Saturday, January 7, 2012

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Friday, January 6, 2012

[Comment] Treatment of prostate cancer metastases: more than semantics

Prostate cancer is a unique disease that is characterised at advanced stages by a dominance of bone-forming metastases. Our understanding of bone metastasis with support from experimental findings has led investigators to target these metastases therapeutically, and the report by Matthew Smith and colleagues 1 in The Lancet is a result of these efforts.

Denosumab is an inhibitor of RANK ligand (RANKL), which is mechanistically implicated in, and clinically associated with, prostate cancer progression ...

Source: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61540-7/fulltext?rss=yes

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More US women having twins; rate at 1 in 30 babies (AP)

ATLANTA ? The number of twins born in the U.S. soared over the last three decades, mostly the result of test-tube babies and women waiting to have children until their 30s, when the chances of twins increase.

In 2009, 1 in every 30 babies born in the U.S. was a twin, an astounding increase over the 1 in 53 rate in 1980, according to a government report issued Wednesday.

"When people say it seems like you see more twins nowadays, they're right," said Joyce Martin, an epidemiologist who co-authored the Centers for Disease Control and Prevention report.

Some increase was expected as more women are delaying starting a family until they are over 30. For some unknown reason, mothers in their 30s are more likely to have twins than younger or older women. As much as a third of the increase can be attributed to that, Martin said.

The rest of the rise is due to fertility drugs and treatments.

"You have a double whammy going on. There are more older moms and more widespread use of fertility-enhancing therapies," Martin said.

Starting in the early 1980s, couples who had trouble conceiving began to benefit from medical advances like fertility drugs and in vitro fertilization and other procedures. These treatments became fairly widespread in the 1990s but are expensive, and availability and insurance coverage varies.

The twin birth rate rose by more than 2 percent a year, on average, from 1980 through 2004. It leveled off to less than 1 percent annually although the rise from 2008 to 2009 was nearly 2 percent.

In 2009, twin rates increased in all 50 states, though the jumps were highest in lower New England, New Jersey and Hawaii. In Connecticut, twins now account for nearly 5 percent of births.

That's high. Nationally, 3.3 percent of all births were twins in 2009, up from 2 percent in 1980.

Over the last three decades, rates rose for white, black and Hispanic women, but the increases were not uniform. Rates doubled for whites, rose by half for blacks and by about a third for Hispanics. Historically, black moms have twins most often, but white moms have almost caught up.

"That's changed with infertility treatments," said Barbara Luke, a Michigan State University expert on twin births.

The greatest increase in twin rates was for women 40 and older. They are more likely to use fertility treatments and to have two embryos implanted during in vitro fertilization, whereas younger women are more likely to get just one.

About 7 percent of all births for women 40 and older were twins, compared to 5 percent of women in their late 30s and 2 percent of women age 24 or younger.

While a lot of attention is focused on the impact of fertility treatments, that's not the only factor. Before fertility treatments existed, about 2.5 percent of the babies born to women in their late 30s were twins, compared to under 2 percent for younger and older women. Some research has suggested women in that age group are more likely to produce multiple eggs in a cycle, increasing their chances of twins.

Clearly, there are more older moms. In recent years, more than a third of all births have been to women 30 and older, up from just one-fifth in 1980.

Take Victoria Jacobson. At 31, she gave birth to twin girls last April ? her first children. With no history of twins in her family, and no fertility drugs, it was a big surprise when she found out at six months pregnant.

"I cried, because I'm more of a realist. My husband laughed," said Jacobson, of Glen Ellyn, Ill. "They were not tears of joy. Maybe shock, more than anything."

Still, Jacobson doesn't find the new report on twin births surprising. A good friend had twins four months after Jacobson's girls were born. "I'm stopped at every corner and in every store" by mothers who also have twins, or who know of other twins, she says.

"I never knew how many twins were around until I got twins."

Are more twins good news? Some experts say the trend is worrisome, noting that multiple births are more dangerous for the mother and their babies. The infants tend to be born earlier, smaller and weaker, and require much more care.

Jacobsons' twins arrived a month early and were tiny, about 3 pounds each. They had to be cared for in a hospital intensive care unit, and one needed a ventilator at first to help her breathe.

At 8 months, they are still small, but healthy and doing fine. Still, they don't sleep through the night, and breastfeeding two and getting them on the same schedule hasn't been easy, she said.

Despite the challenges, she has this advice to other moms of twins: Don't "think about it as double trouble. It's still a double blessing."

