The disruptive medtech M&A of recent years was not matched in the past year for volume, but there were isolated outbreaks of major activity, as shown in our company rankings. 

A preview of the emerging health care companies profiled in the current issue of Start-Up. This month's profile group, "Antibiotics Start-Ups," features profiles of Indel Therapeutics, MicuRx Pharmaceuticals and Trius Therapeutics. Plus these Start-Ups Across Health Care: DFine, NexeonMedSystems, SmartCells and Somnus Therapeutics.

Somnus Therapeutics is developing a timed-release formulation of zaleplon, a GABA agonist that is currently approved for short-term difficulty in falling asleep. According to company, its version of the drug is expected to offer patients an initial two hours of drug-free delta sleep, followed by the controlled release of a short-acting active ingredient, which may allow people to awaken more refreshed and alert.

The recent acquisition of ACMI by Gyrus boosts both companies considerably and creates a powerful competitor in urology, gynecology, and general surgery. But having created critical mass, have they also attracted the attention of much larger companies--threatening both the comfortable niches they occupy and their independence?