February 2009 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 February 2009. 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.

Goserelin Treatment Shows Similar Benefits As Tamoxifen

FRIDAY, Feb. 27 (HealthDay News) -- The use of goserelin was associated with improved rates of survival and recurrence over the long term in women with breast cancer, according to research published online Feb. 24 in the Journal of the National Cancer Institute.

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Ischemic Strokes Rise Steeply with Age Even in Young

FRIDAY, Feb. 27 (HealthDay News) -- Modifiable risk factors for stroke, such as high cholesterol and hypertension, were common in a group of younger stroke patients, according to research published online Feb. 26 in the journal Stroke.

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Technique Renders Breast Cancer Sensitive to Tamoxifen

FRIDAY, Feb. 27 (HealthDay News) -- Switching on the estrogen receptor (ER) gene in the one-third of breast cancers that do not produce the receptor, which have a poor prognosis, restores their sensitivity to tamoxifen, according to the results of a study published online Feb. 23 in the Proceedings of the National Academy of Sciences Early Edition.

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Variables Predicting Cancer After Mammography Identified

FRIDAY, Feb. 27 (HealthDay News) -- Among women who develop invasive breast cancer after abnormal mammographic findings, the best predictors of cancer are masses and calcifications, with asymmetry and architectural distortions having much lower positive predictive value, researchers report in the March issue of Radiology.

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Light Alcohol Use Linked to Cancer Risk in Women

THURSDAY, Feb. 26 (HealthDay News) -- Even low levels of alcohol consumption may raise women's risks of certain cancers, according to research published in the Mar. 4 issue of the Journal of the National Cancer Institute.

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Causes of Stillbirth Remain Poorly Understood

THURSDAY, Feb. 26 (HealthDay News) -- In a bid to tackle the lack of understanding about the risk factors and causes of stillbirth, the American College of Obstetricians and Gynecologists has issued guidelines for clinicians in a new Practice Bulletin published in the March issue of Obstetrics & Gynecology.

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Novel Drugs May Help Prevent Cerebral Palsy

THURSDAY, Feb. 26 (HealthDay News) -- In high-risk pregnancies, the use of selective neuronal nitric oxide synthase inhibitors could help prevent cerebral palsy, according to research published online Feb. 20 in the Annals of Neurology.

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Various Diet Compositions Effective for Weight Loss

WEDNESDAY, Feb. 25 (HealthDay News) -- Diets where calories come from a range of fat, protein and carbohydrate combinations are similarly effective in promoting weight loss and reducing cardiovascular risk factors, researchers report in the Feb. 26 issue of the New England Journal of Medicine.

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Gene Mutations Linked to Premature Ovarian Failure

WEDNESDAY, Feb. 25 (HealthDay News) -- Mutations in the NR5A1 gene may be a cause of ovarian insufficiency, according to research published online Feb. 25 in the New England Journal of Medicine.

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Iodine Levels of Many Prenatal Multivitamins Inaccurate

WEDNESDAY, Feb. 25 (HealthDay News) -- Although sufficient maternal iodine is important for normal thyroid and neurological function, many prenatal vitamins available in the United States that claim to contain iodine do not carry the amount indicated on the label, according to a letter published in the Feb. 26 issue of the New England Journal of Medicine.

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HPV-Positive Test Less Likely Than Previously Reported

WEDNESDAY, Feb. 25 (HealthDay News) -- The incidence of a positive carcinogenic human papillomavirus (HPV) test in a general population of women is less likely than previously reported, suggesting concerns over HPV testing in general clinical practice may be overstated, according to research published in the March issue of Obstetrics & Gynecology.

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More Rapid Communication of Breast Biopsy Results Needed

WEDNESDAY, Feb. 25 (HealthDay News) -- Uncertainty while awaiting a final diagnosis following a large-core breast biopsy is associated with an abnormal salivary cortisol profile, indicative of biochemical distress, according to research published in the March issue of Radiology.

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Diabetes May Increase Risk for Perinatal Depression

TUESDAY, Feb. 24 (HealthDay News) -- Women who develop diabetes either prior to or during pregnancy are more likely to experience perinatal depression, including postpartum depression, researchers report in the Feb. 25 issue of the Journal of the American Medical Association.

