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March 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 March 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.

Safe Practice Scores Do Not Add Up to Fewer Patient Deaths

TUESDAY, March 31 (HealthDay News) -- In hospitals, higher self-reported scores for improvements in safe practices do not correlate with reduced mortality rates, researchers report in the April 1 issue of the Journal of the American Medical Association.

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Study Urges More Clinical Research on Gynecologic Testing

TUESDAY, March 31 (HealthDay News) -- While professional guidelines call for human papillomavirus (HPV) testing in the follow-up of treatment for cervical intraepithelial neoplasia (CIN), there is insufficient clinical research to guide the clinician in the selection of the test to use, according to a report in the April issue of the American Journal of Obstetrics & Gynecology.

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Staff Education Can Help Reduce Elective Labor Inductions

TUESDAY, March 31 (HealthDay News) -- Staff education and more rigorous enforcement of guidelines for labor induction can reduce the number of unwarranted inductions and lower the cesarean birth rate for first-time births, researchers report in the April issue of Obstetrics & Gynecology.

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Protein Seen to Play Role in Herpes Reactivation

TUESDAY, March 31 (HealthDay News) -- Expression of a virion protein called VP16 appears to be necessary for herpes simplex virus to exit its latent state, according to research published in the March issue of PLoS Pathogens.

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Obese Women Face High First-Time Pregnancy Risks

MONDAY, March 30 (HealthDay News) -- Obese women who are pregnant for the first time have an elevated risk of preterm birth, cesarean section delivery and preeclampsia, according to a report in the April issue of the American Journal of Obstetrics & Gynecology.

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Children's Lung Function Linked to Genetic Variants

MONDAY, March 30 (HealthDay News) -- In children, variants in GST mu genes are associated with decreased lung capacity and small airway flow, according to a study published in the April 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Early-Pregnancy Smoking Cessation Beneficial

FRIDAY, March 27 (HealthDay News) -- Pregnant women who stop smoking before 15 weeks' gestation can reduce their risk of spontaneous preterm birth and small-for-gestational-age infants to the same level of pregnant non-smokers, according to research published online March 26 in BMJ.

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Aspirin May Protect Against Cancer

FRIDAY, March 27 (HealthDay News) -- People who take aspirin for vascular protection have less incidence of cancer, but only after 10 years of taking the drug, indicating that it may have a protective effect against cancer, according to a review published online March 27 in The Lancet.

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Most US Adults Should Reduce Sodium Intake

FRIDAY, March 27 (HealthDay News) -- Nearly 70 percent of U.S. adults are in groups at high risk of hypertension and should reduce their sodium intake to less than a teaspoon of salt a day, officials from the U.S. Centers for Disease Control and Prevention report in the March 27 issue of the Morbidity and Mortality Weekly Report.

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Weight Gain Between Births Raises Cesarean Risk

FRIDAY, March 27 (HealthDay News) -- Women who have developed gestational diabetes in a prior pregnancy and have gained more than 10 pounds of weight between pregnancies are at increased risk for cesarean delivery of subsequent babies, according to a report published in the April issue of Obstetrics & Gynecology.

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Pregnancy Feasible After Anterior Spinal Surgery

THURSDAY, March 26 (HealthDay News) -- In women of childbearing age, anterior spinal surgery may not affect fertility, although it may be associated with a higher rate of cesarean section deliveries, according to the results of a study published in the April issue of The Spine Journal.

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Same-Day IUD Insertion May Promote Contraception

THURSDAY, March 26 (HealthDay News) -- Offering women who seek walk-in pregnancy testing or emergency contraception same-day insertion of an intrauterine device (IUD) may be an effective strategy for promoting contraception, according to a report published in the April issue of Obstetrics & Gynecology.

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Prenatal Drug Linked to Impaired Uterine Development

THURSDAY, March 26 (HealthDay News) -- Prenatal exposure to diethylstilbestrol (DES), which is associated with defects in the development of the female reproductive tract, is associated with hypermethylation of a gene that controls uterine development, according to study findings published online March 19 in Endocrinology.

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Circumcision Lowers Risk of Sexually Transmitted Disease

WEDNESDAY, March 25 (HealthDay News) -- In a study of Ugandan men, circumcision reduced both the incidence of herpes simplex virus (HSV-2) and the prevalence of human papillomavirus (HPV), two co-factors in HIV/AIDs, according to a report in the March 26 issue of the New England Journal of Medicine.

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Cost Barriers Slow Adoption of Electronic Health Records

WEDNESDAY, March 25 (HealthDay News) -- Citing cost barriers, relatively few U.S. hospitals have adopted electronic health records, posing a major obstacle for policy makers who say health information technology is critical to the improvement of health care quality and cost-effectiveness, according to an article published online March 25 in the New England Journal of Medicine.

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Childhood Soy Intake May Help Prevent Breast Cancer

WEDNESDAY, March 25 (HealthDay News) -- In Asian American women, high soy intake during childhood is associated with a significantly decreased breast cancer risk in adulthood, according to the results of a study published online March 24 in Cancer Epidemiology, Biomarkers & Prevention.

