TIME reviews the advances
and setbacks - from AIDS cocktails to zinc supplements - that
made 2000 such a remarkable year for patients and doctors alike.
A
AIDS
Efforts to quell the epidemic took three steps forward and
one step back this year. The first human trials of a vaccine
against African strains of HIV began in Kenya and England.
The FDA approved a new anti-HIV drug. And leaders of developing
nations, in which 95% of aids cases occur, pledged more funding
to fight the economic and social devastation caused by the
disease. But South African President Thabo Mbeki sounded a
sour note when he openly questioned whether HIV causes aids.
That prompted more than 5,000 scientists to sign a declaration
decrying the waste of valuable time and resources arguing
over a well-established scientific fact. Mbeki reportedly
remains unconvinced but has stopped talking about it publicly.
Alzheimer's Disease
Scientists began safety testing the first drug designed to
tackle the root cause rather than the symptoms of this brain-addling
disease. Patients in the early stages of Alzheimer's were
given a gamma secretase inhibitor, a compound that blocks
the formation of the sticky plaques that gum up the brain's
neural connections. So far, the drug seems to have been well
tolerated.
B
Breasts
Back in 1992, NIH scientists were asked by Congress to study
the safety of silicone breast implants. The first part of
their investigation, completed in November, studied breast-cancer
rates in 13,500 women who had breast implants (most of them
silicone) and 4,000 who did not. Results: the implant patients
showed no added risk for breast cancer when compared with
the controls. Researchers warn, however, that further studies
are needed to determine whether the implants are linked to
other cancers or connective-tissue disorders.
C
Cell Phones
Do they or don't they cause brain cancer? After a handful
of studies yo-yoed back and forth on the answer, the Cellular
Telephone Industry Association tried to seize control of the
uncertainty this summer and, they hoped, pre-empt any future
lawsuits. (Noted class-action attorneys have already joined
an $800 million suit against Motorola.) The association suggested
that cell-phone manufacturers voluntarily disclose radiation
levels emitted by each unit's antenna. Meanwhile, those who
walk and talk at the same time can take solace; the latest
studies find no increased risk of brain tumors. But please
note: the studies followed users for only two to three years
and were partly funded by an organization of cell-phone manufacturers.
Chromosones
The human genome may have dominated the news last year, but
mouse geneticists were busy too. They created an artificial
mouse chromosome and, for the first time, showed that it could
be passed from parent to offspring. If the same holds true
in people, inherited genetic diseases may someday be corrected
by injecting parents with man-made chromosomes.
Colon Cancer
Colorectal cancer is the third deadliest cancer in the U.S.,
and last April the FDA gave the 130,000 people in whom it
is diagnosed each year some much needed help. It ruled that
Camptosar, in use since 1999 as a second-line treatment, was
potent enough in combination with other chemotherapy agents
to now be used as a first-line therapy, even in advanced cases.
Corneas
There aren't many treatments for a scarred cornea, the opaque
outer layer of the eye, since corneal tissue can't be easily
replaced. But it may be possible to grow a new one. Doctors
have successfully transplanted tissue from other parts of
the eye to reconstruct the cornea and restore sharper sight
to a handful of patients.
CPR
In case of a heart attack, standard cardiopulmonary resuscitation
(CPR) procedure calls for alternating mouth-to-mouth resuscitation
with carefully counted chest compressions. A study of emergency
medical technicians demonstrated, however, that chest compressions
alone may be enough. Survival rates of heart-attack victims
were the same whether they were given CPR or chest compressions
alone.
D
Defibrillators
Heart patients may rest easier knowing that the cardiac jump-start
that might save their lives is in the next room. Agilent Technologies,
based in Palo Alto, Calif., and CVS.com last year launched
Heartstream, the first defibrillator available directly to
consumers with a doctor's prescription.
Diabetes
It's getting easier for diabetics to keep tabs on the ups
and downs of their glucose levels. The first fully automated
monitoring device - one press of a button pricks, analyzes
blood and provides results - has been approved by the FDA.
