Painkillers, prostate cancer and the PSA test

Many men remain undecided about whether to have the prostate-specific antigen (PSA) test for prostate cancer, as part of a routine health check. On the one hand, screening can detect cancers at an early stage; on the other, it may lead to needless investigations, and treatments that have risks of serious side effects. That's because many prostate cancers are very slow-growing and could safely be left undiagnosed and untreated.

Now a new study threatens to muddy the waters further. It suggests that men who regularly take aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) could have lower blood levels of PSA, the protein that is a marker for prostate cancer.

In the study, researchers looked at the PSA levels of more than 1,300 men over age 40. They found that men who used NSAIDs regularly had PSA levels that were around 10 percent lower than those of men who did not take these drugs.

The problem is, researchers don't know what this signifies. Do men who take these drugs run the risk of cancer not being detected because NSAIDs affect levels of PSA in their blood? Or do men who take NSAIDs have less of this protein because they are less likely to have prostate cancer?

Tip of the day: Help your kids get some zzzz's

School's in session, but your children might have grown accustomed to staying up late over the summer break. When kids don't get a proper night's rest, their mood and performance can be affected. So, how do you get them to settle on a healthier sleep routine? Try having your kids minimize or avoid stimulating activities, such as heavy reading and computer games, within one hour of bedtime. And make sure they go to bed and wake up about the same time every day.

Read more on what you can do if your child isn't sleeping, and find out why technology could be the cause of your teen's poor sleep hygiene. And learn what you can do about your own sleep woes.

What nationality is your ground beef?

Until now, when I bought commodity ground beef, I had no clue where it came from. But as of Sept. 30, 2008, long awaited government regulations require most supermarkets and grocery stores to inform consumers about the nationality of their beef, veal, lamb, pork, chicken, and even goat. These retail stores must also identify where in the world their fresh and frozen fruits and vegetables, peanuts, pecans, ginseng, and macadamia nuts were grown.

Congress passed the so-called, "country of origin labeling" or "COOL" legislation back in 2002, but under pressure from industry, delayed its implementation—requiring only labeling of wild and farm-raised fish and shellfish—until now.

COOL's full implementation is a big step forward for food safety-conscious people. A Consumer Reports poll released last year found that 92 percent of Americans agree that imported foods should be labeled by their country of origin. Labeling allows consumers to choose to buy foods raised locally, domestically, and from countries they trust. Some people may like to buy only U.S. products, or certain imported products, such as New Zealand lamb or Holland tomatoes.

Tip of the day: Have a drink for your heart

Drinking a little bit of alcohol—one drink a day for women, one or two a day for men—can raise HDL (good) cholesterol and reduce inflammation and blood clots. But more than that can cause heart problems. So, have a glass of wine—red or white—and toast to your heart health!

Q&A: Vitamin A in wheatgrass

You've warned about the dangers of taking too much vitamin A. I regularly drink wheatgrass juice, which has lots of it. Should I cut back? —C.W., Nyack, N.Y.

There's no need to. It's true that wheatgrass juice can be a good source of beta-carotene, which your body converts to vitamin A. But the warnings about vitamin A generally apply to the animal-derived form of the vitamin, called retinol. Research has linked high daily doses of retinol to increased risk of birth defects, hip fracture, and liver damage. For that reason, men should get no more than 3,000 IU of retinol daily and women no more than 2,300 IU. As for beta-carotene, megadoses from pills do increase lung-cancer risk in smokers, but the amount in food, including wheatgrass juice, is probably safe.

This article first appeared in the September 2008 issue of Consumer Reports On Health.

Read more on how to fill your nutritional gaps (free) and which supplements to should avoid (free), and check out our Natural Medicine Ratings for Vitamin A (subscribers only).

Congress passes legislation to end insurance discrimination

After nearly a decade of fits and starts, this week Congress has passed landmark legislation that ends insurance discrimination against mental health and substance abuse claims for more than 113 million Americans .

