentne tehnologije, imamo vsi v žepu.
02:17
we all have in our pocket.
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02:19
So if you think about it, these are really dramatically improving.
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Torej, če o tem razmislite,
to se res dramatično izboljšuje.
to se res dramatično izboljšuje.
02:22
I mean this is the iPhone 4.
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Hočem reči, to je iPhone 4.
02:24
Imagine what the iPhone 8 will be able to do.
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Predstavljajte si,
kaj bo sposoben narediti iPhone 8.
kaj bo sposoben narediti iPhone 8.
02:27
Now, I've gained some insight into this.
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Dobil sem nekaj uvida v to.
02:29
I've been the track share
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Sem eden od udeležencev
na medicinskem delu nove institucije,
imenovane Singularity University,
imenovane Singularity University,
02:31
for the medicine portion of a new institution called Singularity University
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02:34
based in Silicon Valley.
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s sedežem v Silicijevi dolini.
02:36
And we bring together every summer
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In tukaj vsako poletje združimo
približno 100 zelo nadarjenih
študentov z vsega sveta.
študentov z vsega sveta.
02:38
about 100 very talented students from around the world.
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02:40
And we look at these exponential technologies from medicine, biotech,
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In obravnavamo te tehnologije
iz medicine, biotehnologije,
iz medicine, biotehnologije,
02:42
artificial intelligence, robotics, nanotechnology, space,
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umetne inteligence, robotike,
nanotehnologije, vesolja,
nanotehnologije, vesolja,
02:45
and address how can we cross-train
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in iščemo, kako bi jih
navzkrižno usposobili
navzkrižno usposobili
02:47
and leverage these to impact major unmet goals.
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in izkoristili za vpliv na glavne
neizpolnjene cilje.
neizpolnjene cilje.
02:49
We also have seven-day executive programs.
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Imamo tudi sedem-dnevne
izvedbene programe.
izvedbene programe.
02:51
And coming up next month is actually Future Med,
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In naslednji mesec je
pravzaprav Future Med,
pravzaprav Future Med,
02:54
a program to help cross-train and leverage technologies into medicine.
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program interdisciplinarnega usposabljanja
in izkoriščanja tehnologij v medicini.
in izkoriščanja tehnologij v medicini.
02:57
Now I mentioned the phone.
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Omenil sem telefon.
02:59
These mobile phones have over 20,000 different mobile apps available --
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Ti mobilni telefoni imajo na voljo več kot
20.000 različnih mobilnih aplikacij -
20.000 različnih mobilnih aplikacij -
03:02
to the point where there's one out of the U.K.
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vse do tiste iz VB,
03:04
where you can pee on a little chip connected to your iPhone
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kjer lahko lulate na
mali čip priključen na vaš iPhone
mali čip priključen na vaš iPhone
03:06
and check yourself for an STD.
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in preverite sami za SPB.
03:08
I don't know if I'd try that yet, but that's available.
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Ne vem, če bi sam že poskusil,
ampak je na voljo.
ampak je na voljo.
03:10
There are all other sorts of applications,
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Obstajajo vse vrste aplikacij,
03:12
merging your phone and diagnostics, for example --
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ki združujejo vaš telefon
in diagnostiko, na primer -
in diagnostiko, na primer -
03:14
measuring your blood glucose on your iPhone
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merjenje glukoze v krvi
na vašemu iPhonu
na vašemu iPhonu
03:16
and sending that, potentially, to your physician
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in pošiljanje vašemu zdravniku,
03:18
so they can better understand and you can better understand
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da oni in vi lahko bolje razumete
03:21
your blood sugars as a diabetic.
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vaš krvni sladkor,
če imate sladkorno bolezen.
če imate sladkorno bolezen.
03:23
So let's see now how exponential technologies are taking health care.
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Poglejmo zdaj, kako skokovite
tehnologije prevzemajo zdravstvo.
tehnologije prevzemajo zdravstvo.
03:25
Let's start with faster.
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Začnimo s tem, da so hitrejše.
03:27
Well it's no secret that computers, through Moore's law,
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Ni skrivnost, da so, po Moorovemu zakonu,
računalniki vse hitrejši in hitrejši.
računalniki vse hitrejši in hitrejši.
03:29
are speeding up faster and faster.
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03:31
We have the ability to do more powerful things with them.
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Z njimi lahko naredimo
bolj zmogljive stvari.
bolj zmogljive stvari.
03:33
They're really approaching, in many cases surpassing,
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Oni res dohajajo,
v mnogih primerih presegajo,
v mnogih primerih presegajo,
03:35
the ability of the human mind.
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sposobnost človeškega uma.
03:37
But where I think computational speed is most applicable
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Ampak mislim, da je računska hitrost
najbolj uporabna za slikanje.
najbolj uporabna za slikanje.
03:40
is in that of imaging.
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03:42
The ability now to look inside the body in real time
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Možnost vpogleda v telo v realnem času
03:44
with very high resolution is really becoming incredible.
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z zelo visoko ločljivostjo
res postaja neverjetna.
res postaja neverjetna.
03:47
And we're layering multiple technologies -- PET scans, CT scans
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In uporabljamo različne tehnologije -
PET skeniranje, CT skeniranje
PET skeniranje, CT skeniranje
03:50
and molecular diagnostics --
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in molekularno diagnostiko -
03:52
to find and to seek things at different levels.
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da najdemo in poiščemo stvari
na različnih ravneh.
na različnih ravneh.
03:55
Here you're going to see the very highest resolution MRI scan done today,
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Tukaj boste videli najvišjo ločljivost
MRI skeniranja danes,
MRI skeniranja danes,
03:58
reconstructed of Marc Hodosh, the curator of TEDMED.
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rekonstrukcijo Marca Hodosha,
skrbnika TEDMED-a.
skrbnika TEDMED-a.
04:01
And now we can see inside of the brain
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In zdaj lahko vidimo notranjost možganov
04:03
with a resolution and ability that was never before available,
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z do sedaj nedosegljivo
ločljivostjo in zmogljivostjo,
ločljivostjo in zmogljivostjo,
04:06
and essentially learn how to reconstruct,
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in se naučimo rekonstrukcije
in morda celo reinženiringa
in morda celo reinženiringa
04:08
and maybe even re-engineer,
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04:10
or backwards engineer, the brain
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ali povratnega inženiringa možganov,
04:12
so we can better understand pathology, disease and therapy.
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da bi bolje razumeli patologijo,
bolezni in zdravljenje.
bolezni in zdravljenje.
04:15
We can look inside with real time fMRI -- in the brain at real time.
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Notranjost možganov lahko gledamo
v realnemu času z fMRI.
v realnemu času z fMRI.
04:18
And by understanding these sorts of processes and these sorts of connections,
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In z razumevanjem
te vrste procesov in povezav
te vrste procesov in povezav
04:21
we're going to understand the effects of medication or meditation
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bomo razumeli učinke
zdravil ali meditacije
zdravil ali meditacije
04:24
and better personalize and make effective, for example,
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in bolje in učinkoviteje
bomo personalizirali, na primer,
bomo personalizirali, na primer,
04:27
psychoactive drugs.
