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Health Headlines - August 15

Posted Oct 23 2008 2:24pm
School Backpacks Can Be a Real Pain

Backpacks are a convenient and efficient way for children to carry school books and other items, but if overloaded or improperly worn they can harm children's backs, experts warn.

"Wearing backpacks improperly or ones that are too heavy put children at increased risk for spinal injury," Mary Ann Wilmarth, director of the transitional doctor of physical therapy degree at Northeastern University in Boston, said in a prepared statement.

"Back pain is already the most common ailment among working American adults. If we don't correct the backpack issues that are causing children back pain, the issue will become magnified in years to come," Wilmarth said.

She offers the following advice for safe backpack use:

* Use both straps. Using just one strap means that one side of the body has to bear the entire weight of the backpack. Wearing both straps means that the weight is more evenly distributed.

* Load up with care. When taking backpacks on and off, kids should keep their torsos stable and avoid excessive twisting. Shoulder straps should be adjusted so that the child can easily put on and take off the backpack and have free movement of their arms.

* Don't go too low. The backpack should be worn over the strongest mid-back muscles and rest evenly in the middle of the back. It should not extend below the lower back.

* Stay light. Keep the backpack load at just 10 percent to 15 percent or less of a child's weight. Heaviest items should be placed closest to the back in order to reduce risks for postural misalignment and overworked muscles.

Utilities Tout Tap Water Vs. Bottled

With the public's insatiable thirst for bottled water, municipal water utilities are tapping into the market to fight competition from profit-making companies.

The utilities' message to consumers: Our product is as good as what's found on store shelves -- and less expensive. The utilities hope to make a few bucks and help their ratepayers in the process.

"People should not have to spend an exorbitant amount for quality water," said Ken Blomberg, executive director of the Wisconsin Rural Water Association, which promotes the sale of bottled municipal water as a less-expensive alternative to the commercially bottled product.

Consumers often buy bottled water thinking that it's safer or better than tap water, Blomberg said, when up to 70 percent of bottled water sold commercially comes from a municipal tap.

"However, water is a very local thing," said Greg Kail, senior public affairs manager for the American Water Works Association, which includes water treatment plant operators, scientists, environmentalists, regulators and others interested in the nation's water supply and public health.

Kail said there are thousands of water utilities around the country, using many different sources for their product and with different types of treatments. There is no organized national effort to promote bottled tap water over water bottled commercially, he said.

Nonetheless, some other major cities have started selling bottled tap water, including Kansas City, Mo., which provides retailers with cases of 24, 20-ounce bottles, each for $9.50 -- retailers set their own prices -- and San Francisco, which offers its water in 16.9-ounce bottles for $1.25 each.

Louisville, Ky., has given away empty reusable sports bottles for eight years with the message: "If you want really great bottled water in our community, all you need is the bottle." The city has filled smaller bottles with its municipal tap water and distributed them free for seven years to community groups and at events.

Blomberg's Wisconsin group, which represents rural water utilities, began pushing the sale of bottled municipal water about two years ago after hearing of a successful effort in the Milwaukee suburb of Oak Creek. The group's push is at the front end of the trend nationally, said Mike Keegan, an analyst for the National Rural Water Association.

"I think a lot of others will follow," he said.

Beverage Marketing Corp., a consultant to the industry, said bottled water consumption in the nation increased from 10 1/2 gallons per capita in 1993 to 24 gallons in 2004.

Judith Thorman, vice president for state and local affairs for the American Beverage Association, a trade group that represents commercial water companies and producers of other nonalcoholic beverages, said she did not have figures on the percentage of bottled water that comes from municipal taps.

"Obviously, the public thinks it is a good product and a good value, because they are buying it," she said of the commercially bottled water.

Although municipal and commercial bottlers must meet government standards for the water they sell, Thorman said commercial bottlers each set their own standards for the product as well.

Twig's Beverage Inc. in Shawano, which has bottled soft drinks for more than 50 years, has joined with several other Wisconsin communities, including Shawano and the state rural water association, to bottle water. Those sales have increased about 40 percent during the last two years to about 15,000 cases in 2004, company president Dan Hartwig said.