If enacted into law as expected, the new federal mental health parity measure would:

• Require health insurers to place mental health and substance-use-disorder benefits on a par with physical health benefits.
• Extend to all aspects of an individual's health plan, including day/visit limits, dollar limits, coinsurance, copayments, deductibles, and out-of-pocket maximums.
• Preserve strong state parity and consumer protection laws while extending parity protection to 82 million more people who cannot be protected by state laws.
• Ensure parity coverage for both in-network and out-of-network services.

"This measure stops insurance companies from setting higher co-pays or placing stricter limits on mental-health benefits," said Adrienne Hahn, a senior attorney for Consumers Union . "It will level the playing field for those suffering from mental illness and give them the same protections and coverage as those with physical ailments."

Should you consider a period-reducing birth-control pill?

You've probably seen the ads: An attractive young woman releases colorful balloons into the air bearing words like "acne," "bloating," "irritability"—the premenstrual symptoms she's ostensibly able to kiss goodbye now that she's taking the birth-control pill Yaz. In a print and Web spot for Lybrel, a similar-looking woman dances in a field, liberated from her period altogether, since Lybrel is taken every day, 365 days a year, with no placebos. And a TV ad for Seasonique features two versions of the same woman—Logical and Emotional—conversing with each other about having just four periods a year while taking that pill. The ads are so visible they've even spawned a Saturday Night Live parody for a fictional, one-period-a-year drug called Annuale. (Warning: Content is hilarious.)

Yaz, Lybrel, and Seasonique are all extended-cycle oral contraceptives, so named because they decrease (or in Lybrel's case, eliminate) the no-hormone "placebo days" that result in withdrawal bleeds, or periods. With a traditional birth-control pill, a woman takes 21 days of active (hormone) pills followed by 7 days of very low-dose or placebo pills, resulting in 13 withdrawal bleeds a year. With Yaz, you take 24 days of active pills followed by just 4 days of placebos; it's approved not just for contraception but also for treating acne and a severe form of PMS called premenstrual dysphoric disorder. Seasonique, like its precursor Seasonale, provides 84 days of active pills followed by 7 days of placebos, resulting in just 4 periods a year. In 2007, Lybrel became the first oral contraceptive approved by the Food and Drug Administration for continuous, year-round use—meaning no placebo days, and thus no periods.

Doctors, patients need to improve dialogue on pain

When my husband threw out his back recently, he shuffled painfully around the house for a couple days until I convinced him to go to the doctor. He came home with a leaflet on back exercises, but no pain medication. The doctor hadn't offered it, and he hadn't asked for any. With the weekend approaching and his pain not ebbing, he made another appointment with the sole purpose of getting some relief. He came home with medication this time, no problem; his doctor was happy to provide it. But why had this taken two visits? Should my husband have been clearer about his pain? Should his doctor have asked more questions about his discomfort? Probably some of both.

My husband's experience is not unique. Measuring and managing pain can be extremely difficult for patients and doctors. A patient's experience of pain is subjective, after all; it's not something that can be measured with a lab test. If patients don't talk openly and descriptively about their pain, or their doctors don't ask the right questions or listen attentively, patients can miss out on treatments that could give them relief. This can limit what they can do and how much they enjoy life, especially if they have chronic pain.

Tip of the day: Staying healthy while cutting costs

In this time of economic uncertainty, health care costs can be an added strain to your wallet. It's a challenge to take care of yourself and your family's well being, while keeping a watchful eye on your budget. Read our recommendations on staying healthy on the cheap and lowering your drug costs.

Tip of the day: Healthy eating for frequent flying

Frequent travel often means eating lots of airport food--typically fries, burgers, and a hodgepodge of salty and sugary snacks. Instead of binging at the fast-food joints in airport terminals, pack healthy snacks, such as baked tortilla chips, unsalted nuts and pretzels, dried fruit, or low-fat cheese sticks to hold you over during a flight.

Read more on travel health and on how to NOT get sick while flying.

Six dos and dont's of heartburn relief

If you're prone to heartburn, or even if you've got a tough stomach—here are some tips to help stave off tummy troubles.

