July 2007 Briefing - Obstetrics/Gynecology

Here are what the editors at HealthDay consider to be the most important developments in OBGYN & Women's Health for July 2007. 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.

Air Bubble Position in Embryo Transfer Affects Success

TUESDAY, July 31 (HealthDay News) -- Higher pregnancy rates are achieved when the air bubbles surrounding the embryo during transfer procedures are positioned closer to the fundus, according to a study published in the July issue of Fertility and Sterility.

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Health Risks Higher for Assisted Reproduction

TUESDAY, July 31 (HealthDay News) -- Although the health risks for mother and child are higher for assisted reproduction than spontaneous conception, much of this is related to the underlying health risks of being infertile, according to a review of singleton pregnancies in the July 28 issue of The Lancet. Children born after assisted reproduction appear to develop normally with normal family relationships.

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Magnetic Resonance Superior for Breast Cancer Diagnosis

TUESDAY, July 31 (HealthDay News) -- Magnetic resonance imaging detects occult breast cancer in high-risk women better than mammography or ultrasound but is associated with a higher biopsy rate, according to a study in the August issue of Radiology.

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Intrauterine Growth Restriction Doesn't Affect Mid-Life Quality

FRIDAY, July 27 (HealthDay News) -- Being born with intrauterine growth restriction (IUGR) does not appear to adversely impact health-related quality of life in middle age, according to a study in the July issue of Archives of Disease in Childhood.

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Increased Complications Found in Reduced Pregnancies

FRIDAY, July 27 (HealthDay News) -- Twins born after the reduction of fetuses from a high-order multiple pregnancy are more likely to be born prematurely and to weigh less at birth than twins born without fetal reduction, although the impact of both outcomes is "relatively small," according to a study published in the July issue of Fertility and Sterility.

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Hysterectomies Have Slight Effect on Fracture Risk

THURSDAY, July 26 (HealthDay News) -- Hysterectomies, including oophorectomies, don't increase the long-term risk of osteoporotic fractures of the hip, spine or wrist except in cases in which surgery is performed for uterine prolapse, according to study findings published in the July issue of Fertility and Sterility.

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One Failed Glucose Test May Suggest Risk in Pregnancy

THURSDAY, July 26 (HealthDay News) -- Pregnant women who have one abnormal value on a glucose tolerance test are "clinically indistinguishable" from women with gestational diabetes mellitus, and both groups have insulin abnormalities compared to other women, researchers report in the July issue of Diabetes Care.

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Lactation May Be Unimpaired by Breast Reduction Surgery

WEDNESDAY, July 25 (HealthDay News) -- Women with macromastia who have undergone superior, medial or inferior pedicle breast reduction surgery have similar breast-feeding success rates as matched controls, according to a report published in the July issue of Plastic and Reconstructive Surgery.

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Some Crohn's Drugs Linked with Risk of Preterm Birth

WEDNESDAY, July 25 (HealthDay News) -- Women with Crohn's disease who take steroids or azathioprine (AZA)/6-mercaptopurine (6-MP) alone or in combination with other drugs during pregnancy may have an increased risk of preterm birth compared to women who take no medication or other medications, according to an analysis of a large Danish registry published in the July issue of the American Journal of Gastroenterology.

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Technologist Review Improves Breast Cancer Detection

WEDNESDAY, July 25 (HealthDay News) -- Cancer detection rates improve when mammograms are double screened by technologists in addition to radiologists, according to study findings published online July 24 in the Journal of the National Cancer Institute. The study found that screening specificity decreased slightly with the added screenings.

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Hepatitis B Linked to Higher Risk of Gestational Diabetes

TUESDAY, July 24 (HealthDay News) -- Women who are infected with hepatitis B virus are more likely to develop gestational diabetes than women who are not, according to a retrospective analysis conducted in Hong Kong and published in the July issue of the Journal of Hepatology.

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New Cancer Drugs Improve Breast Cancer Survival

TUESDAY, July 24 (HealthDay News) -- Improving survival for women with metastatic breast cancer in the last decade appears to be related to the introduction of new therapeutic agents, including aromatase inhibitors, docetaxel and trastuzumab, according to the results of a large, population-based study published online July 23 in Cancer.

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Taking Tykerb with Food Boosts Bioavailability, Could Cut Cost

TUESDAY, July 24 (HealthDay News) -- Although the package insert for lapatinib (Tykerb) indicates that this oral targeted therapy for breast cancer should be taken at least an hour before or after food, taking it with food boosts bioavailability and could allow a smaller, less-expensive dose and reduced side effects, according to a commentary in the Aug. 10 issue of the Journal of Clinical Oncology.

