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July 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 July 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.

Pregestational Diabetes Raises Birth Defect Risk

THURSDAY, July 31 (HealthDay News) -- Pregnant women with pregestational diabetes mellitus are more likely than pregnant women with gestational diabetes mellitus to have a child with birth defects, according to a report published online July 31 in the American Journal of Obstetrics & Gynecology.

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Glomerular Filtration Screening Should Not Be Universal

THURSDAY, July 31 (HealthDay News) -- Estimated glomerular filtration rate (eGFR) should not be used to universally screen for chronic kidney disease and should be restricted to high-risk groups due to the potential to falsely diagnose women and particularly the elderly, according to two articles published online July 30 in the Clinical Journal of the American Society of Nephrology.

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Two Different Breast Cancer Screening Programs Compared

THURSDAY, July 31 (HealthDay News) -- Although the organized, population-based screening program in Norway has a longer screening interval, opportunistic mammography screening in Vermont achieves similar outcomes, according to a report published online July 29 in the Journal of the National Cancer Institute.

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Adverse Outcomes in IVF Babies Analyzed

THURSDAY, July 31 (HealthDay News) -- Babies conceived spontaneously and as a result of assisted fertilization by the same woman have similar risks of adverse outcomes, meaning that adverse outcomes among assisted fertilization babies may be attributable to the underlying causes of infertility rather than the fertility treatment itself, according to a report published online July 31 in The Lancet.

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Endothelial Function Linked to Cardio Risk in Sedentary

THURSDAY, July 31 (HealthDay News) -- Endothelial function is significantly associated with cardiovascular risk in women in sedentary professions, with cardiorespiratory fitness being the best predictor of endothelial function, according to study findings published in the Aug. 1 issue of the American Journal of Cardiology.

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Genetic Factor Studied in Susceptibility to Migraine

THURSDAY, July 31 (HealthDay News) -- Carriers of the MTHFR 677C>T genotype who have migraines with aura are at increased risk of cardiovascular disease, according to research published online July 30 in Neurology.

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Mouse Model of Postpartum Depression Developed

THURSDAY, July 31 (HealthDay News) -- Mice lacking a major target of neurosteroid hormones, which have been implicated in various psychiatric and neurological disorders, display abnormal postpartum behavior and may be a useful model for postpartum depression, researchers report in the July 31 issue of Neuron.

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Microbicidal HIV Prevention Trial Halted Early

WEDNESDAY, July 30 (HealthDay News) -- Cellulose sulfate gel -- investigated as a vaginal microbicide against HIV -- didn't reduce HIV infections and may have even increased the risk in a sample of women, according to research published in the July 31 New England Journal of Medicine.

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Increased Hip Bone Density Linked to Breast Cancer

WEDNESDAY, July 30 (HealthDay News) -- In postmenopausal women, hip bone mineral density predicts breast cancer risk independently of the Gail score, suggesting that the two measurements could be used together to better quantify the risk, according to a study published online July 29 in Cancer.

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FDA Approves First Generic Divalproex Sodium

WEDNESDAY, July 30 (HealthDay News) -- The U.S. Food and Drug Administration has approved generic versions of Depakote delayed-release tablets (divalproex sodium) for the first time, according to a press release issued by the FDA this week.

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Use of Antibiotic Prophylaxis for Endocarditis Discouraged

TUESDAY, July 29 (HealthDay News) -- Antibiotic prophylaxis should no longer routinely be given to prevent infective endocarditis in patients undergoing dental and other medical procedures, according to updated guidelines published online July 28 in the Journal of the American College of Cardiology. The guidelines were jointly developed by the American College of Cardiology and the American Heart Association.

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Diabetes-Diet Link Examined in Trio of Studies

MONDAY, July 28 (HealthDay News) -- Increased consumption of fruits and vegetables may decrease the risk of diabetes mellitus, while increased consumption of fruit drinks may increase risk, and diets low in fat have no effect on development of diabetes, according to three articles published in the July 28 issue of the Archives of Internal Medicine.

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Exercise Is Key for Long-Term Weight Loss

MONDAY, July 28 (HealthDay News) -- Sustaining a 10 percent or more weight loss requires fairly high levels of physical activity in combination with reduced energy intake, according to an article published in the July 28 issue of the Archives of Internal Medicine.

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Nevirapine Dosing Studied in Breast-Feeding Moms with HIV

FRIDAY, July 25 (HealthDay News) -- In HIV-infected mothers, risk of HIV transmission to their uninfected breast-feeding infants may be reduced by a prolonged postpartum course of nevirapine, according to an article published in the July 26 issue of The Lancet.

