The Year In Medicine From A to Z

Not only is the air cleaner in the Centennial State, but the people there also l ive longer. A Harvard study showed that the seven U.S. counties with the greatest average life expectancy--81.3 years--were all in Colorado. (Clear Creek, Eagle, Gilpin, Grand, Jackson, Park and Summit, for those of you thinking about packing a U-Haul.) Exactly what's so special about Colorado is not entirely clear, since the study authors controlled for any bias caused by race or income. Perhaps the residents' good fortune has to do with the fact that they all live in mountainous areas, where being physically active is easy, as opposed to more lowland, sedentary portions of the U.S.

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DDT

Nearly 30 years after phasing out the widespread use of DDT to control malaria, the World Health Organization (WHO) has reversed itself. But instead of authorizing indiscriminate spraying of fields and ponds--which had a disastrous effect on wildlife--the WHO is focusing this time on spraying DDT on the inside walls of homes once or twice a year in malaria-prone areas. Why? DDT is particularly effective at repelling and not just killing mosquitoes, which helps protect enclosed spaces. Environmental organizations aren't thrilled by the idea, but two of the largest have endorsed limited spraying, figuring that some risk to the environment is justified to save human lives.

DEPRESSION

Researchers still don't understand why severely depressed teenagers are more likely than adults to commit suicide while taking antidepressant drugs like Paxil, but a major study out of UCLA concluded that the drugs do more good than harm. Starting in the early 1960s, the annual U.S. suicide rate held fairly steady at 12 to 14 instances per 100,000--until 1988, when the first of a new generation of antidepressants, the selective serotonin reuptake inhibitors, was introduced. The suicide rate has been falling ever since, to around 10 per 100,000. The investigators estimate that nearly 34,000 lives have been saved.

DIABETES

Doctors have long that an active lifestyle and sensible eating habits can help keep people who are at high risk of Type 2 diabetes from developing the condition. But taking diabetes medication before you have symptoms also helps. A study of more than 5,000 prediabetic men and women found that treatment with rosiglitazone, a drug that controls blood-sugar levels, decreased their risk of progressing to diabetes 62%. About half the participants who were given the drug returned to normal blood-sugar levels, compared with 30% of those who relied on diet and exercise alone. About 41 million Americans are thought to be prediabetic.

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ESTROGEN

Things got even more confusing for women considering hormone-replacement therapy. Studies had shown that a combination of estrogen and progesterone increased the risk of breast cancer, heart attack, stroke and blood clots. A new study found that estrogen-only treatments appear safer, with no increase in breast-cancer risk but some increased risk of stroke or clots. A later study found a breast-cancer risk from estrogen therapy, however, among some postmenopausal women. If you must have hormone therapy, get it in small doses for short periods.