On science blogs this week: Aftershocks
Written by Tabitha M. Powledge Blog
Left, Japan's Northeast coast Mar 14 from Terra spacecraft. Right, August 2008. (Photo courtesy of NASA/GSFC/METI/ERSDAC/JAROS)
AFTERSHOCKS IN JAPAN — AND OTHER PLACES. So Northeastern Japan has just suffered another big earthquake, magnitude 7.4, although apparently it's only an aftershock from the Big One a month ago. At Nature's the Great Beyond, Quirin Schiermeier summarizes.
The Big One and its sequelae are providing opportunities for Nature and Scientific American to integrate their coverage somewhat, a move to be expected since the former bought the latter last year. You can view Nature's roundup here; it appears to be open access, no sub needed. Scientific American has also been maintaining short summaries here. And at SciAm's Observations, see Phil Yam's edited Nature Q&A with energy experts about Fukushima.
Nature hired Ed Yong to put together an earthquake-and-aftermath timeline at his Discover blog Not Exactly Rocket Science. He used the online timeline software Dipity, his second adventure with it. Here we have another example of how digital tools are fashioning the future of science news online even as we speak. In his post, Yong speculates on the kinds of stories that adapt well to being Dipitied. One thing he doesn't mention, although it's obvious when you see the intricacy of his timeline, is that this stuff is a helluva lot of work.
If that's just too much information for you in these frenetic times, at Technology Review's Potential Energy, Kevin Bullis summarizes a group of Nature articles examining the long-term impact of the nuclear disaster at the Fukushima power plant.
At the Columbia Journalism Review's Observatory, Curtis Brainard praises the Wall Street Journal for its Page One piece on the environmental impacts of the earthquakes and aftermaths in Japan that have nothing to do with nuclear power. They concern destruction and contamination of the land from chemicals and toxins (including salt) the tsunami left behind. There's also a pat on the back for two posts by Elizabeth Grossman at The Pump Handle. As Brainard notes,
it doesn’t have to be radioactive to be troublesome.
WARNING: THE FOLLOWING, WHICH IS OSTENSIBLY ABOUT SEX HORMONES, IS REALLY ABOUT THE ICKY TOPIC OF FEMALE PLUMBING. Early this century, when the government shut down most of the massive clinical trial known as the Women's Health Initiative and data were first released that showed taking sex hormones after menopause was not always a pure and everlasting good, the workaday cliche was all about the pendulum.
The pendulum was swinging back, it was said, because it had swung too far in favor of prescribing a combination of estrogen and progestins not just to prevent the discomfort of hot flashes but in hopes the hormones would ward off chronic and potentially fatal disorders of aging, especially heart disease and osteoporosis.
The result: millions of women stopped hormone replacement therapy (now known simply as hormone therapy or HT), and millions more women who might have begun it around menopause didn't.
Well, darned if that pesky pendulum isn't reversing direction once more. Yet more data from the WHI, in a long-term follow-up study of more than 10,000 women just published in JAMA, have shown that women who were taking estrogen by itself because their uteruses had been removed do indeed have a reduced risk of heart attacks. But wait, there's more. Astonishingly, they also have a reduced risk of breast cancer, down 23% compared to study women on placebo. Breast cancer has long been thought to be the most dangerous potential consequence of HT.
The new paper confirms a preliminary study of these women that JAMA published in the spring of 2006, which I wrote about at the time. Tara Parker-Pope has a detailed analysis of the new paper and what it might mean at the New York Times blog Well.
One of its implications is that the main villain in HT is not estrogen but medroxyprogesterone (MPA), the synthetic progesterone analog most commonly used in HT to prevent the small risk of uterine cancer that accompanies estrogen therapy. The probable dangers of MPA have been known for a long time too; I wrote about them in 2003.
I was surprised there was so little blogging about the new HT study, but of course I shouldn't have been. The explanation is doubtless largely demographic. HT affects millions of women, but most bloggers are men, and younger men at that. Who are not very brave about Female Troubles and in any case supremely uninterested in persons of advanced years, for example 50. Are there any men within the sound of my voice? I didn't think so.
Most women bloggers are younger too. They still secretly believe they are not only immortal, but they will never age. I'm not mocking them; once upon a time I believed those things too.
One exception is Boston.com's Daily Dose, where Deborah Kotz interviews JoAnn Manson, perhaps the most expert expert on this chaotic topic. Manson was involved in the WHI from the beginning, is an author on several of the papers about it, but is sane and undefensive about its deficiencies and gaps. Her advice is probably the most reasonable around, given the many unknowns. But that's just it. There are many unknowns, which means even the best advice may not be terribly helpful for individual decisions about HT.
Another blog exception is the engaging Flashfree ("Not your mama's menopause.") Liz Scherer, who is, as she notes, not a fan of HT, attempts to sort through the paper and JAMA's accompanying and unenthusiastic editorial. She ends up asking
Are you confused yet?
Of course you are. It's become painfully clear — actually, it was painfully clear almost from the beginning of the WHI controversy to those who read carefully — that HT is yet another failure of one-size-fits-all medicine.
The many thousands of women in the WHI study were, for one thing, on average more than a decade older than the usual HT taker who begins the regimen as her menstrual periods end.. The data suggest that the potential dangers of HT are increased for women who begin it when they are well beyond menopause.
So does that mean that HT is probably OK if you start as your periods wane? Or if you wear an estrogen patch instead of taking a pill that must be processed by your liver? Or take bio-identical hormones? Or take HT for only 3 weeks a month or every three months or some cyclical pattern other than daily? Or if you don't have a family history of breast cancer? Or a whole other bunch of ifs?