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HIV Transmission Possible Despite Effective Treatment

FRIDAY, July 25 (HealthDay News) -- While individual risk of HIV transmission per sexual encounter is fairly small when one partner is effectively treated and the other is seronegative, the rate of transmission over large numbers of sexual encounters may be substantial, according to research published in the July 26 issue of The Lancet.

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Timing Is Crucial in Measles Vaccination

FRIDAY, July 25 (HealthDay News) -- The age at which the protective effect of maternal measles antibodies wears off varies widely from region to region and should be taken into account when formulating optimum immunization strategies, according to an editorial published online July 24 in BMJ.

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HIV Survival Increases with Antiretroviral Therapy

FRIDAY, July 25 (HealthDay News) -- Significant declines in mortality and an increase in life expectancy have been seen among HIV-positive patients using combination antiretroviral therapy, according to study findings published in the July 26 issue of The Lancet.

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Population Policy Key to Environmental Protection

FRIDAY, July 25 (HealthDay News) -- Controlling population growth by providing better access to contraception could help combat global warming by reducing greenhouse gas emissions and the human strain on the world's resources, according to an editorial published online July 24 in BMJ.

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Postmenopausal Estrogen May Increase Reflux Symptoms

THURSDAY, July 24 (HealthDay News) -- Estrogen therapy in postmenopausal women may slightly increase the incidence of gastroesophageal reflux, according to research published in the July issue of Gastroenterology.

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Timing of Lymph Node Dissection Studied in Breast Cancer

THURSDAY, July 24 (HealthDay News) -- The timing of axillary lymph node dissection does not affect the number of lymph nodes recovered or long-term complications in patients with breast cancer that has metastasized to the sentinel lymph nodes, according to a report in the July 20 issue of the Journal of Clinical Oncology.

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Self-Assessment Detects Alcohol Abuse in Pre-Op Patients

THURSDAY, July 24 (HealthDay News) -- A computer-based self-assessment is much better than anesthesiologists at detecting alcohol abuse among preoperative patients, according to a report in the August issue of Anesthesiology.

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'Tier 4' Drugs Raise Questions About Affordability

WEDNESDAY, July 23 (HealthDay News) -- The emergence of a fourth tier of copayment for expensive drugs calls into question how Americans are going to handle the rising costs of health care, according to a perspective article in the July 24 issue of the New England Journal of Medicine.

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Consequences of Genetic Non-Discrimination Act Examined

WEDNESDAY, July 23 (HealthDay News) -- The Genetic Information Non-discrimination Act (GINA), recently signed into U.S. law, creates a troublesome distinction between those at genetic risk for a disease and those with other characteristics that predispose them to a condition, according to a perspective article published in the July 24 issue of the New England Journal of Medicine.

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Physicians to Get Bonus for Electronic Prescribing

WEDNESDAY, July 23 (HealthDay News) -- Doctors using an electronic prescriptions system will be eligible for a bonus from Medicare from 2009 onwards for four years, according to U.S. health officials.

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Sildenafil May Help Women Treated for Depression

TUESDAY, July 22 (HealthDay News) -- Among women taking serotonin reuptake inhibitors for depression, sildenafil may help relieve sexual dysfunction associated with the use of the antidepressants, according to research published in the July 23/30 issue of the Journal of the American Medical Association.

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Treatment for Infertile Men Looks Promising

TUESDAY, July 22 (HealthDay News) -- For infertile men with varicoceles, embolization improves sperm count and motility and may aid in pregnancy, researchers report in the August issue of Radiology.

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Drugs Can Reduce Discomfort During Mammography

TUESDAY, July 22 (HealthDay News) -- Premedication with lidocaine can help reduce discomfort in women who expect pain during mammography screening and make it more likely they will continue to undergo regular screening, according to a report released online July 22 in advance of publication in the September issue of Radiology.

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Topiramate Therapy During Pregnancy Raises Concerns

TUESDAY, July 22 (HealthDay News) -- The use of topiramate as monotherapy or as an adjunct to other treatment for epilepsy during pregnancy raises some concerns about the increased risk of congenital malformation, according to a report published in the July 22 issue of Neurology.

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Peers Play Key Role in Nutrition Education of Latinos

MONDAY, July 21 (HealthDay News) -- Peer education can help improve diabetes self-management and breast-feeding outcomes among Latinos, researchers report in the July issue of the Journal of Nutrition Education and Behavior.

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Protein Linked to Poorer Ovarian Cancer Outcomes

MONDAY, July 21 (HealthDay News) -- Overexpression of tissue type transglutaminase (TG2) in ovarian carcinoma is associated with poorer patient survival; TG2 also spurs cancer cell attachment, invasion, and resistance to chemotherapy, according to research published in the July 15 issue of Cancer Research.

