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April 2008 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 April 2008. 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.

Behavioral Intervention Improves Obstetric Care

WEDNESDAY, April 30 (HealthDay News) -- A multifaceted behavioral intervention to encourage adherence to obstetrical guidelines resulted in increased use of prophylactic oxytocin during the third stage of labor and decreased rates of episiotomy, according to an article published in the May 1 issue of the New England Journal of Medicine.

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Potential Susceptibility Genes for Osteoporosis Identified

WEDNESDAY, April 30 (HealthDay News) -- Genes associated with bone mineral density and low-energy fractures in European populations have been identified, according to a report published online April 29 in the New England Journal of Medicine.

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FDA Approves Drug for Women with Irritable Bowel Syndrome

WEDNESDAY, April 30 (HealthDay News) -- The U.S. Food and Drug Administration announced this week that it has approved Amitiza (lubiprostone) for the treatment of irritable bowel syndrome with constipation (IBS-C) in women aged 18 and older.

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Rising Insurance Premiums Outpace Salary Increases

WEDNESDAY, April 30 (HealthDay News) -- The cost of family health insurance plans in the United States is increasing 10 times faster than salary increases, meaning that a growing share of workers' earnings are eaten up by health care costs, according to a report issued April 29 by the Robert Wood Johnson Foundation.

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Doctors Overestimate Ability to Make Right Diagnosis

WEDNESDAY, April 30 (HealthDay News) -- Physicians have a tendency to underappreciate the scope to make wrong diagnoses and are overconfident in their diagnostic decisions, according to an article published in a supplement to the May issue of The American Journal of Medicine.

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Physicians Lack Feedback on Accuracy of Diagnoses

TUESDAY, April 29 (HealthDay News) -- Clinical diagnosis is a largely open-loop system in which there is no systematic way for clinicians to obtain feedback on the outcome of their diagnoses, according to an article published in a supplement to the May issue of The American Journal of Medicine.

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Increasing Incidence of Pre-Pregnancy Diabetes Alarming

TUESDAY, April 29 (HealthDay News) -- The incidence of gestational diabetes has remained stable over time and is similar across different racial and ethnic groups, but the rising number of young, pregnant women with pre-existing diabetes is cause for concern, according to a report published in the May issue of Diabetes Care.

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Phenytoin Accelerates Bone Loss in Premenopausal Women

TUESDAY, April 29 (HealthDay News) -- In premenopausal women with epilepsy, phenytoin monotherapy is associated with a significant loss of bone mineral density over a one-year period, according to the results of a study published in the April 29 issue of Neurology.

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Oral Cefixime Availability Improves

TUESDAY, April 29 (HealthDay News) -- Availability of cefixime, the standard treatment for uncomplicated urogenital or rectal gonorrhea, should improve as it is now being manufactured by Lupin Pharmaceuticals, Inc. of Baltimore, according to an article published in the April 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Hormone Therapy Increases Stroke Risk Despite Timing

TUESDAY, April 29 (HealthDay News) -- In postmenopausal women, hormone therapy is associated with a significantly increased risk of stroke regardless of the type of regimen or the timing of therapy initiation, according to a report published in the April 28 issue of the Archives of Internal Medicine.

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Alendronate May Raise Risk of Atrial Fibrillation

MONDAY, April 28 (HealthDay News) -- Alendronate may increase the risk of developing atrial fibrillation, according to an article published in the April 28 issue of the Archives of Internal Medicine.

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Thiazolidinediones May Raise Risk of Hip, Wrist Fractures

MONDAY, April 28 (HealthDay News) -- Patients with diabetes who take the oral insulin-sensitizing drugs rosiglitazone and pioglitazone may be at an increased risk of suffering hip and wrist fractures, according to an article published in the April 28 issue of the Archives of Internal Medicine.

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Palliative Care Can Improve Patient Care Most, Poll Finds

MONDAY, April 28 (HealthDay News) -- In an international poll conducted by BMJ to determine which area of health care would enable doctors to make the greatest difference to patients, palliative care for non-malignant disease received the most votes, the BMJ Group announced at the International Forum on Quality and Safety in Health Care in Paris this week.

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Pre-Pregnancy Diet Choices Linked to Sex of Baby

MONDAY, April 28 (HealthDay News) -- Women with a higher calorie intake before conception are more likely to bear boys, according to research published online April 22 in the Proceedings of the Royal Society B.

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Biofuels Partially to Blame in Global Food Crisis

FRIDAY, April 25 (HealthDay News) -- The global food shortage, which threatens millions of people with starvation, is due to a number of factors, including the growing use of biofuels -- potential food crops that are used as fuel for car engines -- and requires that the international community address the root causes of the crisis, according to an editorial published in The Lancet in April.