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pri psihoaktivnih zdravilih.
04:29
The scanners for these are getting small, less expensive and more portable.
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Ti skenerji so vse manjši,
cenejši in bolj prenosni.
cenejši in bolj prenosni.
04:32
And this sort of data explosion available from these
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In te vrste eksplozija podatkov,
ki je na voljo, res skoraj postaja izziv.
ki je na voljo, res skoraj postaja izziv.
04:35
is really almost becoming a challenge.
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04:37
The scan of today takes up about 800 books, or 20 gigabytes.
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Skeniranje danes zavzame približno
800 knjig ali 20 gigabajtov.
800 knjig ali 20 gigabajtov.
04:40
The scan in a couple of years will be one terabyte, or 800,000 books.
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Skeniranje bo v nekaj letih
en terabajt ali 800.000 knjig.
en terabajt ali 800.000 knjig.
04:43
How do you leverage that information?
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Kako izkoristite te informacije?
04:45
Let's get personal. I won't ask who here's had a colonoscopy,
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Postanimo osebni. Ne bom vprašal,
kdo je bil na kolonoskopiji,
kdo je bil na kolonoskopiji,
04:48
but if you're over age 50, it's time for your screening colonoscopy.
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a če ste stari nad 50 let,
je čas za presejalno kolonoskopijo.
je čas za presejalno kolonoskopijo.
04:51
How would you like to avoid the pointy end of the stick?
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Kako bi vam bila všeč možnost
da se temu izognete?
da se temu izognete?
04:53
Well now there's essentially a virtual colonoscopy.
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Zdaj v bistvu obstaja
virtualna kolonoskopija.
virtualna kolonoskopija.
04:56
Compare those two pictures, and now as a radiologist,
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Primerjajte ti dve sliki in kot radiolog
04:58
you can essentially fly through your patient's colon
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lahko poletite skozi
bolnikovo debelo črevo
bolnikovo debelo črevo
05:00
and, augmenting that with artificial intelligence,
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in z uporabo umetne inteligence (U.I.)
05:02
identify potentially, as you see here, a lesion.
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prepoznate potencialno lezijo,
kot vidite tukaj.
kot vidite tukaj.
05:04
Oh, we might have missed it, but using A.I. on top of radiology,
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Mogoče smo jo spregledali,
a z uporabo U.I. pri radiologiji,
a z uporabo U.I. pri radiologiji,
05:07
we can find lesions that were missed before.
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najdemo lezije, ki smo jih spregledali.
05:09
And maybe this will encourage people to get colonoscopies
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In morda bo to spodbudilo ljudi,
05:11
that wouldn't have otherwise.
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da opravijo kolonoskopijo,
ki je sicer ne bi.
ki je sicer ne bi.
05:13
And this is an example of this paradigm shift.
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In to je primer spremembe paradigme.
Gibljemo se k integraciji biomedicine,
informacijske tehnologije,
informacijske tehnologije,
05:15
We're moving to this integration of biomedicine, information technology,
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brezžične in, rekel bi, mobilne
- v ero digitalne medicine.
- v ero digitalne medicine.
05:18
wireless and, I would say, mobile now -- this era of digital medicine.
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05:21
So even my stethoscope is now digital.
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Celo moj stetoskop je zdaj digitalni.
In seveda tudi za to obstaja aplikacija.
In seveda tudi za to obstaja aplikacija.
05:23
And of course, there's an app for that.
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05:25
We're moving, obviously, to the era of the tricorder.
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Očitno se gibljemo k eri trikorderja.
05:28
So the handheld ultrasound
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Ročni ultrazvok je v bistvu presegel
in izpodrinil stetoskop.
in izpodrinil stetoskop.
05:30
is basically surpassing and supplanting the stethoscope.
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05:33
These are now at a price point
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Sedaj imajo ceno - včasih je bila
100.000 € ali nekaj 100.000 $ -
100.000 € ali nekaj 100.000 $ -
05:35
of -- what used to be 100,000 euros or a couple of hundred-thousand dollars --
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05:37
for about 5,000 dollars, I can have the power
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za približno 5.000 $ lahko imam moč
05:39
of a very powerful diagnostic device in my hand.
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zelo zmogljive
diagnostične naprave v roki.
diagnostične naprave v roki.
05:42
And merging this now with the advent of electronic medical records --
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In združevanje tega s pojavom
elektronskih zdravstvenih kartotek -
elektronskih zdravstvenih kartotek -
05:45
in the United States, we're still less than 20 percent electronic.
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v ZDA je še vedno manj kot
20 odstotkov elektronskih.
20 odstotkov elektronskih.
05:48
Here in the Netherlands, I think it's more than 80 percent.
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Tukaj na Nizozemskem,
mislim, da je več kot 80 %.
mislim, da je več kot 80 %.
05:50
But now that we're switching to merging medical data,
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A zdaj, ko prehajamo na
združevanje zdravstvenih podatkov,
združevanje zdravstvenih podatkov,
05:52
making it available electronically,
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da so dostopni elektronsko,
05:54
we can crowd source that information,
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lahko te podatke damo v
množično zunanje izvajanje
množično zunanje izvajanje
05:56
and now as a physician, I can access my patients' data from wherever I am
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in kot zdravnik, lahko od kjerkoli
dostopam do podatkov svojih bolnikov
dostopam do podatkov svojih bolnikov
05:59
just through my mobile device.
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le s svojo mobilno napravo.
06:01
And now, of course, we're in the era of the iPad, even the iPad 2.
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Zdaj pa smo, seveda,
v dobi iPada, celo iPada 2.
v dobi iPada, celo iPada 2.
06:04
And just last month the first FDA-approved application
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In ravno prejšnji mesec je
FDA odobrila prvo aplikacijo,
FDA odobrila prvo aplikacijo,
06:07
was approved to allow radiologists
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ki bo radiologu omogočila,
da dejansko odčitava s tovrstne naprave.
da dejansko odčitava s tovrstne naprave.
06:09
to do actual reading on these sorts of devices.
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06:11
So certainly, the physicians of today, including myself,
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Vsekakor so današnji zdravniki,
z mano vred,
z mano vred,
06:14
are completely reliable on these devices.
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popolnoma zanesljivi na teh napravah.
06:16
And as you saw just about a month ago,
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In kot ste videli, le kakšen mesec nazaj,
je IBM-ov Watson premagal
dva prvaka v kvizu "Jeopardy".
dva prvaka v kvizu "Jeopardy".
06:18
Watson from IBM beat the two champions in "Jeopardy."
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06:20
So I want you to imagine when in a couple of years,
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Rad bi, da si zamislite,
kako bomo v nekaj letih,
kako bomo v nekaj letih,
06:22
when we've started to apply this cloud-based information,
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po začetku uporabe
informacij "iz oblaka",
informacij "iz oblaka",
06:25
when we really have the A.I. physician and leverage our brains to connectivity
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res imeli U.I. zdravnika in
bomo svoje možgane povezali,
bomo svoje možgane povezali,
06:28
to make decisions and diagnostics
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da bi sprejemali odločitve in diagnostike
06:30
at a level never done.