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Maternal Obesity Linked to Obesity in Offspring in Rats

MONDAY, July 21 (HealthDay News) -- Offspring of obese mother rats or those overfed after birth are considerably heavier and are more likely to be fatter, glucose intolerant, have high lipid levels and have changes in appetite hormones, according to study findings published online July 17 in Endocrinology.

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Uterine Rupture in Vaginal Birth After C-Section Studied

MONDAY, July 21 (HealthDay News) -- Women having a vaginal birth after a previous Caesarean delivery should receive a maximum oxytocin dose of 20 mU/min to avoid uterine rupture, according to a report in the July issue of the American Journal of Obstetrics & Gynecology. A related study in the same issue found that the risk of uterine rupture in these patients cannot be predicted by factors available before admission.

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Retinoic Acid May Spur Tumor Vessel Growth

MONDAY, July 21 (HealthDay News) -- Treating SKBR-3 breast cancer cells with retinoic acid can encourage the growth of extensive network structures and induces endothelial genes, suggesting a method of creating blood supply to tumors, according to research published online July 16 in PLoS ONE.

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Breast-Feeding Lowers Infant Risk of Stomach Infection

MONDAY, July 21 (HealthDay News) -- Infants of low-income women who are predominantly breast-fed have a lower risk of gastrointestinal infection but a higher risk of iron deficiency than infants who are partially or entirely formula-fed, according to the results of a study published in the August issue of the Journal of Nutrition.

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One-Fourth of the U.S. Population Is Obese, CDC Reports

MONDAY, July 21 (HealthDay News) -- Obesity rates in the United States remain well above goals for Healthy People 2010, according to a report by researchers at the U.S. Centers for Disease Control and Prevention published in the July 18 issue of the Morbidity and Mortality Weekly Report.

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Routine Human Papillomavirus Vaccination Cost-Effective

FRIDAY, July 18 (HealthDay News) -- Routine vaccination of 12-year-old girls against human papillomavirus, combined with an initial catch-up campaign to cover girls up to the age of 18, would likely be cost-effective, according to research published online July 17 in BMJ.

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Ovary Removal Linked to Less Depression After Hysterectomy

FRIDAY, July 18 (HealthDay News) -- Removal of both ovaries in premenopausal women undergoing hysterectomy is associated with less depression or no change in depression depending on whether they were depressed before surgery, according to a report in the July issue of the American Journal of Obstetrics & Gynecology.

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Anti-HIV Microbicides Could Have Surprising Outcomes

FRIDAY, July 18 (HealthDay News) -- Vaginal microbicides containing antiretrovirals to prevent HIV infection in women could lead to many cases of drug resistance, according to research published in the July 15 issue of the Proceedings of the National Academy of Sciences.

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Longer Sleep Linked to Higher Stroke Risk in Older Women

FRIDAY, July 18 (HealthDay News) -- Sleep duration affects the risk of stroke in postmenopausal women, with a sharply higher risk for women who sleep more than seven hours a night, according to research published online July 17 in Stroke.

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Fiber Intake in Early Pregnancy Affects Preeclampsia Risk

FRIDAY, July 18 (HealthDay News) -- Total fiber intake during the early stages of pregnancy may attenuate the risk of developing preeclampsia, according to study findings published online July 17 in the American Journal of Hypertension.

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PET Scans Offer Information on Breast Cancer Survival

THURSDAY, July 17 (HealthDay News) -- Positron emission tomography (PET) provides predictive information regarding survival in women with locally advanced breast carcinoma, according to research published online July 14 in the Journal of Clinical Oncology.

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Exception Reporting Improves Pay-for-Performance Benefits

THURSDAY, July 17 (HealthDay News) -- Pay-for-performance programs benefit from use of exclusion reporting, whereby certain patients are excluded from quality calculations, and the practice of excluding patients to disguise missed targets, known as gaming, is rare, according to study findings published in the July 17 issue of the New England Journal of Medicine.

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Most Breech Infants Born by Caesarean in United States

THURSDAY, July 17 (HealthDay News) -- More than 80 percent of breech infants in the United States are born by Caesarean section, although rates vary widely by state, researchers report in the July issue of the American Journal of Obstetrics & Gynecology.

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Medical Education Must Adapt to Changing Times

THURSDAY, July 17 (HealthDay News) -- Medical schools must adapt their admission requirements and curricula to changes in scientific theory, and are also facing a challenge to the traditional definition of who is suited to the study of medicine, according to two articles published in the July 17 issue of the New England Journal of Medicine.

