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July 2010 Briefing - OBGYN & Women's Health

Here are what the editors at HealthDay consider to be the most important developments in OBGYN & Women's Health for July 2010. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

FDA: Evamist Tied to Adverse Effects in Children, Pets

FRIDAY, July 30 (HealthDay News) -- The U.S. Food and Drug Administration has warned that unintentional exposure to estradiol transdermal spray (Evamist) through skin contact with patients using the spray may cause adverse effects in children and pets.

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Calcium Supplements May Increase Heart Attack Risk

FRIDAY, July 30 (HealthDay News) -- Calcium supplementation is associated with an increased risk of myocardial infarction, according to a meta-analysis published online July 29 in BMJ.

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Specialties See Modest Compensation Increases in '09

FRIDAY, July 30 (HealthDay News) -- Most medical specialties saw modest compensation increases in 2009, but many provider organizations are still operating at a substantial loss, according to the findings of the American Medical Group Association's (AMGA) 2010 Medical Group Compensation and Financial Survey.

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Early Puberty More Likely in Obese, Overweight Girls

THURSDAY, July 29 (HealthDay News) -- Overweight and obese girls are likely to reach puberty earlier than their normal-weight counterparts, and are also at risk for the long-term health consequences related to obesity, according to a review published online July 29 in the Journal of Adolescent Health.

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Thiazolidinediones May Up Fracture Risk in Older Women

THURSDAY, July 29 (HealthDay News) -- In type 2 diabetes patients, thiazolidinedione (TZD) exposure is associated with an increased risk of fracture in women age 50 and older -- especially in higher doses -- and in men who are concurrently exposed to loop diuretics, according to research published online July 14 in the Journal of Clinical Endocrinology and Metabolism.

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Behavioral Training Doesn't Help Incontinence Outcomes

WEDNESDAY, July 28 (HealthDay News) -- Women who are on drug therapy for urge urinary incontinence do not improve their outcomes by adding behavioral intervention to their treatment program, according to a study in the August issue of The Journal of Urology.

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Mammogram Failure in 40s Mostly Due to Detection Limits

WEDNESDAY, July 28 (HealthDay News) -- Poorer mammographic screening outcomes in women in their 40s compared with older women are mostly due to the reduced ability of mammograms to detect cancer in that age group, as opposed to a faster tumor doubling time, according to research published online July 27 in the Journal of the National Cancer Institute.

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Genetics-Based Risk Score Tied to Risk for Breast Cancer

TUESDAY, July 27 (HealthDay News) -- Higher risk scores for breast cancer based on genetic variants linked to breast cancer are associated with a higher risk for cancer and are especially predictive of estrogen receptor (ER)-positive disease, according to research published in the July 28 issue of the Journal of the American Medical Association.

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Late Preterm Babies Still at Risk for Respiratory Morbidity

TUESDAY, July 27 (HealthDay News) -- Late preterm babies -- those born at 34 to 37 weeks' gestation -- are more likely than full-term babies to suffer respiratory distress syndrome and other respiratory morbidity, though the risk decreases with each additional week of gestation, according to research in the July 28 issue of the Journal of the American Medical Association.

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Raising Hysterectomy Volume Can Lower Surgery Time

MONDAY, July 26 (HealthDay News) -- Increasing surgical volume may reduce the operating time for laparoscopic hysterectomy and also lower the risk for conversion to laparotomy, but high- and low-volume surgeons have similar rates of serious complications, according to a study in the July issue of the American Journal of Obstetrics & Gynecology.

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Seat Belts Protect Pregnant Drivers During Collisions

FRIDAY, July 23 (HealthDay News) -- Wearing a seat belt protects pregnant drivers by reducing the risk of abdominal pressure or contact with the steering wheel during frontal and rear collisions, according to a study published in the July issue of the American Journal of Obstetrics & Gynecology.

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Pelvic Radiation in Girls Tied to Higher Stillbirth Risk

FRIDAY, July 23 (HealthDay News) -- Female survivors of childhood cancer treated with pelvic radiation have a much higher risk of stillbirth and neonatal death in their offspring than do females who did not get radiation, but there is no increased risk for male survivors who received gonadal radiation, according to research published online July 23 in the The Lancet.

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New Standardized Method Determines Causes of Stillbirth

FRIDAY, July 23 (HealthDay News) -- A new standardized method may help assign cause of death in stillbirth based on data collected during prenatal care and assessment of fetal death, according to a study published in the August issue of Obstetrics & Gynecology.