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Insurance Essential for Good Health, Well-Being

TUESDAY, Feb. 24 (HealthDay News) -- Having health insurance is vital for health and well-being, and when rates of uninsurance are high, even insured people are more likely to struggle to obtain necessary care, according to a new report from the Institute of Medicine released online Feb. 24.

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Denosumab May Benefit Patients with Bone Metastases

TUESDAY, Feb. 24 (HealthDay News) -- In patients with bone metastases from prostate, breast or other cancers, who have elevated urinary N-telopeptide levels despite ongoing intravenous bisphosphonate therapy, treatment with denosumab may be more effective at normalizing levels and reducing skeletal-related events than continuation of bisphosphonate therapy, according to a report published in the Mar. 1 issue of the Journal of Clinical Oncology.

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Letter Program May Benefit Breast Cancer Patients

TUESDAY, Feb. 24 (HealthDay News) -- A letter notification program targeting women with early-stage breast cancer may prompt some patients to take advantage of extended adjuvant letrozole therapy, researchers report in the Mar. 1 issue of the Journal of Clinical Oncology.

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US Health Spending May Have Hit $2.4 Trillion in 2008

TUESDAY, Feb. 24 (HealthDay News) -- Health spending in the United States was estimated to be $2.4 trillion last year, and is expected to account for an unprecedented share of the economy this year, according to a report published online Feb. 24 in Health Affairs.

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Procedure Significantly Improves Urinary Incontinence

MONDAY, Feb. 23 (HealthDay News) -- A transobturator tape procedure resulted in nearly an 80 percent improvement in urge urinary incontinence, according to research published in the March issue of Obstetrics & Gynecology.

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Increased Cesarean Efficiency with Improvement Program

MONDAY, Feb. 23 (HealthDay News) -- Cesarean delivery efficiency, measured by the time from decision to incision, significantly improved over two years with the implementation of a quality improvement program, according to research published in the March issue of Obstetrics & Gynecology.

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Tibolone Linked to Breast Cancer Recurrence

MONDAY, Feb. 23 (HealthDay News) -- The synthetic steroid tibolone increases the risk of breast cancer recurrence, according to a report published in the February issue of The Lancet Oncology.

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Contralateral Prophylactic Mastectomy Use On The Rise

FRIDAY, Feb. 20 (HealthDay News) -- During recent years, contralateral prophylactic mastectomy has become a more commonly used treatment in women with ductal carcinoma in situ, according to research published online Feb. 17 in the Journal of Clinical Oncology.

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Chorionic Villus Sampling Method Deemed Safe

THURSDAY, Feb. 19 (HealthDay News) -- Chorionic villus sampling (CVS) is a frequent and safe prenatal method for genetic screening, according to the conclusions of a review published online Feb. 11 in the Journal of Craniofacial Surgery.

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Most US Newborns Receiving Screening for Many Disorders

THURSDAY, Feb. 19 (HealthDay News) -- Nearly all of the more than 4 million children born annually in the United States are now required to undergo screening for at least 21 genetic or functional disorders, according to a report released Feb. 18 by the March of Dimes.

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Proposed Changes to Health Care Would Reduce Costs

THURSDAY, Feb. 19 (HealthDay News) -- Simultaneous gains in universal health coverage, improved health outcomes and slowed spending growth would have a major impact on the development of public policy, according to a perspective published in the Feb. 26 issue of the New England Journal of Medicine.

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Transparency, Globalization Growing in Clinical Research

THURSDAY, Feb. 19 (HealthDay News) -- All clinical trial data and the U.S. Food and Drug Administration database should be publicly available, and global clinical research should be conducted in relevant populations for potential applications of the intervention, according to two articles published in the Feb. 19 issue of the New England Journal of Medicine.

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Implementing a Quality Improvement Faculty Path

WEDNESDAY, Feb. 18 (HealthDay News) -- A new career pathway in academic medicine, termed clinicians in quality improvement, is a justified concept to achieve and recognize excellence in patient safety, according to a commentary published in the Feb. 18 issue of the Journal of the American Medical Association.

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Unemployment Higher Among Cancer Survivors

TUESDAY, Feb. 17 (HealthDay News) -- Cancer survivors, especially of the breast, gastrointestinal system and female reproductive organs, have an increased risk of experiencing unemployment, according to a review published in the Feb. 18 issue of the Journal of the American Medical Association.

