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This week in the medical journals

By Peggy Peck
MedPage Today Managing Editor

Editor's note: has a business partnership with, which provides custom health content. A medical journal roundup from MedPage Today appears each Thursday.



Food and Drug Administration (FDA)
Health Organizations
Medical Research
Centers for Disease Control & Prevention

An eclectic week

Reports this week in the major medical journals ranged from improved treatment for early breast cancer to Harry Potter's effect on preventing children's accidents.

Femara gets nod for early breast cancer

First, evidence suggested that Femara (letrozole) is a better adjuvant therapy for early breast cancer than tamoxifen, the old standby that is so much better than nothing.

The finding was reported in the New England Journal of Medicine just moments after the Food and Drug Administration approved Femara for treatment of early breast cancer.

Both Femara and tamoxifen reduce the risk of recurrent breast cancer. But in a study of more than 8,000 women with early breast cancer, daily oral Femara reduced the risk of a recurrence by an additional 19 percent over the reduction offered by tamoxifen.

Femara is an aromatase inhibitor and it is second drug in this class to be approved for adjuvant therapy -- treatment after surgery -- of early breast cancer. In September the FDA approved Arimidex (anastrazole) for a similar use.

FDA expands Femara indication to early breast cancerexternal link

When clot-busters fail

Clot-busting drugs can save lives by quickly dissolving coronary-artery blockages that cause heart attacks. But when the clot-busters are a bust, it's time to call in the interventional cardiologists for rescue angioplasty.

Don't try another clot-buster dose. Using tiny balloons and flexible tubes called stents that are threaded into the heart, the interventionalists can open narrowed vessels and restore blood flow to damaged heart muscle.

This was the take-home message from a study of 427 heart attack patients in whom clot-busters failed. The results were also reported in the New England Journal of Medicine.

Angioplasty saves the day after failed thrombolysis for MIexternal link

It's the dose

One of the problems with drug therapy for heart attacks may be the dose. About 40 percent of people with heart attacks are given the wrong dose of drugs like blood thinners and anti-clotting drugs, according to researchers from Duke Clinical Research Institute.

When the researchers reviewed records from 387 U.S. hospitals, they found that 42 percent of patients had at least one dose that was outside of recommended dosing ranges. They reported the findings in the Journal of the American Medical Association.

Dosing Of antiplatelet and antithrombin drugs often too highexternal link

The family heart

And speaking of heart disease, if you have a brother or sister with heart disease, you, too, may be at risk.

So said researchers from the ongoing Framingham Heart Study who reported in the Journal of the American Medical Association that people who have a sibling with heart disease are about 45 percent more likely to develop heart disease than people with healthy siblings.

Heart risk higher for those whose siblings already have itexternal link

The nose knows

An article in the Journal of Infectious Diseases suggests that antibiotic resistant bugs -- especially methicillin-resistant Staphylococcus aureus -- are a lot more common than previously believed.

In fact 2.3 million Americans are walking around with a thriving colony of these bugs in nasal passages. And since these data are based on a "snapshot" analysis of data that were collected in 2000 and 2001, this may be a low estimate.

The good news, said Centers for Disease Control and Prevention researchers, is that only a small number of people who are "colonized" with these bugs go on to develop active infections.

One American in 100 found with MRSA-resistant colonyexternal link

No cures here

Rounding out the week's medical news was a trio of studies from the British Medical Journal, a medical journal where the editors like to make merry during this season.

First -- and just in time for the New Year's revelry -- is this sobering news: hangover cures don't work.

Researchers at the Peninsula Medical School of the University of Exeter and Plymouth said their exhaustive study of medical literature leads the unavoidable conclusion that cures ranging from bananas, milkshakes, pizzas, aspirin and even kidney dialysis are bogus.

The only proven cure is to avoid "the hair of the dog" that bit you.

When all else fails for hangover, try sobrietyexternal link

Harry to the rescue

Turning from pubs to publications, a team of trauma surgeons from the John Radcliffe Hospital in Oxford, England, reported that Harry Potter can protect muggle (non-magical) kids from harm.

The BMJ study found that the number of pediatric admissions for broken bones, sprains, scrapes, and bruises declines significantly when a new Harry Potter book is released. The kids stay home to read quietly.

Harry Potter keeps muggle kids safeexternal link

Say it's not so, Dr. Joe

And finally, there was this distressing report: The doctors on General Hospital don't really know what they are doing. Moreover, they are not alone.

It turns out that the medical knowledge handed out by TV docs practicing on Guiding Light, One Life to Live, Days of Our Lives, All My Children, Passions, As the World Turns, The Young and the Restless and The Bold and the Beautiful -- in other words all of the daytime soaps -- is also wrong, especially when it comes to depiction of comas.

Soaps, said researchers from the University of Pennsylvania, tend to paint a much rosier picture of coma than seen in real hospitals. In Soapland, it seems, patients routinely recover from coma with virtually no long-term disability.

An exception, of course, is coma caused by failure to renew an actor's contract.

Soap operas distort public perception of coma recoveryexternal link

Endnote: Happy New Year!

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