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na ravni, ki je še nikoli ni bilo.
06:32
Already today, you don't need to go to your physician in many cases.
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Že danes vam v mnogih primerih
ni treba iti do zdravnika.
ni treba iti do zdravnika.
06:35
Only for about 20 percent of actual visits do you have to lay hands on the patient.
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Le v približno 20 % obiskov
je fizični kontakt z bolnikom nujen.
je fizični kontakt z bolnikom nujen.
06:38
We're now in the era of virtual visits --
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Zdaj smo v eri virtualnih obiskov -
06:40
from sort of the Skype-type visits you can do with American Well,
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od obiskov tipa Skype,
ki jih lahko storite z "American Well",
ki jih lahko storite z "American Well",
06:43
to Cisco that's developed a very complex health presence system.
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do "Cisca", ki je razvil kompleksen
sistem zdravstvene prisotnosti.
sistem zdravstvene prisotnosti.
06:46
The ability to interact with your health care provider is different.
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Možnost interakcije s svojim izvajalcem
zdravstvenih storitev je drugačna.
zdravstvenih storitev je drugačna.
06:49
And these are being augmented even by our devices again today.
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In naše sedanje naprave
to še naprej spreminjajo.
to še naprej spreminjajo.
06:52
Here my friend Jessica sent me a picture of her head laceration
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Prijateljica Jessica mi je poslala
sliko raztrganine na glavi
sliko raztrganine na glavi
06:54
so I can save her a trip to the emergency room -- I can do some diagnostics that way.
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in lahko ji prihranim pot na urgenco
in nekaj diagnosticiram na ta način.
in nekaj diagnosticiram na ta način.
06:57
Or might we be able to leverage today's gaming technology,
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Mogoče bi lahko izkoristili
igričarsko tehnologijo,
igričarsko tehnologijo,
06:59
like the Microsoft Kinect,
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kot je Microsoft Kinect,
in jo shekamo za potrebe diagnostike,
in jo shekamo za potrebe diagnostike,
07:01
and hack that to enable diagnostics, for example,
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07:03
in diagnosing stroke,
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na primer za diagnosticiranje kapi
07:05
using simple motion detection, using hundred-dollar devices.
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s preprosto zaznavo gibov
z napravami za sto dolarjev.
z napravami za sto dolarjev.
07:08
We can actually now visit our patients robotically --
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Dejansko lahko sedaj robotsko
obiščemo svoje bolnike -
obiščemo svoje bolnike -
07:11
this is the RP7; if I'm a hematologist,
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to je RP7; če sem hematolog,
07:13
visit another clinic, visit a hospital.
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lahko obiščem drugo kliniko,
bolnišnico.
bolnišnico.
07:16
These will be augmented by a whole suite of tools actually in the home now.
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To bo obogateno s celo vrsto orodij,
ki jih imamo doma že zdaj.
ki jih imamo doma že zdaj.
07:19
So imagine we already have wireless scales.
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Zamislite si, brezžične tehtnice že imamo.
07:21
You can step on the scale.
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Lahko stopite na tehtnico.
Lahko tvitnete svojo težo prijateljem,
ki vas lahko nadzirajo.
ki vas lahko nadzirajo.
07:23
You can Tweet your weight to your friends, and they can keep you in line.
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07:25
We have wireless blood pressure cuffs.
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Imamo brezžične manšete krvnega tlaka.
07:27
A whole gamut of these technologies are being put together.
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Cel razpon tehnologij se združuje.
07:29
So instead of wearing these kludgy devices, we can put on a simple patch.
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Namesto nošenja teh nerodnih naprav,
lahko nadenemo preprost obliž.
lahko nadenemo preprost obliž.
07:32
This was developed by colleagues at Stanford, called the iRhythm --
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To so razvili kolegi na Stanfordu,
imenuje se iRhythm -
imenuje se iRhythm -
07:35
completely supplants the prior technology at a much lower price point
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povsem je izpodrinil prejšnjo
tehnologijo, po precej nižji ceni
tehnologijo, po precej nižji ceni
07:38
with much more effectivity.
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z veliko več učinkovitosti.
07:40
Now we're also in the era, today, of quantified self.
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Zdaj smo tudi v eri, t. i. določanja sebe.
07:42
Consumers now can buy basically hundred-dollar devices,
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Potrošniki lahko zdaj kupijo stodolarske
naprave, kot je ta majhni FitBit.
naprave, kot je ta majhni FitBit.
07:44
like this little FitBit.
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07:46
I can measure my steps, my caloric outtake.
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Lahko merim svoje korake,
svojo porabo kalorij.
svojo porabo kalorij.
07:48
I can get insight into that on a daily basis.
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To lahko dnevno nadziram.
07:50
I can share that with my friends, with my physician.
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Lahko delim s prijatelji,
s svojim zdravnikom.
s svojim zdravnikom.
07:52
There's watches coming out that will measure your heart rate, the Zeo sleep monitors,
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Prihajajo ure, ki bodo merile srčni utrip,
Zeo monitorji spanja,
Zeo monitorji spanja,
07:55
a whole suite of tools that can enable you to leverage
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celotna zbirka orodij,
ki vam omogoča vpogled v lastno zdravje.
ki vam omogoča vpogled v lastno zdravje.
07:57
and have insight into your own health.
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07:59
And as we start to integrate this information,
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In ko začnemo integrirati te informacije,
bomo bolje vedeli, kaj naj z njimi
počnemo, in kako izboljšati vpogled
počnemo, in kako izboljšati vpogled
08:01
we're going to know better what to do with it and how better to have insight
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08:04
into our own pathologies, health and wellness.
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v lastne bolezni,
zdravje in dobro počutje.
zdravje in dobro počutje.
08:06
There's even mirrors today that can pick up your pulse rate.
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Obstajajo celo ogledala,
ki lahko zaznajo vaš srčni utrip.
ki lahko zaznajo vaš srčni utrip.
08:09
And I would argue, in the future, we'll have wearable devices in our clothes,
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In trdim, da bomo v prihodnosti imeli
nosljive naprave v naših oblekah,
nosljive naprave v naših oblekah,
08:12
monitoring ourselves 24/7.
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in se nenehno nadzirali.
08:14
And just like we have the OnStar system in cars,
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In tako kot imamo OnStar
sistem v avtomobilih,
sistem v avtomobilih,
08:16
your red light might go on -- it won't say "check engine" though.
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se vam bo prižgala rdeča lučka -
a ne bo "preveri motor",
a ne bo "preveri motor",
08:18
It's going to be "check your body" light,
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ampak "preveri svoje telo"
in za "pojdi in poskrbi za to".
in za "pojdi in poskrbi za to".
08:20
and go in and get it taken care of.
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08:22
Probably in a few years, you'll check into your mirror
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Verjetno se boste čez nekaj let
gledali v svojem ogledalu
gledali v svojem ogledalu
08:24
and it's going to be diagnosing you.
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in le-to vas bo diagnosticiralo.
