Harvard Health Content API

Physical therapy may relieve one type of back pain as well as surgery does, a new study finds. The study included 170 people in their late 60s. All of them had lumbar spinal stenosis. This is a narrowing of the channel inside one or more bones of the spine. People had severe back pain and problems with movement. They were randomly assigned to receive either surgery or physical therapy. The surgery removed areas of bone that were narrowing the spine and pressing on nerves. The physical therapy program lasted 6 weeks. But people in the physical therapy group were allowed to get surgery instead. More than half of them did so. People in both groups had tests of movement 10 weeks, 6 months and a year after surgery or physical therapy. They also were asked about pain. After 2 years, they filled out a survey to assess overall results.

It can be hard to teach kids to swallow pills, but a few techniques can be helpful, a study shows. The study looked at previous research on pill swallowing among children. Few studies had been done. Researchers found 5 small studies with successful results. Two studies worked on teaching or showing kids how to swallow pills. In one, 17 of 29 children were able to take large capsules for at least 6 months. The other study reported success for all but 1 of 23 children. Another study included 67 children who could not swallow pills at first. Of these, 47 learned with the use of specific instructions. Nine others succeeded with the instructions plus a small pill cup. A study of 11 children helped 7 of them to swallow small candies with the aid of a throat spray. Another study taught 33 children the best ways to hold their heads to take pills.

Doctors often find it hard to talk with patients about end-of-life care, a new study shows. And differences in culture, ethnic group and language make things even more difficult, they told researchers. The study was based on a survey. In all, 1,040 doctors in training (residents) answered the questions. They were asked if they had difficulty talking about end-of-life care with seriously ill patients and their families. Almost everyone said yes. They also were asked about the top 3 problems that came up when they had these talks with someone from a different ethnic group. They named language differences, the patient’s or family’s spiritual beliefs about death and dying, and the doctor’s ignorance of the patient’s cultural values and practices. Other problems listed were the patient’s or family’s limited understanding of medical information and mistrust of the health-care system.

Women with breast cancer who carry a high-risk gene can lower their risk of death from the disease 62% by having their ovaries removed, a new study finds. They can reduce their risk even more by not delaying that surgery for more than a year or two, researchers said. The study included  676 women who had early-stage breast cancer. All of them were carriers of a BRCA1 or BRCA2 gene mutation. Women with these genes have a much higher than average risk of breast cancer and ovarian cancer. About half of the women in the study decided to have their ovaries removed. Those with a BRCA1 gene who had their ovaries removed were 62% less likely to die of breast cancer in the next 20 years. Death rates were up to 73% lower for women who had the surgery within 2 years of their breast cancer diagnosis.

Heart-failure patients who have problems understanding medical instructions may die sooner than those with a firmer grasp of what they need to do, a study finds. Heart failure means that the heart’s pumping action is weak. Treatment is complicated. People have to keep track of their weight. They often take many medicines. Heart failure can lead to repeat hospital stays and even death. The study included more than 1,300 people who had a recent hospital stay for heart failure. Before leaving, they filled out questionnaires on health literacy. They were asked about how well they could read and understand medical information. They also said how confident they felt about filling out medical forms. Researchers kept track of people for an average of 21 months.