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This week in the medical journals

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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Another one bites the dust

Another natural remedy bit the dust, or at least failed to meet expectations, in the major medical journals.

This week nature's answer for sore joints-glucosamine plus chondroitin sulfate -- failed to measure up to scientific scrutiny.

A federally-funded study compared the supplements either alone or together against Celebrex (celecoxib) or placebo in more than 1,500 people with knee pain caused by osteoarthritis. According to a report in New England Journal of Medicine the combo was no better than placebo for relieving mild pain. But placebo was pretty effective with more than 60 percent of patients reporting that pain decreased by at least 20 percent.

That surprisingly good placebo response plus the use of glucosamine hydrocholoride rather than glucosamine sulfate, a formulation that demonstrated efficacy in other studies, may have doomed the study from the start according to some experts. There was, however, a silver lining in the study results: Patients with severe knee pain had a significant benefit from treatment with glucosamine plus chondroitin sulfate.

Glucosamine-chondroitin sulfate can ease severe painexternal link

No need for prescription

On the other hand, there was pleasant news this week for those who prefer over-the-counter remedies to prescription drugs for runny noses caused by allergies.

Researchers from the University of Chicago reported in the Archives of Otolaryngology-Head & Neck Surgery that nonprescription allergy medications that contain pseudoephedrine performed as well as Singulair (montelukast), a pricey prescription medication, for controlling symptoms such as runny nose, sneezing, itching and congestion.

OTC decongestant and prescription drug found equal for allergic rhinitisexternal link

FPs demonstrate expertise

And following that same "keep it simple" theme, primary-care doctors -- in this case FPs and GPs -- proved to be just as good at handling follow-up care for breast cancer patients as specialists, according to a study of 968 patients.

Writing in the Journal of Clinical Oncology, researchers from Halifax, Nova Scotia, and other Canadian centers reported that women treated by their family doctors had the same risk for recurrence or death as women who received follow-up care from breast cancer specialists.

Generalists equal specialists in follow-up care for early breast cancerexternal link

Gum, anyone?

But the prize for the simplest -- and cheapest -- treatment reported this week went to a team of surgeons from Santa Barbara, California, who reported in the Archives of Surgery that chewing gum can speed recovery in patients who undergo colon surgery.

In a small group of patients who had elective surgery to treat either cancer or diverticulitis chewing sugarless gum three-times a day after surgery speeded the return of bowel function, which meant shorter hospital stays. Cost? Four cents per stick of gum.

Gum chewing stirs bowel after colon resectionexternal link

Work it out

Exercise -- for the body and the brain -- was the subject of a trio of studies reported in medical journals this week.

First, researchers from the Breast Cancer Detection Demonstration Project, a National Cancer Institute-sponsored group, reported that women cannot exercise their way to healthy colons.

They tracked exercise practices in 31,783 postmenopausal women and reported in the International Journal of Cancer that physical activity offered the women no protection from colon cancer.

Exercise fails to protect women against colon cancerexternal link

But exercise, the kind that keeps the heart healthy, also keeps the brain healthy, according to the NIH Cognitive and Emotional Health Project, an expert panel that reported its conclusions in the online version of Alzheimer's & Dementia.

The experts reviewed almost 100 published studies and found that exercise, healthy diet and medications that keep the heart healthy by controlling blood pressure, blood sugar and cholesterol also keep the brain up to speed.

Exercise and heart health may keep dementia at arm's lengthexternal link

And finally, exercising the brain with a little task-specific training such as how to "Google" to find a phone number, keeps aging brains in shape.

Moreover, when you think better, you look better, said the researchers from the University of Illinois who reported that people who mastered the task specific training looked and acted younger. The research was reported in Neurobiology of Aging.

Mental training bestows youthful vigor on aging brainsexternal link

Downside to higher education

However, even the well-exercised brain sometimes fails and when it does the decline may be quicker than previously believed, according to a team of Columbia University Alzheimer's disease researchers.

Writing in the Journal of Neurology, Neurosurgery and Psychiatry, they reported that a study of 312 New Yorkers found that while more education meant a lower risk of Alzheimer's disease, when dementia was diagnosed among those with advanced education the disease progressed more rapidly.

Higher education levels tied to faster Alzheimer's declineexternal link

Double your pleasure

Twins used to be a rare phenomenon, but seeing double is becoming more common these days.

Fertility experts have known for years that the likelihood of twin births goes up with maternal age, but they didn't have an explanation for this observation.

This week a team of Dutch researchers reported that the as women age, their hormones kick into overdrive and producing more follicle-stimulating hormone to help ensure a successful pregnancy. The result, the Dutch wrote in Human Reproduction, is that older mothers have a higher rate of nonidentical twins.

Hormonal overdrive sends twinning rates higher for older womenexternal link

When Viagra fails, try Lipitor

Finally, when a little blue pill doesn't work maybe it is time to try an oblong white one.

Writing in the Journal of Sexual Medicine researchers from the Hospital of the University of Pennsylvania reported that eight men who didn't achieve good sexual function using Viagra (sildenafil) improved their response when they started taking the cholesterol-lowering drug Lipitor (atorvastatin) along with Viagra.

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