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Uptake of Human Papillomavirus Vaccine is High

FRIDAY, April 25 (HealthDay News) -- Uptake of the first two doses of the human papillomavirus vaccine among adolescent schoolgirls in Manchester, United Kingdom, was encouraging, but high coverage for the third dose will determine the overall success of the vaccination program, according to a study published online April 24 in the BMJ.

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Wide Variations in Health Care Seen Across Europe

FRIDAY, April 25 (HealthDay News) -- The wide diversity of health care provision in European countries makes any regionwide legislation mandating a unified approach unfeasible, and quality of care across countries will likely be ensured through more informal mechanisms, according to an article published in the April 26 issue of the BMJ.

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Studies Examine Letrozole in Long-Term Cancer Prevention

THURSDAY, April 24 (HealthDay News) -- Three articles in the April 20 issue of the Journal of Clinical Oncology support the use of the aromatase inhibitor letrozole in women with hormone receptor-positive breast cancer who had discontinued tamoxifen for a substantial length of time and also in older women.

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Treatment of Hirsutism Addressed in Guideline

THURSDAY, April 24 (HealthDay News) -- Testing for elevated androgen levels should be considered in premenopausal women who have moderate to severe hirsutism and in those with milder hirsutism accompanied by menstrual dysfunction, obesity or clitoromegaly, according to a clinical practice guideline published in the Journal of Clinical Endocrinology & Metabolism in April.

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Oral Contraceptive Use May Increase in Acne Treatment

THURSDAY, April 24 (HealthDay News) -- Recently changed guideline stating that physicians no longer need to perform a pelvic examination and Papanicolaou smear before prescribing oral contraceptive pills may encourage more dermatologists to prescribe the pills as an acne treatment for women of childbearing age, according to an article published in the May issue of the Journal of the American Academy of Dermatology.

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Risedronate Protects Bone Mass in Breast Cancer Patients

THURSDAY, April 24 (HealthDay News) -- Once-weekly risedronate protects against chemotherapy-related bone loss in women with breast cancer, according to an article published online April 21 in The Journal of Clinical Oncology.

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Regular Mammography Helpful in Older Women

WEDNESDAY, April 23 (HealthDay News) -- Elderly women who develop breast cancer may present with the disease at earlier stages and have better breast cancer-specific five-year survival if they've had regular mammograms, according to research published online April 21 in the Journal of Clinical Oncology.

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Statistics Reveal Mortality Inequalities Between Counties

WEDNESDAY, April 23 (HealthDay News) -- An investigation into trends of mortality and mortality disparities in the United States, focused on the county level, found that mortality inequality across counties rose between 1983 and 1999, according to research published in the April issue of PLoS Medicine.

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Lab Studies Link Brd4 to Breast Cancer Inhibition

WEDNESDAY, April 23 (HealthDay News) -- Activation of the bromodomain protein Brd4 inhibits tumor growth and metastasis in mice and helps predict outcome in human breast cancer, according to research published online April 21 in the Proceedings of the National Academy of Sciences of the United States of America.

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ACS: Report Details Cancer Prevention Trends in U.S.

TUESDAY, April 22 (HealthDay News) -- Several favorable trends linked to falling cancer rates in the United States may be in jeopardy, according to a report issued by the American Cancer Society, which points out that the decline in smoking appears to be leveling off and that mammography rates are no longer increasing and may even be decreasing.

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Obesity, Inactivity Undermine Cancer Survivors' Prognosis

TUESDAY, April 22 (HealthDay News) -- Cancer survivors in Canada may be at higher risk from disease because they have low levels of physical activity and a high prevalence of obesity, according to a study published online April 21 in Cancer.

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Migraine Sufferers Are Most At Risk for Allodynia

TUESDAY, April 22 (HealthDay News) -- Cutaneous allodynia is more common in people who have migraine headaches than it is among people with other types of severe or chronic headaches, according to a study published in the April 22 issue of Neurology.

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Cesarean is Independent Risk Factor for Postpartum Stroke

MONDAY, April 21 (HealthDay News) -- Women who undergo cesarean delivery have a higher risk of postpartum stroke than those who deliver vaginally, according to research published in the April issue of the American Journal of Obstetrics & Gynecology.

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Hormone Receptors Linked to Breast Cancer Recurrence

MONDAY, April 21 (HealthDay News) -- The risk of local recurrence and distant metastases is associated with hormone receptor status in women who underwent breast-conserving therapy for breast cancer, according to a study published online April 14 in the Journal of Clinical Oncology.