Still in the works is an infrared system that measures glucose
levels by scanning the tongue.
DNA
Want
to join the genetic revolution?Fill out a questionnaire and
provide a blood sample and you can donate your DNA for genetic-disease
research at www.DNA.com. Run by DNA Sciences, the site has
drawn 4,500 volunteers so far and is hoping for a total of
100,000 samples.
E
Estrogen
It still soothes hot flashes and protects your bones, but
two major studies showed that taking estrogen long after menopause
may not benefit the heart. In fact, the potent female hormone
may slightly increase the risk of suffering a heart attack
in some women. A long-term study is expected to produce a
definitive answer sometime during the next five years or so.
Until then, women with high cholesterol levels should get
plenty of exercise, limit the amount of saturated fat in their
diet and listen carefully if their physician suggests taking
a cholesterol-lowering drug.
F
FastPack
As
if undergoing treatment for prostate cancer weren't bad enough,
men usually have to wait up to a week for blood tests to determine
whether or not their tumor has returned. In June the FDA approved
FastPack, an automated blood analyzer designed by Qualigen
of Carlsbad, Calif., that measures in as little as 15 minutes
the level of prostate-specific antigen found in a blood sample.
The FDA concluded, however, that there weren't enough data
to approve FastPack as a screening tool for the general population
as well.
Fatty Fish
Remember good cholesterol and bad cholesterol? It turns out there are good fats
and bad fats too - although all fats still contain nine calories per gram. Health
experts are increasingly intrigued by a group of good fats called omega-3 fatty
acids, and what's good about them is that they lower the level of triglycerides
(one of the bad fats) and decrease the risk of suffering a blood clot. Salmon,
sardines and tuna are so full of omega-3 fatty acids that the American Heart
Association for the first time recommended that everyone eat two 3-oz. servings
of fatty fish each week.
Fiber
Three
big studies concluded that a diet rich in fiber - found in
whole-grain cereals, fruits and vegetables - won't necessarily
protect you against colon cancer. Study participants who consumed
as much as 35 g of fiber a day were just as likely to develop
precancerous growths in the intestines as those who were addicted
to processed food. But fiber still has its benefits: it helps
lower blood pressure, moderates cholesterol levels and combats
type II (adult-onset) diabetes.
G
Gene Therapy
Programs
in several medical centers were either put on hold or severely
restricted following the 1999 death of Jesse Gelsinger, 18,
the first American known to have died as a direct result of
gene therapy, an attempt to replace defective genes with normal
ones. Meanwhile, doctors in France successfully used gene
therapy to treat four infants suffering from a congenital
immune disorder.
Genetically Modified
Foods
Millions of bushels of genetically modified
corn, approved for animal feed but not for human consumption,
turned up in Taco Bell taco shells and other food products.
Though most of the food was recalled before it was eaten,
the high-tech mix-up increased public skepticism about so-called
Frankenfoods. In the meantime, public-health experts still
have high hopes for golden rice, a strain that's genetically
enriched with a precursor of vitamin A and that could help
prevent blindness in hundreds of thousands of children in
impoverished countries each year.
Genome
Five years ahead of schedule, scientists announced that they had sequenced the
3.1 billion pairs of biochemical "letters" of human DNA, the coded instructions for
building and operating a fully functional human. Fierce rivalry between J. Craig
Venter, the prickly head of a private genetics company, and Dr. Francis Collins,
leader of a government consortium, fueled the lightning-fast pace.
H
Heart
A
powerful new clot-busting drug, tenecteplase, reduced treatment
time for heart-attack victims from 90 minutes to just five
seconds. Clinical trials showed the drug to be as effective
as the standard clot buster t-PA and easier to use since it
can be administered in one quick injection instead of an hour-and-a-half
infusion. Tenecteplase, which was approved by the FDA last
June, is also longer acting and specifically targets blood
clots, rather than indiscriminately thinning the blood. Good
news for the more than 1.1 million Americans each year who
suffer a heart attack.