08:26
(Laughter)
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(Smeh)
08:28
For those of you with kiddos at home,
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Za tiste, ki ste doma z otroci,
08:30
how would you like to have the wireless diaper that supports your ...
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kako bi vam bilo všeč, da imate
brezžično plenico, ki podpira vaš...
brezžično plenico, ki podpira vaš...
08:33
too much information, I think, than you might need.
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več informacij, kot jih potrebujete.
08:35
But it's going to be here.
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Ampak to bo tukaj.
08:37
Now we've heard a lot today about new technology and connection.
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Danes smo veliko slišali
o novi tehnologiji in povezavo z njo.
o novi tehnologiji in povezavo z njo.
08:40
And I think some of these technologies
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Mislim, da bo nekaj od teh tehnologij
08:42
will enable us to be more connected with our patients,
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omogočilo večjo povezanost
z našimi bolniki,
z našimi bolniki,
08:44
and take more time
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da si bomo vzeli več časa
08:46
and actually do the important human touch elements of medicine,
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in dejansko izvajali,
kar je pomembno, humano medicino,
kar je pomembno, humano medicino,
08:48
as augmented by these sorts of technologies.
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obogateno s tovrstnimi tehnologijami.
08:50
Now we've talked about augmenting the patient, to some degree.
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Govorili smo o, do neke mere,
izboljševanju bolnika.
izboljševanju bolnika.
08:52
How about augmenting the physician?
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Kaj pa izboljševanje zdravnika?
08:54
We're now in the era of super-enabling the surgeon
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Zdaj smo v eri,
ko je kirurg super opremljen,
ko je kirurg super opremljen,
08:56
who can now go inside the body
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da lahko gre v telo
08:58
and do things with robotic surgery, which is here today,
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in operira z robotsko kirurgijo,
ki je danes tukaj,
ki je danes tukaj,
09:00
at a level that was not really possible
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na ravni, ki ni bila mogoča
celo pred petimi leti.
celo pred petimi leti.
09:02
even five years ago.
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09:04
Now this is being augmented with further layers of technology
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Zdaj je to razširjeno
z dodatnimi plastmi tehnologije
z dodatnimi plastmi tehnologije
09:06
like augmented reality.
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kot je obogatena resničnost.
09:08
So the surgeon can see inside the patient, through their lens,
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Tako da lahko kirurg vidi
notranjost bolnika skozi leče,
notranjost bolnika skozi leče,
09:11
where the tumor is, where the blood vessels are.
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kje je tumor, kje so krvne žile.
09:13
This can be integrated with decisions support.
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To je lahko integrirano
s podporo za odločitve.
s podporo za odločitve.
09:15
A surgeon in New York can be helping a surgeon in Amsterdam, for example.
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Kirurg v New Yorku lahko pomaga
kirurgu v Amsterdamu, na primer.
kirurgu v Amsterdamu, na primer.
09:18
And we're entering an era
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In prehajamo v ero
kirurgije resnično brez brazgotin
imenovane NOTES,
imenovane NOTES,
09:20
of really, truly scarless surgery called NOTES,
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09:22
where the robotic endoscope can come out the stomach
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kjer lahko gre
robotski endoskop ven iz želodca
robotski endoskop ven iz želodca
09:24
and pull out that gallbladder
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in izvleče žolčnik
09:26
all in a scarless way and robotically.
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robotsko in brez brazgotin.
09:28
And this is called NOTES, and this is coming --
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To se imenuje NOTES in to prihaja -
v bistvu kirurgija brez brazgotin,
v bistvu kirurgija brez brazgotin,
09:30
basically scarless surgery,
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09:32
as mediated by robotic surgery.
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kot jo omogoča robotska kirurgija.
09:34
Now how about controlling other elements?
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Kako je pa s kontroliranjem drugih delov?
09:36
For those who have disabilities -- the paraplegic --
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Za tiste, ki so invalidi - paraplegike -
09:38
there's the era of brain-computer interface, or BCI,
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smo v eri možganskih
računalniških vmesnikov ali BCI,
računalniških vmesnikov ali BCI,
09:41
where chips have been put on the motor cortex
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kjer so čipi v motorični
možganski skorji tetraplegika,
možganski skorji tetraplegika,
09:43
of completely quadriplegic patients
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09:45
and they can control a curser or a wheelchair or, eventually, a robotic arm.
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ki lahko nadzorujejo kurzor ali
voziček ali morebiti robotsko roko.
voziček ali morebiti robotsko roko.
09:49
And these devices are getting smaller
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In te naprave so vse manjše,
uporablja pa jih vse več teh bolnikov.
uporablja pa jih vse več teh bolnikov.
09:51
and going into more and more of these patients.
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Še so v kliničnih preizkušanjih,
a zamislite si, ko bodo povezane,
a zamislite si, ko bodo povezane,
09:53
Still in clinical trials, but imagine when we can connect these,
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09:55
for example, to the amazing bionic limb,
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na primer, z bioničnim udom,
09:57
such as the DEKA Arm built by Dean Kamen and colleagues,
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kot je DEKA roka, ki so je zgradili
Dean Kamen in kolegi,
Dean Kamen in kolegi,
10:00
which has 17 degrees of motion and freedom
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ki ima 17 prostostnih stopenj
10:03
and can allow the person who's lost a limb
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in lahko omogoči osebi, ki je izgubila ud,
10:05
to have much higher levels of dexterity or control
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da ima veliko višje nivoje
spretnosti ali nadzora,
spretnosti ali nadzora,
10:07
than they've had in the past.
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kot jih je imela v preteklosti.
10:09
So we're really entering the era of wearable robotics actually.
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Torej, res vstopamo v ero
nosljive robotike.
nosljive robotike.
10:12
If you haven't lost a limb -- you've had a stroke, for example --
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Če niste izgubili uda -
imeli ste možgansko kap, na primer -
imeli ste možgansko kap, na primer -
10:14
you can wear these augmented limbs.
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bi lahko nosili te zmogljive okončine,
10:16
Or if you're a paraplegic -- like I've visited the folks at Berkley Bionics --
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ali, če ste paraplegik - obiskal sem
ljudi na Berkley Bionics -
ljudi na Berkley Bionics -
10:19
they've developed eLEGS.
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oni so razvili eLEGS.
10:21
I took this video last week. Here's a paraplegic patient actually walking
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Prejšnji teden sem posnel ta video.
Tukaj je paraplegik, ki dejansko hodi
Tukaj je paraplegik, ki dejansko hodi
10:24
by strapping on these exoskeletons.
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s pomočjo jermenov na teh eksoskeletih.
10:26
He's otherwise completely wheelchair-bound.
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Sicer je priklenjen na invalidski voziček.
10:28
And now this is the early era of wearable robotics.
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In to je zdaj zgodnja
era nosljive robotike.
era nosljive robotike.
10:30
And I think by leveraging these sorts of technologies,
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Mislim, da bomo s tovrstnimi tehnologijami
spremenili definicijo invalidnosti
spremenili definicijo invalidnosti
10:32
we're going to change the definition of disability
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10:34
to in some cases be superability, or super-enabling.