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Light Eating During Labor Not Linked to Adverse Effects

WEDNESDAY, March 25 (HealthDay News) -- In selected patients, consumption of a light diet during labor has no effect on obstetric or neonatal outcomes and is not associated with an increased incidence of vomiting, according to research published online March 24 in BMJ.

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Ovarian Cancer Screenings Show Low Positivity Rate

TUESDAY, March 24 (HealthDay News) -- In older women, regular screening for ovarian cancer has a low positivity rate, suggesting that existing technology is not beneficial in the detection of early cancer, according to research published in the April issue of Obstetrics & Gynecology.

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Vitamin D Insufficiency Increasing in United States

TUESDAY, March 24 (HealthDay News) -- About three out of four American adolescents and adults currently have insufficient levels of vitamin D, though oral vitamin D supplementation is effective in preventing fractures among older adults, according to two studies published in the March 23 issue of the Archives of Internal Medicine.

Abstract - Ginde
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Abstract - Bischoff-Ferrari
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Amniocentesis Linked to Loss in Twin Pregnancies

MONDAY, March 23 (HealthDay News) -- Women pregnant with twins who undergo amniocentesis may face a higher risk of pregnancy loss, according to research published in the March issue of the American Journal of Obstetrics & Gynecology.

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Prolactin Maintains Mating-Induced Prolactin Surges

MONDAY, March 23 (HealthDay News) -- Prolactin injected directly into the brains of rats can induce a prolactin secretory rhythm similar to that induced after mating, but only maintains and does not initiate mating-induced prolactin surges, according to a study published online March 12 in Endocrinology.

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Metastases in Breast Cancer Patients Should Be Tested

MONDAY, March 23 (HealthDay News) -- Treatment for breast cancer patients with metastatic disease is often changed when tests reveal discordance between the receptor status of primary and metastatic tumors, according to an article published online March 18 in the Annals of Oncology.

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Research Seeks Infertility Cause in Transgenic Mice

FRIDAY, March 20 (HealthDay News) -- In GnRHR-TAg transgenic mice, females may be infertile due to altered gonadotropin production and secretion before they even develop pituitary tumors, according to research published online March 12 in Endocrinology.

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Pregnant Women With Bowel Disease Face Higher Risks

FRIDAY, March 20 (HealthDay News) -- Pregnant women with inflammatory bowel disease have an elevated risk of developing adverse pregnancy and maternal outcomes, according to research published in the March issue of Clinical Gastroenterology and Hepatology.

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Endometrial Polyp Diameter Points to Risk of Cancer

THURSDAY, March 19 (HealthDay News) -- Among postmenopausal women without abnormal bleeding who are incidentally diagnosed with polyps, abnormal histology is only significantly associated with polyps greater than 18 mm in diameter, according to research published in the March issue of the American Journal of Obstetrics & Gynecology.

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Lymphedema Burden High After Breast Cancer

THURSDAY, March 19 (HealthDay News) -- Within two years after breast cancer treatment, a significant number of patients develop lymphedema, resulting in a greater risk of complications and increased treatment costs, according to a study published online March 16 in the Journal of Clinical Oncology.

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Premature Births Costly to American Businesses

THURSDAY, March 19 (HealthDay News) -- Employer health plans spend more than 10 times as much money to care for babies born prematurely to their employees as they do for healthy, full-term babies, according to a report issued March 17 by the March of Dimes Foundation.

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Moderate Drinking May Improve Bone Health

THURSDAY, March 19 (HealthDay News) -- In men and postmenopausal women, moderate alcohol consumption may be beneficial to bone health. In men, however, consumption of more than two drinks per day of liquor is associated with significantly lower bone mineral density, according to a study published ahead of print Feb. 25 in the American Journal of Clinical Nutrition.

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Cytomegalovirus Vaccine Shows Promise in Women

WEDNESDAY, March 18 (HealthDay News) -- A vaccine against cytomegalovirus (CMV) had a 50 percent efficacy in women of childbearing age, researchers report in the March 19 issue of the New England Journal of Medicine.

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Study Finds Imaging Exams of Pregnant Women on the Rise

WEDNESDAY, March 18 (HealthDay News) -- Imaging examinations of pregnant women at one Rhode Island medical center increased dramatically over a recent 10-year period, in particular the use of computed tomographic (CT) examinations, according to a report released online March 17 in advance of publication in the May issue of Radiology.

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Protein Excess Implicated in Ovarian Cystic Disorder

TUESDAY, March 17 (HealthDay News) -- Ovaries from women with polycystic ovarian syndrome (PCOS) produce high levels of nerve growth factor, and mice overproducing nerve growth factor in the ovaries develop cystic ovarian morphology and similar reproductive abnormalities as PCOS patients, according to research published online March 5 in Endocrinology.

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Studies Support Menopausal Breast Cancer Risk Screening

MONDAY, March 16 (HealthDay News) -- Evidence supports screening postmenopausal women for risk of breast cancer and the consideration of chemoprevention for women at high risk, as well as the use of lifestyle changes for cancer prevention, according to research published in the March 18 issue of the Journal of the National Cancer Institute.