• Don’t eat spicy, acidic, or fatty foods or drink too much alcohol or lots of caffeinated or carbonated drinks. Limit chocolate, garlic, onions, and peppermint.
• Do sleep on your left side to avoid putting extra pressure on the stomach. Also, keep your head elevated 4 to 6 inches if you suffer from nighttime acid reflux.
• Don’t snack right before bedtime. Stop eating and drinking 3 hours before you lie down.
• Do try to get more fiber in your diet. In addition to improving your overall health, there is some evidence that getting more fiber may reduce heartburn symptoms.
• Don’t smoke. Nicotine relaxes the esophageal sphincter and increases acid production.
• Do watch your weight. Being even slightly overweight puts pressure on the lower esophageal sphincter, causing reflux. Losing just a few pounds can help.

Read more on how to sooth your stomach (free), find out if you're at risk for gastroesophageal reflux disease (GERD) (free), and check out our Treatment Ratings for heartburn and GERD (subscribers only).

To vaccinate or not to vaccinate?

For parents looking for information on vaccines, the Web can be a confusing place. Misinformation abounds about a purported link between childhood vaccines and autism, and anti-vaccination Web sites have been on the rise in recent years. Naturally, that can cause parents anguish about when and whether to vaccinate their children. But the science is clear; there is no concrete evidence of a link between vaccinations and autism. Meanwhile, largely because of the movement by a determined minority against vaccination, long eradicated diseases are gaining a new foothold, making vaccination as important as ever.

Another in a long line of studies, this one by researchers from Columbia University's Mailman School of Public Health, and released this month in the Public Library of Science, has also helped dispel the myth of a link between the measles, mumps and rubella (MMR) vaccine, and the development of autism in children.

Another theory, that mercury in thimerosal—a preservative that was once used in many vaccines—causes autism has also been disproved by several reliable studies. Nevertheless, thimerosal has been removed as an ingredient in most vaccines as a precautionary measure to lower children’s exposure to mercury (thimerosal is still used in most flu shots and is considered safe).

Could exercise help seniors stay sharp?

The President's HealthierUS initiative is encouraging Americans to get active for at least half an hour a day, and the benefits of exercise are well known. Staying active keeps you fit, keeps your heart healthy and can have a positive effect on your mood.

Doctors have also been wondering whether exercise can help keep our minds sharp as we get older. Research has suggested that people who exercise might be less likely to get Alzheimer's disease or dementia. However, there's a problem with most of the studies. They've mostly looked at the amount of activity people were already doing. So, we can't tell whether exercise helps, or whether people in the early stages of Alzheimer's simply find it harder to get out and exercise.

A new study gets round this problem. Researchers in Australia took 170 people and split them into two groups. People in the first group were asked to do 50-minutes of exercise, three times a week. The second group just got some general health advice, for comparison. It's a bit like drug trials, where people are given either the drug being tested or a pretend treatment (placebo).

Buzzword: Nanotechnology

What does it mean? Nanotechnology, or nanotech for short, refers to the creation of incredibly tiny materials and devices for a whole host of uses, from cancer treatments to food and cosmetics. "Nano" comes from the Greek word for "dwarf," and in the metric system a nanometer is equal to a billionth of a meter. How small is a nanometer? A black strand of human hair is between 50,000 and 180,000 nanometers in size or less, and a sheet of paper is about 100,000 nanometers thick. Nanotechnologists typically work on materials and devices at the molecular or atomic scale of 100 nanometers in size or less. The principles of quantum physics rule the land of nanotechnology, meaning materials can display characteristics that appear to come from science fiction: Carbon can be 100 times stronger than steel, gold can melt at room temperature, and aluminum can turn explosive. In addition, researchers can manipulate individual atoms and molecules to form microscopic tubes, spheres, wires, and films for specific tasks, such as generating electricity or transporting drugs in the body.

Why the buzz? Nanotechnology is making its way into products and materials at a breathtaking rate, with about $2.6 trillion worth of goods worldwide expected to use nanotechnology by 2014, a 5,200 percent increase from just $50 billion in 2006. But even though nanotech materials are pushing their way into products of every kind, size, and shape, the nanotech industry is barely regulated.

Study finds more cause for concern over bisphenol A in plastic bottles, containers

Like many parents, I've been schooled in the ABCs of BPA this year.

