News in brief - Feb. 24, 2003

Preventing hip fractures - Prudent antibiotic labeling - Scientists assess data lost with Space Shuttle Columbia - Antidote to dirty bombs? - Children's lead levels, passive-smoke exposure down

Preventing hip fractures

Without stronger preventive measures, aging baby boomers will likely have more need for orthopedic care, often because of a fall and resulting hip fracture, according to a study released at the annual meeting of the American Academy of Orthopaedic Surgeons.

Ninety percent of the 350,000 hip fractures that occur each year in the United States are the result of a fall, and by the year 2050 there will be an estimated 650,000 hip fractures each year, or nearly 1,800 hip fractures a day.

Hip fractures are often devastating injuries that can lead to long-term hospitalization and even death. "The goal in geriatric orthopedics is to maximize independence and mobility in our older population," said Kenneth J. Koval, MD, director of the orthopedic trauma service at New York University School of Medicine.

"Ongoing education about the serious consequences of a fall provides seniors with an opportunity to take preventive action now, and maintain health and independence for years to come," Dr. Koval noted at a media briefing.

Prudent antibiotic labeling

The Food and Drug Administration on Feb. 5 unveiled a final rule outlining new labeling regulations designed to help reduce the development of drug-resistant bacterial strains. This directive is aimed at reducing the inappropriate prescription of antibiotics to children and adults for common ailments such as ear infections and chronic coughs.

Currently, the Centers for Disease Control and Prevention estimates that about half of the 100 million prescriptions written each year by office-based physicians in the United States are for the common cold or other viral infections -- thus contributing to the growing problem of antibiotic resistance. According to the FDA, this new rule will help raise awareness. It applies to all systemically absorbed antibacterial drugs and requires statements in several places in the physician labeling advising that these drugs should be used only to treat infections that are believed to be caused by bacteria.

The rule also requires a label statement encouraging physicians to counsel their patients about the proper use of these drugs and the importance of taking them exactly as directed. This step represents the achievement of one of the objectives of the Public Health Action Plan to Combat Antimicrobial Resistance, a joint initiative of the FDA, the CDC and the National Institutes of Health.

Scientists assess data lost with Space Shuttle Columbia

As NASA picks up the pieces of the Space Shuttle Columbia and tries to figure out what went wrong, scientists are scrambling to figure out what science was lost and what can be salvaged.

The 16-day mission was science-heavy with more than 80 experiments on board, including those that could have benefited medicine. Early reports indicate that much of the computer data are probably in hand or recoverable. Any specimens, however, have been lost.

According to documents released before the shuttle left Earth, the spacecraft was carrying cell cultures with the expectation that growing them in a weightless state could lead to a better treatment for prostate cancer. Another experiment was attempting to form protein crystals with the hope that weightlessness would make them purer and lead to improved pharmaceuticals.

The astronauts themselves were also being studied for clues to the causes of bone and muscle loss that could have led to a better understanding of those conditions in normal gravity.

"All seven Columbia astronauts sought to advance human exploration of space," said Mary Kicza, associate administrator for NASA's Office of Biological and Physical Research. "They dedicated their lives to NASA and their countries, and helped us uncover knowledge that could help improve the lives of all people."

Antidote to dirty bombs?

The Food and Drug Administration has asked manufacturers to submit marketing applications for Prussian blue, an artist's pigment, that has been shown to be a good antidote when used in capsule form to treat people exposed to such radioactive elements as cesium-137.

After reviewing the literature, the FDA determined that 500-mg Prussian blue capsules would be safe and effective for the treatment of patients with known or suspected internal contamination from radioactive thallium, nonradioactive thallium or radioactive cesium.

Cesium-137 is of particular concern because it is a potential component of a conventional bomb that contains radioactive material -- a so-called dirty bomb. Cesium-137 contamination can cause serious illness or death and has been associated with cancer that occurs long after exposure.

Prussian blue helps reduce exposure by binding with radioactive particles while they are in the gut, capturing the isotopes and allowing them to be eliminated from the body.

Prussian blue has been used as an artist's pigment since 1724.

Children's lead levels, passive-smoke exposure down

Blood lead and cotinine levels in children have decreased, according to a report issued by the Centers for Disease Control and Prevention.

Cotinine is a marker of exposure to tobacco smoke.

The second "National Report on Human Exposure to Environmental Chemicals" found that, in 1999-2000, 2.2% of children younger than 5 had elevated blood lead levels. That figure was 4.4% for 1991-1994.

"Although this finding is encouraging, we must note that exposure of children to lead from homes containing lead-contaminated dust remains a serious public health problem," said Jim Pirkle, MD, PhD, deputy director for science at the CDC's environmental health laboratory.

The report also found that cotinine levels in children have decreased 58% but were still twice that of adults. The numbers also varied by race, with African-Americans having twice the levels of whites.

The CDC plans to continue releasing similar reports every two years and also to expand the number of toxins monitored. The first report, released in March 2001, monitored 27 chemicals. This one included data about 116 chemicals.