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March 15th, 2010
05:00 PM ET

Hip fractures more deadly to men

By Saundra Young
CNN Medical Senior Producer

Editor's note: In a previous version of this post, the form of zoledronic acid that reduced death rates by 28 percent over a three-year period was inaccurately identified. The correct form of the drug is Reclast

Hip fractures. They're breaks in the upper part of the femur or thigh bone, most often caused by a fall. People 65 and older are most vulnerable, and according to the American Academy of Orthopedic Surgeons, women have two to three times as many fractures as men. But a new study in the Annals of Internal Medicine says men are at greater risk of dying because of it.

Hip fractures are more deadly for men.

Hip fractures are more deadly for men.

Researchers looked at 39 studies involving nearly 600,000 women and 155,000 men over the age of 50, with hip fracture. They found that while older women are nearly six times more likely to die after a fracture than a woman without a break, older men are about eight times as likely to die in the first three months after their injury.

"Hip fractures are associated with a substantially increased risk of death for both men and women which lasts for at least 10 years after the fracture," said Dr. Cathleen Colon-Emeric, one of the study authors at Duke University Medical Center in Durham, North Carolina. "This highlights the importance of interventions which reduce operative complications and the physical decline that frequently results from a hip fracture."

Researchers are not quite sure why the risk of death increases. But Colon-Emeric says hip fracture is a major blow to your body. "People with hip fractures tend to be more frail. Many have underlying medical problems that put them at higher risk of death, like stroke, Parkinson's disease and dementia."

Earlier studies found that after a hip fracture men are more likely than women to die of infectious conditions such as sepsis and pneumonia.

Only 25 percent of these fractures occur in men. Dr. Jay Magaziner, chairman of the Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland in Baltimore, and a study co-author, says if you project forward to 2050, there will be as many hip fractures in men as there are currently in women today. "We know that men who fracture their hip are generally a bit sicker. They have more medical conditions at the time of their fracture than women. One of the reasons that we believe that is the case, is the natural process of aging post-menopausally in women."

Magaziner says the combination of falling and weak bones will create a hip fracture. He says women lose a little bit of bone each year after menopause, but men don't lose bone naturally. In fact, in order for men to lose enough bone to have a break when they fall, they generally have to have an underlying medical condition. "Women who fracture don't have these other medical problems, so that may be one of the reasons that we're seeing a higher mortality rate in men than women."

Dr. Sandra Fryhofer, an Atlanta, Georgia, internist and past president of the American College of Physicians, says the study is a wake-up call that men can get osteoporosis too. "It stresses the importance of prevention, making sure people are getting calcium, vitamin D and weight-bearing exercises like walking. Anything that puts weight on the bones, because that stimulates new bone formation."

Because men have not received a lot of attention on hip fracture and osteoporosis, Magaziner is working on new research to try to better understand the disparities. "If we can understand the differences in the way men and women respond to having a hip fracture then we can tailor our treatments to these differences and the way people recover," he said. "We want to individualize the way we treat patients."

Colon-Emeric says one treatment has proved to reduce mortality after fracture, an osteoporosis drug zoledronic acid or Reclast. It's made by pharmaceutical giant Novartis and new data show it reduced death rates by 28 percent over a three-year period. It's given once a year intravenously in a doctor’s office and it reduced the chance of additional fractures by 20 percent in a two-year period. Promising, because statistics show one in five will re-fracture their hip.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


March 15th, 2010
08:55 AM ET

Virtual tragedies get teens’ attention behind the wheel

By Leslie Wade
CNN Medical Producer

Sometimes a single choice can change a life forever. It's especially true with new teen drivers. A new program called One Simple Decision, available later this month to schools and law enforcement agencies across the country, drives home the risks of being distracted or impaired when you're behind the wheel - without putting anyone in danger. (watch video)

Training with a  virtual driving program can help teens be safe drivers in real situations.

Training with a virtual driving program can help teens be safe drivers in real situations.

Students sit at a computer screen and control a small steering wheel on a simulated drive, adjusting speed with a gas petal. The program uses videotaped scenes with real police officers and a judge to help teens experience a mock arrest, booking and sentencing for mistakes they make behind the wheel.

Per mile driven, teenagers have about four times the risk of other people of being in a car accident, according to the Injury Free Coalition for Kids, a community-based education and advocacy group. And the first 18 months when new drivers are gaining experience is the most dangerous time. Experts say about 4,000 teens die each year in car accidents, and being distracted or impaired is often a contributing factor.

