The Top 10 Medical Advances of the Decade

Dr. Thomas Coates, of the University of California Los Angeles, pointed out that the HIV death rates still are dropping because of continual HIV research.

"The drop in death rates from HIV in the developed world [is] due to improved medications," Coates said. "There was the 10 percent drop in deaths due to HIV in the U.S. between 2006 and 2007."

In Africa, where the HIV/AIDS crises hits hardest today, Coates said doctors are slowly making progress. One of the most triumphant feats in the past decade has been to use antiretroviral drugs to block mother-to-infant HIV transmission.

"It has made a big difference in the developed world where vertical transmission rates have plummeted from over 1000 at the peak to fewer than 100 per year (in the US)," said Coates. "Advances are being made in the developing world, with Botswana leading the way now with a 3 percent vertical transmission rate. It was the first and still is the most effective prevention strategy we have."


8. Minimally Invasive Techniques Revolutionize Surgery

Ten years ago someone would expect to see a six inch scar after a doctor removed an organ, but new techniques in minimally invasive surgery have virtually eliminated scars from some procedures.

In the late 2000s, doctors at the Cleveland Clinic started using a technique that removed the kidney-through the naval, leaving patients examining their belly buttons in search of a scar after donating their kidney.

Today women can look forward to much shorter recovery times from hysterectomies due to another form of natural orifice surgery. Now doctors can remove the uterus through the vagina, not a large incision in the abdomen.

Medical historian Dr. Sandra Moss could testify to the shortened recovery time from minimally invasive surgery.

"My younger sister and I had the same operation 20 years apart. I was hors de combat (out of commission) for one month and loopy from pain meds for two weeks," Moss said. "She was back at work in a few days on no pain medications."

Doctors also have used robotic surgery to improve the accuracy of procedures, especially in cancer cases.

"Robotic surgery increased the ability of cancer surgeons to get clean margins as well, due to the magnification of the structures," said Dr. Douglas Bacon of the Mayo Clinic in Rochester, Minn.

Dr. Richard Caselli of the Mayo Clinic in Scottsdale, Ariz., pointed out that robotic surgery "offers the potential for surgeons to operate on patients remotely."

But critics, and there are many, say the cost of the robotic hardware may outweigh the benefit. Moreover, critics say that the robot revolution is racing ahead of the evidence.

9. Study Finds Heart, Cancer Risk With Hormone Replacement Therapy

Until July 2002, most doctors treating middle-aged women believed that giving their patients hormones -- either estrogen alone or estrogen combined with progestin -- would protect their hearts from the ravages of age that seemed to attack women after menopause.

Hormone replacement therapy, or HRT, also was thought to be good for the bones, the brain, the skin, the figure and the libido, and was considered the best treatment to control the annoying and sometimes disabling symptoms of menopause such as hot flashes, depression and sleep disturbances.

And then the world changed.

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