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As we age our bones get more brittle: What you need to know about falling

Supreme Court Justice Ruth Bader Ginsburg, 85, was hospitalized Thursday morning with three broken r..

Supreme Court Justice Ruth Bader Ginsburg, 85, was hospitalized Thursday morning with three broken ribs after falling on Wednesday evening. She went home after her fall, but had discomfort throughout the night and was later admitted to the hospital for broken ribs on her left side. This is not the first time Ginsburg has suffered this kind of injury; she broke two ribs in 2012 as well. Unfortunately, this is a common injury for the elderly.

How common are falls in the elderly?

Falls are the leading cause of injury and death among older Americans. According to the U.S. Centers for Disease Control and Prevention, one in four Americans age 65 and over falls each year. Every 11 seconds, an older adult is treated in the ER after a fall, and every 19 minutes, an older adult dies from a fall.

What causes falls in the elderly?

Accidents, environmental hazards, and falls from bed are leading causes. As we age, our senses dull, our sense of balance is compromised and we can have difficulty walking, weakness, pain related to arthritis, confusion, cognitive impairment, and poor vision, which all contribute to the problem.

What injuries happen after falls?

Every case is different and a fall may result in nothing serious or severe damage. Common injuries after a fall can include bruising, broken bones, internal bleeding and head injuries. These range from minor injuries to life threatening injury, particularly if there is internal bleeding or head injury. Rib fractures can lead to potentially life-threatening conditions including pneumonia and lung collapse. Falls also have a heavy impact on quality of life — many older adults fear falling, and as a result decrease their daily activities often leading to physical decline and depression.

“In patients with rib fractures, its important to adequately manage pain and pay careful attention to fluid status to help ensure a good outcome,” said Dr. Robert Glatter, emergency medicine physician at Lenox Hill Hospital in New York City. “Its especially important to avoid excessive administration of IV fluids — without evidence of ongoing bleeding — since this can lead to fluid overload in the lungs known as pulmonary edema.”

What is the recovery time after a fall?

This really depends on the injuries sustained. Broken ribs usually heal on their own and this often takes about six to 10 weeks. In some cases, if you have many broken ribs, your doctor may recommend rib fixation which is a surgery that uses plates and screws to stabilize broken ribs; the recovery time for this varies.

“Rib fractures in the elderly population are quite common following even the most seemingly innocuous falls from ground level,” said Dr. David Forsh, chief of orthopedic trauma for the Mount Sinai Health System. “Generally these injuries heal rather readily in a matter of eight to 10 weeks, but may be a source of significant pain and debilitation for a short time. Treatment is usually supportive with pain medication and expectant management. If patients have intractable pain that causes respiratory dysfunction they may be candidates for an epidural to alleviate symptoms and facilitate improved breathing mechanics.”

Dr. Gisele Wolf-Klein, Director, Geriatric Education, Northwell Health, Great Neck, New York, said “the number of ribs broken is also a major factor in recovery.”

“Three or more rib fractures will double the risk of death,” said Wolf-Klein. “Pre-existing conditions such as cardiopulmonary disease, and congestive heart failure also increase the risk of potential complications after rib fractures. Therefore, older patients may require admission to hospitals for monitoring and management of their rib fractures.”

How the injuries will impact Justice Ginsburg is yet to be seen, but her history suggests they are not likely to keep her away from the next Supreme Court term beginning on Nov. 26. In 2012, she broke two ribs without missing work.

When should the elderly see a doctor after falling?

Following up with a doctor after a fall is critical to identifying injuries and discussing the best ways to prevent additional falls. People can be seen in an ER immediately after the fall or be seen by their primary care physician. The elderly should be seen in the ER if they hit their head, lose consciousness, are on blood thinners, have chest pain, have difficulty breathing, cant walk after falling, have an obvious broken bone, or have been on the ground for a prolonged period of time. They should also be seen in the ER if they fell from passing out (as opposed to tripping and falling), if the fall was unwitnessed, or for anything else that is concerning to them.

How can falls be prevented?

Talk with a doctor about falls and fall prevention. Medical assessment by a doctor can identify risk factors and provide appropriate interventions to reduce the risk of falling. These interventions include making the home safer by removing loose rugs from the floor, removing objects scattered on the floor, proper lighting, and placing hand rails in commonly used spaces. Get an eye exam and update glasses or contacts as needed. Talk to a doctor about medications that may make it more likely to fall and be evaluated for any mental status changes including increased confusion. Participating in programs to improve balance and strength is also helpful.

“With elderly individuals at risk for trips or falls its important to consider making space in the home or office to mobilize freely and eliminate clutter or items that one could trip over,” said Dr. Forsh. “Keeping active with exercise or doing physical therapy can also help with proprioceptive neuromuscular coordination/control to help prevent missteps or falls.”

Dr. Johanna Kreafle is an emergency medicine physician at the Carolinas Medical Center in Charlotte, North Carolina, and a member of the ABC News Medical Unit.

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The organization helping to bring new drugs for rare diseases to market

A research team has reason to celebrate after the Food and Drug Administration granted it approval o..

A research team has reason to celebrate after the Food and Drug Administration granted it approval on Friday to begin a clinical trial for a new pediatric brain cancer drug, one that might have ended up overlooked by pharmaceutical companies.

The lead researcher on the team, Dr. Teresa Purzner has already beat impossible odds. The neurosurgeon and mom of three managed to get the approval in record time and with little money thanks to the help of a team of scientific altruists called SPARK.

