The top 5 health stories of 2007: Harvard Medical School

Today, Harvard Medical School published its top 5 health stories of 2007. Not surprisingly, the human brain made the list:

AVANDIA: What lessons did we learn?

1. The FDA is supposed to allow drugs on the market only if they are safe and effective. In 2007, rosiglitazone (Avandia), became the latest medication found to have serious side effects that weren’t apparent when it was approved.

   The surprise came with study results showing that AVANDIA — markedly increases the risk of heart attack, as well as overall risk of dying from heart disease. The absolute risk is small: about one additional heart attack or cardiac death in 1,000 people taking the drug. . The surprise came with study results showing that AVANDIA markedly increases the risk of heart attack, as well as overall risk of dying from heart disease. The absolute risk is small: about one additional heart attack or cardiac death in 1,000 people taking the drug. The FDA put a “black box” warning on it, but rosiglitazone stayed on the market, unlike rofecoxib (Vioxx), the COX-2 painkiller that was pulled off in 2004 when it was found to cause heart problems.

   2. Waking up to a new health habit: Sleep None of us needs a study to tell us that we feel better after a good night’s sleep. But research is showing that getting enough sleep — between seven and nine hours a night for most people — is one of the pillars of good health, along with exercise, eating plenty of fruit and vegetables, and staying slim. No one study made a big splash in 2007, but the evidence has reached a critical mass. Studies have linked short and poor sleep to many modern maladies: diabetes, heart disease, high blood pressure, inflammation, stroke. Short sleep may be a factor in the obesity epidemic: sleep lab studies have shown that it alters the activity of leptin, the “fullness” hormone, and ghrelin, the “appetite” hormone. . 3. Putting out the fire When it’s under control, inflammation is a normal part of our immune response. But when it gets out of control, inflammation causes disease and pain, and fanning the flames is a protein called tumor necrosis factor-alpha (TNF-alpha). In the 1990s, researchers genetically engineered a protein that blocks TNF-alpha. The FDA approved the fruits of this labor, etanercept (Enbrel), in 1998. Now two others — infliximab (Remicade) and adalimumab (Humira) — are on the market, and a third — certolizumab — is waiting in the wings. The medications have greatly improved the treatment of several inflammatory conditions, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis (a condition that affects the spine and the sacroiliac joints), and Crohn’s disease, a bowel disorder. 4. A Better Mamogram For most women, mammograms do a good job of finding breast cancer early. But no screening test is perfect, and the x-ray images of the traditional mammogram miss some cancers. Magnetic resonance imaging (MRI) scans provide extremely detailed images of soft tissues. Two studies of high-risk women published in 2007 compared breast MRIs with other screening tests — including standard x-ray mammography, ultrasound, and clinical breast exams — and found that MRI scans identified cancers the other techniques missed. The MRIs were especially helpful in women with dense breasts, which have more glandular and connective tissue — and less fat — than normal. The American Cancer Society revised its screening recommendations to say that women at high risk for breast cancer should get a breast MRI every year, in addition to a regular mammogram. . 5. Peeking into the brain When doctors diagnose Alzheimer’s disease, depression, and many other conditions related to the brain, they have only symptoms to go by. But with advances in imaging technology, researchers are getting the brain to give up its secrets, and more direct tests may soon be possible. Functional magnetic resonance imaging scans are allowing researchers to measure minute changes in brain activity. Voltage-sensitive dyes can isolate specific brain circuits. Positron emission tomography (PET) scans use radioactive tracers and CT scanners to generate exquisitely detailed images of brain metabolism. University of Pittsburgh researchers have developed a PET tracer — dubbed PIB, short for Pittsburgh Compound B — that labels beta amyloid, the protein fragment that many Alzheimer’s researchers believe is the main cause of the disease. Researchers are heralding PIB testing as a breakthrough. It could — at last — provide a way to detect Alzheimer’s disease before symptoms appear. Treatments directed at reducing beta amyloid are under development. If beta amyloid plaque could be found with PIB testing, these medications might be given early in the disease, before symptoms occur.

   he COX-2 painkiller that was pulled off in 2004 when it was found to cause heart problems.

The only FDA approved long-term treatment option for depression is vagus nerve stimulation therapy.