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This week in the medical journals

By Peggy Peck 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.



National Institutes of Health (NIH)
Medical Research
Government Health Care

Mixed message

Hormones. Can't live with them, can't live without them.

That mixed message has been vexing older women and their physicians since 2002 when the National Institutes of Health pulled the plug on its massive study of hormone replacement therapy.

The NIH said it stopped the study because women who took Prempro, an estrogen-progestin combination, had a higher risk of stroke, heart attack, blood clots and breast cancer.

Estrogen and breast cancer, take 1

Many women zeroed in on the breast cancer message and dropped their hormones like hot potatoes.

But that is only one side of this evolving story, according to a new analysis from the same researchers who reported that Prempro increased the risk of breast cancer. A parallel hormone study -- one that tracked the affect of Premarin, which is conjugated equine estrogen without progestin in women who had undergone hysterectomy -- was reported this week the Journal of the American Medical Association.

This estrogen study found no increased risk of breast cancer among women who took Premarin for more than seven years.

Estrogen alone does not increase risk of breast cancerexternal link

Estrogen and breast cancer, take 2

But there was more on the hormone front this week. Boston University researchers reported in Archives of Internal Medicine that black women who use hormones for 10 years or more had a 50 percent increase in the risk of developing breast cancer compared with similar women who never used hormones.

In this study, which included data from more than 23,000 black women, risk was slightly higher when women took estrogen plus progestin, but estrogen alone also increased the relative risk of breast cancer.

HRT-breast cancer link holds true for black womenexternal link

Chemotherapy benefit

There was, however, some positive news for women who develop what is called estrogen receptor-negative breast cancer.

Researchers from the M.D. Anderson Cancer Center in Houston reported in the Journal of the American Medical Association that chemotherapy after surgery works much better in women with this variety of breast cancer than in women with the more commonly found estrogen receptor-positive cancers.

This was surprising since most cancer doctors thought that the opposite was true. But detailed analysis of data from three large breast cancer treatment trials suggested that chemotherapy works in both types of cancer, although the treatment regimen should be targeted to the estrogen status.

Chemotherapy a positive for ER-negative breast cancerexternal link

A real shocker

The news was not so positive for people who undergo a high-tech treatment for kidney stones.

Mayo Clinic researchers reported in the Journal of Urology that people who had their kidney stones treated with shockwaves that pulverized the stones had a fourfold increase in the risk of diabetes and a significantly higher risk of developing high blood pressure than people who had medical treatment for kidney stones.

Lithotripsy linked to diabetes and hypertension riskexternal link

Pregnant? Time for a dental checkup

Also this week, researchers at Cleveland's Case Western Reserve University confirmed something that has been suspected for decades: bacteria in the mouth can travel to the womb where they can trigger premature births.

The researchers reported that Bergeyella, which is a fairly common oral infection, was found in both the mouth and uterus of a woman who gave birth at 24 weeks of gestation.

They published the finding in the Journal of Clinical Microbiology.

Oral bacteria linked to uterine infections and preterm birthexternal link

Smoke gets in your pancreas

Secondhand smoke has been on the health hazard radar for more than a decade, but here is a new twist: Breathing other people's tobacco smoke significantly increases the risk of developing glucose intolerance, according to researchers from the University of Alabama at Birmingham.

Writing in BMJ, the researchers pointed out that smokers have been known to have an increased risk of glucose intolerance, which is considered a precursor of diabetes, but this is the first study to link passive smoke exposure to glucose intolerance.

Passive smoke fingered as trigger for glucose intoleranceexternal link

Tiny couch potatoes

Human tele-tubbies are not quite as cute as TV's computer-generated, brightly colored Teletubbies that can mesmerize the toddler set, but they are more common.

Toddlers who spend two or more hours a day watching TV are more likely to be overweight than same-age kids who are playing rather than viewing, according to University of Michigan researchers who studied more than 1,000 three- and four- year-olds.

They reported their findings in Archives of Pediatrics and Adolescent Medicine.

Tube-watching tots Become tele-tubbiesexternal link

Getting some 'Zs' in the nursery

And speaking of tots, it looks like snoring may be an inherited trait.

Researchers from Children's Hospital Medical Center in Cincinnati reported in Chest that kids whose parents are allergy prone -- atopic adults -- are likely to snore and 15 percent of kids whose parents are habitual snorers have an increase risk of obstructive sleep apnea.

Snoring in tots signals sleep-disorder riskexternal link

Transplant overcomes rare disease

Maple syrup urine disease is a rare and serious genetic disorder that causes a toxic buildup of amino acids in blood and tissue. The only known treatment was a severely restricted diet, but even so there was always a high risk for metabolic crisis and neurological injury, according to researchers at the University of Pittsburgh.

But liver transplantation turned out to be effective for 11 children who have the disorder that was named for the maple syrup smell emitted by their urine.

The researchers hit upon liver transplantation as a treatment when a girl who had the disease underwent transplant to treat liver failure, the researchers wrote in the American Journal of Transplantation.

Liver transplants provide long-term control of rare disorderexternal link

We'll drink to that

Finally, the Dorothy Parker Excellence in Medical Research Award went to researchers at Columbia's College of Physicians and Surgeons in New York who reported this week that moderate drinking is associated with sharper minds -- sharper female minds, at least.

The researchers studied more than 2,200 women who live in northern Manhattan and found that women ages 40 or older who said that had one or two drinks a day had higher scores on tests that measured cognitive ability.

They report the results in Stroke, Journal of the American Heart Association.

Moderate drinking linked to quick-witted womenexternal link

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