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v super-zmogljivost
ali super-opremljenost.
ali super-opremljenost.
10:37
This is Aimee Mullins, who lost her lower limbs as a young child,
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To je Aimee Mullins, ki je kot otrok
izgubila svoje spodnje okončine,
izgubila svoje spodnje okončine,
10:40
and Hugh Herr, who's a professor at MIT
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in Hugh Herr, ki je profesor na MIT,
10:43
who lost his limbs in a climbing accident.
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ki je izgubil svoje ude
v plezalni nesreči.
v plezalni nesreči.
10:45
And now both of these can climb better, move faster, swim differently
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In sedaj oba lahko plezata bolje,
se hitreje gibljeta, plavata drugače
se hitreje gibljeta, plavata drugače
10:48
with their prosthetics than us normal-abled persons.
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s svojimi protezami od nas,
z normalnimi sposobnostmi.
z normalnimi sposobnostmi.
10:51
Now how about other exponentials?
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Kako je z drugimi hitro
naraščajočimi trendi?
naraščajočimi trendi?
10:53
Clearly the obesity trend is exponentially going in the wrong direction,
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Trend debelosti gre
skokovito v napačno smer,
skokovito v napačno smer,
10:56
including with huge costs.
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vključno z velikimi stroški.
10:58
But the trend in medicine actually is to get exponentially smaller.
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Ampak v medicini je trend
skokovito zmanjševanje.
skokovito zmanjševanje.
11:01
So a few examples: we're now in the era
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Nekaj primerov: Zdaj smo v eri
filma "Fantastic Voyage," t. i. iPill,
filma "Fantastic Voyage," t. i. iPill,
11:03
of "Fantastic Voyage," the iPill.
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to popolnoma integrirano napravo,
ki jo lahko pogoltnete
ki jo lahko pogoltnete
11:05
You can swallow this completely integrated device.
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11:07
It can take pictures of your GI system,
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in bo lahko slikala vaša prebavila.
11:09
help diagnose and treat as it moves through your GI tract.
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Pomagala bo diagnostiki in zdravljenju,
potujoč skozi vaša prebavila.
potujoč skozi vaša prebavila.
11:12
We get into even smaller micro-robots
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Prišli smo do še manjših mikrorobotov,
11:14
that will eventually autonomously move through your system again
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ki se bodo sčasoma samostojno
premikali skozi vaš sistem
premikali skozi vaš sistem
11:16
and be able to do things that surgeons can't do
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in delali stvari,
ki jih kirurgi ne morejo početi,
ki jih kirurgi ne morejo početi,
11:18
in a much less invasive manner.
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veliko manj invazivno.
11:20
Sometimes these might self-assemble in your GI system
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Včasih se bodo lahko sami sestavili
v vaših prebavilih
v vaših prebavilih
11:23
and be augmented in that reality.
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in se obogatili v tem okolju.
11:25
On the cardiac side, pacemakers are getting smaller
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Glede srca, spodbujevalniki so vse manjši
in jih je veliko lažje vstaviti,
in jih je veliko lažje vstaviti,
11:27
and much easier to place
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torej ni treba usposabljati
interventnega kardiologa.
interventnega kardiologa.
11:29
so you don't need to train an interventional cardiologist to place them.
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11:31
And they're going to be wirelessly telemetered again to your mobile devices
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Brezžično se bodo povezali
z vašimi mobilnimi napravami,
z vašimi mobilnimi napravami,
11:34
so you can go places and be monitored remotely.
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da vas bodo lahko spremljali na daljavo.
11:37
These are shrinking even further.
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Velikosti se še naprej krčijo.
11:39
Here's one that's in prototyping by Medtronic that's smaller than a penny.
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Tukaj je prototip Medtronica,
ki je manjši od penija.
ki je manjši od penija.
11:42
Artificial retinas, the ability to put these arrays on the back of the eyeball
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Umetna mrežnica, ki se lahko vgradi
na zadnjo stran očesnega zrkla
na zadnjo stran očesnega zrkla
11:45
and allow the blind to see.
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in omogoča slepim, da vidijo.
11:47
Again, in early trials, but moving into the future.
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Čeprav v zgodnjih preizkušanjih,
a gre v prihodnost.
a gre v prihodnost.
11:49
These are going to be game changing.
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To bo popolna sprememba.
Ali pa za tiste med nami z dioptrijo,
11:51
Or for those of us who are sighted,
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kako se vam zdijo
vseživljenjske kontaktne leče?
vseživljenjske kontaktne leče?
11:53
how about having the assisted-living contact lens?
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BlueTooth, WiFi so na voljo -
teleportirajo žarke nazaj na oko.
teleportirajo žarke nazaj na oko.
11:55
BlueTooth, WiFi available -- beams back images to your eye.
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11:58
Now if you have trouble maintaining your diet,
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Zdaj, če imate težave
z vzdrževanjem diete,
z vzdrževanjem diete,
12:01
it might help to have some extra imagery
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lahko pomagajo dodatne podobe,
12:03
to remind you how many calories are going to be coming at you.
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da vas spomnijo,
koliko kalorij boste zaužili.
koliko kalorij boste zaužili.
12:07
How about enabling the pathologist to use their cell phone again
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Kaj, če bi patologa opremili,
da preko svojega mobilnega telefona
da preko svojega mobilnega telefona
12:09
to see at a microscopic level
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vidi na mikroskopski ravni
12:11
and to lumber that data back to the cloud and make better diagnostics?
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in da te podatke vrne
v oblak, da bi boljše diagnosticiral?
v oblak, da bi boljše diagnosticiral?
12:14
In fact, the whole era of laboratory medicine
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V bistvu se celotna era laboratorijske
medicine popolnoma spreminja.
medicine popolnoma spreminja.
12:16
is completely changing.
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12:18
We can now leverage microfluidics,
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Sedaj lahko izkoristite
mikrofluidne naprave
mikrofluidne naprave
12:20
like this chip made by Steve Quake at Stanford.
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kot je ta čip, ki ga je naredil
Steve Quake na Stanfordu.
Steve Quake na Stanfordu.
12:22
Microfluidics can replace an entire lab of technicians.
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Mikrofluidiki lahko nadomestijo
cel laboratorij tehnikov.
cel laboratorij tehnikov.
12:25
Put it on a chip, enable thousands of tests to be done
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Na čipu omogočajo,
da se naredi na tisoče testov
da se naredi na tisoče testov
12:27
at the point of care, anywhere in the world.
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na točki oskrbe, kjerkoli na svetu.
12:29
And this is really going to leverage technology
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In to bo res tehnološki vzvod
12:31
to the rural and the under-served
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na podeželju in za
nezadostno preskrbljene,
nezadostno preskrbljene,
12:33
and enable what used to be thousand-dollar tests to be done at pennies
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ker bodo testi, včasih vredni 1.000 $,
narejeni za nekaj penijev
narejeni za nekaj penijev
12:35
and at the point of care.
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in to na kraju oskrbe.