L
Lung Cancer
Researchers
were pleased to find that a diet rich in fruits and veggies
reduced the risk - at least in women - of the No. 1 cancer
killer in the U.S. Apples, pears, cauliflower and grapefruit
were particularly active against the incidence of lung cancer
for reasons are that are still unclear (although scientists
suspect carotenoids may be powerful anticarcinogens). But
the bottom line is that no quantity of cabbages or citrus
fruits can outweigh the benefits of quitting smoking.
M
MRI
A
new form of noninvasive "black blood" magnetic-resonance-imaging
technique allows doctors to detect problem spots in carotid
arteries, the aorta and coronary arteries before patients
develop symptoms of atherosclerosis or stroke. The high-resolution
MRI blacks out blood flow, offering doctors a clear view of
the blood vessels and allowing them to precisely measure the
thickness of their walls. Though the black-blood technique
still needs improvement, doctors hope the technology will
eventually identify those at risk of heart attack long before
they have one.
N
Nerve
TransplantIn a surgical first, Houston doctors
transplanted nerves from a living donor to her infant son.
To repair torn nerves in eight-month-old Rodrigo Cervantes
Corona's left shoulder and arm, doctors took 3 ft. of neural
tissue from his mother's legs and tracked it from the right
side of his body to his left hand. The transplanted nerves
act as a conduit to allow the baby's undamaged right-hand
nerves to grow over to his left side. The mother will feel
a bit of numbness on each side of her feet for the rest of
her life.
P
Parkinson's Disease
In
an important step forward for both Parkinson's research and
the struggling field of gene therapy, scientists in Chicago
used a gene that boosts dopamine production and strengthens
brain cells to successfully treat monkeys showing symptoms
of the neurodegenerative disorder. By injecting a virus containing
the GDNF (glial-derived neurotrophic factor) gene directly
into monkeys' brains, scientists stimulated cell growth in
areas normally injured by Parkinson's and reduced symptoms
of the disease, such as hand tremors. Although success in
primates doesn't mean success in humans, researchers hope
to start clinical trials in humans within five years.
Polio
Last
spring a strain of wild polio virus was unexpectedly discovered
in the sewage system of Strasbourg, France. It's likely that
the virus, considered extinct in that country, had instead
escaped from one of Strasbourg's many biomedical laboratories.
Still, the appearance of wild polio in a certified polio-free
region undermined World Health Organization plans to eliminate
universal vaccination once it declares polio eradicated, which
it had hoped to do by 2005. Widespread on five continents,
including the Americas, Europe and Asia, through the late
1980s, polio has now been contained mostly to parts of subSaharan
Africa and the Indian subcontinent.
PPA
After decades of use as a decongestant and a weight-loss drug,
a six-year study showed that the amphetamine-like stimulant
phenyl-propanolamine (ppa) increases the risk of hemorrhagic
stroke, especially in young women. The FDA subsequently deemed
it unsafe and asked manufacturers to pull medications containing
ppa off pharmacy shelves. ppa has been on the market since
the mid-1930s, and consumers take 6 billion doses of it annually,
in such products as Alka-Seltzer, Robitussin, Dexatrim and
Tavist-D. Though ppa is widely used in many popular cold and
diet pills, medications with the safer alternative pseudoephedrine
are easy to find.
R
Ritalin
For millions of children who suffer from with attention deficit
hyperactivity disorder (adhd), drugs like Ritalin have been
a godsend. Yet at the same time there is real concern that
the use of Ritalin to curb all manner of fidgety behavior
has become too casual and that the drug is actually being
abused as a performance booster. A Duke University study suggested
that the drug is, in fact, both over- and underprescribed.
The Duke team found that 25% of kids with confirmable adhd
are not getting the drug, while more than half of kids who
are taking the drug should not.
RU-486
It
was a long time coming, but finally, 12 years after its debut
in France, RU-486 (mifepristone) was approved by the FDA,
and the controversial "abortion pill" hit American shores.