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Maternal Diet May Affect Childhood Asthma Risk

WEDNESDAY, July 16 (HealthDay News) -- Children whose mothers ate nuts on a daily basis during pregnancy may be at increased risk of asthma, according to the results of a study published in the July 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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AMA Actions Fostered U.S. Medical Racial Divide

TUESDAY, July 15 (HealthDay News) -- From the post-Civil War years to the civil rights era a century later, the American Medical Association (AMA) made decisions that helped support a division between white and black Americans in the field of medicine in the United States, according to an article in the July 16 issue of the Journal of the American Medical Association.

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Amino Acids Not Beneficial for Postmenopausal Women

MONDAY, July 14 (HealthDay News) -- In postmenopausal women, treatment with the amino acid L-isoleucine does not reduce hot flushes, and treatment with L-isoleucine and another amino acid -- L-valine -- either alone or in combination, has no effect on fasting serum homocysteine levels, according to research published in the July issue of Obstetrics & Gynecology.

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Breast Cancer Onset in Susceptible Groups Differs

MONDAY, July 14 (HealthDay News) -- The onset of breast cancer in the unaffected twin of a sister with breast cancer and the onset of bilateral breast cancer based on family history differs from that normally seen in unilateral disease and is largely unaffected by age and time since diagnosis, according to a report released online June 30 in advance of publication in the Journal of Clinical Oncology.

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Aspirin Improves Bone Density in Mouse Osteoporosis

MONDAY, July 14 (HealthDay News) -- Aspirin treatment of estrogen-deficient osteoporosis in mice can improve bone mineral density by stimulating the production of bone-forming cells and inhibiting bone-resorbing cells, researchers report in the July issue of PLoS ONE.

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Consumer-Directed Health Plans Affect Patient Choices

MONDAY, July 14 (HealthDay News) -- Enrollees in high-deductible consumer-directed health plans may be more likely than those with other coverage to either delay seeking care or stop taking medications for chronic illnesses, according to two studies published in the July/August issue of Health Affairs.

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Shoulder Dystocia Training Improves Neonatal Outcomes

MONDAY, July 14 (HealthDay News) -- The introduction of shoulder dystocia training for all hospital maternity staff can significantly improve management of the complication as well as neonatal outcomes, according to research published in the July issue of Obstetrics & Gynecology.

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Low Job Satisfaction Seen Among Obstetrician-Gynecologists

MONDAY, July 14 (HealthDay News) -- The workforce of obstetrician-gynecologists in the United States is facing a future shortage, exacerbated by low levels of job satisfaction, researchers report in the July issue of the American Journal of Obstetrics & Gynecology.

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Higher Education Tied to Lower Cancer Death Rates

MONDAY, July 14 (HealthDay News) -- Reductions in death rates from four major cancers in the United States in recent years were generally confined to better-educated individuals, and epidemiological studies on cancer and other diseases are vulnerable to false-positive findings, according to two papers published online July 8 in the Journal of the National Cancer Institute.

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Younger Breast Cancer Patients Have Worse Prognosis

FRIDAY, July 11 (HealthDay News) -- Breast cancer patients aged 45 and younger have a worse prognosis than their older counterparts, and their disease represents a subset of breast cancers that share gene expression patterns, according to a study published in the July 10 issue of the Journal of Clinical Oncology.

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Oral Hormone Therapy Raises Risk of Gallbladder Disease

FRIDAY, July 11 (HealthDay News) -- Postmenopausal women using hormone replacement therapy (HRT) are at higher risk of gallbladder disease if they use oral rather than transdermal drugs, according to study findings published July 10 in BMJ Online First.

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Endometrial Cancer Prevention Strategies Needed for Obese

FRIDAY, July 11 (HealthDay News) -- In most obese women, neither oral contraceptives nor current screening methods are cost-effective endometrial cancer prevention strategies. But oral contraceptives may be a cost-effective strategy for subgroups of women who are morbidly obese or have longstanding anovulation, researchers report in the July issue of Obstetrics & Gynecology.

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Breast-Conserving Surgery Outcomes Affect Quality of Life

FRIDAY, July 11 (HealthDay News) -- Women with pronounced breast asymmetry after breast-conserving surgery may be at high risk of poor psychosocial functioning, according to study findings published in the July 10 issue of the Journal of Clinical Oncology.

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Study Probes Resveratrol's Anti-Cancer Activities

THURSDAY, July 10 (HealthDay News) -- Resveratrol, an antioxidant found in grapes and other plant foods, may inhibit breast cancer initiation through its actions in the estrogen genotoxicity pathway, according to research published in the July issue of Cancer Prevention Research.

