Quotes of the Day

1. New Mammography Guidelines
It usually takes a Washington scandal to put the discussion of women's breasts on political agendas, but in November it was a routine update of breast-cancer-screening guidelines by a government panel of medical advisers that stirred up a furor. Based on new calculations weighing the risks and benefits of routine screening, the U.S. Preventive Services Task Force's new recommendations advised women to begin routine mammograms at age 50 instead of 40 and to switch from yearly to biennial screenings; it also advised women to eliminate breast self-exams altogether. Doctors, patients, cancer advocacy groups and politicians vehemently opposed the rolled-back recommendations, fearing they were a harbinger of health care rationing or that insurance companies would be tempted to stop covering screening in younger women. That concern was put to rest in December, however, when the Senate cast its first votes on health care reform, approving an amendment to guarantee coverage of mammograms and preventive screening tests.

2. AIDS Vaccine
In a field that has seen more failure than success, experts received the news of an effective new AIDS vaccine with a fair share of skepticism. In September, a $105 million trial of a novel combination of two older vaccines was the first to show protection against HIV infection. The results of the trial, which involved more than 16,000 volunteers, suggested that the vaccine was 31% effective at preventing infection among those who were inoculated. It was a modest outcome, given that behavior-based prevention methods, like condom use, can be equally if not more effective. The volunteers were also largely heterosexual and monogamous, putting them at low-to-moderate risk for HIV infection — rather than high-risk, like intravenous drug users — and prompting questions about how impressive the results of the study really were. But given that no other inoculation has shown any effect against the AIDS virus, it was reason to celebrate — cautiously.

3. Funding Ban Lifted on Stem-Cell Research
It was eight years in coming — which felt like eons to some researchers — but on March 9, President Obama rescinded his predecessor's Executive Order prohibiting the use of federal money to fund research on stem cells. A congressional law still prevents scientists from using government funds to create new lines of embryonic stem cells, which can develop into any of the body's tissues, but at least scientists are now free to use that money to study the hundreds of stem-cell lines already in existence. Before embarking on such research, however, scientists had to wait for a working group at the National Institutes of Health to vet the stem-cell lines and ensure that they were generated responsibly, according to stringent ethical and scientific principles. In December, the first lines to pass this test became available.

4. H1N1 Vaccine
With the world already grappling with a pandemic of 2009 H1N1 influenza, no treatment was more hotly anticipated or more in demand in the U.S. (and the rest of the northern hemisphere) than the new H1N1 vaccine when flu season officially kicked off in the fall. Despite the fact that the vaccine had proved effective in trials with one dose — rather than two, as researchers had originally expected — the vaccine supply from U.S. manufacturers still couldn't keep pace with demand in the first weeks of October, when the first million or so shots rolled off production lines. In many places around the country, there was not enough vaccine even to cover members of priority groups targeted by the government, including young children, pregnant women, health care workers, parents of infants younger than 6 months and those with underlying conditions such as asthma or diabetes. And yet according to the latest polls, 55% of Americans said they would not get the new vaccine — which was created and tested in record time after H1N1 first appeared last spring — because of worries about its safety.

5. Stem-Cell-Created Mice
The birth of yet another laboratory mouse is hardly worth noting — unless the furry creature is the first to be developed from stem cells that do not involve embryonic cells. That deserves to be called a breakthrough. The new pups, whose creation in two separate labs in China was announced in July, were the first to be bred from induced pluripotent stem (iPS) cells. These are adult cells (usually skin cells) that scientists reprogram back to their embryonic state by introducing four genes. The reprogrammed stem cells are then programmed again to develop into mice, a feat that has been accomplished before only using embryonic stem cells. Breeding an entire mouse that is itself capable of reproducing — as the mice did in one of the Chinese labs — is a strong sign that iPS cells may be as useful as embryonic stem cells for a potential source of treatments for disease, scientists said.