In addition to promoting consumption of municipal water, Steve Yttri, general manager of the Oak Creek Water and Sewer Utility, and Andy Onesti, general manager of Shawano Municipal Utilities, said they hoped to make money to keep water rates down.

But both said the sales have not yet produced much profit. Yttri said his water system made about $27,000 on bottled water last year.

Smokers Taking Controversial Cancer Test

If a simple, painless test can find the world's deadliest cancer when it is smaller than a pea -- and such a test does indeed exist -- shouldn't people who are most at risk have one? Surprisingly, the federal government, American Cancer Society and a raft of cancer specialists say the answer is "no."

They are waging an uphill battle as frightened current and former smokers rush to get a special kind of X-ray that other physicians are urging for lung cancer detection but that has not yet conclusively been shown to save lives.

A huge federal study is under way to see if it can, and answers may come as soon as next year. In the meantime, it's generating a classic "can't wait for science" stampede.

The clamor rose last week with the deaths of newsman Peter Jennings and "Dallas" star Barbara Bel Geddes, and the news that "Superman" widow Dana Reeve has lung cancer.

Patricia Dowds and her husband, David Byrom, psychologists from Long Island, are among the many former smokers who voted with their wallets and had the $300 test on Friday.

"We do it for our own peace of mind," Dowds explained.

No one disputes that the test, called a spiral or helical CT scan, detects lung abnormalities as small as 5 millimeters -- less than a fifth of an inch.

The argument is over whether that's a good thing.

For every cancer these scans detect, many more "false positives" occur -- harmless bumps and lumps leading to painful, expensive and unnecessary biopsies and surgeries. Complications can include lung collapse, bleeding and infection.

"The concern that we have is false positive rates," which range from 25 percent to as high as 60 percent, said Tom Glynn, the cancer society's director of science and trends. "What we don't want to do is create even more anxiety" by backing a test that is so imprecise, he said.

Even when cancers are found, experts argue about whether that's a benefit or a risk. No one knows how many of these tumors are so slow-growing that they pose less of a health threat than the surgery, radiation and chemotherapy used to treat them.

However, screening proponents say there's no mystery about how deadly the disease is, and that survival improves the sooner it is detected. About 172,570 Americans will be diagnosed with lung cancer this year and almost as many, 163,510, will die of it.

The morning after Jennings' death, the chairman of internal medicine at St. Louis University, Dr. D. Douglas Miller, contacted the public relations staff, urging them to get out the word on lung CT scans' benefits.

Dr. Len Horovitz, a lung specialist at Lenox Hill Hospital in New York City, also has been urging the test. Though there's no proof yet that it improves survival, "I can't believe it wouldn't," he said. "There are half a dozen people I could bring into my office today who are alive for that reason."

As for the risk of unnecessary followup procedures, "You don't have to biopsy everything you see," Horovitz notes. "You could also elect to watch it," and do a biopsy only if the lump appears to be growing.

The scans' biggest proponent is Dr. Claudia Henschke, director of the Lung Cancer Screening Program at New York-Presbyterian Hospital/Weill Cornell Medical Center, who published a landmark paper in 1999, reporting that the scans found far more lung tumors than conventional chest X-rays.

"We feel we have evidence that CT screening saves lives," not just from that 1,000-person study but followup work on 30,000 patients around the world, she said.

But her study isn't considered the gold-standard kind of evidence that insurers, policy-makers and scientists require. That will come from the huge randomized screening study the National Cancer Institute commissioned after Henschke's paper appeared. The cancer society, the American College of Radiology and other professional groups are participating in the enormous effort.

As an indication of how eagerly anticipated this study is, doctors allowed themselves two years to recruit 50,000 people for it -- and got 53,000, four months ahead of schedule, said Dr. Denise Aberle, the University of California at Los Angeles scientist leading the study. It will compare regular chest X-rays to CT scans and see whether either improves survival.

If it shows benefit, "I would feel great," she said, but won't recommend it until then, "and a lot of my peers and the scientific community are not."

One is Mary Yagjian, coordinator of lung screening at the University of Pittsburgh Cancer Institute, who advised against testing for her own 82-year-old mother, a former smoker at high risk of lung cancer.

"She's scared to death about getting it," and has a brother just diagnosed with cancer and a friend going through a recurrence now, according to Yagjian.

