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Published: 12/26/2004

The year in medicine

The creation of new, more rigorous standards for cholesterol control was the most important health story of 2004, according to Harvard Health Publications.

The federal government's new guidelines, updated for the first time in eight years, will almost triple the number of people eligible for cholesterol-lowering drugs. If physicians and patients follow the new guidelines, 18 percent of American adults - some 36 million people - will be on cholesterol-lowering drugs.

The rest of the Top 10 list:

2. Cloning for stem cells. A team of South Korean scientists became the first to create human embryos from an adult cell nucleus. One of these embryos was dissected to obtain a line of stem cells, which can make any tissue in the body.

3. "The rise and fall of Vioxx." Merck took its "super aspirin" off the market in September when a study revealed the COX-2 inhibitor doubled heart attack and stroke risk.

4. Smart cancer drugs: New therapies for cancer target particular molecules on a cancer cell. Traditional chemotherapy attacks all dividing cells.

5. Let the sunshine in. In attempt to get the whole story about how drugs perform in clinical trials, legislators and researchers proposed the creation of a mandatory registry of all clinical trials that take place in the United States. Under the current system, a drug maker need not publicly reveal any of the results of clinical trials, and research journals are often reluctant to publish studies when they simply show a drug doesn't work. A mandatory registry would require drug-makers to register every single trial they undertake and then make results of the trial available in some form. The organization that represents the pharmaceutical companies created a voluntary registry, but most experts say mandatory registration is a must if the drug-consuming public is to be protected.

6. Want to help your brain? Take a walk regularly. Recent research shows regular physical activity, including walking, lowers the risk of cognitive decline by 20 percent among women in their 70s. Walking also brought some protection against dementia.

7. PSA speed. Prostate-specific antigen screening is one way to detect for prostate cancer. But it may be even more important to know how fast the PSA score rose. A study found that patients who saw PSA levels increased more than 2.0 in one year had a higher mortality rate. 8. "Pay-tients" pay the price. Health insurers continue to shift costs to customers by increasing copayments for medical treatment, and charging larger copayments for non-generic drugs.

9. While it's possible to scan arteries to look for calcium - and early signs of atherosclerosis - some believe the test fails the cost-benefit analysis. Almost all Americans have minimal atherosclerosis and may end up with a positive scan, which can lead to further unnecessary tests and treatment. The American Heart Association this year again published a statement opposing the scans.

10. The shortage of flu vaccine "shows that the American system of immunizing people may be a disaster waiting to happen."



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