THE YEAR IN MEDICINE
There is growing scientific evidence that acupuncture, a pillar of Chinese medicine, can relieve many kinds of pain, but there’s no clear agreement about how it works. That was underscored by a German study of migraines: it found that inserting needles at various acupuncture points in the body relieved pain just as effectively as inserting them in the points that are supposed to affect migraines. Both therapies cut the number of episodes more than 50% over a 12-week period; a control group that did not receive either treatment continued to suffer as before.
This was the year that the World Health Organization (WHO), under the banner of its innovative “3 by 5” campaign, was supposed to put 3 million AIDS patients in the developing world on life-saving antiretroviral drugs, With only a month left in 2005, the WHO is expected to fall short of its goal, but most expert still consider the plan a success, Fourteen of the countries harder hit by the epidemic now provide therapies to at least half their patients who need them. Such aggressive treatment programs are critical as the AIDS virus continues to spread and mutate. The WHO and U.N. last week reported that an estimated 40 million people are HIV-positive, including a record 1 million in the U.S. In New York City, doctors were alarmed to discover a particularly powerful strain of HIV in a sexually active gay man. Resistant to all but one of the classes of anti-AIDS drugs, that fast-working virus appears to lead to full-blown AIDS in a matter of months.
The National Highway, Traffic Safety Administrations boast that inflatable air bags have saved nearly 14,000 lives since 1998, when they were required in all new cars, was challenged by a University of Georgia statistician, By analyzing a random sample of all accidents (rather than just those in which a death occurred), she found that airbags were actually associated with a slightly higher chance of death in an accident. Some of that discrepancy may be attributed to the greater risk of air-bag injuries to children who ride against all advice in the front seat of a car.
One of the most tragic features of this neurological disease is the way patients slip away, slowly losing memory and other brain function over a span of years. Now there is evidence that the long goodbye of Alzheimer’s may begin even earlier than doctors suspected. A Swedish analysis of nearly 50 studies of the condition found that patients who go on develop Alzheimer’s show telltale signs lapses in memory, reasoning problem solving ability, verbal fluency and attention skills years before the disease is diagnosed. Such symptoms could serve as warning signals say experts, but doctors need better screening tools to distinguish those changes from the decline in brain function that occurs naturally with age. Meanwhile, University of Southern California researchers found that inflammation caused by lost of loose teeth, and the resulting infection, can quadruple the risk of developing Alzheimer’s. Treating those inflammatory episodes could help stave off the disease. Remain in place, new initiatives at the state level ( and abroad) may make them irrelevant.
By mid 2004, California and New Jersey had passed laws specifically authorizing the cloning of human eggs to create stem cells (so-called therapeutic cloning), and the legislatures of seven other states, including Illinois and New York, were considering similar bills. California was preparing a ballot measure authorizing up to $3 billion in state funding for stem-cell research over 10 years, which would dwarf federal outlays, which currently hover around $17 million annually. Harvard and Stanford universities also announced that they were launching stem-cell research centers, for which they hoped to raise $100 million each. All of which may (or may not come just in time to prevent America’s lead in stem- cell research in encouraged and where, in May 2004, medical authorities opened the world’s first stem-cell “bank,” which will cultivate, store and supply stem-cell lines for research. This initiative, coming just a few months after the stunning news that a South Korean research team had succeeded in creating a new stem-cell line from a cloned human embryo, left many American scientists feeling they were at a competitive disadvantage but determined to catch up.
Anxiety can make us mentally tense and unhappy, but new research shows that stress actually causes changes in our immune systems. Take Charge to beat stress, experts say, you should comfort it head on rather than seeking ways to compensate for it. Smoking or eating too much only builds more stress. Researchers conducting a new analysis involving some 19,000 subjects of stress arrived at some surprising conclusions. They found that modern stresses prompt complex reaction beyond the simple fight-or-flight response, the primordial motivator that send your heart racing and pumps up your blood pressure. In particular, they found that stress triggers a variety of changes in the immune system some beneficial some decidedly less so depending on how long the stress lasts and whether an end to it is in sight. When test subjects were asked to speak in public or do mental math in the lab, the tasks tended to mobilize their fast-acting immune response, the body’s all purpose defense system for fending off infection and healing wounds. Compared with controls, people subjected to such short-term stresses had up to twice as many natural killer cells in their blood, ready to fight the early stages of infection. Short-term stressors faced with high stakes, like the SATS or the bar exam, appeared to hinder the immune response by suppressing Th1 cells, which normally activate killer cells and wound-healing chemicals called cytokines. This suppression can also boost the concentration of Th2 cells, which produce antibodies and can make allergies worse. Chronic stress agents that alter a person’s role in society or sense of self and show no sign of ending, such as unemployment, permanent disability or the need to care for a parent with dementia, are bad news. They have significantly negative effects on almost all immune functions. Do people subjected to such stresses actually get sick?
There have been surprisingly few studies to test that theory, but research on long-term hardship at work finds that stress is associated with an increase in heart disease. Other studies found that people suffering chronic stress on the job or in relationships are at least twice as likely to get sick from a cold or flu. Expert suggest that those subject to stress apply management strategies that anyone can adopt. For example, avoid situations that you know cause stress. Discuss problems with friends, family or a mental-health professional before they become overwhelming. Face stress head on, and don’t resort to coping mechanisms like smoking, eating more or exercising less; that only adds to the strain. And remember: you can’t avoid stress altogether, but you can learn to it at bay.