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CDC Reports Declining Birth Rate for Women Under 25

FRIDAY, April 18 (HealthDay News) -- The proportion of pregnancies among U.S. women under the age of 25 has declined during the period from 1990 to 2004, according to a report prepared by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Factors Predict Survival in Extreme Prematurity

WEDNESDAY, April 16 (HealthDay News) -- The decision to administer intensive care to an extremely premature infant is often based on gestational age alone, but factors such as birth weight, sex and exposure to antenatal corticosteroids also impact prognosis and should be taken into consideration, researchers report in the April 17 issue of the New England Journal of Medicine.

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Adjuvant Chemo with Taxanes Studied in Breast Cancer

WEDNESDAY, April 16 (HealthDay News) -- In the treatment of breast cancer, weekly dosing of paclitaxel after a standard doxorubicin-cyclophosphamide chemotherapy regimen may improve survival, according to an article published in the April 17 issue of the New England Journal of Medicine.

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Jury Still Out on Testosterone for Low Libido in Women

TUESDAY, April 15 (HealthDay News) -- Although intermediate-dose testosterone supplementation modestly improves measures of sexual function in premenopasual women with low libido, more robust evidence of efficacy is needed before the treatment can be recommended, report the authors of an article published in the April 15 issue of the Annals of Internal Medicine.

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Human Papillomavirus Vaccine Effective in Mice

TUESDAY, April 15 (HealthDay News) -- A peptide vaccine targeting human papillomavirus 16 (HPV16) protects mice against the virus as well as other HPV subtypes, according to a report published online April 14 in the Proceedings of the National Academy of Sciences Early Edition.

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Complex Relationship Between Estrogen, Eye Disease Risk

TUESDAY, April 15 (HealthDay News) -- Postmenopausal hormone use is associated with an increased risk of early signs of age-related macular degeneration (AMD) but a reduced risk of neovascular AMD, the late stage of the disease, according to an article published in the Archives of Ophthalmology in April.

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Drug Resistance Threatens Gonorrhea Control

TUESDAY, April 15 (HealthDay News) -- The emerging resistance of Neisseria gonorrhoeae to multiple antimicrobial agents is a major public health challenge, and heightened surveillance of antimicrobial resistance patterns and improved screening practices are necessary for adequate prevention and control of gonorrhea, according to an article published in the April 15 issue of the Annals of Internal Medicine.

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Younger Women More Vulnerable to Postpartum Depression

TUESDAY, April 15 (HealthDay News) -- As many as one-fifth of new mothers experience postpartum depression, according to a study published in the April 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Statins Reduce Blood Pressure in Normotensive Subjects

MONDAY, April 14 (HealthDay News) -- Statins modestly reduce blood pressure in men and women with normal blood pressure, according to a report in the April 14 issue of the Archives of Internal Medicine. A related study in the same issue notes that a diet high in fruits, vegetables, low in dairy products, and low in animal proteins is associated with a lower risk of coronary heart disease and stroke in women.

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Acupuncture, Exercise May Help Insulin Sensitivity in PCOS

MONDAY, April 14 (HealthDay News) -- Low-frequency electro-acupuncture and exercise both improve insulin sensitivity and correct defects in adipose tissue gene expression in a rat model of polycystic ovary syndrome (PCOS), according to study findings published online April 3 in Endocrinology.

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Prenatal Ultrasound Limited in Congenital Cytomegalovirus

MONDAY, April 14 (HealthDay News) -- In women who contract primary cytomegalovirus infection during pregnancy, ultrasound predicts whether their infants will have symptomatic congenital cytomegalovirus in only one-third of cases, according to research published in the April issue of the American Journal of Obstetrics & Gynecology.

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Individualized Health Care Budgets Improve Care

FRIDAY, April 11 (HealthDay News) -- The U.K.'s National Health Service (NHS) should allow patients individual control of their health care budgets, an approach that has been shown in pilot studies to improve outcomes and patient satisfaction in a cost-effective manner, according to an analysis published April 12 in BMJ.

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Estrogen Therapy Linked to Reflux Symptom Risk

FRIDAY, April 11 (HealthDay News) -- Postmenopausal estrogen hormone therapy is associated with a higher risk of reflux symptoms, while oral contraceptives appear to have no association, according to the results of a study published in the April issue of Gastroenterology.

