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June 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 June 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.

Expectant, New Moms Uninformed on Preterm Birth

WEDNESDAY, June 30 (HealthDay News) -- Most new or expectant moms have not discussed the possibility of preterm birth with their health care providers, despite the fact that one in eight babies born every year is preterm, according to the results of a survey conducted by the March of Dimes and BabyCenter.

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Many Breast Cancer Patients Don't Adhere to Therapy

WEDNESDAY, June 30 (HealthDay News) -- Only half of hormone-sensitive stage I to III breast cancer patients prescribed adjuvant hormonal therapy adhere to that therapy for the full duration at the optimal schedule, and younger women in particular are at high risk of non-adherence, according to a study published online June 28 in the Journal of Clinical Oncology.

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Mammograms for Poor Insured Rise With Stepwise Reminders

TUESDAY, June 29 (HealthDay News) -- A stepwise screening mammogram reminder program significantly increases the likelihood that an insured, very low-income woman will obtain a mammogram, according to research published online June 29 in Cancer Epidemiology, Biomarkers & Prevention.

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Maternal Smoking May Impact Child's Mental Health

TUESDAY, June 29 (HealthDay News) -- Maternal smoking may have an intrauterine effect on child conduct and externalizing problems, and there may be a biologically mediated association between paternal smoking and increased childhood body mass index (BMI), according to two studies published online June 29 in Pediatrics.

Abstract - Brion
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Abstract - Kwok
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Doctors Agree Malpractice Fears Drive Overuse of Tests

MONDAY, June 28 (HealthDay News) -- A large majority of physicians agree that the practice of defensive medicine -- stemming from malpractice concerns -- is responsible for an overuse of medical tests and procedures, according to a research letter in the June 28 issue of the Archives of Internal Medicine.

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Chronotropic Incompetence May Up Death Risk in Women

MONDAY, June 28 (HealthDay News) -- An attenuated heart rate response -- or chronotropic incompetence -- to exercise stress testing is linked to an increased risk of mortality in asymptomatic women, but the traditional calculation -- based on data from males -- overestimates women's maximum heart rate for age, according to a study published online June 28 in Circulation.

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Teen Girls More Likely to View Drug, Alcohol Use Positively

MONDAY, June 28 (HealthDay News) -- Teenage girls are more likely than their male counterparts to perceive potential benefits -- including "self-medicating" benefits -- from drug and alcohol use, according to survey data released by the Partnership for a Drug-Free America and the MetLife Foundation.

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Maternal Homocysteine Does Not Predict Low Birth Weight

FRIDAY, June 25 (HealthDay News) -- Maternal levels of homocysteine and related B vitamins in late pregnancy have no association with birth weight, according to a study in the June issue of the American Journal of Obstetrics & Gynecology.

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Updated Recommendations for Endometriosis Released

FRIDAY, June 25 (HealthDay News) -- Women who suffer from endometriosis-related pain should be treated first with conservative, non-surgical approaches and then with more invasive options if pain does not resolve, and hysterectomy only as a last resort, according to a practice bulletin issued by the American College of Obstetricians and Gynecologists (ACOG) and published in the July issue of Obstetrics & Gynecology.

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Panel Urges Two Yearly Preventive Visits for Teens

FRIDAY, June 25 (HealthDay News) -- Adolescent girls may require two "well-child" visits annually -- one general preventive visit and one dedicated to reproductive health, and both visits should be covered by health insurance, according a committee opinion of the American College of Obstetricians and Gynecologists (ACOG) published in the July issue of Obstetrics & Gynecology.

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Menstrual Cycle, OCPs Affect High-Risk HPV Detection Rates

THURSDAY, June 24 (HealthDay News) -- The timing of human papillomavirus (HPV) testing within the menstrual cycle affects detection rates in women who are taking non-continuous oral contraceptives, as well as in women who are not on oral contraceptives, according to research published in the July issue of Obstetrics & Gynecology.

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Computerized Decision Support Boosts Postpartum Vaccination

THURSDAY, June 24 (HealthDay News) -- A computer-based clinical decision-support algorithm can dramatically increase rates of tetanus, diphtheria, and acellular pertussis (Tdap) vaccination of postpartum women, according to a study in the July issue of Obstetrics & Gynecology.

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Parents Divided Over Genetic Testing of Minors for Cancer

THURSDAY, June 24 (HealthDay News) -- Genetic testing of minors for adult hereditary cancer syndromes is not currently recommended, and parents' opinions on testing of minors for BRCA1/2 mutations are divided, according to research published online June 21 in the Journal of Clinical Oncology.

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Underinsured African-Americans With Breast Cancer Fare Worse

THURSDAY, June 24 (HealthDay News) -- Underinsured African-American patients are more likely to experience poorer breast cancer-specific survival than their non-Hispanic white counterparts, though the effect of race on survival is not statistically significant after adjustment for sociodemographic and clinical factors, according to research published online June 23 in the Journal of the National Cancer Institute.

