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This week in the medical journals

Possible cystic fibrosis treatment from inexhaustible supply

By Michael Smith
MedPage Today Staff Writer

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



Health Treatment
Duke University
Northwestern University
The American College

Saline solution

In the major medical journals this week, there was a report of a long-sought remedy for cystic fibrosis, the devastating lung disease. Even better, the remedy is inexpensive, and there's a virtually inexhaustible supply -- salty water.

The journals also carried a debate between U.S. and European investigators on what to do about flu -- not just avian flu but plain, old seasonal flu.

Saltwater treatment

In a world where drugs are increasingly expensive, two studies this week showed that one of the world's cheapest commodities -- saltwater -- can dramatically improve the symptoms of cystic fibrosis.

Inhaling a mist of saline quickens the clearance of the mucus that accumulates in the lungs of CF patients, as well as reduces pulmonary exacerbations, and improves lung function in general, University of North Carolina and Australian research teams reported in the New England Journal of Medicine.

What's more, the finding provided proof that rehydration of the lungs is a key factor in improving mucus clearance, a theory that has been hotly debated among cystic fibrosis researchers.

Saltwater treatment effective for cystic fibrosisexternal link

Tempest over flu drugs

Only a few days after the Centers for Disease Control and Prevention made recommendations about what drugs to use against seasonal flu, European researchers said the Atlanta agency was all wet.

The CDC had said that doctors should prescribe Tamiflu (oseltamavir) and Relenza (zanamivir), instead of the standby agents amantadine and rimantadine. But in The Lancet, a new report based on an analysis of more than 50 studies said none of the four drugs is really suitable to treat seasonal flu. It added that Tamiflu and Relenza should be held in reserve in case of flu pandemic.

The CDC is sticking to its guns. "Our recommendations are pretty clear," the CDC said.

Save newer flu drugs for pandemic, researchers adviseexternal link

Bad news for the young

As teenagers become young adults, they are often already habituated to smoking, excessive drinking, and a fast-food, low-exercise lifestyle that climaxes with obesity, University of North Carolina researchers said this week in the Archives of Pediatric & Adolescent Medicine.

The study followed 14,000 young people as they passed through middle school and high school and moved into young adulthood. Of 20 health indicators that were tracked, 15 got worse as the kids got older -- including smoking and binge drinking.

Part of the problem might be the movies, a Dartmouth study suggested. Researchers said in the Journal of Studies on Alcohol that youngsters watch a lot of boozing on the silver screen, and the exposure seems to be associated with a tendency to experiment with drinking.

Bad health habits that spell early death start youngexternal link

At the movies, adolescents indoctrinated to drinkingexternal link

And some good news

On the other hand, University of Maryland research in the journal Heart suggests that watching a funny movie can have cardiovascular benefits, while watching a sad show can cause ... er ... heartbreak.

Turns out that funny stuff causes arteries to relax, allowing greater blood flow, while the sad stuff has the opposite effect.

Cardiovascular risks of ethos and pathos at the moviesexternal link

But avoid the popcorn ...

Eating a sound, well-balanced diet -- but keeping the calories extremely low -- is good for your heart. People whose daily diets were extremely low in calories had significantly lower levels of inflammatory markers and more flexible ventricles, which translated into better diastolic function, according to a Washington University study in the Journal of the American College of Cardiology.

Calorie restricters seem young at heartexternal link

Work out regularly ...

People 65 and older who exercise for at least 15 minutes three or more times a week have a 30 to 40 percent lower risk of developing Alzheimer's disease or other forms of dementia than their more sedentary counterparts, investigators at the Group Health Cooperative in Seattle said in the Annals of Internal Medicine.

Exercise fends off dementia in older adultsexternal link

And take an aspirin

Aspirin protects women against stroke but not heart attacks, while in men it's the other way around, researchers at the State University of New York at Stony Brook and elsewhere reported in the Journal of the American Medical Association.

Both sexes can benefit from a daily dose of aspirin, but the habit does increase the risk of major bleeding episodes.

Aspirin prevents stroke in women and heart attack in menexternal link

Genetic link to diabetes

Researchers in Iceland, taking advantage of the country's relatively homogenous population and good genealogical records, have found that a variant gene carried by about four in 10 people increases the risk of type 2 diabetes, they reported in Nature Genetics.

And you thought it was all just because we're getting fatter and lazier.

Variant gene linked to diabetes is carried by 38 percentexternal link

Breast cancer and kids

Women who are diagnosed with breast cancer shortly before or during a pregnancy can be reassured that the disease won't affect the baby, researchers said in the British Journal of Cancer.

The only significant risk the researchers found was that boys may be born underweight.

On the other hand, early-stage breast cancer in moms can cause problems for school-age children, particularly girls, British investigators said in the same journal.

The problems vary greatly, but there's a significant risk of overall family dysfunction, as well emotional and behavioral problems in the children.

Breast cancer during pregnancy doesn't affect babiesexternal link

Kids may have psychological upheaval during mother's cancerexternal link

Are fat rats happy?

Leptin, a hormone touted as being involved in weight regulation, also appears to act as an antidepressant.

When researchers at the University of Texas at San Antonio made rats miserable by subjecting them to chronic unpredictable stress, leptin levels fell and the animals showed signs of ratty depression, they reported in the Proceedings of the National Academy of Sciences.

Giving them shots of the hormone appeared to reverse the effects of the stress.

Leptin acts as rodent antidepressantexternal link

New HIV regimen called simple, effective

Only a few years ago, a person being treated for HIV could expect to take dozens of pills a day on a complicated schedule.

But Johns Hopkins researchers said this week in the New England Journal of Medicine that a new regimen of drugs, which can be taken once a day, is more effective than the current gold standard.

In the near future, as well, all the medications may be combined in a single pill.

New HIV regimen outperforms gold standardexternal link

Urine test improves bladder cancer detection

People who once had bladder cancer have a high risk of recurrence. Now a simple urine test, with results available in the doctor's office within an hour, can dramatically improve the detection of renewed cancer, investigators at the M.D. Anderson Cancer Center in Houston said in the Journal of the American Medical Association.

Combined with standard procedure that examines the tissue of the bladder directly, the BladderChek test detected 99 percent of all recurrent cancers in a new study.

Urine test speeds detection of bladder cancer recurrenceexternal link

Flying can be hazardous to your health

In these days of avian flu and SARS, we fear the thought of nasty new diseases arriving in America by jetliner. But while the scary stuff is grabbing the headlines, a host of more mundane illnesses is slipping through.

Every year more than 4 million Americans who travel abroad are sick enough to seek medical care either while out of the country or on returning home, researchers said in the New England Journal of Medicine this week.

Luckily for the rest of us, most of the problems are mild and self-limiting, such as diarrhea, respiratory infections and skin disorders.

Hospital trips may follow trips to the developing worldexternal link

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