nj.com - Report links estrogen levels to joint replacement surgery for women

Women who've had multiple births, are on hormone replacement therapy or underwent early puberty are at significantly higher risk for knee or hip replacement surgery, reports one of the largest studies to look at the relationship between reproductive issues and joint replacement surgery.

The findings, published on-line today ahead of print in Annals of the Rheumatic Diseases, are based on the experiences of some 1.3 million middle-aged women in the United Kingdom. Researchers at the University of Oxford tracked the women beginning in 1996 for about six years -- from around the age of 50 upwards -- to see if they had a knee or hip replaced due to osteoarthritis, an inflammatory joint disease.

A little more than 12,000 required a hip replacement by the end of the study period and just under 10,000 needed a knee replacement.

After quizzing the women on how when they had their first and last periods, how many children they had and whether they had used oral contraceptives and hormone replacement therapy (HRT), several patterns emerged.

If a woman started menstruation before the age of 11, her probability of having both hip and knee replacement surgery increased between 9 and 15 percent, the researchers found. Every successive birth increased the risk of a hip replacement by 2 percent and a knee replacement by 8 percent.

While previous use of oral contraceptives did not appear to have an effect, current use of hormone replacement therapy boosted the chances of a hip replacement by 38 percent and of a knee replacement by 58 percent, the study found.

"These findings, along with other evidence, strongly suggest that the female sex hormone, estrogen, plays a role in the development of osteoarthritis of the hip and knee and the subsequent need for joint replacement," lead study author Bette Liu, of the University of Oxford, said in an e-mail to The Star-Ledger.

Estrogen is a female sex hormone that controls the reproductive cycle, and prepares the body for pregnancy.

Liu cautioned that the is evidence is not strong enough to recommend women change their use of HRT. In fact, the study suggests that such "non-biological factors" as women having greater access to health services if they are on hormonal therapy could be a factor in them having joint replacement surgery.

Overall, women have a higher incidence of osteoarthritis, in particular of the knee, when compared to men, the study notes.

Daily Exspress - EXAM JOY AS STUDENTS RECORD BEST EVER RESULTS AT A LEVEL

STUDENTS across the country were last night toasting the nation’s best ever A-level results.
Brushing off concerns that the exams have become too easy, teenagers celebrated after recording an unprecedented 97 per cent pass rate.And one in four sixth-formers were awarded at least one A grade (25.9 per cent, up from 25.3 per cent last year).Teachers and ministers denied A levels have been dumbed down, despite the national pass rate rising to a record level for the 26th year in a row.Results received by some 300,000 teenagers in England, Wales and Northern Ireland, showed only 2.8 per cent of them failed the exams.But for the first time the exam board released a regional breakdown, examining pass rates and the proportion of students getting A grades in various areas of the country.It showed the greatest improvements in the last six years have been in the south-east with the north-east appears to be lagging behind.While the south-east has seen A grades rise 6.1 per cent – to 29.1 per cent since 2002 – the north- east has seen an improvement of just 2.1 per cent – to 19.8 per cent in the same period.Shadow Children’s Secretary Michael Gove said the divide was “worrying”.He said: “It underlines yet again the need for reform to create new good school places so that children in the less well-off areas get the same opportunities as others."

But there remained fierce argument over whether the tests had become too easy.While critics said the pass rate meant A levels were becoming meaningless, supporters argued that the results were simply a testament to students’ hard work and better teaching.Chris Keates, leader of the Nasuwt teachers’ union said: “These are Olympian achievements and represent years of hard work and sustained effort by students and teachers alike.”Dr John Dunford, of the Association of School and College Leaders, said: “If you continue to get nearer to 100 per cent it would suggest schools and colleges’ guidance programmes are improving. That’s got to be in the best interests of students.”There was a whole gamut of success stories yesterday, including a set of 18-year-old quadruplets who scored stunning results. Tolu, Tayo, Tobi and Tosin, all members of the Oke family, were born just a few minutes apart.They all achieved A, B or C grades at the St Francis Xavier Sixth Form College in Clapham, south-west London.Sisters Tayo and Tolu and brothers Tobi and Tosin will now go to their first-choice universities.Tolu was awarded a grade A in history, an A in sociology and a B in English language and literature. Tobi achieved a B in English language and literature, a B in sociology and a C in history. Tayo got an A in business, an A in sociology and a C in biology. Tosin kept up the high standard with an A in sociology, a B in business and a C in IT.But the quads were not the only tale of success among families with multiple births.A set of triplets was also celebrating after a clean sweep in their A-level results – notching up a stunning 13 grade As between them.Tim, Rachel, and Clare Heard, all 18, are now looking forward to going to university.Tim, who gained the top grade in geography, chemistry, biology and general studies said: “We are all absolutely delighted with our results. Rachel and Clare worked really hard but I preferred to socialise with my friends.”The trio all attended King Edward Camp Hill School in Birmingham, but will now go their separate ways to different universities. Other successes saw identical twins Anika and Nicola Ueckermann scoring impressive results.The 18-year-olds, from Colchester County High School for Girls, were delighted with their A and B grades and will both go to the University of East Anglia. They rejected criticism that exams are becoming easier. “They are definitely not,” said Anika. “This year was really hard.”

mirror - Meet the Quains* (ER, THAT'S QUADS WHO ARE ALSO TWINS..)