The development of new medications in the United States is driven by pharmaceutical companies; researchers at universities rarely bring their discoveries to the bedside. For every 10,000 potential new medicines sitting on laboratory shelves around the country, only one will ever reach patients in need, according to the National Institutes of Health. Why? Because the process can take 10 to 15 years, costing upwards of a billion dollars per drug.

As a result, the number of new medications approved by the FDA has remained stagnant at about 31 per year over the past 10 years. The majority of these medications are similar to already existing ones, and many target diseases for which there are large markets — like hypertension and high cholesterol — and therefore, a return on investment.

Enter SPARK, a non-profit program created in partnership between Stanford University and volunteers from the biotechnology, pharmaceutical, and investment industries, which helps academic researchers bring their discoveries to patients. Since its founding, SPARK has given special consideration to projects typically neglected by pharmaceutical companies, including rare diseases and diseases affecting children.

Purzner put her neurosurgery practice on pause to study medulloblastoma, a type of childhood brain cancer. Compared to diseases like hypertension and high cholesterol, which affect millions of Americans, medulloblastoma is rare, affecting only 250 to 500 children every year.

“Theres something especially poignant about seeing children —beautiful, wonderful, innocent things — and seeing the impact of the therapies we are giving them. The medications, the radiation therapies impact their cognition, their quality of life and their ability to function as independent adults in the future,” Purzner said in an interview with ABC News.

Purzner had a clear goal: to find a targeted therapy that could shut down the basic biochemical pathway responsible for the development of this cancer, and she did. She tested the potential drug in mice with good results, and she just received FDA approval to test it in clinical trials, which she will do through the Pediatric Brain Tumor Consortium. She did it all in five years and for a price tag of $500,000.

“To get from my initial findings in the lab to the point where the Pediatric Brain Tumor Consortium picked it up for clinical trials would have never happened without the help of SPARK… they gave me a clear pathway and made me believe it was possible,” said Purzner.

Every year, SPARK provides 10 teams with funding and expert mentorship to promote efficient and cost-effective drug development. (more…)

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Widowed father works with congresswoman on legislation to prevent maternal deaths

Sitting in the hospital room, mother and newborn baby were sound asleep.

“I was overjoyed. I reme..

Sitting in the hospital room, mother and newborn baby were sound asleep.

"I was overjoyed. I remember thinking my family is complete," Charles Johnson told ABC News.

But then he looked down and saw his wife Kiras catheter turn pink and then red with blood.

April 12, 2016 was supposed to be a joyous day for the Johnson family, but it turned into a "nightmare."

Ten hours later, Kira Johnson died as a result of internal bleeding following a cesarean section.

Now, two years later, Johnson is raising two children on his own and advocating to rectify the country's maternal health policies and regulations to prevent anyone else from sharing the same tragedy. Johnson took to Capitol Hill to share his wife's story before members of Congress, working alongside a congresswoman who experienced her own personal difficulties during pregnancy.

Charles and Kira Johnson welcomed their first son Charles V. in 2014. He was delivered via C-section. Two years later, the Johnson family relocated from Atlanta to Los Angeles and learned they were expecting their second baby boy.

"Kira and I had always wanted two boys," Johnson said. "I was excited."

The Johnsons decided to have Langston delivered at Cedars Sinai medical center, a non-profit hospital that is currently ranked as the eighth best hospital in the country by U.S. News and World Report.

Charles Johnson said his wife was in exceptional health and that she took all the necessary prenatal measures to ensure their second child would be born healthy. Since their first son was born via C-section, the doctor suggested the same for their second. (more…)

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States look to breathalyze convicted drunk drivers to reduce fatalities

This story is from Kaiser Health News

On Jan. 1, California joined the majority of states that ha..

This story is from Kaiser Health News

On Jan. 1, California joined the majority of states that have laws requiring drivers with drunken-driving convictions to install breathalyzers in vehicles they own or operate.

Researchers, public health advocates and political leaders believe these laws are helping reduce alcohol-related road deaths.

The gadgets, known as ignition interlock devices, are mounted on the steering wheel of a vehicle and prevent it from starting if the drivers blood-alcohol reading is above a predetermined level.

In California, the breathalyzers are mandatory only for repeat offenders. Five other states — Georgia, Indiana, Massachusetts, Montana and Ohio — have similar laws. Thirty-two states and D.C. require the devices even for first-time offenders.

The advent of such laws across the United States in the past 15 years has been accompanied by some good news: Deaths involving drunken driving are only about half of what they were in the early 1980s, though they have ticked back up in recent years. The long-term decline is largely attributable to greater public awareness, stricter seat belt enforcement and the establishment in 2000 of a nationwide legal blood-alcohol threshold of 0.08 percent — far below the 0.15 percent standard commonly used before then.

State Sen. Jerry Hill (D-San Mateo), the author of the California law, said breathalyzers in cars will make roads safer than under the current law, which generally relies on license restrictions and suspensions.

“Weve seen people on a suspended license continue to drive and continue to cause destruction,” said Hill, who lost his best friend to drunken driving in the 1980s.

There is some evidence that the breathalyzers have an impact. Nationally, from 2006 to 2016, ignition-locking breathalyzers prevented 2.3 million attempts to drive by people with a blood-alcohol level at or above 0.08 percent — the legal threshold for driving under the influence — according to a 2017 report by the advocacy group Mothers Against Drunk Driving.

Emma McGinty, an associate professor at the Johns Hopkins Bloomberg School of Public Health, found that laws requiring interlocks for all DUI offenders were associated with a 7 percent drop in the rate of fatal crashes caused by drunken drivers. Another study found that laws covering all offenders were associated with 15 percent fewer alcohol-related fatalities compared with states that have less stringent laws. (more…)

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