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Child, Maternal Mortality Not Improving in Poorest Nations

FRIDAY, April 11 (HealthDay News) -- Despite some positive signs, progress towards meeting Millennium Development Goals for reducing maternal and child mortality in the world's poorest countries is inadequate, according to the Countdown report and other articles in a special edition of The Lancet published April 12.

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New Schema for Diagnosis of Ovarian Cancer Proposed

FRIDAY, April 11 (HealthDay News) -- A new model of ovarian cancer that distinguishes between slow-growing and rapidly growing tumors may allow more targeted screening and a more rational treatment approach, according to a review article published in the American Journal of Obstetrics & Gynecology in April.

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Acculturation Worsens Health Behaviors in U.K. Immigrants

FRIDAY, April 11 (HealthDay News) -- Women from ethnic minority groups who immigrate to the United Kingdom are less likely to smoke and drink alcohol during pregnancy and more likely to breast-feed than British white women, but acculturation into British society leads to worsening of these health behaviors, according to an article published online April 10 in BMJ Online First.

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Maternal Smoking Linked to Congenital Heart Defects

THURSDAY, April 10 (HealthDay News) -- Women who smoke in the month before they become pregnant or at any time up to the end of the first trimester are more likely than their non-smoking counterparts to give birth to a baby with congenital heart defects, according to the results of a study funded by the U.S. Centers for Disease Control and Prevention and published in the April issue of Pediatrics.

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Raloxifene Effectiveness Unaffected by Kidney Disease

THURSDAY, April 10 (HealthDay News) -- Raloxifene increases bone mineral density at the hip and spine better than placebo in postmenopausal women with osteoporosis and chronic kidney disease, and also reduces vertebral fractures, according to study findings published online April 9 in the Journal of the American Society of Nephrology.

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Benign Breast Disease Linked to Equine Estrogen

THURSDAY, April 10 (HealthDay News) -- Postmenopausal women taking conjugated equine estrogen have about double the risk of developing benign proliferative breast disease, which is associated with increased breast cancer risk, compared with women taking placebo, researchers report in the April 16 issue of the Journal of the National Cancer Institute.

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Consider Health Literacy Level When Writing for Patients

THURSDAY, April 10 (HealthDay News) -- Giving patients clearly written educational materials that convey key messages without resorting to jargon is an important part of engaging patient compliance with treatment and can contribute to health literacy, according to an article published in the April issue of Chest.

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Study Shows Advantage of Breast Cancer Staging Method

WEDNESDAY, April 9 (HealthDay News) -- In breast cancer patients who were staged node-negative by conventional single-section pathology, current sentinel lymph node biopsy techniques detect occult axillary node metastases that are prognostically significant, according to an article published in the April 10 issue of the Journal of Clinical Oncology.

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Little Difference with Further Chemo for Breast Cancer

WEDNESDAY, April 9 (HealthDay News) -- Breast cancer patients who initially respond to chemotherapy have similar outcomes with further cycles of chemotherapy, while patients who do not initially respond and are treated with further chemotherapy or a different chemotherapy regimen also have similar outcomes, according to two studies published in the April 16 issue of the Journal of the National Cancer Institute.

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Doctors Vote on the Ways to Make Biggest Difference

WEDNESDAY, April 9 (HealthDay News) -- The BMJ has begun accepting votes on which areas of health care allow doctors to make the biggest difference to patient care, with a shortlist of six areas each being championed by eminent doctors and researchers. The winning topic will gain special coverage in the BMJ and the BMJ Group's 24 other specialist journals and online education products.

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Childhood Abuse May Raise Adult Inflammation Levels

TUESDAY, April 8 (HealthDay News) -- Depressed adults with a history of maltreatment in childhood tend to have higher levels of C-reactive protein than their counterparts without a history of abuse, putting them at increased risk of cardiovascular disease, according to a report published in the April issue of the Archives of General Psychiatry.

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Women's Heart Disease Risk Not Predicted By Sex Life

MONDAY, April 7 (HealthDay News) -- Although there is a modest association between dissatisfaction with sexual activity and prevalence of incident peripheral arterial disease in women, sexual dissatisfaction does not predict incident cardiovascular disease in women, according to a report published in the April issue of The American Journal of Medicine.

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Some Increased Cancer Survival Due to Cure Rate

MONDAY, April 7 (HealthDay News) -- Treatment advances have increased the life expectancy of late-stage colorectal and testicular cancer patients mostly by increasing the percentage cured, while the increase in life expectancy for ovarian cancer patients is primarily due to longer survival of uncured patients, according to study findings published online April 7 in Cancer.