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Ads Featuring 'Drug Facts Box' Help Educate Consumers

TUESDAY, Feb. 17 (HealthDay News) -- Replacing the brief summary in direct-to-consumer ads with a "drug facts box" may result in improved consumer knowledge and judgment about medication benefits and side effects, according to study findings released online Feb. 17 in advance of publication in the Apr. 21 issue of the Annals of Internal Medicine.

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Counseling by Phone or in Person Helps Weight Loss

TUESDAY, Feb. 17 (HealthDay News) -- Frequent contact with a dietitian in person or by phone may be equally as effective in helping individuals lose weight, according to research published in the Feb. 17 issue of the Annals of Internal Medicine.

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Increase Seen in Early Neonatal Group B Strep Infections

MONDAY, Feb. 16 (HealthDay News) -- There was an increase in the incidence of early-onset neonatal group B Streptococcus infections from 2003 to 2006, but the incidence of late-onset infections has remained stable from 2000 to 2006, according to a report published in the Feb. 13 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Poorer Prognosis for Black Women with Uterine Tumors

MONDAY, Feb. 16 (HealthDay News) -- Black women with uterine corpus tumors have a higher likelihood of mortality compared with white women, revealing a racial disparity that has continued over time, according to research published online Feb. 9 in Cancer.

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Breast Imaging Useful for Assessing Cancer Extent

MONDAY, Feb. 16 (HealthDay News) -- Breast MRI can be useful for assessing the extent of disease in women diagnosed with breast cancer, but surgical treatment decisions should not be made solely on breast MRI results, according to a review in the February issue of the Journal of the National Comprehensive Cancer Network.

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Breast Cancer Risk Raised in Hodgkin's Disease Survivors

FRIDAY, Feb. 13 (HealthDay News) -- Women who survived Hodgkin's disease as children have a 37-fold higher risk of developing breast cancer than women in the general population, particularly bilateral disease, according to study findings published in the September issue of the International Journal of Radiation Oncology - Biology - Physics.

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Many Women Do Not Follow Pre-Pregnancy Guidelines

FRIDAY, Feb. 13 (HealthDay News) -- Few women comply with nutrition and lifestyle recommendations when planning a pregnancy, and greater efforts are needed to improve compliance to these recommendations, according to research published online Feb. 12 in BMJ.

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Pregnancy Can Mean Delayed Breast Cancer Diagnosis

FRIDAY, Feb. 13 (HealthDay News) -- Although pregnancy may conceal breast cancer in younger women and lead to a delay in diagnosis, evaluation and treatment, pregnancy-associated breast cancers are not associated with a worse outcome compared to non-pregnancy-associated breast cancers, according to research published online Feb. 9 in Cancer.

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Social Factors Affect Smoke Avoidance in Pregnant Women

THURSDAY, Feb. 12 (HealthDay News) -- In pregnant non-smoking black women, social factors play a significant role in the avoidance of environmental tobacco smoke, according to an article published in the March issue of the American Journal of Preventive Medicine.

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Statins Not Effective As Cancer Preventatives

THURSDAY, Feb. 12 (HealthDay News) -- Despite recent epidemiologic evidence suggesting statins decrease breast cancer incidence, they had no activity in a rat model of mammary cancer, according to research published in the February issue of Cancer Prevention Research.

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Financial Incentives May Improve Smoking Cessation

WEDNESDAY, Feb. 11 (HealthDay News) -- Offering workers financial incentives to stop smoking was associated with higher long-term smoking cessation rates, according to research published in the Feb. 12 issue of the New England Journal of Medicine.

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Additional Drug Improves Survival in Early Breast Cancer

WEDNESDAY, Feb. 11 (HealthDay News) -- Tamoxifen or anastrozole treatment of premenopausal women with endocrine-responsive early breast cancer leads to similar rates of disease-free survival, which is improved by additional treatment with zoledronic acid, according to a report in the Feb. 12 issue of the New England Journal of Medicine.

