The Cincinnati Enquirer from Cincinnati, Ohio • Page 23

THE CINCINNATI ENQUIRER WEDNESDAY, JULY 30, 1986 SECTION Cl Preparing for kindergartenC-2 Popular cordless toolsC-5 The sexual revolutionC-6 'Nothing in Common7C-7 Tipoff Jim Knippenberg ni EDITOR: LINDA CAGNETTI, 369-1011 1 i EMPO Body I mm Does device detect disease? is 4 i Bugs getlucky Herds of bugs out eating the yard will probably love this; people who lug around sprayers full of insecticide trying to kill the things probably won't: Seems the pesticides can't do much good because there's no way to properly apply them. In fact, says a Cornell University study, 99 of the pesticides people spray at pests accomplishes nothing. Because, scientists buzz, the drops coming out of the sprayer are so large they bounce off bugs and branches and whatnot, then land somewhere else where they don't do any good at all. What's needed, says study leader David Pimental, is for somebody to build a better way of getting pesticides to pests so chemicals can do their dirty deed. Failing that, Pimental suggests consumers dress up like a bug and go crawl around bushes, telling other bugs about the tasty junipers over in the neighbor's yard.

Then again, maybe we made up that last part. Hotel niceties Meanwhile, off in the hotel lobby, there's this in re the freebies hotels put in its rooms: They aren't free. In fact, the New York Times says, amenities now cost hotels anywhere from 50t for basic soap to $9 for packages of soap, shampoo, shower cap, suntan oil', gels, mouthwash, shaving cream, razor, chocolate, shoe horn, polish, vitamins and toothbrushes. Others, especially what you call your high-priced joints where they're so snooty they don't even tell what's been sanitized for your protection, spend $25 and more to include such amenities as jewelry box, robe, slippers and more. Overall, it's estimated hotels spend $60 million a year on amenities and may someday, given the gas war atmosphere with hotels all the I time trying for bigger packages, hit $300 million a year, which is roughly the price of the airline ticket it takes to get you there in the first place.

i Keeping a count success as doctors found ways to get around the regulations, but CT scanners quickly proved their worth, making the containment effort moot. With other technology, including thermography, the controversy about value and cost hasn't been resolved although decades have passed. The debate about the value of thermography focuses on its use in everyday medical practice. No one questions the benefits of doing basic research into the technology. First introduced in the 1950s, thermography was embraced with great enthusiasm by many physicians after it was learned that areas of the skin above breast tumors are often hotter than other skin.

By placing a material with heat-sensitive crystals on the skin, doctors thought they could discover tumors with an inexpensive procedure that sidestepped the danger of X-rays. Unfortunately, further study showed that this approach was unreliable. Too many tumors didn't cause changes in skin heat patterns. In 1983, the American College of Radiology warned that thermography had no value in clinical use for breast cancer detection. But even then some physicians argued that thermography was a good tool when used by skilled people, and some doctors continue to use it today for routine breast exams.

The leading clinical use for thermography is in pain diagnosis, another subject of great controversy in the medical profession. According to Dr. Charles Wexler, an Encino, radiologist, the technique has value because damaged nerves tend to cause spasms in nearby blood vessels, which cause surface skin to become colder than normal. Wexler, president of the Academy of Neuromuscular Thermography, said many doctors are confused over what thermography can do and how to use it. "A thermogram can tell you have irritation," (Please see HEAT, Page C-4) BY JON VAN" Chicago Tribune Scientists have long suspected that the way human bodies give off heat could hold significant clues about health if only doctors were skilled enough to read them.

This fascination with body heat has spawned a sophisticated technology called medical thermography, which makes colorful anatomical maps of hot and cold spots and other heat patterns in and around the body. The technology is appealing because it provides information without inconvenience or risk to the patient. But whether this information holds any relevance to patient care is widely disputed. Skeptics say medical thermography is technology in search of a purpose providing pretty pictures and extensive data that now have no demonstrated value in either diagnosing or treating ailments. Earner claims that it was a safe and inexpensive way to detect breast cancer have been rejected.