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Modest Weight Loss Linked to Urinary Incontinence Benefits

FRIDAY, July 23 (HealthDay News) -- In overweight and obese women, modest weight loss can result in significant urinary incontinence benefits, according to a study in the August issue of Obstetrics & Gynecology.

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Folate-Related Genes Plus Lifestyle Tied to Heart Defects

THURSDAY, July 22 (HealthDay News) -- Women who have functional single-nucleotide polymorphisms in folate-related genes as well as lifestyle factors that may alter folate metabolism appear to be at increased risk of having a fetus with a congenital heart defect (CHD), according to a study published in the August issue of Obstetrics & Gynecology.

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ACOG: Cervical Cytology Not Recommended for Adolescents

THURSDAY, July 22 (HealthDay News) -- Although prior recommendations of major societies advised cervical cytology screening in adolescents based on onset of vaginal intercourse, the American College of Obstetricians and Gynecologists now recommends that screening begin at age 21, regardless of sexual activity, due to the rarity of cervical cancer in women under 21. These recommendations have been published in the August issue of Obstetrics & Gynecology.

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Miscarriage, Preterm Birth Not Tied to Modest Caffeine Intake

THURSDAY, July 22 (HealthDay News) -- Moderate caffeine intake -- defined as less than 200 mg of caffeine, which equates to about 12 ounces of coffee -- does not appear to be linked to miscarriage or preterm birth, according to a new committee opinion published in the August issue of Obstetrics & Gynecology.

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ACOG Guidelines Call for More Vaginal Births After Cesarean

THURSDAY, July 22 (HealthDay News) -- Vaginal birth after cesarean (VBAC) is a safe option for most women who have had one prior cesarean delivery and for some who have had two prior cesarean deliveries, according to new guidelines released by the American College of Obstetricians and Gynecologists and published in the August issue of Obstetrics & Gynecology.

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HPV Vaccine Demonstrates Sustained Protection

WEDNESDAY, July 21 (HealthDay News) -- The quadrivalent human papillomavirus (HPV) vaccine appears to provide strong and sustained protection against low-grade lesions attributable to HPV, according to research published July 20 in BMJ.

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FDA Panel Advises Against Bevacizumab for Breast Cancer

WEDNESDAY, July 21 (HealthDay News) -- A U.S. Food and Drug Administration advisory panel has recommended that bevacizumab (Avastin) not be used to treat patients with advanced breast cancer, based on lacking evidence of survival benefits.

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Prenatal Anxiety in Moms Tied to Higher Infant Illness Risk

WEDNESDAY, July 21 (HealthDay News) -- Babies whose mothers experience prenatal stress and anxiety appear to be at higher risk for illnesses and require more antibiotics in their first year of life, according to research published online July 19 in Pediatrics.

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Overweight, Obese Mothers at Higher Risk for Preterm Birth

WEDNESDAY, July 21 (HealthDay News) -- Overweight and obese women appear to be at greater risk of delivering preterm babies, and, after publication bias is taken into account, maternal overweight and obesity do not have beneficial effects on low infant birth weight, according to research published July 20 in BMJ.

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5.2 Percent of Residency Applicant Essays Plagiarized

TUESDAY, July 20 (HealthDay News) -- About 5 percent of the application essays to residency programs -- often referred to as the personal statement -- contain plagiarized material, according to research published in the July 20 issue of the Annals of Internal Medicine.

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Dense Breasts + Hormones Up Cancer Risk After Menopause

MONDAY, July 19 (HealthDay News) -- Postmenopausal women with high breast density, especially those undergoing hormone therapy with estrogen plus progestin, are at higher risk for developing breast cancer, according to a study published online July 19 in the Journal of Clinical Oncology.

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Surgical Residents' Fellowship Decisions Are Gender-Neutral

MONDAY, July 19 (HealthDay News) -- A surgery resident's decision to pursue fellowship training is largely due to a desire for clinical mastery and specialty activities regardless of gender, with lifestyle factors of only midrange importance and program size appearing more influential than gender, according to research published in the July issue of the Archives of Surgery.

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In Vitro Fertilization Linked to Children's Cancer Risk

MONDAY, July 19 (HealthDay News) -- Children conceived by in vitro fertilization (IVF) may have a moderately increased risk of cancer, according to research published online July 19 in Pediatrics.