6. Prostate-Cancer Screening
To screen or not to screen? When it comes to cancer, doctors say early detection is the best defense. But the picture is a little fuzzier when it comes to prostate cancer, which in many cases progresses slowly and may not require aggressive treatment. In March, a 10-year National Cancer Institute study involving more than 76,000 men seemed to make the case for watchful waiting. About half of the study volunteers were randomly assigned to the screening group, getting either a manual exam or a prostate-specific antigen test each year; the latter test measures blood levels of a protein associated with prostate cancer. The other study participants received no screening guidance and were left to decide on their own whether they would get a yearly test. At the seven-year mark, 50 men had died from prostate cancer in the screening group, and 44 had died in the usual-care group. In other words, screening and early detection did not lower the death rate from prostate cancer.

Based on this and other studies, the U.S. Preventive Services Task Force said there was insufficient evidence to assess the balance of benefits and harms of prostate-cancer screening in men younger than age 75. The task force recommended against prostate-cancer screening in men 75 and older.

7. New Research on Autism
Some blame vaccines, while others target mercury. But the truth is that nobody knows what causes autism or what exactly accounts for the recent rise in cases. According to new data released by the Federal Government in October, 1 in 100 American children is now affected by an autism spectrum disorder, up from the previous federal estimate of 1 in 150. The roots of the increase are still unclear, but researchers this year identified one possible genetic clue: variations on a region of chromosome 5, which appear to play a crucial role in about 15% of cases of autism. Working with the Autism Genetic Resource Exchange — a DNA database of more than 2,000 families affected by autism, and the largest genetic study of the disorder ever attempted — researchers zeroed in on variations in genes that code for proteins involved in forming connections in the brain. Differences in these particular genes are extremely common — present in more than half of healthy people — but they are even more common in people with autism, affecting 65%.

8. New Drug for Osteoporosis
Halting osteoporosis, the inevitable weakening of bone, is the best way to avoid the hip and spine fractures that are the leading cause of health problems in the elderly. Current drugs for osteoporosis work by blocking the effect of bone-destroying cells, which increase in number as people age. But a new compound under review by the FDA tackles the problem in a different way — by curbing the formation of the bone-gnawing cells. That tilts the balance in favor of bone-building. In two studies published in August, the experimental compound denosumab was shown to reduce the risk of fractures in postmenopausal women as well as men being treated for prostate cancer, the two largest patient populations at risk for bone loss. What's not clear, however, is how the new drug, if approved, would compare with existing osteoporosis drugs like Fosamax, Boniva and Reclast.

9. New Alzheimer's Genes
When it comes to understanding a disease as complex as Alzheimer's, the more the better — genes, that is. In September, 15 years since the last discovery of its kind, scientists finally identified a new set of genes that may contribute to the memory-robbing disorder. Two groups of researchers, working separately, homed in on three genes linked to the late-onset form of the disease, the type that hits people in their 60s or later and accounts for 90% of Alzheimer's cases in the U.S. Two of the genes are known to interact with the amyloid-protein plaques that build up in the brain of Alzheimer's patients and eventually cause nerve-cell death and cognitive problems. The third affects the junction of nerve cells, where various neurochemicals work to relay signals from one nerve cell to another. It's not clear yet exactly how the genes increase Alzheimer's risk — in fact, most healthy people have some version of the three genes — but researchers hope that the growing pool of genetic factors will eventually help them develop more effective and better-targeted treatments for the disease.

10. Brown Fat in Adults
When you're struggling to button your pants around your ever expanding waistline, it probably doesn't occur to you to wonder whether your body fat is brown or white. But perhaps you should. Researchers have long known that brown fat, so called because it is packed with dark-hued mitochondria (the engines that feed cells with energy), actively breaks down sugar into heat and consumes a lot more energy than white fat does. In other words, brown fat burns energy instead of storing it. However, researchers also known that while brown fat is abundant in rodents and newborns, who need it to keep warm right out of the womb, those brown-fat stores shrink and white fat emerges as people age. But now it seems that adults retain more brown fat than previously thought, in deposits in the front and back of the neck, according to a study by Swedish researchers, published in the New England Journal of Medicine in April. Two other studies published in the same journal found that lean people tend to have more of these deposits than obese folks and that brown-fat cells are more active in the cold. Could a fat-based fat fighter be far behind?