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  This week in the medical journalsBreathlessness signals risk of deathBy Peggy Peck Editor's note: CNN.com has a business partnership with MedPageToday.com, which provides custom health content. A medical journal roundup from MedPage Today appears each Thursday. More than a symptom Leading the news in the medical journals this week was the finding that breathlessness is more than just a symptom of disease. By itself it signals the risk of death from heart disease or other causes. Breathing lessonsThat was the surprising finding from a study of more than 17,000 individuals who were referred for cardiac stress testing during the 1990s. Researchers led by a team at Cedars-Sinai Medical Center in Los Angeles, California, looked at dyspnea, the medical term used to describe a number of breathing problems. They discovered that people who had no history of heart disease but did have dyspnea are four times more likely to die from heart disease than people with no breathing problems. In the study, which was published in the New England Journal of Medicine, breathing problems were a more reliable predictor of death than chest pain caused by coronary artery disease. Dyspnea is predictive of cardiac and all-cause mortality Coming up for airOn the subject of breathing, air pollution can make breathing difficult, but there may be other risks as well. Researchers at Beth Israel Deaconess Medical Center in Boston, Massachusetts, reported in Stroke, Journal of the American Heart Association, that the number of ischemic strokes -- strokes that occur when the blood supply to the brain is blocked -- goes up when the air pollution index worsens. The increase, according to the researchers, is just 1 percent, but every year about 700,000 Americans will suffer strokes and 70 percent to 80 percent of those strokes are ischemic strokes. So, a 1 percent increase means about 7,000 strokes. Air pollution associated with increased stroke risk New bug, but is it the right bug?Also in the New England Journal of Medicine this week, researchers from the Fred Hutchinson Cancer Research Center and the University of Washington reported that they have identified new bacteria that may be responsible for a common vaginal infection called bacterial vaginosis. The condition occurs in 10 to 20 percent of white women and 30 to 50 percent of black women, but the precise cause remains a medical mystery. It's treated with antibiotics, but it has never been clear which bacteria are causing it. In this study, the researchers report that they have identified 19 new species of bacteria in vaginal fluid taken from women with the infection. Scientifically, that's an interesting finding, but an editorial in the journal pointed out that the researchers have not offered compelling evidence that these new bugs are the long-sought perpetrators of the infection, or just some innocent bystanders. Unknown bacteria found in women with vaginosis Better and longer livesCardiac rehabilitation programs are a mainstay of treatment after heart attacks, which is a good thing, according to a study in Annals of Internal Medicine. It credits the programs not only for helping patients to a longer life, but also for improving quality of life. Researchers from the University of Alberta Evidence-Based Practice Center in Candad wrote that cardiac rehab can reduce risk of a second heart attack within the first year by 17 percent and can cut heart attack risk by almost 50 percent in the second year after a first heart attack. Moreover, the benefit is seen whether the program includes supervised exercise or relies on just dietary intervention and risk factor counseling with no supervised exercise component. Cardiac rehab offers longer life to heart attack survivors Working out the painExercise is just the ticket to keep knees with damaged cartilage limber and pain-free, according to a team of physical therapists from Malmo, Sweden. Writing in Arthritis & Rheumatism, they reported that moderate exercise can build up damaged knee cartilage and ward off osteoarthritis of the knee, a common complaint among aging weekend warriors. In their study, 68 percent of people who exercised about three times a week for four months reported less pain and more gain. Exercise may benefit damaged cartilage Too many pillsExercise is a safer option than simply taking high doses of Advil or Motrin (ibuprofen) to relieve pain, according to a study from researchers at McMaster University in Hamilton, Ontario. The Canadian team found that taking high doses of ibuprofen -- 2,400 mg a day -- for three days is likely to trigger gastrointestinal bleeding, even among healthy men. Writing in Clinical Gastroenterology and Hepatology, they pointed out that people who are self-medicating for chronic arthritis pain may be putting themselves at risk of anemia if they grab more pills to fight painful flare-ups of joint pain. The recommended maximum dose is just 1,200 mg a day. Short-term use of high-dose ibuprofen linked to GI bleeding Stopping too soon?News in medical journals usually comes from well-designed studies that are intended to show a clear benefit -- or lack of benefit -- for a specific treatment. But large studies are sometimes stopped when safety monitoring boards realize that patients in one group of the study are achieving a clear benefit, while patients in the comparison group are not. This week another group of McMaster University researchers pointedly questioned this practice in a paper published in the Journal of the American Medical Association. Stopping a study early robs physicians and patients from learning the "real" benefit of a treatment and may put patients at risk for unanticipated longer term adverse events, they said. Moreover, when the studies are stopped early it creates a statistical bias that may exaggerate the reported benefit. The flip side is the ethical quandary: Do you keep a study going when there is clear evidence that one group of patients is benefiting and the other group gets no benefit and may be harmed? The dilemma of halting clinical trials early This vegetable's for youFinally, what's a week in medical news without the pluses or minuses of this vegetable or that? The ever-popular cruciferous vegetables, such as broccoli and cabbage, may reduce the risk of lung cancer, according to a team of French researchers who reported this in The Lancet. But there is a catch -- you have to have the right genes for this to work. People who have inactive variants of the GSTM1 and GSTT1 genes who eat cruciferous vegetables at least once a week decrease their risk of lung cancer by 72 percent. End note: Dump the smokes and you can pass on sauerkraut. Cruciferous vegetables may protect some against lung cancer 
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