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Stress in Pregnancy May Contribute to Preterm Birth

FRIDAY, July 16 (HealthDay News) -- Women who experience severe life events stress during the first or second trimester of pregnancy may be at increased risk for delivering preterm babies and infants with low birth weight, according to research published in the July issue of the American Journal of Obstetrics & Gynecology.

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Many Postpartum Women Visit ER Within Weeks of Delivery

THURSDAY, July 15 (HealthDay News) -- Nearly 5 percent of women who deliver babies in hospitals across the United States visit the emergency department within 42 days of delivery, most often for pregnancy-related conditions, according to research published in the July issue of the American Journal of Obstetrics & Gynecology.

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Gestational Diabetes Risk Rises With Prior GDM Pregnancies

THURSDAY, July 15 (HealthDay News) -- The risk of subsequent gestational diabetes mellitus (GDM) increases with the number of previous episodes of the condition, and Hispanics and Asian/Pacific Islanders have a higher recurrence risk, according to research published online July 14 in the American Journal of Obstetrics & Gynecology.

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Intervention Helps Mothers Prevent Weight Gain

WEDNESDAY, July 14 (HealthDay News) -- Mothers who receive self-management guidance in a community setting are less likely to gain weight and more likely to improve health-related behaviors, according to research published July 13 in BMJ.

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ASCO Guidelines Recommend Aromatase Inhibitor Use

TUESDAY, July 13 (HealthDay News) -- An aromatase inhibitor (AI) should be included in adjuvant endocrine therapy for postmenopausal women with hormone receptor-positive breast cancer, according to updated American Society of Clinical Oncology guidelines published online July 12 in the Journal of Clinical Oncology.

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Nomogram Helps Predict Best Treatment for DCIS

TUESDAY, July 13 (HealthDay News) -- A nomogram using clinical and pathological tumor characteristics can predict the risk for local recurrence of ductal carcinoma in situ (DCIS), and can assist in making individualized treatment decisions, according to research published online July 12 in the Journal of Clinical Oncology.

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Weight Loss Efforts May Reduce Symptoms of Hot Flushes

TUESDAY, July 13 (HealthDay News) -- An intensive behavioral weight loss intervention can lead to improvements in hot flushes in overweight and obese women, according to research published in the July 12 issue of the Archives of Internal Medicine.

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Breast Density Not a Risk Factor for BRCA Carriers

MONDAY, July 12 (HealthDay News) -- Although breast density is a risk factor for breast cancer in the general population, it does not appear to increase risk in women with BRCA mutations, according to research published online July 12 in the Journal of Clinical Oncology.

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C-Section Scar Appearance Similar With Staples, Sutures

MONDAY, July 12 (HealthDay News) -- There is little difference in cosmetic outcomes for patients whose cesarean section wounds were closed by staples and those whose wounds were closed with subcuticular sutures, according to research published in the July issue of the American Journal of Obstetrics & Gynecology.

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Infant Heart Defects Linked to Pregnancy Bupropion Use

MONDAY, July 12 (HealthDay News) -- Maternal use of bupropion during early pregnancy appears to have a modest positive association with left outflow tract heart defects in infants, according to a study published in the July issue of the American Journal of Obstetrics & Gynecology.

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Preterm Births, Births to Teens Decline; Child Poverty Rises

FRIDAY, July 9 (HealthDay News) -- The welfare of America's children has improved in many areas in the last few years, with a decline in preterm births and babies born to adolescents, better reading and math scores for eighth-graders, and improved health insurance status; however, there have also been more negative changes, such as a rise in the proportion of children living in food-insecure homes, according to the new report, "America's Children in Brief: Key National Indicators of Well-Being, 2010."

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Pregnancy Exercise Program Prompts Modest Activity Increase

FRIDAY, July 9 (HealthDay News) -- An individualized exercise program for obese pregnant women with an energy expenditure goal of 900 kcal/week is feasible and can lead to modest increases in physical activity, though it may not be enough to prevent gestational diabetes mellitus, according to a study in the July issue of Diabetes Care.

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Wrist Fractures, Functional Decline Linked in Older Women

FRIDAY, July 9 (HealthDay News) -- Wrist fractures in older women can result in clinically important functional decline, according to a study published online July 8 in BMJ.