12:37
If we go down the small pathway a little bit farther,
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Če gremo po poti majhnosti malo dlje,
vstopamo v ero nanomedicine,
vstopamo v ero nanomedicine,
12:40
we're entering the era of nanomedicine,
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12:42
the ability to make devices super small
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možnosti izdelave super majhnih naprav,
12:44
to the point where we can design red blood cells
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do točke, ko bomo lahko oblikovali
rdeče krvne celice
rdeče krvne celice
12:46
or microrobots that will monitor our blood system or immune system,
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ali mikro robote, ki bodo nadzirali
naš krvni ali imunski sistem,
naš krvni ali imunski sistem,
12:49
or even those that might clear out the clots from our arteries.
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ali celo takšne, ki bodo zmogli
očistiti strdke v naših žilah.
očistiti strdke v naših žilah.
12:52
Now how about exponentially cheaper?
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Kaj če bi bilo skokovito cenejše?
12:54
Not something we usually think about in the era of medicine,
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To ni nekaj,
kar se običajno pomisli v eri medicine,
kar se običajno pomisli v eri medicine,
12:57
but hard disks used to be 3,400 dollars for 10 megabytes -- exponentially cheaper.
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ampak trdi diski, nekoč po 3.400 $
za 10 megabajtov, so skokovito cenejši.
za 10 megabajtov, so skokovito cenejši.
13:00
In genomics now,
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V genomiki so bili stroški genoma
okoli milijarde dolarjev
okoli milijarde dolarjev
13:02
the genome cost about a billion dollars
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13:04
about 10 years ago when the first one came out.
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pred približno 10 leti,
ko se je pojavil.
ko se je pojavil.
13:06
We're now approaching essentially a thousand-dollar genome --
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Zdaj se približujemo
genomu po 1.000 $ -
genomu po 1.000 $ -
13:08
probably next year to two years, probably a hundred-dollar genome.
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verjetno naslednje leto,
ali v dveh letih po 100 $.
ali v dveh letih po 100 $.
13:10
What are we going to do with hundred-dollar genomes?
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Kaj bomo naredili s stodolarskimi genomi?
13:13
And soon we'll have millions of these tests available.
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In kmalu bomo imeli
na milijone teh testov.
na milijone teh testov.
13:15
And that's when it gets interesting, when we start to crowdsource that information.
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In takrat postane zanimivo, ko bomo
začeli s crowdsourcingom teh informacij.
začeli s crowdsourcingom teh informacij.
13:18
And we enter the era of true personalized medicine --
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Vstopili bomo v ero osebne medicine -
13:20
the right drug for the right person at the right time --
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pravo zdravilo
za pravo osebo ob pravem času -
za pravo osebo ob pravem času -
namesto tega, kar danes dajemo -
enako zdravilo vsem -
enako zdravilo vsem -
13:23
instead of what we're doing today, which is the same drug for everybody --
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neke vrste uspešnice zdravil,
13:26
sort of blockbuster drug medications,
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zdravil, ki ne delajo za vas osebno.
13:28
medications which don't work for you, the individual.
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In mnogo različnih podjetij
dela na spodbujanju teh pristopov.
dela na spodbujanju teh pristopov.
13:30
And many, many different companies are working on leveraging these approaches.
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13:33
And I'll also show you a simple example, from 23andMe again.
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Prikazal vam bom preprost primer
podjetja 23andMe.
podjetja 23andMe.
13:35
My data indicates that I've got about average risk
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Moji podatki kažejo,
da imam povprečno tveganje
da imam povprečno tveganje
13:38
for developing macular degeneration, a kind of blindness.
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za razvoj procesa degeneracije makule,
neke vrste slepote.
neke vrste slepote.
13:40
But if I take that same data, upload it to deCODEme,
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A če vzamem iste podatke
in jih naložim na deCODEme podjetje,
in jih naložim na deCODEme podjetje,
13:43
I can look at my risk for sample type 2 diabetes.
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lahko vidim svoje tveganje
za diabetes tipa 2.
za diabetes tipa 2.
13:45
I'm at almost twice the risk for type 2 diabetes.
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Imam skoraj dvakrat večje tveganje
za diabetes tipa 2.
za diabetes tipa 2.
13:47
I might want to watch how much dessert I have at the lunch break for example.
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Mogoče bi želel paziti,
koliko sladic lahko pojem za kosilo.
koliko sladic lahko pojem za kosilo.
13:50
It might change my behavior.
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To lahko spremeni moje vedenje.
13:52
Leveraging my knowledge of my pharmacogenomics --
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Z izkoriščanjem znanja
o svoji farmakogenomiki -
o svoji farmakogenomiki -
13:54
how my genes modulate, what my drugs do and what doses I need
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kako moji geni modulirajo,
učinke in odmerke mojih zdravil
učinke in odmerke mojih zdravil
13:57
are going to become increasingly important,
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bo postalo izredno pomembno
13:59
and once in the hands of the individual and the patient,
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in ko bo enkrat v rokah
posameznika in bolnika,
posameznika in bolnika,
14:01
will make better drug dosing and selection available.
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bo boljše odmerjanje in izbor zdravila.
14:04
So again, it's not just genes, it's multiple details --
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Torej še enkrat, ne gre samo za gene,
ampak za različne podrobnosti -
ampak za različne podrobnosti -
14:07
our habits, our environmental exposure.
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za naše navade,
našo okoljsko izpostavljenost.
našo okoljsko izpostavljenost.
14:09
When was the last time your physician asked you where you've lived?
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Kdaj vas je zdravnik
nazadnje vprašal, kje živite?
nazadnje vprašal, kje živite?
14:12
Geomedicine: where you've lived, what you've been exposed to,
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Geomedicina: kje ste živeli,
čemu ste bili izpostavljeni,
čemu ste bili izpostavljeni,
14:14
can dramatically affect your health.
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lahko močno vpliva na vaše zdravje.
Lahko ujamemo te informacije.
Lahko ujamemo te informacije.
14:16
We can capture that information.
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14:18
So genomics, proteomics, the environment,
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Torej genomika, proteomika, okolje,
vsi ti podatki se zlivajo k nam
posamično in mi, kot ubogi zdravniki,
posamično in mi, kot ubogi zdravniki,
14:20
all this data streaming at us individually and us, as poor physicians,
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14:22
how do we manage it?
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kako lahko to obvladamo?
14:24
Well we're now entering the era of systems medicine, or systems biology,
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Vstopamo v ero sistemske medicine
ali sistemske biologije,
ali sistemske biologije,
14:27
where we can start to integrate all of this information.
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kjer bomo lahko začeli
integrirati vse te informacije.
integrirati vse te informacije.
14:29
And by looking at the patterns, for example, in our blood
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In na vzorcih, na primer v naši krvi,
10.000 biomarkerjev v enem testu,
14:32
of 10,000 biomarkers in a single test,
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14:34
we can start to look at these little patterns
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lahko začnemo gledati te majhne vzorce
14:36
and detect disease at a much earlier stage.
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in bolezni bomo odkrili veliko prej.
