Ferreting Out Elder Abuse; Fitness-Tape Risks; Probing the Dentist's
Quesitons on abuse; Risky video; Dentists and AIDS; Cheap flights
FERRETING OUT ELDER ABUSE. Older patients may be startled to hear their doctor ask, "Has anyone at home ever hurt you? Have you signed any documents you don't understand? Has anyone ever scolded or threatened you?" But such questions may soon be standard. New guidelines from the American Medical Association urge doctors to identify, treat and help prevent abuse of the elderly. The AMA suggests that doctors routinely interview elderly patients alone and ask leading questions like those above. Up to 2 million older people a year are subjected to abuse ranging from violence to theft of money. Nearly every state requires physicians and other health professionals to report suspected cases of elder abuse to the adult protective service agency or other appropriate state agencies for investigation.
FITNESS-TAPE RISKS. Supermodel Cindy Crawford's "Shape Your Body Workout" videotape, the top-selling fitness tape in the country since its October release, has some medical experts alarmed. "I would call on Ms. Crawford to correct some of these exercises before the average exerciser gets hurt," says Nicholas DiNubile, an orthopedist and special adviser to the President's Council on Physical Fitness and Sports. He and other doctors who screened the video cite several exercises that could injure the back, neck, leg, hip or knee. For example, Crawford's version of a leg kick could strain hip joints because the back is arched, according to DiNubile. And Crawford-style full sit-ups could sprain the lower back or inflame the sciatic nerve. Fitness experts stress that only the shoulders and upper back -- not the small of the back -- should leave the floor.
The video carries a disclaimer to check with a doctor first but doesn't say that the exercises are particularly strenuous. Crawford's trainer and co-star, Radu Teodorescu, defends his exercises as safe and told a U.S. News reporter to "call the American College of Sports Medicine -- they understand what I'm trying to do." Lyle Micheli, past president of the group and a professor of orthopedic surgery at Harvard Medical School, says the tape is appropriate for trained athletes. The average exerciser, he says, runs "a risk of injury." For athletic types seeking a vigorous workout, fitness experts recommend "Karen Voight's Great Weighted Workout" and "Charlene Prickett's Muscle Building," available from Collage Video at (800) 433-6769 for $ 29.95 and $ 19.95 respectively plus shipping.
PROBING THE DENTIST'S DRILL. It's no surprise that dentists' drills and teeth-cleaning instruments can become contaminated after use on patients infected with HIV -- the virus that causes AIDS -- and the hepatitis B virus. Findings published November 21 in The Lancet merely confirm the notion with tests involving patients. What's unexpected is that of dentists whose drills can be heat-sterilized between patients, only about 60 to 70 percent actually are heat-sterilizing them. That's according to an unpublished national survey of 510 dentists last May by the American Dental Association. Only 75 percent heat-sterilize their major cleaning tools. Heat sterilization kills viruses in places that disinfectant can't reach. After the survey, the ADA strengthened its heat-sterilization guidelines. How many dentists changed their routines is unknown. The ADA maintains that no documented cases of HIV or hepatitis B are associated with contaminated drilling or cleaning tools. Federal health authorities agree but concede that such infections would be extremely difficult to trace and that patients could be at risk. Those with concerns should question their dentist. But you might not have to ask. Many dentists now tack a $ 15 "infection control" charge for each visit to cover the costs of heat-sterilization as well as gloves and gowns.
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