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Excess Gestational Weight Gain Linked to Long-Term Issues

THURSDAY, June 24 (HealthDay News) -- Gaining an excessive amount of weight during pregnancy may have long-term effects on mothers' and children's body sizes, but the benefits of lower gains should be balanced against the risk of small-for-gestational-age (SGA) births, according to research published in the June issue of the American Journal of Obstetrics & Gynecology.

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In Older Women, HPV Results Useful for Colposcopy Triage

WEDNESDAY, June 23 (HealthDay News) -- Human papillomavirus (HPV) and Pap test results can be used together in some cases to triage patients for further evaluation for cervical cancer with colposcopy, according to research published in the July issue of Obstetrics & Gynecology.

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Childhood Cancer Risk Not Linked to Cell Tower Exposure

WEDNESDAY, June 23 (HealthDay News) -- The risk of early childhood cancer does not appear to be linked to a mother's exposure to a mobile phone base station during pregnancy, according to a study published June 22 in BMJ.

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Oral Bisphosphonate Use May Reduce Breast Cancer Risk

WEDNESDAY, June 23 (HealthDay News) -- The use of oral bisphosphonates by postmenopausal women appears to significantly reduce the risk of some breast cancers, according to a pair of studies published online June 21 in the Journal of Clinical Oncology.

Abstract - Chlebowski
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C-Section Risk Found High for First-Time Moms Induced at Term

WEDNESDAY, June 23 (HealthDay News) -- Nulliparous women who undergo induced labor at term have double the risk of requiring cesarean delivery, according to a study in the July issue of Obstetrics & Gynecology.

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Imaging Combo Holds Promise for Breast Cancer Detection

TUESDAY, June 22 (HealthDay News) -- Ultrasound-guided optical tomography appears to be an effective means for differentiating early-stage breast cancers from benign lesions, and it has the potential to reduce the number of breast biopsies women undergo for suspicious lesions, according to research published online June 22 in Radiology.

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Panel Says Ob-Gyn Hospitalist Trend Aids Patients, Doctors

TUESDAY, June 22 (HealthDay News) -- The increasing number of obstetrician-gynecologist hospitalists has the potential to improve patient safety, streamline patient care, and improve the lifestyle of currently practicing Ob-Gyns, according to a committee opinion of the American College of Obstetricians and Gynecologists (ACOG) published in the July issue of Obstetrics & Gynecology.

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Some Moist Toilet Paper Can Cause Severe Reaction

TUESDAY, June 22 (HealthDay News) -- A preservative used in moist toilet paper can cause a severe allergic reaction in some people, as demonstrated by four case reports published online June 21 in the Archives of Dermatology.

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Flame Retardant Affects Thyroid Levels in Pregnant Women

TUESDAY, June 22 (HealthDay News) -- In pregnant women, blood levels of polybrominated diphenyl ether (PBDE) are associated with lower levels of thyroid-stimulating hormone and higher odds of subclinical hyperthyroidism, according to research published online June 21 in Environmental Health Perspectives.

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Breast-Feeding for Six Months Best for Infection Prevention

MONDAY, June 21 (HealthDay News) -- Exclusive breast-feeding until age 6 months is slightly more protective against infectious diseases than exclusive breast-feeding for four months and partially thereafter, according to research published online June 21 in Pediatrics.

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PCBs Linked to Reduced Response to Vaccinations

MONDAY, June 21 (HealthDay News) -- Exposure to polychlorinated biphenyls (PCBs) early in life may reduce the effectiveness of childhood vaccinations and impair immune-system responses to infection, according to research published online June 20 in Environmental Health Perspectives.

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Rescue Antenatal Steroids Beneficial for Preterm Infants

MONDAY, June 21 (HealthDay News) -- If it has been at least 14 days since an initial dose of antenatal steroids, an additional course of rescue antenatal steroids administered to pregnant women at continued risk of premature delivery can improve their infants' postnatal respiratory function, according to research published in the June issue of the American Journal of Obstetrics & Gynecology.

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Gene Mutation Increases Clot Risk in Women on Tamoxifen

FRIDAY, June 18 (HealthDay News) -- Women taking adjuvant tamoxifen for early-stage breast cancer who develop a thromboembolism (TE) are nearly five times more likely to carry the factor V Leiden (FVL) mutation than women on the medication who don't have a TE, according to a study published online June 16 in the Journal of the National Cancer Institute.

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Questionnaire Poorly Predicts Sleep Apnea in Pregnancy

FRIDAY, June 18 (HealthDay News) -- The Berlin questionnaire performs poorly in predicting obstructive sleep apnea (OSA) in pregnant women compared to polysomnography, according to research published in the June issue of the American Journal of Obstetrics & Gynecology.