Despite such criticism, an estimated 2,000 to 3,000 thermography units are operating in the United States, identifying asymmetric differences in body heat. From these differences, some doctors are inferring such things as the sources of pain or the existence of nerve damage. Thermography units can cost up to $150,000, and a typical thermographic exam costs about $325. Some insurance companies pay for the tests, but many do not. I The thermography controversy illustrates a problem with modern medicine's love affair with technology.

The benefits of sophisticated new equipment may not justify the costs, and promising technologies are sometimes rushed prematurely into clinical use without sufficient experimentation to ensure their value. In the 1970s, for example, the federal government imposed regulations aimed at limiting the sale of computerized tomographic X-ray scanners before their clinical value was proven. That effort met little -) is I hV- w- -T In these thermograms of a Deaconess Hospital patient's knees, the pink and red areas denote heat and possible inflammation. The temperature range is divided into 1 0 areas with white being the hottest and purple the coldest. The letters on the screen denote certain areas pinpointed for temperature readings.

Debate over thermography heats up here In case anyone's going out to buy aspirin or Deep Heet or anything: The age group which complains most about aches and pains are the 18-to-24-year-olds. That the August Self, which just for the heck of it counted up a raft of slightly odd health-related things. And found, in addition to a lot of aching 18-year-olds: 50 of Americans 18 and older are involved in diet or exercise programs; they're led by trainers who don't grunt but who do pull down $40 to $60 an hour; about 3 million Americans will this year turn 40 and, we assume, go into a pout shortly thereafter; or visit a psychologist, who now charges an average of $46 to $57 an hour; or a doctor, 94 of whom will tell them not to smoke but 16.7 of whom do it themselves. As for wounded bodies, Self adds, 36 million Americans will this year undergo surgery, of it unnecessary, and 90 will get hospital bills with errors, mostly overcharges which may or may not send them into some kind of seizure and back into the hospital for another billion-dollar visit. few use it because I don't think it's reliable as a clinical tool yet.

I'm not against it, but more scientific controlled studies need to be done." Braddom explained that attorneys use thermography in cases concerning soft tissue injuries. "Soft tissues don't show up on plain film (used in standard X-rays). A person can have a painful injury, but they don't have hard evidence, so attorneys use the technique for evidence in court." In the mid-'70s, the University of Cincinnati Medical Center was one of 28 centers nationwide that researched thermography as a diagnostic tool for screening breast cancer. According to Dr. Myron Moskowitz, director of the Medical Center's Breast Cancer Detection Center, the thermography units were removed from all the centers in 1977-78 because the American Council on Radiology decided the technique did not serve a useful purpose.

The National Association of Blue CrossBlue Shield views thermography as an experimental technique, according to Lawrence L. Weier, vice president and secretary of Community Mutual Blue CrossBlue Shield. "We do not provide benefits for thermography," he said. "We consider it to be experimental and investigational, and therefore, not covered." BY DOROTHY GOEPEL The Cincinnati Enquirer Cincinnati physician Frank Noyes says thermography doesn't have a place in general medicine, but it does play a role in sports medicine in some cases. The debate continues here.

Noyes is director of the Cincinnati Sports Medicine and Orthopaedic Center downtown. Three years ago, he began researching the usefulness of thermography in soft tissue injuries' when the Olympic Sports Medicine Council asked several sports medicine centers across the country to research the technique. So far, Noyes and his colleagues have found that computerized thermography accurately measures the temperature changes in one disorder, reflex sympathetic dystrophy, in which the nervous system constricts the blood supply to parts of the body. The majority of Noyes' thermography patients have reflex sympathetic dystrophy of the knees, where the patella (the main tendon around the knee), is damaged. "It's like a heart attack where vessels shut down around the knee," Noyes said.

Noyes said these patients have a subtle pain in the knees, but show no outward signs. "Sometimes they're referred to as wimps. But their pain is real," he said. "We were able to measure their temperature differences with thermography and establish a diagnosis. "There's no question that it's useful in reflex sympathetic dystrophy." Noyes sees patients at his downtown office and at the Deaconess Hospital, where he is co-director.

The $150,000 computerized thermography unit he uses is at the hospital. The fee for a thermogram is about $150. While he endorses computerized thermography, Noyes does not support crystalline thermography, in which the skin is placed against a sheet of paper that changes color to show differences in temperature. This was the first form of thermography, used in the 1970s. "I don't support this technique because it's not scientific," he said.

