Croup Researchers Say Injections More Effective Than Inhalants

Steroid injections work better than an inhaled treatment for children suffering from croup, a condition that causes coughing and hoarseness, a study in Thursday’s New England Journal of Medicine found. Steroids are usually used to treat the condition, which afflicts about 3% of children younger than 6.

Dr. David W. Johnson and his colleagues at Alberta Children’s Hospital reported that in a study of 144 children treated for moderate or severe croup, an injected steroid dexamethasone sold under the brand name Decadrom was a bit more effective than the inhaled steroid budesonide sold under the name Pulmicort Nebuam.

The children were split into three groups, one of which received a placebo. Seventy-one percent of the placebo children ended up in the hospital, the rate was 38% in the budesonide group and 23% among those who got dexamethasone.

Genetic Switch May Direct Muscle Fibers

Texas researchers have discovered a genetic switch that tells muscle fibers whether to be the fast strength muscle seen in weight lifters or the slow endurance muscle developed by runners. The discovery opens the possibility of creating drugs that would mimic some of the health-promoting effects of regular exercise, according to Dr. R. Sanders Williams of the University of Texas Southwestern Medical Center at Dallas.

The discovery, reported in Thursday’s issue of the journal Genes and Development, might make it possible to restore endurance muscle tissue in people who have lost it as a result of congestive heart failure. Diabetics might also benefit from a drug that would enhance slow, endurance-promoting muscle, which is more sensitive to insulin.

Pot or Crack Smoking May Boost Cancer Risk

Long-term marijuana or cocaine smoking increases the risk of lung cancer, according to a small UCLA study that compared tissue samples from people who smoke tobacco and illegal drugs. Dr. Sanford Barsky and his colleagues found that smoking marijuana and crack can cause the same precancerous changes in their bronchial cells that tobacco smoking causes--well before the smoker gets cancer.

The study, reported in Tuesday’s Journal of the National Cancer Institute, also found that smoking both tobacco and marijuana or cocaine increased the risk, because those smokers were more likely to sustain additional precancerous changes. Also, these combination smokers were more likely to have damage to their p53 gene, an important gene in fending off cancer.

The study compared respiratory tract tissue samples from 28 healthy volunteers and 76 smokers of tobacco, marijuana, cocaine or a combination of the drugs.

No Alcohol Advised for Those Trying for Baby

Women who are having difficulty conceiving should avoid drinking any alcohol, Dr. Tina Kold Jansen of the National University Hospital in Denmark warns in Friday’s Lancet. Although it has been known for some time that women who drink heavily have difficulty conceiving, new results from Jansen and her colleagues show that even women who have five drinks per week are affected.

The researchers studied 430 Danish couples, 20 to 35 years old, who were trying to conceive for the first time. Adjusting for other factors, such as smoking, sperm counts and female weight, they found that women consuming fewer than five drinks per week were twice as likely to conceive within six months as were women consuming 10 drinks or more.

Study: Oral MS Drug as Effective as Intravenous

Oral methylprednisolone is as effective as the commonly used intravenous form in shortening multiple sclerosis relapses, Danish researchers report in Thursday’s issue of Neurology. While intravenous forms of the steroid must be administered in a hospital, the oral form can be used at home, providing greater convenience for patients and reduced costs.

Dr. Finn Sellebjerg and his colleagues at the University of Copenhagen studied 51 patients with relapsing-remitting MS, which is characterized by unpredictable relapses during which new symptoms appear or existing symptoms are exacerbated. Such relapses can last for days to months. Although intravenous steroids are commonly used, their efficacy has not been proved, Sellebjerg said.

Twenty-six of the patients received oral methylprednisolone; the other 25 received a placebo. The team found that those receiving the drug had a 30% greater improvement in areas such as walking and voluntary movements.

--Compiled by THOMAS H. MAUGH II