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Somatic BRCA1/2 Aberrations Frequent in Ovarian Cancer

THURSDAY, July 8 (HealthDay News) -- Somatic and germline mutations and expression loss in BRCA1 and BRCA2 are common enough in ovarian cancer to warrant assessment in trials for predicting the benefit of poly(ADP ribose) polymerase-1 (PARP1) inhibitors, according to research published online July 6 in the Journal of Clinical Oncology.

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Fish Oil Usage Linked to Lower Risk of Certain Breast Cancers

THURSDAY, July 8 (HealthDay News) -- The use of fish oil supplementation may be associated with a lower risk of certain breast cancers, according to research published in the July issue of Cancer Epidemiology, Biomarkers & Prevention.

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Many Doctors in Specialties Other Than Their Early Choices

WEDNESDAY, July 7 (HealthDay News) -- Ten years after graduation, approximately one-fourth of doctors work in a specialty other than the one they chose in their third year post-graduation, according to research published online July 6 in BMJ.

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FOBT Accuracy Declines As Temperature Rises

WEDNESDAY, July 7 (HealthDay News) -- Fecal occult blood testing (FOBT) for the detection of colorectal cancer is significantly less accurate in the summer than in the winter, according to research published online July 5 in Gut.

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Olaparib Shows Benefit in Cancer With BRCA Mutations

WEDNESDAY, July 7 (HealthDay News) -- Olaparib may be useful in treating women with BRCA1 or BRCA2 mutations who have advanced breast or ovarian cancer, according to the results of two studies published online July 6 in The Lancet.

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CDC: U.S. Colorectal Cancer Screening Rates Up

TUESDAY, July 6 (HealthDay News) -- Colorectal cancer (CRC) screening rates have increased in the United States since 2002 and mammography rates have plateaued, while millions of people have not undergone recommended CRC screening, and millions of women have not had a recent mammogram, according to research published July 6 in an early issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Review Updates Evidence on Osteoporosis Screening

TUESDAY, July 6 (HealthDay News) -- Screening methods are available to predict risk of osteoporotic fractures, and medications to reduce fractures are effective, but studies have yet to directly identify the effectiveness or potential harm of screening or establish ideal screening intervals, according to a review published online July 5 in the Annals of Internal Medicine.

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Primary Care Residents Benefit From Breast-Feeding Course

TUESDAY, July 6 (HealthDay News) -- Primary care residents who participate in a breast-feeding curriculum have improved knowledge, practice patterns, and confidence in breast-feeding management compared with residents who do not participate in the curriculum, and babies at their institutions are more likely to be breast-fed exclusively six months after the intervention, according to research published online July 5 in Pediatrics.

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Planned Home Births Linked to Tripled Neonatal Mortality Rate

FRIDAY, July 2 (HealthDay News) -- Planned home births, which have fewer medical interventions than planned hospital births, are associated with a significantly higher neonatal mortality rate, according to research published online July 2 in the American Journal of Obstetrics & Gynecology.

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CDC: Vaccinia Virus Infection Linked to Sexual Contact

FRIDAY, July 2 (HealthDay News) -- Following sexual contact with her military serviceman boyfriend, who had been recently vaccinated for smallpox, a woman in Washington state contracted vaccinia virus infection in her vagina, according to a case report published in the July 2 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Report Addresses Physician Financial Conflicts in Care

THURSDAY, July 1 (HealthDay News) -- In a new report, the Association of American Medical Colleges (AAMC) urges U.S. teaching hospitals to establish policies that ensure financial relationships between physicians and industry do not result in conflicts of interest that influence patient care.

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In Women, Early Life Activity Cuts Cognitive Impairment Risk

THURSDAY, July 1 (HealthDay News) -- Women who have been physically active at any point in their lives -- but especially during the teenage years -- are at lower risk of developing cognitive impairment in late life than women who have been inactive, according to research published online June 30 in the Journal of the American Geriatrics Society.

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Patterns in Substance Abuse Admits for Pregnant Teens Shift

THURSDAY, July 1 (HealthDay News) -- Between 1992 and 2007, there was a substantial increase in the proportion of pregnant teens admitted for treatment of marijuana and methamphetamine abuse -- though the proportion of admissions for alcohol abuse declined over that time period; and admissions are up among Hispanic pregnant teens and down among black and non-Hispanic white pregnant teens, according to a report issued June 28 by the Substance Abuse and Mental Health Services Administration (SAMHSA).

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