I've learned that bisphenol A (BPA for short) is found in many plastic baby bottles and sippy cups, as well as metal cans and hard-plastic food containers and water bottles. I've read about lab findings that BPA can leach out of plastic baby bottles into milk. And I've heard reports suggesting that this chemical, which mimics the hormone estrogen in the body, may be linked to higher rates of cancer, diabetes, reproductive abnormalities, and other health problems in adults and children. Some experts think that infants and unborn babies might be at particular risk because of their developing brains and bodies.

But much of the research on BPA so far has come from studies on animals and in the laboratory. Now the first major study has been published looking into possible health effects in people. Its results are far from reassuring.

Zetia: Down for the count?

For the second time in six months, ezetimibe (Zetia), a featherweight LDL (bad) cholesterol fighter, has taken a hit, and this blow could well end its career. The referee, with the initials FDA emblazoned on his white lab coat, has begun the countdown.

Ezetimibe (made by Schering-Plough and still on patent as the brand name Zetia) was approved in 2002 for use with a statin to achieve additional small reductions in LDL cholesterol, compared to just the statin alone. In 2004, when Merck's brand of simvastatin, known as Zocor, was about to go off patent, Merck teamed up with Schering-Plough to produce a new patented product called Vytorin, a combination of simvastatin and Zetia. A vigorous advertising campaign resulted in billions of dollars in sales.

Then, in February of this year, the first blow landed: A two-year study showed that the combination product was no better than simvastatin alone in decreasing the growth rate of plaque in the carotid arteries. At that time the Consumer Reports Health blog referred to ezetimibe, alone or in combination, as "excess and expensive baggage, to be put back on the shelf and be used only in people who were either intolerant of statins or in conjunction with a generic statin only when LDL cholesterol goals were difficult to achieve."

Q&A: Epsom salts for pain?

I’ve heard that soaking sore muscles in epsom salts can ease the pain. Is there any evidence to support that? —C.H., Hinesburg, Vt.

None that we could find. Magnesium, the major ingredient in epsom salts, does play a role internally in promoting healthy muscle and nerve function. And one small study found that it can be absorbed through the skin. But we found no evidence that soaking in epsom salts provides any relief to achy muscles. Still, heat in general can relax muscles, so a warm bath or foot soak might help. And adding epsom salts probably won't hurt. But talk to your doctor first if you have dry, sensitive skin or diabetes, which can make skin fragile.

This article first appeared in the October 2008 issue of Consumer Reports On Health.

Read more on conditions that affect your bones and muscles (free), learn how to better manage pain (free), and check out our Natural Medicine Ratings (subscribers only) on epsom salts.

Popcorn and nuts back on the menu for diverticular disease

For years, people with a common digestion disorder have been told to avoid foods like nuts, corn, and seeds. But new research shows that advice may have been over-cautious.

Diverticular disease happens when the wall of the colon bulges out to forms small pouches. This happens to about half of Americans over the age of 60. Often, it doesn't cause any symptoms, but for some people the pouches bleed or get infected. This can cause bloating and painful stomach cramps.

Mostly, people with diverticular disease don't need medication. They are usually advised to eat a healthy diet with plenty of fiber. A low-fiber diet is thought to be one of the causes of diverticular disease.

Doctors often advise people with diverticular disease to avoid foods like nuts, maize, popcorn, and seeds. That's because they're concerned that these foods could get stuck in the pouches and cause inflammation or bleeding. When the pouches in the intestine get inflamed, it's called diverticulitis.

Study: Ibuprofen better than acetaminophen for children's fevers

With the start of the school year, I'll wager that my preschool son will bring home a cold or throat infection in a week or two. A runny nose isn't a cause for concern, but a high temperature can make a child feel miserable. Like many parents, I keep two common fever remedies on hand: acetaminophen (Tylenol) and ibuprofen (Advil, Motrin). A new study has looked at which of these drugs works best to bring down children's fevers and whether taking both drugs together might be better than taking just one.

The study included about 150 children between 6 months and 6 years old. It found that ibuprofen worked faster and for longer than acetaminophen at reducing high temperatures. Taking both medicines together didn't seem to be any better than taking ibuprofen on its own, although children given both medicines might have had an extra couple of hours without a fever on the first day.

