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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.




Happy New Year

The major medical journals hit the ground running in 2006 with results of important studies of ovarian cancer, sudden cardiac arrest, and investigational vaccines.

Ovarian cancer advance

First, researchers reported that delivering chemotherapy directly into the gut can extend ovarian cancer survival by more than a year.

The study compared outcomes of women who had surgery to remove the cancer and then followed that with standard intravenous chemotherapy plus chemotherapy delivered into the stomach, called intraperitoneal chemotherapy. Compared with standard IV chemotherapy alone, the 25 percent increase in survival with intraperitoneal therapy added to the mix was so dramatic that the National Cancer Institute immediately endorsed the approach.

The findings were reported in the New England Journal of Medicine.

Intraperitoneal chemotherapy extends ovarian cancer survival by yearexternal link

Surviving sudden cardiac arrest

Also this week the largest-ever study of in-hospital sudden cardiac arrest found that children are more likely to survive a sudden arrest episode than are adults.

In both children and adults, in-hospital sudden cardiac death are usually associated with progressive respiratory failure and shock, not by an irregular heartbeat (usually the cause for sudden arrests that occur outside the hospital).

The take home, for both kids and adults, according to report in the Journal of the American Medical Association, is that resuscitation efforts in hospitals should focus on breathing problems -- not out-of-sync hearts.

Children survive in-hospital cardiac arrests better than adultsexternal link

Diarrhea vaccine

A nasty bug called rotavirus is the number one cause of serious diarrhea in babies and toddlers -- and when it strikes kids it usually takes down the entire family.

Now, however, two investigational vaccines that were tested in more than 131,000 infants appear to be both safe and very effective. The vaccines -- Rotateq from Merck and Rotarix from GlaxoSmithKline -- are both given orally and both are expected to be licensed for use in the near future. The promising results were reported in the New England Journal of Medicine.

Two investigational rotavirus vaccines safe and effectiveexternal link

Supplement warning

Also this week there were reports about two treatments that don't work, and one of those -- the dietary supplement l-arginine?might be a killer for people with heart failure.

Johns Hopkins researchers reported in the Journal of the American Medical Association that a study of l-arginine was stopped when six patients randomized to the supplement died versus no deaths in the placebo group. Bottom line: just say no to l-arginine for heart failure.

L-arginine supplements linked to increased risk of death in MI patientsexternal link

Statins don't prevent cancer

In the same issue of JAMA, researchers from the University of Connecticut School of Pharmacy said that tentative reports of cholesterol-lowering drugs called statins preventing cancer are probably little more than wishful thinking.

The drugs, like Lipitor and Zocor, are effective for lowering bad cholesterol, which is a major risk factor for heart attacks and stroke, but they have a "neutral effect on cancer and cancer deaths."

Meta-analysis rules out statin cancer preventionexternal link

Low-fat weight loss

Also in this week's JAMA there was encouraging news about the value of healthy eating.

Post-menopausal women who followed a low-fat diet that was high in fruits, vegetables, and whole grains were able to lose weight. So, while the Atkins, South Beach, and Zone folks will tell you otherwise, carbohydrates are not the root of all dietary evil.

In major diet study, carbohydrates found not guiltyexternal link

Toasting kidney health

And having a glass of wine or a metropolitan along with that salad and whole wheat toast is probably not a bad idea, according to researchers at Sweden's Karolinska Institute.

They reported that light-to-moderate drinking -- meaning one drink a day --may lower the risk of kidney cancer in women ages 55 or older. The findings were published in The International Journal of Cancer.

Moderate alcohol consumption may lower kidney cancer riskexternal link

Is this vitamin for you?

If a drink is good, a vitamin is even better -- if the vitamin is vitamin D.

So said researchers at the Moores Cancer Center of the University of California-San Diego, who reported that 1,000 IUs of vitamin D daily may reduce the risk of developing colon, breast, ovarian, and possibly prostate cancer.

The study was published in the American Journal of Public Health. But a note of caution: the conclusion was based on a retrospective analysis of data from observational studies. To scientists, that is a method that is more reliable than reading palms but far from solid evidence.

Boosted vitamin D intake for cancer prevention?external link

Antidepressant-suicide link challenged

There have been a number of news reports linking antidepressants like Prozac and Zoloft to increase risk of suicide, but a study in American Journal of Psychiatry concludes that the evidence does not support that link.

In a study of more than 65,000 children and adults treated for depression over a 10-year period, the risk of suicide declined when patients started taking antidepressants, reported researchers at Group Health Cooperative of Puget Sound in Seattle.

Antidepressants found unrelated to suicide riskexternal link

No pill for poverty

But as good as antidepressants are, they are not powerful enough to overcome the impact of poverty.

That was the conclusion of Harvard researchers who reported Archives of General Psychiatry that poverty is a marker for poor response to treatment for depression. Older adults who lived in middle class neighborhoods were twice as likely to respond to treatment for depression as were adults who lived in poor neighborhoods.

Patients who lived in poor neighborhoods were also twice as likely to think about suicide as richer patients.

Poverty limits efficacy of treatment for depressionexternal link

Safe driving

Keeping kids safe in the family car is top priority for parents, but buying a sports utility vehicle is not the best way to do it, said researchers who reported their findings in Pediatrics.

These uber-vehicles don't easily dent, but they do roll over more often than the family sedan, and that feature negates any safety gained from size.

SUVs no safer than passenger cars for kids during crashexternal link

Take that, Lamaze mavens

As you rethink the plans to order a Humvee, here is another bubble-bursting story: Labor coaches aren't all that helpful.

So said researchers at the University of Texas Southwestern in Dallas who reported in the American Journal of Obstetrics and Gynecology that having someone to tell a women when to breathe and when to push only shortens the second stage of labor by 13 minutes (which many women would consider a very big deal) but offers no clinical benefits.

Mothers who follow their own instincts do just as well as women with coaches, the researchers concluded.

Coaching makes little difference for women in laborexternal link

Gimme an O-U-C-H!

Finally, as if firing the labor coach isn't enough, researchers at the Columbus Children's Research Institute (in the shadow of the Ohio State Buckeyes) say that cheerleading can be hazardous to your health.

All that jumping, flipping, tossing and human pyramid-building sent more than 200,000 cheerleaders aged 12 to 17 to hospital emergencies rooms from 1990 to 2002.

One problem: schools don't consider cheerleading a sport, so squads don't usually get safety training or have an athletic trainer in attendance.

Endnote: Time to turn in the pom-poms?

Injuries to cheerleaders are not out of boundsexternal link

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