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Cytokine Facilitates Breast Cancer Metastasis to Lung

MONDAY, April 7 (HealthDay News) -- Breast cancer metastasis to the lung is dependent on the induction of a cytokine that increases the permeability of lung capillaries and facilitates the passage of tumor cells, researchers report in the April 4 issue of Cell.

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Fetal DNA Testing May Avert Treatment for Blood Disorder

FRIDAY, April 4 (HealthDay News) -- Using high throughput RHD genotyping of fetuses may obviate the need for anti-RhD immunoglobulin in RhD-negative pregnant women, according to research published April 3 in BMJ Online First.

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Provider Input Affects Post-Mastectomy Reconstruction

FRIDAY, April 4 (HealthDay News) -- Disparities in rates of breast reconstruction following mastectomy for breast cancer may in part depend on whether physicians discussed breast reconstruction with their patients, according to an article published in the April issue of the Journal of the American College of Surgeons.

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Prematurity, Income Loss Studied in Relation to Autism

FRIDAY, April 4 (HealthDay News) -- A sample of toddlers who were born extremely prematurely had a high prevalence of autism spectrum behaviors, and families of children with autism tend to face a substantial loss of household income, according to two studies published in the April 1 issue of Pediatrics.

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Domestic Violence Affects Women's Long-Term Health

FRIDAY, April 4 (HealthDay News) -- Even one incident of male-on-female intimate partner violence can have lasting and adverse effects on women's physical and mental health, according to a report published in the April 5 issue of The Lancet.

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Veterinary Work Increases Risk of Miscarriage

THURSDAY, April 3 (HealthDay News) -- Pregnant veterinarians who are exposed to unscavenged anesthetic gases at work have a more than doubled risk of miscarriage than those who are not exposed to such gases, according to study findings published online April 3 in Occupational and Environmental Medicine.

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Cervical Threats May Arrive Without Human Papillomavirus

THURSDAY, April 3 (HealthDay News) -- Out of any sizeable population, the occasional woman with cervical precancer will test negative for high-risk human papillomavirus (HPV) for a variety of possible reasons, according to research published in the April issue of Obstetrics & Gynecology.

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Gynecologists Are Good Source of Preventive Services

THURSDAY, April 3 (HealthDay News) -- Women who receive their health care from gynecologists -- either alone or in conjunction with general physicians -- are more likely to receive preventive services than women who only see general physicians, researchers report in the April issue of Obstetrics & Gynecology.

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Reduced Constipation May Help Women's Pelvic Floor

THURSDAY, April 3 (HealthDay News) -- A 42-day course of gradually increasing fiber intake improved constipation symptoms in women, which may reduce their risk for pelvic organ prolapse, according to research published in the April issue of Obstetrics & Gynecology.

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Child Well-Being Measures Vary Dramatically by State

THURSDAY, April 3 (HealthDay News) -- Across the United States, the location where a child is born and raised can make a huge difference in the child's health and well-being, according to a report released on April 2 by the non-profit Every Child Matters Education Fund.

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Cream Effective for Treating Vulvar Neoplasia

WEDNESDAY, April 2 (HealthDay News) -- An imiquimod cream is effective in treating vulvar intraepithelial neoplasia, reducing lesion size, itching and pain, according to a report in the April 3 issue of the New England Journal of Medicine.

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Obesity Boosts Use of Health Care Services in Pregnancy

WEDNESDAY, April 2 (HealthDay News) -- Women who are overweight or obese before pregnancy or early in pregnancy use more health care services and have longer hospital stays for delivery, researchers report in the April 3 issue of the New England Journal of Medicine.

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Chemotherapy Anemia Linked to Breast Cancer Relapse

WEDNESDAY, April 2 (HealthDay News) -- Premenopausal patients with early-stage primary breast cancer who develop anemia after receiving adjuvant cyclophosphamide/methotrexate/5-fluorouracil chemotherapy have a significantly increased risk of local relapse, according to research published in the April 1 issue of Clinical Cancer Research.

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Genetic Data Adds to Breast Cancer Risk Stratification

TUESDAY, April 1 (HealthDay News) -- Gene expression signatures may offer a valuable source of information to use with clinical risk stratification to enhance prognosis of breast cancer, according to research published in the April 2 issue of the Journal of the American Medical Association.

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Human Papillomavirus Widespread Among U.S. Women

TUESDAY, April 1 (HealthDay News) -- The human papillomavirus (HPV) strains that put women at high risk of cervical cancer are widespread among U.S. women who undergo cervical screening, a finding that could influence whether or not testing for the virus is included in routine screening for cervical cancer, according to a report published in the April 1 issue of the Annals of Internal Medicine.

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Physician's Briefing