Healthoughts

Healthoughts compiled by Jon Nalick and Kathleen O'Neil

Illustrations by Diane Bigda.

straighten up

Viewed from the side, the spine has an undulating shape that curves out at the shoulder blade area, in at the lower back and then out again at the hip area. But viewed from behind, the spine is straight from the neck base to the bottom tip.

Or so it should be. Scoliosis causes an abnormal side-to-side curving of the spine that pulls it into an S or C shape. Scoliosis occurs more often in girls than boys and rarely happens in adults. Adolescents may suffer from self-esteem issues when diagnosed with scoliosis, but medical complications are not the norm.

“There’s a very low chance of scoliosis causing a medical problem,” says Mark Spoonamore, M.D., associate professor of orthopaedics at the Keck School of Medicine of USC. “Most curves have a low chance of getting worse and don’t require treatment.”

A study that tracked patients with scoliosis for 50 years found that even in people with a large curvature that goes untreated, researchers were unlikely to find any health effects other than an increase in back pain, Spoonamore says.

Only in cases that occur before or during adolescence—when a growth spurt causes faster bone growth—is treatment usually considered to keep a curve from getting worse. Plastic torso braces, which force the spine into a straighter position, are commonly used to halt curves with a bend of 25-degrees or greater. Adolescent girls are about 10 times more likely to have a curve that could get worse without a brace. However, boys are much more likely to require surgery for curves of 45 degrees or more.

Because of high post-surgery complication rates, fewer than 10 percent of scoliosis patients have surgery to correct severe curvatures.

While birth defects, hereditary factors or other health problems can lead to scoliosis, doctors do not know what causes most of the cases. Spoonamore recommends keeping tabs on a child’s spine by having a pediatrician do a simple test for scoliosis during regular check-ups.

 

rough it

A recent study published in the Journal of the American Medical Association appears to contradict earlier findings suggesting that dietary fiber protects against colorectal cancers, but one USC nutrition expert says most people should probably eat more of it anyway.

Carol Koprowski, Ph.D., R.D., assistant professor of preventive medicine at the Keck School of Medicine of USC, says the seemingly contradictory studies might be indicating that foods with lots of fiber may confer some protection from cancer—even if dietary fiber is not the actual reason.

“It could be that foods that are naturally high in fiber—such as fruits and vegetables—also contain something else that has a protective effect. Scientists try to isolate the mechanism responsible for that protection and at this point, we can’t really say that fiber is the key,” she says.

Even so, she adds, “It’s a good thing to keep in your diet. It keeps your digestive system functioning properly and foods that are high in fiber tend to be lower in calories while still helping you feel full longer. So those foods can be helpful in maintaining an appropriate weight.”

She says that people should eat 20 to 35 grams of fiber each day, but notes that most Americans consume only about 15 grams daily.

Koprowski recommends that to reach that goal people try gradual substitutions of higher fiber foods that they already enjoy. For example, she suggests whole grain cereals for breakfast, eating whole fruits instead of drinking fruit juices and replacing white rice with brown rice.

 

skin pics

For physicians trying to determine which of their patients’ moles might be cancerous, a picture is worth far more than a thousand words—it can be a matter of life and death.

With that in mind, dermatologists are turning to digital photography and computerized recordkeeping to help track changes in patients’ moles over time, a process called “mole mapping.”

David Peng, M.D., M.P.H., assistant professor of clinical dermatology at the Keck School of Medicine of USC, says that one of the markers of a developing melanoma is a mole that changes size, shape, color or borders. Typically, physicians would take notes about suspicious moles on a patient and supplement the notes with drawings or photos.

“But you cannot draw or describe every mole’s color and borders and size as well as a photo can,” he says.

The USC Department of Dermatology will soon obtain a new digital photography mapping system that allows a dermatologist to quickly scan the entire body of a patient while maintaining precise control over the lighting and a constant distance between the camera and the skin. The digital system provides a higher level of control and consistency compared to a hand-held camera and allows better comparisons of moles over time.

Peng says that the innovative technology will greatly increase the chance that a cancer will be caught early because it improves the ability of a physician to detect suspicious growths.

He adds, “Early detection is key because melanomas are among the deadliest tumors after they spread.”

 

positive recognition

A stroke is caused by a blood clot or a burst blood vessel in the brain. Every minute that passes without treatment deprives brain tissue of oxygen, which causes it to die and increases the risk of irreversible brain damage.

Often, stroke symptoms are not recognized, which results in a deadly delay to get a stroke victim to the hospital.

Recent studies show that only about half of the people questioned about stroke symptoms were able to identify them. The symptoms include difficulty speaking; paralysis, especially on one side; sudden weakness; loss of balance or vision, and a sudden, intense headache.

“It’s surprisingly poor recognition,” says Gene Sung, M.D., assistant professor of neurology at the Keck School of Medicine of USC. “Either they don’t recognize it, or they think it is not serious and will get better.”

A simple three-part test can help identify if someone is experiencing a stroke and speed up seeking help:

Failure of any of the three parts means that the person should go to a hospital as soon as possible, even if the symptoms seem to go away.

“New therapies are only effective in the early post-stroke time,” Sung says. Many of the drugs need to be used in the first three hours, while other treatments have an eight-hour window.

Strokes are the third-leading cause of death and the primary cause of disabilities in adults in the United States. Unlike other organs, the brain does not have the ability to grow new cells and repair itself.

Sung says, “Widespread use of this test could result in prompt diagnosis and treatment of the stroke and prevent extensive brain damage.”