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Group Therapy Doesn't Improve Breast Cancer Survival

MONDAY, July 23 (HealthDay News) -- Among women with metastatic breast cancer, participation in weekly group psychotherapy does not prolong survival compared to controls, according to a report published online July 23 in Cancer. However, researchers did find increased survival of women with estrogen receptor-negative tumors who underwent supportive group therapy.

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Screening for Group B Strep Has Helped Protect Infants

MONDAY, July 23 (HealthDay News) -- Universal screening for perinatal group B streptococcus (GBS) has helped reduce infections in infants, but a recent increase in the disease, especially among black infants, is concerning, according to a report in the July 20 issue of the Morbidity and Mortality Weekly Report.

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Sperm Injection for IVF Increased Sharply Over Decade

WEDNESDAY, July 18 (HealthDay News) -- The use of intracytoplasmic sperm injection (ICSI) during in vitro fertilization rose steeply between 1995 and 2004, even though diagnoses of infertility attributable to male-factor issues stayed steady during that period, researchers report in the July 19 issue of the New England Journal of Medicine.

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Human Papillomavirus More Prevalent in Poor Women

WEDNESDAY, July 18 (HealthDay News) -- Compared with women with more resources, low-income American women are at higher risk for human papillomavirus (HPV) infection, researchers report in the July issue of Obstetrics & Gynecology.

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Healthy Diet Has No Effect on Breast Cancer Recurrence

TUESDAY, July 17 (HealthDay News) -- A diet rich in fruits, vegetables and fiber has no effect on breast cancer recurrence or all-cause mortality, according to a report published in the July 18 issue of the Journal of the American Medical Association.

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FDA OKs Rapid Molecular Test for Sentinel Lymph Nodes

TUESDAY, July 17 (HealthDay News) -- The U.S. Food and Drug Administration has approved a rapid molecular test that can be used to detect breast cancer metastasis in sentinel and other lymph nodes. The GeneSearch BLN (Breast Lymph Node) Assay has a sensitivity and specificity similar to more extensive microscopic examination, which typically takes one to two days.

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Some Women Use Internet for Emergency Contraception

TUESDAY, July 17 (HealthDay News) -- An Internet site that provides emergency contraception was more likely to attract well-off, college-educated, single, urban women, according to a survey in the July issue of Obstetrics & Gynecology.

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Chlamydia Rates Warrant Screening Young Women

TUESDAY, July 17 (HealthDay News) -- The prevalence of chlamydia in the United States is 2.2 percent, compared with just 0.24 percent for gonorrhea, and warrants screening of sexually active young women, according to a report published in the July 17 issue of the Annals of Internal Medicine.

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Antenatal Corticosteroids Largely Equivalent in Efficacy

MONDAY, July 16 (HealthDay News) -- Dexamethasone and betamethasone are equally effective at reducing neonatal morbidity and mortality in preterm neonates, according to a report published in the July issue of Obstetrics & Gynecology. However, dexamethasone is associated with lower rates of intraventricular hemorrhage and brain lesions, the report indicates.

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Herceptin More Cardiotoxic in Sequential Therapy

FRIDAY, July 13 (HealthDay News) -- One in five breast cancer patients who receive trastuzumab sequentially after primary chemotherapy may experience cardiotoxicity, a higher rate than in women treated concurrently, according to a letter published July 5 in the New England Journal of Medicine.

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Platelets Play Role in Corpus Luteum Formation

FRIDAY, July 13 (HealthDay News) -- Platelets regulate neovascularization and luteinization during human corpus luteum formation, and platelet-derived soluble factors induce the migration of endothelial cells, according to a study in the July issue of Endocrinology.

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Neural Tube Defects Drop After Folic Acid Fortification

WEDNESDAY, July 11 (HealthDay News) -- The prevalence of neural tube defects fell by nearly half after folic acid fortification of foods was introduced in Canada in 1998, according to a study in the July 12 issue of the New England Journal of Medicine.

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BRCA Mutations Do Not Affect Risk of Breast Cancer Death

WEDNESDAY, July 11 (HealthDay News) -- The presence of a mutation in the BRCA genes has no significant effect on the risk of death from breast cancer in women with invasive breast cancer, according to a study conducted in Israel and published in the July 12 issue of the New England Journal of Medicine.