"So you take inexperience, add on hand-held electronic devices distracting teenagers and you have a fatal combination," says Dr. Brendan Campbell of Connecticut Children's Medical Center in Hartford. "It's almost like an addiction that teens are not able to recognize the risk that hand held devices pose and they can't resist the urge to use them," says Campbell.

Drivers of all ages are four times more likely to be in an accident when using a cell phone and at least eight times more likely while texting, according to the National Safety Council.

But unlike adults, teens' brains are not fully developed, especially in the areas affecting judgment and decision-making.

"They think that they are invincible and that they're bulletproof and that bad things aren't ever going to happen to them," says Campbell.

On his One Simple Decision drive, Henry Sewell, 17, rear-ended a car while using his cell phone. High school junior Kaley Markham crashed into a fire hydrant while driving under the influence.

Would those lessons apply to their real lives? "I do text sometimes in my car and I occasionally do talk on the phone," says Henry. For Kaley too: "I change the song, I text occasionally and usually my GPS I use when I'm stopped, but sometimes I have to fix it while I'm driving." But watching scenes through the eyes of an arrested driver who is booked in a real police station and then taken before the judge for sentencing was unsettling for Kaley and Henry.

"One minor rear ending while you're texting or calling could end up being jail time," says Henry. Kaley fatally struck a pedestrian during her second driving simulation. "I was actually scared when I saw the video of what you get charged for when you hit people," says Kaley.

But will this virtual driving experience change their driving behaviors? Henry says he'll wait until he's at a stop before calling people and is rethinking his texting habits.

"I'll definitely prohibit myself from texting as often as I do," explains Henry.

Campbell says he's encouraged by the possibilities new virtual driving tools offer but advises teen and parents alike to also remember the low-tech fundamentals.

"The most important thing you can do as a parent is to drive with your teenager," he says.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


March 15th, 2010
08:40 AM ET

Was it a cigarette ad campaign that worked - on teenagers?

By John Bonifield
CNN Medical Producer

 A new study in the journal Pediatrics says that the R.J. Reynolds tobacco company may have influenced underage girls to start smoking by effectively marketing a brand of cigarettes to them.

Cigarette manufacturers aren't supposed to be targeting their ads at young teens - girls or boys. In 1998, the tobacco industry said it wouldn't direct advertising at underage youth. So, what happened here?

The controversial ads were for R.J. Reynold's Camel No. 9 cigarettes. The ads, which were featured in popular women’s magazines like Glamour, Lucky and Vogue back in 2007, look a lot like the pages of a glitzy fashion magazine. The cigarettes are featured right alongside a beautiful dress, shoes, jewelry and a purse - the kinds of items that you might expect teen girls to find glamorous and appealing.

"The ads had a lot imagery that is girl-like," says Cheryl Healton with the American Legacy Foundation, an anti-tobacco advocacy group. "Shocking pink on the packaging. Describing the cigarettes as light and luscious. Making them almost like candy."

 In the study, girls were asked over the course of several years, "What is the name of the cigarette brand of your favorite cigarette advertisement?" In 2004, 10 percent of girls chose Camel as their favorite brand. In 2008, a year after R.J. Reynolds launched its new campaign, nearly 22 percent of girls chose Camel as their favorite brand.

"The majority of these kids had not reported a favorite ad before," says the study's lead author, John Pierce with the University of Southern California-San Diego's Moores Cancer Center.

 This finding has public health officials concerned because studies have found that kids who can tell you the name of the brand of their favorite cigarette ad are 50 percent more likely to take up smoking in the next three years, according to Healton.

 The R.J. Reynolds Tobacco Company tells CNN that it "adheres to numerous restrictions on how it markets its tobacco products and does not take any action to target youth." The company's statement goes on to say, "Camel No. 9 was developed in response to female adult smokers...who were asking for a product that better reflected their taste preferences and style." R.J. Reynolds says it has not run any print advertising for cigarettes, including Camel No. 9, for more than two years. It also says there has been no in-store advertising for Camel No. 9 since 2008.

Pierce, however, says the damage has been done. He estimates Camel's ad campaign may have influenced 174,000 underage girls to start smoking.

"The company made a commitment they wouldn't go after kids," says Pierce. "The question is, are they targeting young adults or young teens, and a lot of people are saying it's targeting young teens."

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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