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INFERTILITY It has been 25 years--and a million births--since the arrival of Louise Joy Brown, the world's first test-tube baby, and you would think doctors would know by now if the procedure carried any extra risks. But only last year studies showed that babies conceived through in-vitro fertilization were more than twice as likely as naturally conceived babies to suffer major birth defects and nearly three times as likely to be born small, a significant risk factor for later cardiac and cognitive problems. It's doubtful either finding will deter many would-be parents who cannot conceive in the usual way.
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KNEE SURGERY Arthroscopic knee surgery has been a popular treatment for people whose knees are racked by osteoarthritis. Minimally invasive, it flushes out debris in the joint and smooths bone surfaces without major surgery. But a surprising study showed that the operation is no more effective than a placebo. One in three patients reported improvement, whether having had real surgery or a sham operation with all the same pre-and post-op procedures but no actual treatment. Even if the placebo benefit is ignored, the study still casts doubt on surgery that succeeds only one-third of the time. Patients may be better off doing strengthening exercises and taking off a few pounds to ease the burden on their aching knees.
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MAMMOGRAPHY For two years, a bitter argument has raged over medical advice that most women thought was unimpeachable: routine mammograms save lives. The contrarians insist that the statistics don't bear this out. They also argue that mammograms miss 10% to 15% of breast cancers and that the vast majority of the abnormalities mammograms do spot are benign, which results in millions of unnecessary biopsies and countless anxious women. In a sharp repudiation of the critics, Health and Human Services Secretary Tommy Thompson declared that while mammograms are not perfect, they are "an important and effective tool that helps to save lives." The last word, for now.
MERCURY You may not be into heavy-metal music, but if you are a fish eater, heavy metals are inside you. The omega-3 fatty acids in big, deep-ocean fish are good for the heart, but the flesh of fish at the top of the pelagic food chain also tends to be laced with pollutants. Chief among them: mercury, which can increase the risk of heart disease. Should you fish or cut bait? So far it's a draw, with two major studies coming to opposite conclusions. Until more studies are completed, doctors believe that the benefits of fish outweigh the risks, except for pregnant women and nursing moms, who should avoid swordfish and shark to protect their babies from mercury exposure.
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NICOTINE You can't smoke 'em if you got 'em in more and more public places, but what about licking 'em or drinking 'em? Not without the government's green light. The FDA warned pharmacists to stop mixing up nicotine-laden lollipops and lip balm, both of which the agency ruled were illegal drugs that could appeal to children. A few months later, the FDA dried up a California company's plans to douse the nation with nicotine water. The only nicotine products the agency okayed for over-the-counter sale were nicotine lozenges, which hit stores in November.
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