14:38
This has been called by Lee Hood, the father of the field,
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To je imenovano po Lee Hoodu,
očetu področja, P4 medicina.
očetu področja, P4 medicina.
14:40
P4 medicine.
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Lahko bomo napovedovali, vedeli bomo
od česa boste verjetno zboleli.
od česa boste verjetno zboleli.
14:42
We're going to be predictive; we're going to know what you're likely to have.
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14:44
We can be preventative; that prevention can be personalized;
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Lahko smo preventivni;
preventiva je lahko personalizirana;
preventiva je lahko personalizirana;
14:47
and more importantly, it's going to become increasingly participatory.
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in še pomembneje,
vedno bolj bo participativna.
vedno bolj bo participativna.
14:49
Through websites like Patients Like Me
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Prek spletnih strani,
kot je Patients Like Me,
kot je Patients Like Me,
14:51
or managing your data on Microsoft HealthVault or Google Health,
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ali z upravljanjem vaših podatkov na
Microsoft HealthVault ali Google Health,
Microsoft HealthVault ali Google Health,
14:54
leveraging this together in participatory ways
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bo izkoriščanje tega na participativni
način postalo izredno pomembno.
način postalo izredno pomembno.
14:56
is going to become increasingly important.
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14:58
So I'll finish up with exponentially better.
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Končal bom s skokovito na boljše.
15:00
We'd like to get therapies better and more effective.
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Radi bi dobili boljše
in učinkovitejše terapije.
in učinkovitejše terapije.
15:02
Now today we treat high blood pressure mostly with pills.
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Danes zdravimo visok krvni tlak
predvsem s tabletami.
predvsem s tabletami.
15:04
What if we take a new device
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Kaj pa, če vzamemo novo napravo
15:06
and knock out the nerve vessels that help mediate blood pressure
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in nokavtiramo živčne prenašalce,
ki pomagajo uravnavati krvni tlak,
ki pomagajo uravnavati krvni tlak,
15:09
and in a single therapy to cure hypertension?
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in v eni terapiji ozdravimo hipertenzijo?
15:12
This is a new device that is essentially doing that.
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To je nova naprava, ki,
pravzaprav, to dela.
pravzaprav, to dela.
15:14
It should be on the market within a year or two.
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Na trgu bo v letu ali dveh.
15:16
How about more targeted therapies for cancer?
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Kaj, če bo več ciljnih terapij za rak?
15:18
Right, I'm an oncologist
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Da, jaz sem onkolog
in moram reči, večina tega,
kar dajemo, je v bistvu strup.
kar dajemo, je v bistvu strup.
15:20
and I have to say most of what we give is actually poison.
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15:22
We've learned at Stanford and other places
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Na Stanfordu in drugje smo se naučili,
15:24
that we can discover cancer stem cells,
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da lahko odkrijemo
izvorne rakave celice,
izvorne rakave celice,
15:26
the ones that seem to be really responsible for disease relapse.
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tiste, ki se zdijo res odgovorne
za ponovitev bolezni.
za ponovitev bolezni.
15:29
So if you think of cancer as a weed,
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Torej, če razmišljate o raku,
kot o plevelu,
kot o plevelu,
15:31
we often can whack the weed away.
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se pogosto lahko znebimo plevela.
15:33
It seems to shrink, but it often comes back.
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Zdi se, da se skrči,
vendar se pogosto vrne.
vendar se pogosto vrne.
15:35
So we're attacking the wrong target.
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Torej napadamo napačno tarčo.
15:37
The cancer stem cells remain,
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Matične celice raka ostanejo
in tumor se lahko vrne
čez nekaj mesecev ali let.
čez nekaj mesecev ali let.
15:39
and the tumor can return months or years later.
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15:41
We're now learning to identify the cancer stem cells
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Zdaj se učimo identificirati
izvorne celice raka
izvorne celice raka
in, ko jih prepoznamo kot tarče,
gremo na dolgoročno zdravilo.
gremo na dolgoročno zdravilo.
15:44
and identify those as targets and go for the long-term cure.
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15:46
And we're entering the era of personalized oncology,
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In prehajamo v dobo osebne onkologije
15:48
the ability to leverage all of this data together,
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z možnostjo uporabe
vseh teh podatkov skupaj,
vseh teh podatkov skupaj,
15:50
analyze the tumor and come up with
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analize tumorja in določanja
15:52
a real, specific cocktail for the individual patient.
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pravega, posebnega koktajla
za posameznega bolnika.
za posameznega bolnika.
15:55
Now I'll close with regenerative medicine.
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Zaključil bom s regenerativno medicino.
15:57
So I've studied a lot about stem cells --
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Veliko sem študiral o matičnih celicah -
15:59
embryonic stem cells are particularly powerful.
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embrionalne matične celice
so še posebej močne.
so še posebej močne.
16:01
We also have adult stem cells throughout our body.
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Imamo tudi odrasle matične celice.
16:03
We use those in my field of bone marrow transplantation.
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Te uporabljamo na mojem področju
presaditev kostnega mozga.
presaditev kostnega mozga.
16:05
Geron, just last year, started the first trial
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Lansko leto je Geron
začel prvo preizkušanje
začel prvo preizkušanje
16:07
using human embryonic stem cells
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z uporabo izvornih celic
človeških zarodkov
človeških zarodkov
16:09
to treat spinal cord injuries.
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za zdravljenje poškodb hrbtenjače.
16:11
Still a Phase I trial, but evolving.
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Še vedno v prvi fazi preizkušanja,
ampak se razvija.
ampak se razvija.
16:13
We've been actually using adult stem cells
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Uporabljali smo izvorne celice odraslih,
16:15
now in clinical trials for about 15 years
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ki so v kliničnih preskušanjih
približno 15 let,
približno 15 let,
16:17
to approach a whole range of topics, particularly in cardiovascular disease.
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da pristopimo celemu spektru vsebin,
predvsem pri boleznih srca in ožilja.
predvsem pri boleznih srca in ožilja.
16:20
We take our own bone marrow cells
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Vzamemo lastne celice kostnega mozga
in zdravimo bolnika s srčnim napadom,
in zdravimo bolnika s srčnim napadom,
16:22
and treat a patient with a heart attack,
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16:24
we can see much improved heart function and actually better survival
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lahko vidimo zelo izboljšano delovanje
srca in boljše preživetje
srca in boljše preživetje
16:27
using our own bone marrow drive cells after a heart attack.
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z uporabo lastne pogonske celice
kostnega mozga po srčnemu napadu.
kostnega mozga po srčnemu napadu.
16:30
I invented a device called the MarrowMiner,
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Izumil sem t. i. MarrowMiner, ki dosti
manj invazivno nabira kostni mozeg.
manj invazivno nabira kostni mozeg.
16:32
a much less invasive way for harvesting bone marrow.
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16:34
It's now been FDA approved,
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Zdaj jo je FDA odobrila in upam,
da bo prišla na trg naslednje leto.
da bo prišla na trg naslednje leto.
16:36
and it'll hopefully be on the market in the next year or so.