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Vitamin A Linked to Lower Infant Mortality

THURSDAY, July 10 (HealthDay News) -- Administering a one-time vitamin A supplement to newborns in Bangladesh within a few days of birth was associated with a lower risk of mortality through six months, according to research published in the July issue of Pediatrics.

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Diagnosis, Treatment of Heart Attack in Pregnancy Reviewed

THURSDAY, July 10 (HealthDay News) -- Although rare, pregnancy-related heart attacks most often occur in women with cardiovascular risk factors and should be diagnosed and treated the same way as in non-pregnant patients while taking maternal and fetal factors into account, according to a review in the July 15 issue of the Journal of the American College of Cardiology.

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Health Cash Incentives for Poor People Debated

WEDNESDAY, July 9 (HealthDay News) -- Should disadvantaged people be paid to take care of their health? That's the question of a "Head to Head" debate published online July 8 in BMJ.

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Swedish Seniors Are More Sexually Active

WEDNESDAY, July 9 (HealthDay News) -- In 70-year-old Swedish men and women, both the quantity and quality of sex has significantly increased since the early 1970s, according to a report published online July 8 in BMJ.

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Handwashing May Lower Neonatal Mortality in Nepal

WEDNESDAY, July 9 (HealthDay News) -- Compared to not washing their hands, maternal and birth attendant handwashing prior to handling neonates significantly lowers neonatal death, according to an article published in the July issue of the Archives of Pediatrics & Adolescent Medicine.

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FDA: Novel Genetic Test Approved for Breast Cancer

WEDNESDAY, July 9 (HealthDay News) -- The SPOT-Light HER2 CISH kit -- a genetic test that measures the number of copies of the HER2 gene in breast tumor tissue -- received approval this week from the U.S. Food and Drug Administration for the identification of patients who might benefit from treatment with the drug Herceptin (trastuzumab).

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Pregnancy Does Not Increase Risk of Most Mental Illnesses

TUESDAY, July 8 (HealthDay News) -- Although certain groups of women have a high prevalence of psychiatric disorders, pregnancy does not in itself increase the risk of most mental illnesses, according to a report published in the July issue of the Archives of General Psychiatry.

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Environmental Factors In Utero May Trigger Adult Illness

WEDNESDAY, July 2 (HealthDay News) -- The long latency period between exposure to an environmental trigger and cancer has already been recognized, but the same phenomenon may apply to chronic diseases such as metabolic disease and osteoporosis, with exposure to triggers in utero and early life causing disease in adulthood, according to a report published in the July 3 issue of the New England Journal of Medicine.

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Tocolytics Commonly Prescribed for Preterm Labor

WEDNESDAY, July 2 (HealthDay News) -- Nearly all maternal-fetal medicine specialists in the United States recommend tocolysis in the setting of acute preterm labor, and less so for a number of other obstetric complications, according to an article published in the July issue of Obstetrics & Gynecology.

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High Birth Weight Linked to Rheumatoid Arthritis

WEDNESDAY, July 2 (HealthDay News) -- In women, a high birth weight is independently associated with an increased risk of developing rheumatoid arthritis, according to the results of a study published in the August issue of the Annals of the Rheumatic Diseases.

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Hormone Therapy Modifies Heart Risk of Lipoprotein(a)

WEDNESDAY, July 2 (HealthDay News) -- In older women, the relationship between high lipoprotein(a) levels and cardiovascular events is modified by hormone therapy, according to study findings published in the July 8 issue of the Journal of the American College of Cardiology.

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Doctors Consider Giving Up Obstetrics After Infant Death

TUESDAY, July 1 (HealthDay News) -- While the tremendous effect of perinatal death on families is well known, perinatal death has a substantive effect on obstetric providers, according to an article published in the July issue of Obstetrics & Gynecology.

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Breast Cancer in Pregnancy May Have Worse Prognosis

TUESDAY, July 1 (HealthDay News) -- Compared to non-pregnancy-associated breast cancers, pregnancy-associated breast cancers present as larger tumors, at a more advanced stage, and are less likely to be hormone receptor-positive, according to an article published in the July issue of Obstetrics & Gynecology.

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Screening Pregnant Women for Bacteriuria Reaffirmed

TUESDAY, July 1 (HealthDay News) -- The U.S. Preventive Services Task Force has reaffirmed its 2004 recommendation to screen all pregnant women at 12 to 16 weeks' gestation for asymptomatic bacteriuria but not to screen non-pregnant women or men, according to an article published in the July 1 issue of the Annals of Internal Medicine.

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Physician's Briefing