1. The new heart attack guidelines.
From QH post Making sense of the new cholesterol and heart disease guidelines:
The big news this week was that the American Heart Association (AHA) passed new guidelines on how people should manage their cardiovascular disease risk. In the past, the emphasis was on your LDL level and getting it below a specific number. Now the focus is on calculating your cardiovascular risk which depends on other factors like diabetes, smoking, and blood pressure in addition to cholesterol. A key role will be played by statins, the primary medication for lowering LDL, because of its superior efficacy (and fewer side-effects) compared to other cholesterol-reducing medications.
2. Michelle Obama's "Drink Up" campaign.
"The First Lady unveiled her newest health initiative late this year, called "Drink Up," which aims to encourage everyone to drink more water, whether it be water from a local tap or a bottle. However, the campaign drew criticism due to the absence of any message to consume fewer sugary drinks."
3. The (glitchy) rollout of healthcare.gov.
From QH post Open enrollment for healthcare insurance under the Affordable Care Act (ACA):
Most people (not covered by Medicaid or Medicare) obtain their health insurance through their employer. However, some businesses do not offer their employees healthcare plans, plus many people are unemployed (but not eligible for Medicaid), and some may simply decide that they do not want health insurance. Obamacare will substantially increase the access and quality of healthcare to the uninsured. Several key provisions make this possible including the following: No denial of coverage for those with pre-existing conditions, a minimum standards requirement for health plans (such as covering essential health benefits), subsidies for low-income individuals and families, and an expansion of Medicaid (in some states) for those slightly above the poverty line. These healthcare plans will be offered through healthcare exchanges administered by each state. The net result is expected to be a reduction in the number of uninsured by approximately one-half.
4. Obama's BRAIN Initiative.
"The BRAIN Initiative (which stands for Brain Research through Advancing Innovative Neurotechnologies) was proposed earlier this year by President Obama, to map brain activity in an effort to better understand brain diseases and conditions such as Alzheimer's, autism and traumatic brain injury -- and potentially develop treatments based on the findings. While exact details of the initiative are still fuzzy, the National Institutes of Health said that a working group is creating a scientific plan that should be developed and delivered by next June."
5. The MERS virus.
"While this new virus was first detected last year, it wasn't given an official name -- Middle East respiratory syndrome coronavirus -- until this past May. The virus has been reported in nine countries so far, including four European countries, though most cases have been identified in Middle Eastern countries. MERS had never been seen in humans before; about half of people who developed the virus have died."
6. The polio outbreak in Syria.
"An outbreak of the crippling disease polio has emerged in Syria amid conflict in the country, leaving at least 17 children crippled by the virus. Syria was considered "polio-free" in 1999, the Christian Science Monitor reports, but vaccination rates have plummeted from above 90 percent in 2011 to 68 percent three years later. As a result, a massive polio vaccination effort has been launched in the country. However, as refugees flee to other surrounding countries, concerns have been raised that polio could spread beyond Syria's borders. Most recently, Reuters has reported that the rebel-held province where the virus has resurfaced was not included in a polio vaccination campaign held last year."
7. The comeback of whooping cough and measles.
"Diseases that vaccines can protect against have reared their ugly heads in the United States this year, including the whooping cough in Texas, and measles all across the U.S. In Texas, whooping cough actually reached epidemic proportions, Reuters reported, with nearly 2,000 cases being reported as of September. Health officials said the epidemic is likely a result of a new pertussis vaccine that seems to not be as effective over a long period of time, and a decrease in vaccinations against whooping cough. Meanwhile there have been eight outbreaks of measles (as of September) in the U.S., mostly in places with low vaccination rates (the MMR vaccine protects against measles)."
8. Increasing use of -- and confusion about -- e-cigarettes.
"Are electronic cigarettes dangerous? Can they help you quit smoking real cigarettes? And how should they be regulated, if at all? These were all questions raised this year, none of which have a clear answer. Some research has suggested that they are effective as smoking cessation aides, but critics say that the products could actually make smoking attractive, or make it harder for people to quit smoking completely."
9. The beginning of the end of trans fats.
From QH post Not all "health hacks" are healthy:
Incidentally, margarine may not be much better. Dr. David Katz weighs in on the butter versus margarine debate pointing out that while margarine does not have saturated fat, many types of margarine contain trans-fat which is just as bad or worse as saturated fat in terms of raising LDL (and also lowering the "good cholesterol" HDL). Instead he recommends trans-fat free margarine spreads that contain vegetable oils (monounsaturated fats).
10. The naming of the "most-stressed" generation.
"And the title goes to … millenials (otherwise known as the 18-to-33 set). The American Psychological Association's "Stress in America" survey showed that millenials have an average stress level of 5.4 out of 10, where 10 is the highest. Meanwhile, the national average was 4.9. In addition, half of millenials said they are kept awake at night because of stress."
This topic warrants a Quantified Health post in 2014 (Figure 1).
11. The new DSM.
From QH post Mental health classification: categories or spectrum?
The "Bible" of mental disorders is the Diagnostic and Statistical Manual of Mental Disorders (DSM), and the newest version (DSM-5) is scheduled to be released next month in May. DSM is extremely important because it provides the standard classification of mental disorders, and is used by the government and the healthcare industry to determine such things as insurance reimbursement, public funding of drug research, and the legal definition of metal impairment.
12. Multiple reports of HIV "cures."
From QH post A functional cure for AIDS? Not yet:
There has been a lot of hype in the press about the possible "functional cure" for AIDS. It started with the report of a baby born HIV-positive (albeit low virus levels) who was treated shortly after birth with an aggressive three drug anti-HIV cocktail. After approximately 18 months, the Mother stopped reporting to the clinic, and so the treatment stopped. Five months later, the Mother returned and the baby was tested. Surprisingly, the baby now tested negative and continues to show no signs of HIV.
Then there was a report from France that some patients given an aggressive combination antiretroviral therapy (cART) during the initial primary infection showed disease non-progression even after stopping treatment for several years. The patients were still HIV-positive, but the virus levels were maintained at a low level in the absence of medication. What the two cases had in common was an early and aggressive treatment with combinatorial therapy. Does this represent a functional cure of AIDS?
13. Increased accessibility to the morning-after pill.
"All age restrictions to purchase Plan B One-Step (and generic versions of the emergency contraceptive) were lifted this year after a lengthy court battle. The contraceptive cuts chances of pregnancy if taken within 72 hours of unprotected sex, and was previously only available for purchase by people 17 and younger if they had a prescription."
14. Honorable Mention: Angelina Jolie's double mastectomy.
From QH post The genetics of BRCA1/BRCA2 and breast cancer:
On Tuesday, the actress Angelina Jolie announced that she carries a mutant allele (version) of the BRCA1 gene, and that this mutant gene conferred an 87% risk of breast cancer (and 50% risk of ovarian cancer). She inherited the mutant allele from her Mother who died of breast cancer when she was 56. In response, Ms. Jolie has elected to have a preventive double mastectomy. She is also planning to have her ovaries removed in the near future.
Figure 1. Are millenials the "most-stressed" generation?
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