These two sets of twins are doubly special - they are also quads.
Ivf tots Andrew and Sienna were born to Karen Wesolowski, and Sophia and Alex to lesbian partner Martha Padgett. All four babies were conceived from Martha's eggs.
Just as unusually both gave birth on the same day. They opted for the double IVF as Karen, 42, had suffered three years of failures. Once Martha, 38, had her eggs fertilised with donor sperm, each woman got two embryos to boost their chances.
Martha, a nurse who already has a 10-year-old daughter, said: "We just wanted one baby. But when the doctor said we were both pregnant, we could hardly contain ourselves."
The couple, of Riverside, California, got a bigger shock when they learnt within a month how many tots were on the way.
Martha said: "We knew from research we'd done that there was a chance but we laughed it off. Once we heard four heartbeats we thought, 'Oh my God, we're going to have quads!' We couldn't believe it."
The final amazing coincidence came as both gave birth within 22 hours of each other. The non-identical tots, a year old next month, are all healthy.
Karen said: "We have four babies who are all brothers and sisters. Our family is complete." Keith Reed of the UK Twins and Multiple Births Association admitted: "This is very unusual."
Baby boom
The odds of having a multiple birth without IVF is just two per cent. But with IVF the risk rockets to 25 per cent.
Large family
The largest surviving multiple birth is the McCaughey septuplets born in Iowa, USA, in 1997 to Kenny and Bobbi.

Irishtimes - Quads well enough to leave Rotunda at three weeks old

THE FIRST quadruplets born in the Rotunda Hospital in Dublin since 2004 went home with their parents Turrty Nkiru Chime (34) and her partner Pius Nwedo (38) yesterday, just three weeks after their birth.
Baby girl Cindy and her brothers Leon, Seán and Divine were remarkable in being born so close to full term having arrived at 32 weeks into the pregnancy on June 17th last.
Quadruplets are very rare, accounting for fewer than one in every 50,000 births, with an average of just one set born here each year. They are becoming more uncommon as advances in IVF (in-vitro fertilisation) mean fewer embryos are implanted.
However, the birth of these babies was even more unusual as their conception was not the result of fertility treatment.
“Spontaneous occurrence of quads is extremely rare. There were more in the past with IVF treatments but because of advances there, they really are exceptional,” Dr Adrienne Foran, neonatal consultant at the Rotunda, said.
The babies were more remarkable still for having such high birth weights for a multiple birth, ranging from 1.66kg to 1.86kg, and being born free from any additional health problems often associated with multiple births, Dr Foran said.
“With any multiple birth, even the birth of twins, there is a higher risk of complications, particularly with pre-term births. Reaching 32 weeks is in itself a huge achievement, but there are all the other risks such as twin-to- twin-transfusion, growth restrictions, poor placental sufficiencies . . . but none of these occurred here.”
Ms Nkiru Chime, who arrived in Ireland from Nigeria seven years ago just before the birth of her first child, was admitted to the Rotunda at just under 24 weeks and was kept in until the delivery by Caesarean section.
“One of the main reasons we kept her in hospital was that she already had three children at home and tiredness can impair growth of the babies,” Dr Foran said
Ms Nkiru Chime, who is already the mother of Junior (6), Tracey (4) and Princess (2), said she was shocked when she learned she was carrying quadruplets. “I came in for my check-up a few months into the pregnancy and they told me. I was very surprised, I thought they were joking, but it was frightening also.” The weeks since the birth had been tiring, she said, but she was delighted by how healthy her babies were.
“I have not had any sleep because I am breastfeeding and using bottles and they are eating a lot! They can never wait four hours, they just start crying for food, but I know this means they are very healthy. I will ask God to give me strength, but it is very stressful

Buxton Advertiser - Expectant quadruplet couple 'not trying for baby'

A Plymouth couple who are to have quadruplets have said they were not even trying for a baby.
Emma and Michael Wing said they will attempt to keep all four of the quads despite the higher risks involved.They were offered "selective reduction" by the hospital, a procedure where one or more of the foetuses are removed to increase the chance
s of the others surviving, but turned it down as there was a chance it could result in a total miscarriage.Mr Wing said if the babies were not born by 34 weeks, the average gestation for a single baby is 40, then they would be born by Caesarian section.The 22-year-old soldier, who serves with 29 Commando Regiment Royal Artillery, said: "We weren't actually trying for a baby but didn't mind if one came along."We've been told there is a one in 700,000 chance of having quads, we should have played the lottery instead."The couple already have two sons, 10-month-old Callum and three-year-old Mason.Mrs Wing admitted she is nervous about carrying four babies and is expecting a difficult pregnancy.The 23-year-old is 12 weeks pregnant and said she wanted to let "nature take its course" despite already suffering severe morning sickness, headaches and stomach pains."It was quite scary to find out that I was expecting quads," she said. "I'll probably be bedridden by the end because I am quite slim and small and it would be too much strain for me to carry."

Daily Mail - Mother gives birth to one-in-500,000 quadruplets, including three identical boys

A mother has given birth to a rare set of quadruplets in which three of the four boys are identical, it was revealed today.
The boys were born 11 weeks premature in January having already survived odds of one in 500,000 to leave their mother's womb alive.
Their parents plan to introduce themselves and their babies at a news conference later today.

There are fewer than 100 documented cases of "identical triplets plus one" in the United States, hospital officials said.
Two embryos were implanted into the mother, and both were fertilized, hospital spokesman Michael Schwartzberg said.
One of them split, then split again, creating the identical triplets.
The boys were delivered by Caesarian section January 29, on their mother's 32nd birthday, at Baltimore Medical Centre in Towson, Maryland.
Joshua Drew was born first, then Gavin Michael, Cody Benjamin and finally Logan Christopher, the non-identical one.
The babies were treated at the hospital's neonatal intensive care unit, and all four have been home in Belcamp, Maryland, about two-and-a-half weeks weeks.