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Sites Contain Graphic Material to Promote Eating Disorders

FRIDAY, June 18 (HealthDay News) -- Pro-eating disorder Web sites are easy to access and contain content that encourages and motivates users to continue their efforts with anorexia and bulimia, though many include recovery-oriented messages as well, according to research published online June 17 in the American Journal of Public Health.

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Bone Health Supplements Don't Increase Coronary Calcium

FRIDAY, June 18 (HealthDay News) -- Postmenopausal women who take calcium plus vitamin D supplements for bone health do not increase their levels of coronary artery calcium (CAC) and increase their cardiovascular disease risk as a result, according to a study published online June 14 in Menopause.

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Prenatal Smoking Linked to Pregnancy, Infant Risks

THURSDAY, June 17 (HealthDay News) -- Prenatal smoking continues to be a substantial contributor to infant death in the United States, according to research published in the July issue of the American Journal of Preventive Medicine.

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Later Age at Menarche Tied to Lower Odds of Endometriosis

THURSDAY, June 17 (HealthDay News) -- The risk of endometriosis is lower in women who experience their first period at an older age and higher in women who report an early dysmenorrhea history, according to research published in the June issue of the American Journal of Obstetrics & Gynecology.

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Antiretroviral Regimens Reduce Mom-Baby HIV Transmission

WEDNESDAY, June 16 (HealthDay News) -- Various antiretroviral treatment options for lactating mothers and breast-feeding infants appear to reduce mother-to-child transmission of human immunodeficiency virus type-1 (HIV-1), according to two studies in the June 17 issue of the New England Journal of Medicine.

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Obesity Has Negative Impacts on Sexual Health, Behavior

WEDNESDAY, June 16 (HealthDay News) -- Obesity has negative impacts on sexual health in both men and women, and young obese women are less likely to use contraceptive health care services and more likely to have unplanned pregnancies, according to a study published June 15 in BMJ.

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Many Doctors May Overscreen With Annual Pap and HPV Tests

TUESDAY, June 15 (HealthDay News) -- Despite cervical cancer screening recommendations that low-risk women be screened every three years after age 30, most primary care providers report that they would advise more frequent testing, and primary care providers are less likely to recommend extending screening intervals to three years with a human papillomavirus (HPV) test used with a Pap test than with the Pap test alone, according to research published in the June 14 issue of the Archives of Internal Medicine.

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Nationally, Unilateral Mastectomy Rate Has Declined

TUESDAY, June 15 (HealthDay News) -- Although several single-institution studies have reported an increase in mastectomy rates in the past decade, unilateral mastectomy rates appear to have decreased from 2000 to 2006, according to a population-based analysis published online June 14 in the Journal of Clinical Oncology.

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Higher BMI Linked to More Breast Cancer Recurrences

TUESDAY, June 15 (HealthDay News) -- Overweight and obese breast cancer patients are more likely to suffer recurrences than their thinner peers, who may benefit more from anastrozole, according to research published online June 14 in the Journal of Clinical Oncology.

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Metformin in Diabetes Linked to Lower Breast Cancer Risk

FRIDAY, June 11 (HealthDay News) -- In women with type 2 diabetes, long-term metformin use is associated with a lower risk of breast cancer, according to research published in the June issue of Diabetes Care.

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Organ Sparing Surgery for Bladder Cancer Feasible

THURSDAY, June 10 (HealthDay News) -- Gynecologic organ sparing procedures for the surgical treatment of bladder cancer appear to be feasible, with acceptable oncologic outcomes and voiding function, according to research published in the June issue of Urology.

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Valproic Acid Use in Pregnancy Tied to Malformation Risk

THURSDAY, June 10 (HealthDay News) -- In pregnant women, first-trimester use of valproic acid is associated with significantly increased risks of five congenital malformations in addition to spina bifida, according to research published in the June 10 issue of the New England Journal of Medicine.

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Maternal Hardships Impact Newborns' and Children's Health

WEDNESDAY, June 9 (HealthDay News) -- Intimate partner violence suffered by mothers is linked to an increased obesity risk in young children, and childhood hardship is associated with women's future pregnancy outcomes, according to two studies in the June issue of the Archives of Pediatrics & Adolescent Medicine.

Abstract - Boynton-Jarrett
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In Utero Exposure to Chemicals May Cause Breast Cancer

WEDNESDAY, June 9 (HealthDay News) -- Prenatal exposure to endocrine-disrupting chemicals found in the environment can cause overexpression of a protein linked to the development of breast cancer in adulthood, according to a mouse study published online May 15 in Hormones & Cancer.