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Many Retain Fertility After Ovarian Cancer Treatment

TUESDAY, July 10 (HealthDay News) -- Many women with malignant ovarian germ cell tumors who undergo fertility-sparing surgery and platinum-based chemotherapy can retain reproductive and sexual functioning after treatment, according to a report in the July 1 issue of the Journal of Clinical Oncology.

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Breast Cancer Diagnosed Later in Blacks Than Whites

TUESDAY, July 10 (HealthDay News) -- Black women are often diagnosed with more-advanced breast cancers than white women, and their tumors are more likely to express Ki-67 and p53, and less likely to have estrogen receptors, according to a report published online July 9 in Cancer.

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Dioxin Exposure Reduces Risk of Uterine Fibroids

MONDAY, July 9 (HealthDay News) -- Women exposed to dioxin are less likely to develop uterine fibroids later in life, indicating it has an antiestrogenic effect in this tissue, according to a study in the July 1 issue of the American Journal of Epidemiology. In contrast, earlier studies have shown that dioxin has estrogenic effects in breast tissue.

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Birth Weight, Mother's Weight Affect Women's Adult Body Size

MONDAY, July 9 (HealthDay News) -- A woman's adult body mass index is affected by her birth weight, mother's weight and rate of weight gain in early childhood, according to a report published in the July 1 issue of the American Journal of Epidemiology. However, women with a smaller body mass index (BMI) in adulthood appear to be more influenced by birth weight and women with a higher adult BMI are more affected by a mother's weight gain in pregnancy.

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Preimplantation Genetic Testing May Reduce Birth Rate

MONDAY, July 9 (HealthDay News) -- Preimplantation genetic screening may reduce the rate of ongoing pregnancies and live births in women 35 and older who are undergoing in vitro fertilization, according to a report in the July 5 issue of the New England Journal of Medicine.

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Newborn Encephalopathy Risk Associated with Poverty

MONDAY, July 9 (HealthDay News) -- Women who live in poor neighborhoods and have less than 12 years of schooling are at increased risk of having a newborn with encephalopathy compared with their peers in higher-income areas who have more education, according to the results of a study in the July issue of the Archives of Pediatrics & Adolescent Medicine.

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Smoking in Youth May Increase Breast Cancer Risk

MONDAY, July 9 (HealthDay News) -- Smoking may increase the risk of breast cancer, with the greatest risk associated with smoking from menarche to first childbirth, but declining afterwards, according to a report published in the July 1 issue of the American Journal of Epidemiology.

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Merck Recalls Three Lots of Invanz Due to Glass Shards

FRIDAY, July 6 (HealthDay News) -- Three lots of Invanz (ertapenem sodium) were recalled this week due to two incidents in which pieces of broken glass were found in the reconstituted solution for injection. Merck & Co., Inc., of Whitehouse Station, N.J., issued a letter to health care professionals noting that it is working closely with the U.S. Food and Drug Administration to inform its direct customers of the recall.

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Some Naturopathic Physicians Provide Pediatric Care

TUESDAY, July 3 (HealthDay News) -- Some naturopathic physicians, who treat the whole person by natural means including nutrition and exercise, provide substantial amounts of pediatric care, according to a report in the July issue of Pediatrics.

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Liquid-Based Cytology Detects More Cervical Cancer

TUESDAY, July 3 (HealthDay News) -- Liquid-based cytology detects more cervical cancers than conventional cytology in Pap smears and also reduces the percentage of unsatisfactory smears, according to the results of two studies published online June 29 in BMJ.

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Spermicidal May Raise Risk for Sexually Transmitted Disease

TUESDAY, July 3 (HealthDay News) -- The commonly used vaginal spermicide, nonoxynol-9, may facilitate human papillomavirus (HPV) infection while vaginal lubricants containing the polysaccharide carrageenan may help prevent infection, according to the results of a study in mice published in the July issue of Nature Medicine.

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New Treatments for Breast Cancer Also Cost-Effective

MONDAY, July 2 (HealthDay News) -- Two newer adjuvant treatments for breast cancer -- Herceptin (trastuzumab) and the aromatase inhibitor, exemestane -- are cost-effective when compared to other oncology treatments, according to two reports in the Aug. 1 issue of Cancer.

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Lymph Node Biopsies Detect Early Breast Cancer

MONDAY, July 2 (HealthDay News) -- The growing trend of diagnostic use of sentinel lymph node biopsies in community settings correlates with the rising rate of some early-stage metastatic breast cancers, according to the results of a population-based study published online June 27 in the Journal of the National Cancer Institute.

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