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This week in the medical journals

Possible cystic fibrosis treatment from inexhaustible supply

By Peggy Peck
MedpageToday.com Managing Editor

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.

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Drug safety questioned

The major medical journals this week published studies that raised serious questions about the safety of two drugs and debunked some popular theories about the value of two of the gods of nutrition, soy and fish oil.

Safety issue for heart surgery drug

A team of independent researchers in California sounded the alarm about Trasylol (aprotinin), a drug used to control bleeding during heart surgery. According to the report in the New England Journal of Medicine, patients treated with Trasylol had almost twice the risk of death, kidney failure, or stroke and a 50 percent higher risk of heart attack.

The researchers based their report on a review of records from more than 4,300 patients who had heart surgery at 69 institutions worldwide.

But Bayer, the maker of Trasylol, denied the charge. The drug company said the drug has had a good safety record for 15 years and pointed out that the California researchers are basing their conclusion on observational data, not on more reliable placebo-controlled studies.

Commonly Used Drug in Heart Surgery May Increase Risk of Deathexternal link

Antibiotic linked to liver damage

Also this week, researchers in North Carolina reported three cases of serious liver damage -- including one death -- among patients treated with the antibiotic Ketek (telithromycin). Editors at the Annals of Internal Medicine released the report online in order to get the word out quickly to doctors.

In the cases reported, one patient developed problems with liver function after taking the drug to treat a sinus infection. That patient recovered when the drug was stopped. A second patient given the drug to treat cough and a runny nose developed liver failure and needed a transplant. The third case involved a patient who died after using the drug for a sinus infection

Three severe liver damage cases linked to ketolide antibioticexternal link

No evidence for soy protein benefit

Meanwhile, the heart-healthy reputation of soy protein has not held up under scrutiny, said the American Heart Association. The AHA, which said in 2000 that supplementing food with soy protein was a "prudent" recommendation, now says that soy protein has no significant benefit.

When the AHA experts analyzed data from 22 randomized clinical trials, they concluded that neither soy protein nor isoflavones -- the so-called plant estrogens -- could significantly lower LDL, the "bad" cholesterol, nor raise HDL, which is good cholesterol. Soy protein, the AHA reported in Circulation, Journal of the American Heart Association, also doesn't lower blood pressure and has no effect on triglycerides.

Heart association ardor cools for soy proteinexternal link

Fish oil fails

Just 24 hours after the shoe dropped on soy, researchers from Rand Health in Santa Monica, California, reported that fish oil doesn't prevent cancer. Their report in the Journal of the American Medical Association concluded that results from 38 published studies found that while omega-3 fatty acids, aka fish oil, may prevent cancer in mice it has no similar benefit in humans. The much-touted heart benefits from eating fish high in omega-3 fatty oils were not affected by the cancer report.

Omega-3 flounders as cancer protectionexternal link

Radiation works

But if fish oil doesn't work for cancer, radiation may work even better than was expected, according to researchers in Australia. They reported that radiation treatments intended to ease the pain of lung cancer, not cure the disease, may sometimes cure it anyway. The cure rate is small -- just 1 percent of 2,297 patients who received palliative radiation -- but real, the researchers reported in Cancer.

Post-op radiation extends survival in endometrial cancerexternal link

Aspirin may be safe for some

And aspirin, usually considered a no-no for patients who have had bleeding in the brain, may be safe for a small number of patients, according to results reported in Neurology. A team of stroke experts from Massachusetts General Hospital said that 22 percent of patients who were given aspirin after brain hemorrhages did not have recurrent hemorrhage. The patients were given the aspirin to lower the risk of blood clots, which could cause ischemic strokes.

Aspirin after cerebral hemorrhage may be okay - sometimesexternal link

Heart surgery change may protect brain

On the subject of the brain, surgeons at Wake Forest University School of Medicine in Winston-Salem, North Carolina, said that the cognitive impairment experienced by some patients after bypass surgery may be caused by manipulation of the aorta, the heart's main artery. In recent years several studies have suggested that problems such as difficulty concentrating and memory deficits after heart surgery are caused by the use of the cardiopulmonary bypass pump. That argument prompted many surgeons to skip the pump and switch to "beating-heart" surgery.

But the Wake Forest team, which reported the findings in the Journal of Thoracic and Cardiovascular Surgery, said the pump is safe. Using a simple single aorta cross-clamp when hooking up the pump will reduce risk of cognitive problems.

In coronary surgery, spare the aorta to save the brainexternal link

Erectile dysfunction a sign of heart disease

Erectile dysfunction may be a good clue to identify men who are likely to need bypass surgery in the future, according to researchers from the University of Chicago, who reported their findings in the Archives of Internal Medicine. Erectile dysfunction, they concluded, is an independent predictor of severe coronary disease.

Erectile dysfunction predicts coronary heart diseaseexternal link

Old kidneys work well when transplanted

Switching organs, Italian researchers reported that kidney transplants from donors older than 60 work as well as kidneys transplanted from donors who died at younger ages. The key to a good outcome, they reported in the New England Journal of Medicine, is a pre-transplant biopsy that can identify poorly functioning donor kidneys.

Donor age no barrier to cadaver kidney successexternal link

Can you hear me, yet?

Meanwhile, if anyone is still worried, yet another study has confirmed the good news: cell phones don't cause brain tumors. This latest report, which was published in BMJ, comes from researchers at the Leeds Institute of Genetics, Health and Therapeutics in Leeds, England. They said that cell-phone users who burn up the minutes are no more likely to develop glioma than people (are there any?) who shun mobile phones.

Glioma and Cell Phones -- Again No Linkexternal link

Genes Tell the Story

Also this week, two teams of geneticists made a different kind of connection -- they linked Ashkenazi Jews and Northern Africa Arabs. The link, as reported in the New England Journal of Medicine, is a single genetic mutation that appears to cause Parkinson's disease in both groups. The mutation suggests a single "founder" thousands of years ago for these two distinct "tribes."

Ashkenazi Jews and Arabs with Parkinson's share same gene mutationexternal link

Finally, a pair studies that remind us once again that researchers share a number of traits with hunters. In these cases, tracking is the skill that comes to mind.

Follow the money

Deep Throat advised Washington Post reporters Bob Woodward and Carl Bernstein to "follow the money" to unravel Watergate, and now epidemiologists used that admonition to predict the path of future pandemics. Writing in Nature, researchers in Germany and California said that following the international trail of a single dollar gave them a good idea of how humans travel in the jet age. Dollar tracking, or the popular game of "Where's George?" on the Internet, is the basis for this new pandemic model.

Money trail may mark path of new pandemicsexternal link

Follow the shopping cart

Other researchers followed grocery carts to learn why wine drinkers are healthier than beer drinkers. The answer, the Danish researchers reported in BMJ, is that people who pick up a bottle of wine are also likely to pick up fruit, vegetables, pasta, and fish, poultry or lean meat to go with the wine. Beer drinkers, on the other hand, are likely to fill their carts with chips, sausages, cookies, and cold cuts to go with the six-pack. Enough said.

End Note: They don't call them beer nuts for nothing

Eating well may explain wine drinkers' better healthexternal link

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