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Recent Newspaper & Online Columns by Kate Scannell MD

The top 10 medical stories of 2010

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 12/26/2010

WHILE THE past year regaled us with a wealth of medical stories, the government's health care reform legislation took center stage. Meanwhile, the swine flu virus whimpered, but a killer bacterium left us with a whooping cough. Scientists created the world's first synthetic organism inside a Petri dish, while old-world bed bugs crawled into our mattresses. A baby was born from a fertilized human egg that had been frozen for two decades, and, following yet another Salmonella epidemic traced to tainted poultry, the FDA finally cracked down on the egg industry.

The swine flu whimpered
The swine flu hogged media attention, panicked millions of people and consumed considerable public health resources. Its causative virus -- H1N1 -- spread throughout the world like a hog on ice, ultimately proving to be much less formidable than experts had predicted. In the bitter end, critics claimed that the World Health Organization (WHO) had exaggerated the danger, fanning public fears about the scarcity of antiviral medications and life-saving medical interventions. An editorial in the British Medical Journal claimed that some experts advising the WHO about the pandemic had financial ties to drug companies that manufactured antivirals and vaccines. Still, the threat of a global pandemic forced governments and health care systems to plan collaboratively for a more coordinated and efficient emergency response to the next public health crisis.

The cough that whooped California
For six decades, whooping cough -- formally known as "pertussis" -- had been rather quiet on the Western front. But in July the CDC reported that six California infants had died from the infection. Experts associated the resurgence of this vaccine-preventable bacterial illness to growing numbers of unvaccinated children and undervaccinated adults. Sadly, by year's end, at least 7,800 cases of pertussis -- including 10 infant deaths -- were reported throughout the state. The CDC reinvigorated its childhood vaccination campaign and urged all Americans to obtain booster shots with the Tdap (tetanus-diphtheria-acellular pertussis) vaccine.

Bed bugs took a bite out of a good night's sleep
Bed bugs were more prevalent in 2010 than "breaking news" about Lindsay Lohan, Kanye West, and Betty White (combined). The speck-sized biting critters left their marks on us -- literally. All the while they infiltrated our mattresses and consumed our blood, we were consumed with fear about them overtaking the Bay Area. Experts attributed the bugging of our beds to global travel and pesticide bans. The good news -- and the only good news -- is that these household pests are not known to transmit disease.

The world's first synthetic organism
Dr. J. Craig Venter -- a scientist who helped map the human genome -- created the first man-made living organism. Using DNA pieces as building blocks, he synthesized the entire genome of a bacterium and subsequently injected that into a cell in which the DNA was able to reproduce. The successful creation of Venter's man-made organism generated infectious excitement about the future of synthetic biology, stoking scientists' hopes about designer organisms that might one day secrete biofuels, vaccines or drugs.
Still, the major import of Venter's discovery remains largely unexplored. The ability to construct life from inanimate component parts poses profound moral and philosophical questions that won't be solved in a Petri dish.

Concussions in sports: Taking a "hit over the head"
It took us a long while to tackle the serious problem of head injuries sustained during amateur and professional sports. But in 2010 we finally came to understand that everyday "concussions" on the playing field often represented serious brain damage that could affect a player for life.
Studies suggested that sports-related head trauma could raise a person's risk for developing chronic brain and neurological disorders. One study showed that nearly one-third of children diagnosed with "concussion" actually suffered traumatic injury to their brains.
After several players sustained major concussions during early season games, the National Football League implemented new post-concussion return-to-play safety guidelines and warned that "head hunters" would be suspended.
Let's hope these implementations kick-off greater public awareness about sports-related brain injury and head protection. But because they do not alter the fundamental conditions of risk that are inherent in head-hazardous sports, we are left waiting and watching from the sidelines for genuinely effective and pro-active interventions.

Some hope on the AIDS front
A groundbreaking study revealed that taking a once-a-day antiretroviral pill (Truvada) reduced the overall risk for infection with HIV -- the causative virus of AIDS -- by 44 percent among at-risk gay men. Furthermore, the risk was reduced by 73 percent when the medication was taken faithfully. In other encouraging news, for the first time a medicated vaginal gel provided substantial -- though incomplete -- protection against HIV infection for sexually active women.

Health care reform
In March, President Obama signed into law the Patient Protection and Accountable Care Act of 2010. Containing sweeping reforms to the country's health care financing and delivery system, the new law aimed to extend coverage to 32 million currently uninsured Americans.
Opponents derisively referred to the legislation as monolithic "ObamaCare." Proponents touted its individual components: research funding to determine optimal medical practices that promote lower cost and higher quality care; maintaining young adults on their parents' private policies until they reached the age of 26; piloting projects to encourage patient-centered medical homes; boosting pay for primary care physicians; barring copayments for most preventive services; eliminating insurers' ability to deny policies for people with pre-existing medical conditions; and reducing the national deficit by $140 billion over 10 years.
Concerns about the cost for these reforms crossed the political divide. Prices for private insurance were expected to rise by 1 percent to 3 percent each year while health care costs in general continued their 6 percent-to-10 percent annual escalation. Expanding health care access to 32 million more Americans was also expected to stress the current shortage of primary care doctors. Stay tuned (and healthy).

The FDA flexes some muscle
In September, the FDA sharply limited access to the anti-diabetes medication Avandia (rosiglitazone) because of persistent concerns that it increased the risks for heart attacks and other cardiovascular problems. The government agency also newly required diabetic patients to sign a consent form in order to obtain the drug. Prescribing doctors had to enlist in a registry to certify their awareness about the drug's attendant risks.
But this lumbering regulation came late in the game. According to government reports, the drug's manufacturer had been aware of Avandia's cardiovascular risks shortly after its blockbuster launch in 1999. Also, independent researchers had begun reporting about those risks in 2007.
For many critics, the significant lag time between risk awareness and mitigation cast a harsh light on the FDA's ability to regulate powerful drug companies in the service of public safety.

Fewer bad eggs to spoil the New Year
As I write this column, the Food Safety Modernization Act awaits President Obama's expected signature. Congressional passage of the bill followed a series of food and product recalls in 2010 which included Salmonella-tainted eggs and cadmium-laced Shrek drinking glasses. Once signed, the act newly (yes, "newly") endows the FDA with the authority to order mandatory recalls of tainted, disease-causing food. This news should prove appetizing to anyone who eats food, especially the one-in-six Americans who are sickened each year from food-borne illnesses.

A child is born -- 20 years in the making
In the September online issue of Fertility and Sterility, doctors reported that a healthy boy was born from a thawed-out embryo that had been frozen for almost 20 years. The embryo had been "left over" by a couple who had successfully conceived during the woman's fertility treatment. This astounding news raised burning questions about the nature and fate of "left over" human embryos -- hundreds of thousands of them stored within freezers throughout the United States alone.
Kate Scannell is a Bay Area physician and syndicated columnist. Her new novel is "Flood Stage."
© Copyright 2011, Kate Scannell