"It's important that we complete the definitive studies and get scientific information," said Dr. Christine Berg, chief of the early detection research group at the cancer institute. In the meantime, doctors have to do the best they can to advise each patient, considering that person's smoking history and other risk factors.

"It's the physician-patient relationship that's paramount," she said.

As contentious as CT scans are, some people are seeking even more controversial tests -- whole body scans. Two years ago, at the insistence of his wife who did not trust the clean bill of health he'd gotten from a regular chest X-ray, Hy Muroff of Windsor, Ontario, went to see Dr. Marc Kahn at EBT-Heart & Body Imaging in the Detroit suburb of Southfield, Mich.

Muroff, 78 at the time, had smoked but not for 20 years. The scan showed a tumor behind his heart; the growth was removed in surgery. He called to schedule another full-body scan a few weeks ago, after hearing that Jennings was diagnosed with lung cancer, to make sure his disease hadn't recurred.

People should get such scans, Muroff said, "only if you want to stay alive."

Ga. MD Accused in Flesh-Eating Paste Aid

A doctor is accused of assisting an unlicensed practitioner who allegedly treats cancer patients with a flesh-eating herbal paste that leaves them with horrible disfigurements, including mutilated breasts.

Georgia's board of medical examiners has accused Lois March, an ear, nose and throat specialist, of aiding and abetting Dan Raber's practice over the last three years by providing pain medication to patients who had received the treatments. One patient's flesh was eaten so badly from his shoulder that the bone was exposed.

Raber is under investigation and could face a felony charge of practicing medicine without a license. Raber, who has declined interview requests, claims on his Web site to offer a paste made with bloodroot that dissolves cancerous tissue, and when used in conjunction with his enzyme tablets, can eliminate cancer from the body.

The medical board said seven patients had sought treatment from Raber for breast cancer and that March knew or should have known that his use of the paste "mutilated their breasts and caused excruciating pain."

"All I can tell you is I'm not guilty," March said when reached by telephone at her office. "These are wild accusations that aren't true."

March can respond to the charges, but if her efforts fail she could lose her license to practice medicine in Georgia.

Raber's Web site advises those considering his treatments to arrange for pain management through a licensed physician. "This allows the doctor to help the patient take care of his health the way he, the patient, sees fit! Yet it allows the doctor to stay out of jail," the site says.

The board contends Raber was practicing medicine without a license -- which carries a penalty of up to five years in prison and a $1,000 fine. No charges have been filed but prosecutors say they are reviewing the allegations.

Raber claims his paste contains bloodroot, an extract from the root of a flower that grows throughout the eastern United States and Canada. Juice from the bloodroot plant is classified as an escharotic, a substance that can kill human tissue.

Mark Blumenthal, executive director of the American Botanical Council, said bloodroot has been used for years by nontraditional healers to treat skin cancers but he acknowledged "the efficacy has been unproven from a scientific point of view."

Raber's Web site includes disclaimers that note that the products lack government approval but he could still run into problems with the FDA, which has the authority to regulate herbal remedies that make claims about treating or curing diseases.

Food Fact:
Soymilky way.

A splash of soy milk on your breakfast cereal may help lower your cholesterol. According to the FDA, 25 grams of soy protein, or about four daily servings, is a good part of a dietary plan for a healthy heart. One cup of soymilk has 6.25 grams. Calcium-fortified soymilk is sold in supermarkets and whole foods stores. It's available in plain, vanilla, chocolate or strawberry flavors. Not all soymilk is calcium-fortified, however, so check labels. You can also use soymilk in custards, baked goods and other desserts -- just as you would with regular dairy milk.

Fitness Tip of the day:
Get back on track.

Fell off the exercise wagon? It's never too late to get back on! Losing your routine may slow you down, but you can get back on track in short order if you resume regular sessions. Get motivated by setting new goals; when you start back up, reduce by half the difficulty level where you left off.

FAQ of the day:
What's a Daily Value?

The Recommended Dietary Allowances (RDAs) and a related number, the Dietary Reference Intakes (DRIs), are suggested intakes of nutrients based on age and sex. They do not appear on food labels, but they were used to develop the Daily Values you see on a label. The Daily Value is a single number for everyone that is set high enough to ensure that the vast majority of people get enough of each nutrient. It's the best general guide for the public.
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