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Stress Reduction Aids Survival in Recurrent Breast Cancer

TUESDAY, June 8 (HealthDay News) -- Patients with recurrent breast cancer who had psychological intervention for stress reduction during their initial disease deal better with the stress of disease recurrence and even improve their odds for survival over the long term, according to a study published online June 8 in Clinical Cancer Research.

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Fatal Medication Errors Rise in July at Teaching Hospitals

TUESDAY, June 8 (HealthDay News) -- In July there is a significant increase in fatal medication errors at medical institutions, and this spike is at least partly due to the arrival of new medical residents, according to a study published online May 29 in the Journal of General Internal Medicine.

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Negative Effects of Having Premature Baby Seldom Last

MONDAY, June 7 (HealthDay News) -- The negative impacts on mothers and families of having an extremely low birth weight (ELBW) child appear to be minimal by the time the child reaches young adulthood, except for an ongoing negative effect on parents' jobs, according to research published online June 7 in Pediatrics.

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Antibiotic Not Found to Reduce Breakthrough Bleeding

FRIDAY, June 4 (HealthDay News) -- Treatment with doxycycline does not appear to decrease unscheduled bleeding associated with the initiation of continuous oral contraceptive pills, according to research published in the June issue of Obstetrics & Gynecology.

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GBS Screening Guidelines Widely Followed in Tennessee

FRIDAY, June 4 (HealthDay News) -- The state of Tennessee has mostly succeeded in implementing and adhering to universal screening guidelines for perinatal group B streptococci (GBS), but the timing of screening and administration of chemoprophylaxis when indicated could be improved upon, according to research published in the June issue of Obstetrics & Gynecology.

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Low-Dose Estrogen Patch Linked to Lower Risk of Stroke

FRIDAY, June 4 (HealthDay News) -- Postmenopausal women who use low-dose estrogen transdermal patches have a lower risk of stroke compared to users of either high-dose estrogen patches or oral hormone replacement therapy (HRT), according to research published June 3 in BMJ.

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Maternal Death Greatly Reduces Child's Survival Odds

FRIDAY, June 4 (HealthDay News) -- In rural Bangladesh, the chance of survival to 10 years of age among children whose mothers die is greatly reduced, but the death of a father has a negligible effect on a child's survival, according to a study in the June 5 issue of The Lancet.

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Restricted Hours Do Not Hurt Ob-Gyn Residents' Experience

THURSDAY, June 3 (HealthDay News) -- The implementation of work-hour restrictions does not appear to have a negative effect on residents' level of experience in obstetric and gynecologic procedures, according to research published in the June issue of Obstetrics & Gynecology.

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Novel Breast Cancer Vaccine Successfully Tested in Mice

THURSDAY, June 3 (HealthDay News) -- Employing an antigen that is present in healthy women only during lactation, but is also found in most breast cancers, researchers have successfully tested a first-of-its-kind breast cancer vaccine in mice, according to a study published online May 30 in Nature Medicine.

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Delayed Umbilical Cord Clamping Advocated

THURSDAY, June 3 (HealthDay News) -- Umbilical cord clamping at birth should be delayed for a few minutes, or until the cord stops pulsing, to permit transfer of important stem cells from the placenta to the newborn, according to a review published in the Journal of Cellular and Molecular Medicine.

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Sequential Treatment Linked to Improved Cancer Survival

WEDNESDAY, June 2 (HealthDay News) -- Doxorubicin and cyclophosphamide followed by docetaxel (sequential ACT) shows some survival benefit compared to doxorubicin-docetaxel or concurrent ACT in women with operable early breast cancer, according to research published in the June 3 issue of the New England Journal of Medicine.

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Moms' Weight Before, During Pregnancy Tied to Kids' Issues

WEDNESDAY, June 2 (HealthDay News) -- Higher pre-pregnancy weight and gestational weight gain (GWG) up to 36 weeks are linked to adverse cardiovascular risk factors and adiposity in offspring, according to research published online June 1 in Circulation.

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Prolia Approved for Postmenopausal Women With Osteoporosis

WEDNESDAY, June 2 (HealthDay News) -- The injected drug Prolia (denosumab) has been approved by the U.S. Food and Drug Administration to treat postmenopausal women at high risk of bone fracture due to osteoporosis.

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Cancer Risk Linked to SNPs Not Affected by Lifestyle Factors

WEDNESDAY, June 2 (HealthDay News) -- The risk of breast cancer associated with a dozen low-penetrance genetic susceptibility polymorphisms isn't affected by a number of established environmental risk factors, according to research published online June 2 in The Lancet.

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Antidepressants Associated With Miscarriage

TUESDAY, June 1 (HealthDay News) -- Use of antidepressants during pregnancy, particularly paroxetine, venlafaxine, or a combination of different antidepressant classes, may increase the risk of miscarriage by 68 percent, according to research published online May 31 in CMAJ, the journal of the Canadian Medical Association.

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