The Year In Medicine From A To Z

A

AIDS

When the epidemic first emerged in the West more than 20 years ago, AIDS was circulating primarily among young gay men. Today, a record 39.4 million people, nearly half of them women, are infected with HIV, according to the latest report from the Joint United Nations Program on HIV/AIDS. The virus moved deeper into Asia and Eastern Europe, and new cases arose in every region of the globe, evidence of the need for more effective programs for treatment and prevention, such as halting the transmission from mother to child. Breast feeding accounts for as much as half of new infections among children in Africa, and studies in Thailand found that adding the antiretroviral drug nevirapine to AZT, which is given to HIV-positive women in their last month of pregnancy, cut transmission from 6% to 1%.

OraQuick, a new and faster HIV test that works with saliva as well as blood, may also help control the spread of AIDS. The sooner doctors can detect the infection, the quicker they can begin treatment--which is one of the best ways to keep a local outbreak in check.

ALCOHOL

For the 14 million Americans battling alcoholism, the holiday season--with its office parties and champagne toasts--presents a special challenge. Campral, the first new drug approved by the Food and Drug Administration (FDA) in almost a decade for helping drinkers remain abstinent, could help. Taken as part of an addiction-treatment program that includes psychosocial support, Campral helped 16% to 38% of alcoholics who had already stopped drinking avoid imbibing for up to four months. Unlike current abstinence aids, which either dampen the alcohol high or make people violently ill if they drink, Campral works by restoring nerve activity in the brain's pleasure center that is altered by overindulgence in alcohol. Campral's makers expect it to be available in time for New Year's celebrations.

ARTIFICIAL HEART

A dozen years after Barney Clark received the first experimental artificial heart, the FDA finally approved a similar device for broad use. The CardioWest, which is surgically implanted in the chest, fills in for the heart's pumping chambers, shunting blood throughout the body. But because it remains connected to a power console outside the chest, the device is only a temporary fix, intended to buy time for the sickest patients while they wait for a heart transplant. Still, it has proved effective. Patients put on CardioWest were more than twice as likely to survive for a year, increasing their chance of finding a suitable donor heart. Doctors are testing a fully implantable artificial heart called the AbioCor, but it has not yet been approved by the FDA.

ANTIDEPRESSANTS