Cover America: Somewhere between insured and uninsured

When it comes to living insured vs. uninsured, the Cover America Tour has learned that it usually isn't a case of one or the other these days. A disturbingly large chunk of the people we have talked to and visited with are somewhere between insured and uninsured—a scary place where they pay budget-blasting premiums for health care coverage that really doesn't cover much of anything except for the most catastrophic illnesses or injuries.

Welcome the world of the underinsured.

Record numbers of Americans are paying dearly each month on health insurance premiums for what is politely called 'catastrophic coverage' that only provides protection in case of cancer or getting hit by a bus, the two grim examples everyone we've talked seems to use. But day-to-day coverage? Preventative care? 'Small' problems that can be toughed out? No way. The out-of-pocket costs are just too high.

Loosely defined as having 'insufficient coverage', being underinsured takes its toll in different and often unpredictable ways. If you ask Gina in St. Joseph, Missouri (above) it meant suffering through the pain of a miscarriage, dealing with it on her own instead of going to the doctor because the $5,000 deductible put that option beyond the reach of the family’s budget. Bobbie in Redding, CA knows the importance of follow-up visits after her diagnosis of skin cancer, but hitting her policy's big annual deductible when the premiums are already so high is out of the question? It just costs too much to go.

Q&A: Could I be allergic to my clothes?

When I wear clothes made from synthetic fabrics, I seem to get itchy and uncomfortable. Could I be allergic to them? —R.L., Chevy Chase, Md.

Yes. Synthetic materials such as acrylic, elastic, and polyester can cause redness and itching in susceptible people, and they also tend to trap moisture, which can add to the discomfort. But because laundry detergent can irritate the skin as well, the simplest first step is to try a mild detergent made for sensitive skin. If that doesn't help, a dermatologist can test to see if you're allergic to synthetic fabrics. If you are, avoid them in favor of natural fibers like cashmere, cotton, linen, or silk. For items where some elastic is unavoidable, such as bras and underwear, look for labels that say "100 percent cotton" and indicate that the elastic has a layer of cotton over it.

This article first appeared in the October 2008 issue of Consumer Reports On Health.

White wine and red may both be heart-healthy

I used to think that white wine wasn't as good for the heart as red wine. After all, white wine contains far less of the heart-healthy antioxidant resveratrol than red. So I was surprised to find two new studies suggesting that white and red wine may BOTH protect against cardiovascular disease.

One study, in the September 2008 issue of The Journal of Nutrition, found that drinking either red or white wine in moderation leads to increased blood plasma levels of resveratrol. In the small clinical trial, 20 healthy men and women in their 40s were divided into two groups: One drank 10 ounces a day of red wine for 15 days; the other drank 10 ounces of white wine daily.

At the end of the trial period, blood tests showed that both groups had higher plasma levels of resveratrol. Both groups also showed increases in nitric oxide production a potential marker of cardiovascular health. The research team, led by investigators at the University of Perugia in Italy concluded that resveratrol stimulates nitric oxide production in the blood's platelets, which may protect the cardiovascular system by aiding the transmission of nerve impulses, transporting oxygen into the tissues, dilating blood vessels, and preventing blood-clot formation.

Popular heartburn drugs linked to increased risk of fractures

My husband spent a small fortune on antacids for his heartburn until he started taking a proton pump inhibitor (PPI) called omeprazole a few years ago. Now, his heartburn is in check and he even occasionally indulges in the spicy curries he loves so much.

For many people with frequent heartburn (called gastro-esophageal reflux disease, or GERD for short), PPIs are something of a wonder drug. Many people take them for years to control their symptoms, with few (if any) noticeable side effects. But now research is showing that long-term use of these drugs, although great for your heartburn, may not be so great for your bones. Studies don't agree, however, on how long you can take these drugs before your bones might be affected.

PPIs work by reducing the amount of acid that your stomach makes. This means there's less acid to cause heartburn or irritate an ulcer (PPIs are also used for peptic ulcers). But by reducing this acid, PPIs may make it more difficult for your body to get calcium from foods. Too little calcium can cause osteoporosis, a condition in which your bones are thinner and more likely to break.

