Oh my aching back!
Suffer from back pain? Not surprising considering it's one of the top adult health complaints (as many as one in four Americans report experiencing lower back pain at least once a day). Wonder what to do about it? So do many doctors, which is why the American College of Physicians and the American Pain Society this week released guidelines on how to diagnose and treat it. Numero uno rule, they say: physicians should rely less on tests such as CAT scans, MRIs or x-rays for patients grumping about nonspecific back pain and more on various medications (but to carefully weigh the risks and benefits of each one) and employ nondrug therapies such as acupuncture and massage. The groups recommend limiting imaging tests to patients with back pain that is severe and accompanied by neurological or spinal symptoms or if an underlying culprit such as cancer is suspected. (summary for patients)

Best Rx for the teenage blues
A new study says that a combo of drugs and counseling is the most effective treatment for teen depression. Over 400 depressed kids were treated for 12 weeks with either the antidepressant Prozac, cognitive behavior therapy or a mix of both. Some 73 percent of those receiving combination therapy responded favorably, compared with only 62 percent of those on Prozac and 48 percent undergoing counseling. Caution: teens treated only with Prozac were found to be twice as likely to experience suicidal thoughts or behaviors as those who received cognitive behavior therapy, researchers report in Archives of General Psychology. (AGP)

Flu shot reduces death, hospitalization of seniors
There has recently been a flurry of debate over whether flu vaccines really protect seniors. Researchers at the Minneapolis Veterans Affairs Medical Center are the latest to weigh in, reporting in The New England Journal of Medicine that a survey of results from the past several flu seasons shows that seniors who received the vaccine had a 48 percent reduced risk of death and a 27 percent reduced risk of being hospitalized from the flu or pneumonia. (NEJM)

Virtual versus traditional colonoscopy
A major new study shows that virtual colonoscopy works just as well as traditional scope exams in scouting for potentially cancerous growths. Researchers from the University of Wisconsin Medical School compared the results of 3,120 patients scanned virtually and 3,163 screened the traditional way and report inThe New England Journal of Medicine that the tests detected nearly the same number of suspicious polyps—123 in the virtual crowd and 121 in the conventional group. Virtual colonography uses a CT scanner to take a series of x-rays of the colon and a computer to create a 3-D view. A small tube is inserted in the rectum to inflate the colon so that it can be viewed more easily. Conventional colonoscopy, the gold standard for colorectal cancer screening, offers both diagnostic and therapeutic options, because a polyp can be removed immediately if discovered during the procedure. If a lesion is found during a virtual exam, the patient must then undergo a traditional colonoscopy to extract it. Virtual colonoscopy is about a third the cost of the conventional variety, but many insurance companies consider it to be experimental and won't cover a portion of the tab. That could change, though, if a large federally funded study now underway confirms these results. Guidelines from the American Gastroenterological Association call for everyone 50 years of age and older (younger in high-risk groups) to have a colonoscopy. According to the National Cancer Institute, an estimated 112,340 new cases of colon cancer and some 41,420 cases of rectal cancer will be diagnosed, and more than 52,000 Americans will die this year from the disease, which is the second-leading cause of cancer-related deaths even though it can be successfully treated if caught early. (NEJM)

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