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Stroke Risk in Women Needs More Research

WEDNESDAY, Feb. 11 (HealthDay News) -- Women account for the majority of stroke deaths in the United States, yet there are major gaps in awareness of risk factors specific to women, and in the knowledge of the causes and treatment of strokes in women, according to several reports published a special themed issue of Stroke released online Feb. 10 and dedicated to the epidemic of stroke among women.

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Maternal Obesity Linked to Birth Defects

TUESDAY, Feb. 10 (HealthDay News) -- Compared to children whose mothers are normal weight, those with obese mothers may be at higher risk of congenital anomalies, according to study findings published in the Feb. 11 issue of the Journal of the American Medical Association.

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Care Coordination Programs Don't Benefit Medicare Patients

TUESDAY, Feb. 10 (HealthDay News) -- For Medicare beneficiaries with chronic illnesses, most care coordination programs have little impact on reducing hospitalizations and costs or improving quality of care, according to a report published in the Feb. 11 issue of the Journal of the American Medical Association.

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More Exercise Means Better Quality of Life

TUESDAY, Feb. 10 (HealthDay News) -- The benefits of exercise to quality of life, both physical and mental, increase with the amount of exercise, even when exercise does not result in weight change, researchers report in the Feb. 9 issue of the Archives of Internal Medicine.

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Migraines Impose Substantial Societal and Economic Burden

TUESDAY, Feb. 10 (HealthDay News) -- Although migraines and their associated disabilities are prevalent and carry a high societal and economic burden, they are not generally considered a serious medical condition, according to a report published in the January/February issue of Value in Health.

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Locoregional Treatment of Breast Cancer Effective

TUESDAY, Feb. 10 (HealthDay News) -- Locoregional treatment of advanced breast cancer, consisting of locoregional radiotherapy to the breast and regional lymphatics in most cases, is effective in improving survival, according to the results of a study published online Feb. 9 in the Journal of Clinical Oncology.

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Mediterranean Diet Benefits Cognitive Function in Elderly

MONDAY, Feb. 9 (HealthDay News) -- In cognitively normal older adults, adherence to a Mediterranean diet is associated with a modestly reduced risk of developing mild cognitive impairment, and in older adults who already have mild cognitive impairment, adherence to the diet is associated with a significantly reduced risk of developing Alzheimer's disease, according to a report published in the February issue of the Archives of Neurology.

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Racial Mix of Patients Affects Doctors' Work Conditions

MONDAY, Feb. 9 (HealthDay News) -- Physicians working in primary care clinics that serve a patient population with higher proportions of minorities have fewer resources and more complex medical problems to treat compared with those that do not, according to an article published in the Feb. 9 issue of the Archives of Internal Medicine.

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FDA OKs Drug Produced Using Genetically Engineered Goats

MONDAY, Feb. 9 (HealthDay News) -- For the first time, the U.S. Food and Drug Administration has approved a product that is produced using genetically engineered animals, according to a release issued by the agency.

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ASCO Guide Addresses High Costs of Cancer Care

MONDAY, Feb. 9 (HealthDay News) -- Communication between patients and their doctors regarding the high cost of cancer care may be improved with the Feb. 5 release of a new patient guide from the American Society of Clinical Oncology (ASCO).

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Vasopressin Improves Some Hysterectomy Outcomes

FRIDAY, Feb. 6 (HealthDay News) -- Intracervical injection of the peptide hormone vasopressin prior to vaginal hysterectomy reduces blood loss but increases postoperative pain, according to research published in the February issue of Obstetrics & Gynecology.

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Fertility Treatment Does Not Affect Ovarian Cancer Risk

FRIDAY, Feb. 6 (HealthDay News) -- Women who are treated with fertility drugs are not at increased risk of ovarian cancer, regardless of what types of drugs are used, according to the results of a study published online Feb. 5 in BMJ.

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Energy Balance Better After Maternal Nutrient Restriction

FRIDAY, Feb. 6 (HealthDay News) -- Maternal nutrient restriction in sheep has little effect on appetite regulation early in life but the offspring are better able to adapt to maintain a neutral energy balance after juvenile obesity, according to a report in the February issue of Endocrinology.

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Nanoprobe Points to Outcome Following Tumor Treatment

THURSDAY, Feb. 5 (HealthDay News) -- A method of assessing vascular permeability in tumors in rats using a nanoprobe helped predict the effect of later treatment with liposomal doxorubicin, according to research published in the February issue of Radiology.