Want an eco-friendly yoga mat? Here's what you need to know

Each year consumers spend a whopping $5.7 billion on yoga classes and gear, according to a 2008 Yoga Journal survey. This popularity—and the big money—has sparked an array of so-called eco-friendly yoga mats. But are the claims they're rolled up with really true? Here are three examples of truly eco-friendly mats, plus how to choose one and keep it clean.

WHAT ARE THE CLAIMS?

Eco-claims are often made on the basis of what mats don't contain—particularly PVC (polyvinyl chloride) plastic, which can contain the heavy metals lead and cadmium, and phthalates, which have been linked to hormone disruption. While we haven't tested yoga mat for those substances, we would expect exposure to be limited. Concerns about PVC manufacturing, use, and disposal have led to bans and restrictions of the plastic in the U.S. and other countries.

Don't let a medical condition keep you grounded

My grandmother always said she had the energy to get ready for a trip or to go on a trip, but not both. Planning for a trip can be a hassle. But if you also have a health condition such as diabetes, epilepsy or a lung disease, it can take twice as much thought to make sure you stay healthy while you're away from home.

Here's a roundup of tips. Talk to your doctor for advice on your specific illness and travel needs.

Consult the experts. Discuss your itinerary with your doctor well before you travel. Your doctor can tell you how much medication to bring and how to adjust your dosing schedule if you're crossing time zones (for example, if you use insulin for diabetes or take medication to prevent epilepsy seizures). Your doctor may also have advice on how to pace yourself, whether you need any vaccinations and what other supplies you should bring. Foot care is important if you have diabetes, so comfortable walking shoes and antifungal cream should be on your packing list. Your doctor may also prescribe additional medication, such as antibiotics or treatments for nausea or diarrhea.

Consider telling your travel agent about your medical condition. He or she can request supplemental oxygen for your flight if you have a lung condition. You can also ask the agent to request special meals if, for example, you follow a low-salt diet for high blood pressure or a low-sugar diet for diabetes. If you have diabetes, be sure to pack plenty of snacks to keep your blood sugar from dropping too low.

For your health: Get a little sun, get a lot of Vitamin D

Up to 36 percent of Americans might be deficient in vitamin D, research suggests. Low levels have been linked to autoimmune disorders, cancers, heart disease, and osteoporosis. Talk with your doctor about whether you need a blood test. Boost vitamin D by consuming fortified milk, salmon and other fatty fish, or supplements. Sunlight also supplies vitamin D. Most people need 10 minutes outdoors without sunscreen three or four times a week. Those who are overweight, over 50, have darker skin or live in the North need more.

Read more on the benefits of vitamin D (free), getting more vitamin D in your diet (free), and on how it can help in the prevention of osteoporosis (subscribers only).

Health Experts: Sleepless teens need to turn off the tech

My 16-year-old son didn't sleep through the night consistently until he was 3, and even now I often hear him stomping through the kitchen in the middle of the night in search of food. His insomnia typically gets worse at this time of the year when school starts.

Sleep disturbance is common in adolescents, according to recent research, with symptoms of insomnia affecting from one-quarter to one-half of all teens. While many physical and psychological issues can contribute to insomnia, there is a little information as to the role poor sleep hygiene may play.

As the recent sleep survey from the Consumer Reports National Research Center (conducted in April 2008) pointed out, there are four approaches to sleep often advised by sleep experts:

• Use the bedroom primarily for sleep, not as an all-purpose room where one watches television, uses the computer, reads, or eats meals.
• Keep the bedroom dark at bedtime.
• Keep the bedroom quiet at bedtime.
• Keep pets and children off the bed at bedtime.

Indeed, most adult respondents did keep their bedrooms dark and quiet at bedtime. On a typical night in the preceding month, 84 percent of respondents told us their bedroom was kept dark at bedtime, and 67 percent stated that their bedroom was completely quiet. Overall, 63 percent indicated their rooms were both dark and quiet at bedtime.