"The whole disagreement about thermography is on the technology. The computerized techniques are highly accurate. The use of crystals is not precise enough; you've got to use the scientific method." Randall L. Braddom, a physician at the physical medicine and rehabilitation department of Providence Hospital, does not use thermography, but he agrees that it has potential. "I don't Forget the stress i And another "we went back to cigarettes because excuse goes up in smoke: Stress, says Psychology Today, won't cut it.

According to Ann Arbor i C' The Cincinnati EnquirerAnnallsa Kraft Rose Knueven of Deaconess Hospital's Sports-medicine Research thermographs Kim Walz's knee. researchers who monitored quitters after a cessation clinic, stress, pressure and nervousness were the main reasons the 40 who went back did it. But, researchers huff, only (J -i 1MI" -J Joan Rivers is only tip of Fox's iceberg Fox's football interest came as a surprise to WXTX executives, who admit they're in the dark about much of the Fox venture. WXIX has not seen a pilot, or prototype, for Rivers' talk show. No one knows who will be her co-host or bandleader, or even if she has a band.

Jenkins estimated that Fox has 70 network affiliates, with the addition of WXIX and three other stations owned by Channel 19's parent company, Malrite Communications. Channel 19 placed Rivers against Carson because her topical humor appeals to viewers who watch the 11 p.m. news, said Patrice Mohn, WXIX program director. This fall Channel 19 will put WKRP In Cincinnati at 11 p.m.; she'll be followed by another new talk show starring David Brenner and rock 'n' roll pianist Billy Preston. Asked about Fox's prime-time schedule in March Mohn replied: "Your guess is as good as mine.

We're putting our faith in the Fox network. We hope they'll do what is best." A television version of Down and Out in Beverly Hills by Touchstone Television, the Disney subsidiary that makes The Golden Girls for NBC. Stephen J. Cannell's Jump Street Chapel, an action adventure about young police officers who infiltrate high schools. Cannell's credits include The A-Team, Rockford Files, Baretta and The Greatest American Hero.

Possible series called Duet by Family Ties creator Gary David Goldberg and a revival of Star Trek, according to industry publications. And, if ABC drops it, Monday Night Football. The NFL's contract with the three major networks expires after the Super Bowl in January. Fox, Home Box Office and Ted Turner want Monday night games, if they're available. "If ABC would drop the package, we'd be interested in Monday Night football," said Michael Binkow, a Fox network spokesman based in Los Angeles.

"It's unlikely that NBC or CBS would pick up the (Monday night) package," Binkow said. "Turner, HBO, Fox we'd be right up there." BY JOHN KIESEWETTER The Cincinnati Enquirer WXIX-TV's decision to air Joan Rivers' new talk show commits Channel 19 to several nights of prime-time Fox network programs and possibly even Monday Night Football. Channel 19's two-year deal as a member of the Fox Broadcasting's new "fourth network" commences with The Late Show Starring Joan Rivers in late September or early October. Channel 19 tentatively plans to delay Rivers' program a half hour, placing her head-to-head with Johnny Carson's Tonight Showit 11:30 p.m. Fox promises to deliver three hours (7-10 p.m.) of Sunday night entertainment by March, 1987, and two hours (8-10 p.m.) another night probably Saturdays by September, 1987, plus other one-shot specials, said Bill Jenkins, WXIX general manager.

The Fox schedule should include several shows already ordered by the network: seven could cite a specific stress incident; in fact, "More relapsers reported no significant life changes than those who continued not to smoke." Meaning, researchers say, stress is "a rationalization" to cope with the guilt of going back. As for those who quit and remained so, more than 65 said they used oral substitutes like food, candy, beer, gum and chewing roofing nails; another group got into mental control techniques and, we're fairly certain, talked about it incessantly; still others said they substituted new habits such as running, biking, reading or TV; still others, one suspects, coped by devising interesting things to do to non-smokers who went around telling them they should never have started in the first place. Jim Knippenberg's column appears Tuesday, Wednesday, Friday and Sunday..