Did it change our world? Not yet. Abortion foes are campaigning
against physicians who prescribe it, and even some doctors
point out that an RU-486-induced abortion is expensive (the
pills alone cost $240) and not as effective as the surgical
procedure. Still, expect the drug to have a growing, if gradual,
impact.
S
Stem Cells
With
their uncanny ability to morph into any type of cell - from
skin to bone and everything in between - stem cells cast a
mighty spell on medical researchers who dream of using them
to treat a whole range of intractable diseases. But because
of religious opposition and fears that embryos - the best
source of stem cells - could become a kind of cash crop, U.S.
scientists have been largely shut out of this promising field.
New NIH guidelines, however, have reversed the earlier ban
and now allow federally funded researchers to use embryonic
stem cells as long as they are not sold for profit and come
from such sources as embryos discarded from in vitro fertility
treatments.
T
Testosterone
It
puts hair on your chest and a rocket in your pocket and is
credited - and blamed - for everything from rape to the urge
to explore new worlds. Four million men in the U.S. with clinically
low levels take testosterone supplements, and lately it's
also gained popularity as a kind of youth boost for both men
and women. A new topical formulation, marketed as AndroGel,
will it easier for legitimate users to take the hormone. AndroGel
may also expand its use for medically dubious reasons.
V
Verteporfin
ge-related macular degeneration (amd) afflicts 13 million
Americans and in its most severe form, characterized by abnormal
growth of blood vessels in the retina, can cause vision loss
or blindness. The first treatment approved for amd, verteporfin,
can slow or halt the most severe form of the disease. The
drug is a photosensitive dye that is activated by a low-intensity
laser and triggers a chemical reaction that destroys the troublesome
vessels.
Virtual Colonoscopy
Despite
Katie Couric's crusade to educate the public about the importance
of screening for colon cancer, there are still too many people
who resist being tested because of discomfort or cost; an
estimated 70% of the population is never screened. A new noninvasive
screening technique may offer those most at risk a lifesaving
alternative. Dubbed virtual colonoscopy, it uses digital data
generated by multiple computer scans to create a high-resolution
3-D image of the intestine, which can then be displayed on
a computer screen and visually probed for tell-tale polyps.
W
Walking
We already knew that walking can reduce adult-onset diabetes
and coronary heart disease. But researchers at Harvard University
have found another good reason to take a hike: to prevent
stroke. According to the Harvard Health Letter, even people
who had been sedentary for much of their life had a lower
stroke risk soon after they started walking regularly. Speed
counts though. For the fastest walkers, the risk reduction
was an impressive 40%. A leisurely stroll does some good,
but the study showed that a brisk pace of three miles per
hour or more is the key - even more important than how far
you walk.
West Nile Virus
In
the second year of a much feared and overpublicized medical
crisis, public-health officials in the Northeast intensified
their campaign against mosquitoes infected with the West Nile
Virus. Spraying programs were launched from Boston to Baltimore,
Md., and wildlife pathologists began searching for clues in
the carcasses of crows, chickens, chipmunks and even a few
bears. Only a handful of human deaths have occurred so far,
but scientists are working hard to figure out how the disease
spreads. Most of what they've gained is a deeper understanding
of mortality among wildlife.
X
Xena
No, not the Warrior Princess, but still perhaps a superhero
in her own right. Xena is a female piglet cloned from fetal-pig
skin cells, and she may prove to be more than the latest addition
to the biotech clone farm. Because of similarities between
porcine and human organs, the techniques that made Xena may
eventually create a supply of genetically modified pig livers
that would be acceptable to the human immune system.
Z
Zinc
Although the conclusions of clinical trials are still split
pretty evenly pro and con, a study from the Annals of Internal
Medicine suggests that folks who have been popping zinc supplements
to ward off colds may be on to something. Zinc seems to reduce
the duration of cold symptoms by four days, provided you start
taking it in the first 24 to 48 hrs. after symptoms appear
and then keep sucking on the lozenges every couple of hours
for several days. Don't overdo it though. Too much zinc can
lower levels of HDL, the "good"cholesterol.