___

AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

____

Online:

CDC report: http://www.cdc.gov/nchs/

Source: http://us.rd.yahoo.com/dailynews/rss/parenting/*http%3A//news.yahoo.com/s/ap/20120105/ap_on_he_me/us_med_twins

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Thursday, January 5, 2012

How Fracking Wastewater Is Tied To Quakes

With the skyline of Youngstown, Ohio, in the distance, a brine injection well owned by Northstar Disposal Services LLC is seen in Youngstown on Jan. 4. The company has halted operations at the well, which disposes of brine used in gas and oil drilling, after a series of small earthquakes hit the Youngstown area. Amy Sancetta/AP

With the skyline of Youngstown, Ohio, in the distance, a brine injection well owned by Northstar Disposal Services LLC is seen in Youngstown on Jan. 4. The company has halted operations at the well, which disposes of brine used in gas and oil drilling, after a series of small earthquakes hit the Youngstown area.

Small earthquakes in Ohio and Arkansas associated with hydraulic fracturing for natural gas have taken many people by surprise. Gas industry executives say there's no hard evidence that their activities are causing these quakes. But some scientists say it's certainly possible; in fact, people have been causing quakes for years.

In the 1960s, geologists realized that gold mines in South Africa had created small earthquakes. Caverns dug into the earth thousands of feet below the surface collapsed. The "pancake" effect caused quakes ? in one case a magnitude-5.2 temblor.

Since then, scientists have found that even pumping water away from underground mines (to keep them from flooding) changes the dynamics of stress in rock formations enough to trigger a quake.

Some rock is saturated with water ? the water occupies pores between rock particles. This creates what's called "pore pressure" and keeps the formation in a sort of equilibrium. If you suck the water out, particles tend to collapse in on themselves: the rock compresses. Add water, and you push particles apart. So moving water around underground can affect the stresses on those formations.

Creating Quakes

Now let's say there's a fault in the earth. If the water content around the fault is changed, the fault might slip. If the water gets into the fault itself, it can lubricate the fault and trigger a quake.

Hydraulic fracturing pumps a lot of water underground, where it's used to crack the rock and liberate gas. This may cause tiny quakes, but fracking goes on for a day or two, and the quakes are small.

Recent quakes reported in Ohio and Arkansas are associated with wastewater wells, not fracking wells. The water first used in fracturing rock is retrieved and pumped into these waste wells, which take in lots of water. And at more than 9,000 feet deep, the water is under high pressure that can build up over months or years. It's this pressure that can actually create earthquakes.

In the 1960s, a wastewater well in Colorado at the Rocky Flats Arsenal is believed to have been the trigger for a magnitude-4.8 quake.

A few geologists are familiar with these induced or triggered quakes. They're rare and usually small, but now fracking is creating thousands of wastewater wells, often in heavily populated areas that historically have not been seismically active. That means even small quakes get noticed.

Shipping Wastewater Out Of State

For decades, scientists have known that activities like mining, drilling and building dams can create earthquakes. As early as the 1960s, observers noted that deep-earth gold mining changed the stresses in rocks and caused earthquakes. Above, miners drill into the rock at the Sub Nigel East Gold Mine in Johannesburg in 1961, more than 6,000 feet below ground. Ron Stone/Getty Images

For decades, scientists have known that activities like mining, drilling and building dams can create earthquakes. As early as the 1960s, observers noted that deep-earth gold mining changed the stresses in rocks and caused earthquakes. Above, miners drill into the rock at the Sub Nigel East Gold Mine in Johannesburg in 1961, more than 6,000 feet below ground.

It can be hard, even then, to definitively nail down the source of a quake. And there are several ways big infrastructure projects can create them: People have created quakes when they excavate quarries ? removing all that rock, or "overburden," changes the vertical stress on rock and the faults below. Likewise, dams increase the stress below when a lake is created. The Aswan Dam in Egypt and another in India are believed to have triggered quakes.

One way to avoid creating earthquakes is not to inject fracking wastewater into waste wells, but to recycle it instead. The state of Pennsylvania tried that, but they found that wastewater treatment plants couldn't get all of the toxic material out of fracking water, and the "cleaned up" water returned to rivers wasn't clean enough. So well operators in the state decided to ship wastewater to Ohio, where it has been going down into wells.

The U.S. Geological Survey is working on ways to head off quakes from wastewater wells. That would include performing seismic surveys before drilling the wells. Permeable rock like sandstone is better than hard, brittle basement rock that is riddled with faults. Operators might also limit the amount of water going into wells: USGS geologists have learned that the more water injected, the bigger an ensuing quake.

Source: http://www.npr.org/2012/01/05/144694550/man-made-quakes-blame-fracking-and-drilling?ft=1&f=1007

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