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Graded Exercise Program Improves Low Back Pain

THURSDAY, Feb. 5 (HealthDay News) -- A graded exercise intervention emphasizing stabilizing exercises reduces disability and improves physical health better than daily walks in patients with recurrent low back pain, researchers report in the Feb. 1 issue of Spine.

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Hormonal Therapy Link to Breast Cancer Explored

WEDNESDAY, Feb. 4 (HealthDay News) -- A decline in the use of combined hormone therapy appears responsible for a decreased incidence of breast cancer among women, according to research published Feb. 5 in the New England Journal of Medicine.

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Early Childhood Stress Linked to Weakened Immune System

WEDNESDAY, Feb. 4 (HealthDay News) -- A stressful early childhood impairs the long-term function of the immune system, according to research published online Feb. 2 in the Proceedings of the National Academy of Sciences Early Edition.

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Resting Heart Rate Can Predict Women's Heart Death Risk

WEDNESDAY, Feb. 4 (HealthDay News) -- A low-tech and inexpensive test to measure women's resting heart rate can predict the risk of myocardial infarction and coronary death, according to research published online Feb. 3 in BMJ.

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Diabetes, Heart Disease Raise Coronary Event Risk in HIV

WEDNESDAY, Feb. 4 (HealthDay News) -- Both diabetes mellitus and pre-existing coronary heart disease (CHD) are associated with an increased risk of a CHD event in individuals with HIV, indicating the need for diabetes screening in this population, according to research published online Feb. 2 in Circulation: Journal of the American Heart Association.

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Lower Birth Weight Linked to Smoking During Pregnancy

WEDNESDAY, Feb. 4 (HealthDay News) -- The reduced fetal growth seen in the offspring of maternal smokers may be due in part to lower endothelial nitric oxide synthase (eNOS) activity in fetal umbilical and chorionic vessels, according to research published online Feb. 2 in Circulation: Journal of the American Heart Association.

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Osteoporotic Fractures Raise Mortality Risk in Elderly

TUESDAY, Feb. 3 (HealthDay News) -- Older adults who experience low-trauma fractures are at increased risk of mortality for the following five to 10 years, and the risk period is extended by subsequent fractures, according to a report published in the Feb. 4 issue of the Journal of the American Medical Association.

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Consensus Review Improves Breast Cancer Detection

TUESDAY, Feb. 3 (HealthDay News) -- Consensus review of discordant mammography findings improves cancer detection while reducing the number of unnecessary and stressful callbacks of non-cancer patients for further assessment, according to research published in the February issue of Radiology.

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Perfluorinated Chemicals Linked to Reduced Fertility

TUESDAY, Feb. 3 (HealthDay News) -- At exposures common in developed countries, the perfluorinated chemicals perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) may reduce a woman's ability to reproduce and increase the time needed to become pregnant, according to research published online Jan. 28 in Human Reproduction.

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Pregnancy Hormone Level May Predict Postpartum Depression

MONDAY, Feb. 2 (HealthDay News) -- Placental corticotropin-releasing hormone levels during mid-pregnancy can be used to predict the risk of postpartum depression, according to the results of a study published in the February issue of the Archives of General Psychiatry.

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High Television Viewing Predicts Poor Dietary Habits

MONDAY, Feb. 2 (HealthDay News) -- Increased television viewing in middle and high school students predicts poor dietary habits in subsequent years, possibly due to increased advertising exposure, according to research published online Jan. 30 in the International Journal of Behavioral Nutrition and Physical Activity.

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Misoprostol Recommended for Post-Abortion Care

MONDAY, Feb. 2 (HealthDay News) -- The synthetic prostaglandin analog misoprostol can provide inexpensive and effective post-abortion care for women experiencing problems related to spontaneous or induced abortion, according to an opinion published in the February issue of Obstetrics & Gynecology.

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Legal Status of Lesbian Couples Has Impact on Health

MONDAY, Feb. 2 (HealthDay News) -- Lack of legal recognition is harmful for women in same-sex relationships, affecting both direct and indirect health care issues, according to an opinion published in the February issue of Obstetrics & Gynecology.

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