Q&A: The safe way to trim toenails?

When clipping my toenails, should I cut straight across or in a rounded shape (and does it really matter)? —W.M., Gresham, Ore.

It does matter. You should cut them straight across and let them extend slightly beyond the tips of your toes. Rounding off a nail or cutting it too short can allow a corner to curve into the skin, causing a painful ingrown nail, a problem especially common with the big toe. If you get a mild ingrown nail, you can probably treat it yourself by soaking your foot in warm water, clipping off the ingrown portion, and placing a small piece of dry cotton ball under the nail's edge to keep it from turning back in as it grows. Nails that are very deeply imbedded or have become infected may require minor surgery. People with diabetes, poor circulation, or compromised immunity should seek professional care for even minor ingrown nails due to the heightened risk of infection, as should those with arthritic hands or poor eyesight.

This article first appeared in the September 2008 issue of Consumer Reports On Health.

Find out more about nail infections and what you can do to prevent them (free), and read our Treatment Ratings to find out what treatments work best (subscribers only).

Old-school exercises beat massage for back pain

Medicine has become a high-tech business, with laser surgery, detailed body scans, and genetic testing. So, if someone told you to treat your back pain with exercises invented in the 1800s, you'd be forgiven for being skeptical.

The Alexander technique is a system for encouraging good posture and relaxed movement. It was invented over a hundred years ago by an Australian actor, Frederick Alexander, to help him recover his voice after long performances. Usually taught one-to-one, it focuses on the teacher correcting the student's bad habits, rather than on a particular set of exercises.

According to a new study, the Alexander technique works better than massage as a treatment for back pain. Unfortunately, the researchers didn't look at other forms of exercise, so we can't say how the Alexander technique compares with physical therapy or yoga.

The researchers looked at around 500 people with long-term back pain. Three months after treatment, people who'd learned the Alexander technique were getting between 11 and 16 fewer days of pain each month. People who'd had massage were getting 13 fewer days of pain.

Buzzword: Retail health clinics

What does it mean? Retail health clinics—also known as convenient care clinics, mini clinics or in-store clinics—are small health-care facilities located in drug stores, grocery stores or big retailers like Target and Wal-Mart. They provide simple, nonemergency services to walk-in patients, regardless of insurance status. They are much cheaper than a traditional doctor's visit because they're generally staffed by nurse practitioners and/or physicians assistants. Retail health clinics have extended hours including nights, weekends, and sometimes even holidays. They charge a set price for common services, everything from sports physicals to treating ear infections. Currently, there are about 1,000 such clinics in the United States, according to the Convenient Care Association, but that number is expected to increase to as many as 1,500 by the end of this year.

Why the buzz? Back in July, Summer Kartchner was hiking in the mountains near Salt Lake City when a bee stung her on the hand. That night her entire hand began to swell and by Saturday morning she knew she needed to have it looked at. It hurt but she didn't think it was bad enough to justify a trip to the emergency room or a clinic, so she decided to try a retail clinic that had recently opened in her local grocery store. Summer got her hand examined within a few minutes and was prescribed an antibiotic to treat the sting. The whole thing took less than an hour and cost just $35, and even that was quickly reimbursed by her health insurance. "It is rare to have such a positive experience with healthcare on both the provider and insurance side," she says.

Fruit juice and medications don't mix

Here's something to contemplate over your morning fruit juice. A few years back, doctors discovered the "grapefruit effect"—the fact that drinking grapefruit juice affects the way certain blood pressure medications work. Doctors have since found that more than 40 different meds can have their effects magnified by grapefruit juice.

Now, the story has gotten a bit more complicated. Orange juice and apple juice could also interfere with some medications. And depending on the drug you're taking, the effects of your treatment could be either be blocked or boosted. This could stop the drug from helping you, or put you at risk of an overdose.

In a new study, researchers looked at healthy volunteers who took a drug called fexofenadine. It's an antihistamine, used to treat allergies.

Some people took the allergy pills with water, and others drank grapefruit, apple or orange juice. The juices stopped people absorbing the drug properly, meaning they got about half the dose they should have done. Grapefruit juice seemed to have the strongest effect.