Now that we are near the end of a tumultuous year, it is appropriate to take a look at the important health events that occurred this year. Here’s my take on the top healthcare events of 2008:
1. Organ transplants using one’s own cells – Claudia Castillo, a 30yr old woman living in Barcelona, was the first person in the world to receive a full trachea (or wind pipe) organ transplant grown entirely from her own stem cells. This meant that she did not have to take lifelong medications to prevent her body from rejecting the transplant.
2. Face transplant – In early December, surgeons at the Cleveland Clinic embarked on a marathon, 22-hour procedure in which they transferred 80 percent of a face — including eyelids, bone, teeth and a nose — from a cadaver to a living female patient. This raised eyebrows because it was done to enhance quality of life rather than to prolong it. More important, unlike stem-cell transplants, the patient will have to be on lifelong drugs to suppress rejection since the parts came from another person.
3. CPR Revisited – I wrote here about the new way of doing resuscitation when you see someone collapsing on the street. Now more changes are afoot. Paramedics in Arizona are using a new CPR method. They skip the breathing step and instead, alternate two minutes of chest compressions with a single shock from a defibrillator. Physicians in Arizona reported that the new regimen has tripled the long-term survival rate, which went from 4.7 percent to 17.6 percent.
4. Food Safety- the melamine scandal from China, with 52,000 requiring hospitalisation and with 6 dead, overshadowed the salmonella outbreak in the US blamed on contaminated chilli peppers which caused 1,400 to be hospitalised. Nevertheless, food safety concerns will become increasingly important in the future.
5. Blood Testing to Detect Down’s Syndrome – One of the best ways to confirm Down syndrome before birth is by amniocentesis, which uses a needle to remove a sample of the amniotic fluid from the distended womb. But needles can be nerve-wracking and the procedure carries a 1 in 200 risk of miscarriage. Now, a new genetic test (SEQureDX) may be able to pick up the disease with a simple blood sample from the mom-to-be.
6. More Stem-Cell Advances- Alzheimer’s Disease has no cure, no vaccine and no way of diagnosing conclusively when the patient is alive. Now, the discovery of 4 genes said to cause this debilitating disease has enabled scientists to accelerate stem cell research efforts to grow new cortical neurons that can replace damaged ones in the brain.
7. The ‘Magic’ Cholesterol Pill- In late November, the JUPITER research trial showed that rosuvastatin reduced heart attack, stroke and hospitalization and other markers for heart troubles by 56 percent. The authors of the study concluded that the drug was so effective that it should even be given to people whose cholesterol was normal but had high C-reactive protein levels, a signs of inflammation in the body. I am still a believer that lifestyle measures (diet,exercise,no smoking) is the real mainstay for lowering cholesterol.
8. ..And The One That Didn’t Work-The ENHANCE research trial pitted the cholesterol-lowering drug simvastatin against the popular combo-drug Vytorin, which had both simvastatin and ezetimibe (Zetia). But instead of proving the power of the combo, early data showed that Vytorin was no better at reducing the thickness of blood vessel walls than simvastatin alone. I covered this in some detail in an earlier posting here.
9. New Vaccines – Not that well known among the public, several vaccines have been proven to be effective in combating cancer, although they were not originally designed specifically for that purpose. A case in point is the Hepatitis B vaccine, useful in preventing liver cancer. Read my posting here.
10. Making Healthcare Affordable & Accessible- this is a tall order for most governments and formed the defining issue in the US Presidential elections. Till today, no clear strategic plan has been formulated. Countries worldwide will grapple with rising costs, insufficient manpower and new diseases; all of which ensure that healthcare costs cannot be reduced, much less contained.