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16:38
Hopefully you can appreciate the device there
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Upam, da boste lahko občudovali,
kako se naprava krivi skozi bolnikovo telo
kako se naprava krivi skozi bolnikovo telo
16:40
curving through the patient's body and removing the patient's bone marrow,
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in odstranjuje kostni mozeg,
namesto z 200 punkcijami,
namesto z 200 punkcijami,
16:42
instead of with 200 punctures, with just a single puncture under local anesthesia.
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z eno samo punkcijo
pod lokalno anestezijo.
pod lokalno anestezijo.
16:45
But where is stem cell therapy really going?
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Kam v resnici gre zdravljenje
z matičnimi celicami?
z matičnimi celicami?
16:47
If you think about it, every cell in your body has the same DNA
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Če pomislite, vsaka celica v telesu ima
enako DNK, kot ste jo imeli kot zarodek.
enako DNK, kot ste jo imeli kot zarodek.
16:50
as you had when you were an embryo.
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16:52
We can now reprogram your skin cells
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Sedaj lahko reprogramiramo
vaše kožne celice,
vaše kožne celice,
16:54
to actually act like a pluripotent embryonic stem cell
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da delujejo kot pluripotentne
embrionalne matične celice
embrionalne matične celice
16:57
and to utilize those potentially to treat multiple organs in that same patient --
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in jih lahko uporabljamo za
zdravljenje več organov v istem bolniku -
zdravljenje več organov v istem bolniku -
17:00
making your own personalized stem cell lines.
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za izdelavo vaše lastne,
osebne linije izvornih celic.
osebne linije izvornih celic.
17:02
And I think they'll be a new era of your own stem cell banking
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Mislim, da bo nova era
lastnih bank za hrambo matičnih celic,
lastnih bank za hrambo matičnih celic,
17:05
to have in the freezer your own cardiac cells,
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da boste imeli v zamrzovalniku lastne
srčne celice, miocite in nevronske celice,
srčne celice, miocite in nevronske celice,
17:07
myocytes and neural cells
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17:09
to use them in the future, should you need them.
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za primer, če jih boste potrebovali.
In sedaj to integriramo
s celotno ero mobilnega inženiringa
s celotno ero mobilnega inženiringa
17:12
And we're integrating this now with a whole era of cellular engineering,
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17:14
and integrating exponential technologies
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in integriramo skokovite tehnologije
za tiskanje 3D organov -
za tiskanje 3D organov -
17:16
for essentially 3D organ printing --
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17:18
replacing the ink with cells
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nadomeščamo črnilo s celicami
17:20
and essentially building and reconstructing a 3D organ.
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in pravzaprav gradimo
in rekonstruiramo 3D organ.
in rekonstruiramo 3D organ.
17:23
That's where things are going to head -- still very early days.
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Stvari bodo šle v to smer
- še zelo zgodnje obdobje.
- še zelo zgodnje obdobje.
17:25
But I think, as integration of exponential technologies,
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Ampak mislim, da je za vključevanje
eksponentnih tehnologij, to primer.
eksponentnih tehnologij, to primer.
17:27
this is the example.
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17:29
So in close, as you think about technology trends
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Tako na koncu,
ko mislite o tehnoloških trendih
ko mislite o tehnoloških trendih
17:32
and how to impact health and medicine,
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in kako vplivajo na zdravje in medicino,
17:34
we're entering an era of miniaturization,
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vstopamo v ero miniaturizacije,
17:36
decentralization and personalization.
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decentralizacije in personalizacije.
17:38
And I think by pulling these things together,
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Če te stvari združimo,
17:40
if we can start to think about how to understand and leverage these,
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lahko začnemo razmišljati,
kako jih razumeti in uporabiti,
kako jih razumeti in uporabiti,
17:42
we're going to empower the patient,
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bomo opolnomočili bolnika,
17:44
enable the doctor, enhance wellness
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opremili zdravnika,
izboljšali dobro počutje
izboljšali dobro počutje
17:46
and begin to cure the well before they get sick.
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in začeli z zdravljenjem,
še preden zbolijo.
še preden zbolijo.
17:49
Because I know as a doctor, if someone comes to me with Stage I disease,
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Ker kot zdravnik vem, če nekdo
pride k meni z začetno stopnjo bolezni,
pride k meni z začetno stopnjo bolezni,
17:52
I'm thrilled -- we can often cure them.
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sem navdušen -
pogosto jih lahko ozdravimo.
pogosto jih lahko ozdravimo.
17:54
But often it's too late and it's Stage III or IV cancer, for example.
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Toda pogosto je prepozno
in je stopnja III ali IV raka, na primer.
in je stopnja III ali IV raka, na primer.
17:57
So by leveraging these technologies together,
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S skupnim izkoriščanjem teh tehnologij,
mislim, da bomo vstopili v novo ero,
mislim, da bomo vstopili v novo ero,
17:59
I think we'll enter a new era
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18:01
that I like to call Stage 0 medicine.
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ki ji rad rečem Medicina na stopnji 0.
18:03
And as a cancer doctor, I'm looking forward to being out of a job.
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In kot onkologa me veseli,
da bom ostal brez službe.
da bom ostal brez službe.
18:06
Thanks very much.
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Hvala lepa.
18:09
Host: Thank you. Thank you.
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Gostiteljica: Hvala. Hvala.
18:11
(Applause)
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(Aplavz)
18:13
Take a bow. Take a bow.
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Poklon. Poklon.
ABOUT THE SPEAKER
Daniel Kraft - Physician scientistDaniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine.
Why you should listen
Dr. Daniel Kraft is a Stanford and Harvard trained physician-scientist with more than 25 years of experience in clinical practice, biomedical research and innovation. He is Faculty Chair for Medicine at Singularity University and is the founder and chair for Exponential Medicine, a program which explores convergent, rapidly developing technologies and their potential to reshape the future of health and biomedicine.
After medical school at Stanford, Kraft was board certified in both Internal Medicine and Pediatrics following residency at the Massachusetts General Hospital & Boston Children's Hospital, and he completed Stanford fellowships in hematology/oncology & bone marrow transplantation. He is a member of the inaugural class of Aspen Institute Health Innovators Fellows.
Kraft has extensive research in stem cell biology and regenerative medicine with multiple scientific publications, medical device, immunology and stem cell-related patents through faculty positions with Stanford University School of Medicine and as clinical faculty for the pediatric bone marrow transplantation service at University of California San Francisco.
Kraft recently founded IntelliMedicine, focused on connected, data-driven and integrated personalized medicine. He is the inventor of the MarrowMiner, an FDA-approved device for the minimally invasive harvest of bone marrow, and he founded RegenMed Systems, a company developing technologies to enable adult stem cell-based regenerative therapies. He is an advisor the XPRIZE (having conceived of the Medical Tricorder XPRIZE and is helping lead a new Cancer focused prize), and advises several digital health and technology companies.
Kraft is an avid pilot and served for 14 years as an officer and flight surgeon with F-15 and F-16 fighter squadrons in the Air National Guard. He has conducted research on aerospace medicine that was published with NASA, with whom he was a finalist for astronaut selection.
Daniel Kraft | Speaker | TED.com