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Periodontal Disease Treatments Lower Birth Risks

MONDAY, March 16 (HealthDay News) -- Treating pregnant women for periodontal disease lowers their risk for a preterm birth or a low birth weight infant, according to a meta-analysis of previous studies published in the March issue of the American Journal of Obstetrics & Gynecology.

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New Medication Relieves Hot Flushes in Menopause

MONDAY, March 16 (HealthDay News) -- Menopausal women who experience daily moderate to severe hot flushes can reduce the symptom by daily doses of the serotonin-norepinephrine reuptake inhibitor (SNRI) desvenlafaxine (desvenlafaxine succinate), according to research published in the March issue of the American Journal of Obstetrics & Gynecology.

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Preterm Babies at High Risk for Learning Problems

MONDAY, March 16 (HealthDay News) -- Babies born at 25 weeks' gestation or less are at high risk for learning difficulties in childhood, and the majority require some form of special educational support, according to a study published online March 12 in the Archives of Disease in Childhood - Fetal and Neonatal Edition.

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BRCA+ Women Receptive to Prophylactic Mastectomy

FRIDAY, Mar. 13 (HealthDay News) -- Women who test positive for the BRCA1 or BRCA2 mutation and are at high risk for breast cancer are more receptive to prophylactic mastectomy to reduce risk than women who test negative, according to research published in the Apr. 15 issue of Cancer.

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Biomarkers Signal Women's Rheumatoid Arthritis Risk

THURSDAY, Mar. 12 (HealthDay News) -- Elevated biomarkers of inflammation in the blood may help identify women with a higher risk of developing rheumatoid arthritis years before symptoms appear, according to study findings published in the March issue of Arthritis & Rheumatism.

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Too Much Sleep for Older Women Raises Mortality Risk

THURSDAY, Mar. 12 (HealthDay News) -- Older women who report napping daily or sleeping nine or more hours in a 24-hour period are at increased risk of mortality from all causes, with the exception of cancer, according to a study published online Feb. 10 in the Journal of the American Geriatrics Society.

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Ovarian Screening Tests Can Be Sensitive and Accurate

THURSDAY, Mar. 12 (HealthDay News) -- Ovarian screening tests comprising transvaginal ultrasound and a CA125 blood test have a high degree of sensitivity and specificity, while transvaginal ultrasound alone is also highly sensitive but lacks the specificity of the combined screening test, according to an article published online Mar. 11 in The Lancet Oncology.

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Migraines in Pregnancy Linked to Vascular Disease

WEDNESDAY, Mar. 11 (HealthDay News) -- Pregnant women who experience migraine headaches are at increased risk of stroke and vascular disease, according to research published online Mar. 10 in BMJ.

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Routine Screening of Excised Breast Tissue Can Backfire

WEDNESDAY, Mar. 11 (HealthDay News) -- Most plastic surgeons routinely send breast reduction tissue for routine histological testing, effectively screening women under the age of 50 for breast cancer without their consent, according to an article published online Mar. 10 in BMJ. Three related editorials discuss the surgical management problems, ethical dilemmas and implications for patients of such a practice.

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Editorial - Treasure
Editorial - Sugarman
Editorial - Boase

Family Docs Provide Other Diagnoses at Prenatal Visits

TUESDAY, Mar. 10 (HealthDay News) -- Family physicians were more likely to diagnose non-obstetric problems in female patients during prenatal visits than obstetricians, according to research published in the March/April issue of the Annals of Family Medicine.

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Specialists Spend Much Time on Routine Care

TUESDAY, Mar. 10 (HealthDay News) -- A substantial portion of medical specialists' office-based activity is devoted to routine and preventive care for known patients, for services that might often be handled by primary care physicians, according to research published in the March/April issue of the Annals of Family Medicine.

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No Link Between Wine and Breast Cancer Risk

MONDAY, Mar. 9 (HealthDay News) -- Higher alcohol consumption, with the exception of red and white wine, is associated with a greater risk of breast cancer, researchers report in the March issue of Cancer Epidemiology Biomarkers & Prevention.

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Patient Confidentiality Versus Disease Prevention Reviewed

MONDAY, Mar. 9 (HealthDay News) -- The morality of patient confidentiality laws are questioned in recent research presented in a special report in the March issue of The Lancet Oncology.

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Obesity Linked to Altered Ovarian Follicular Environment

FRIDAY, Mar. 6 (HealthDay News) -- An altered ovarian follicular environment may help explain why overweight and obese women have more difficulty achieving pregnancy than normal-weight women, according to research published online Feb. 17 in the Journal of Clinical Endocrinology & Metabolism.

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Compound Could Be Useful As an HIV Microbicide

FRIDAY, Mar. 6 (HealthDay News) -- The use of glycerol monolaurate to protect monkeys from infection following intravaginal exposure to simian immunodeficiency virus (SIV) points to the potential efficacy of this product against HIV in humans, according to research published online Mar. 4 in the journal Nature.

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Transdermal Patches Pose Burn Risk During Scans

FRIDAY, Mar. 6 (HealthDay News) -- The U.S. Food and Drug Administration has issued a warning about the risk of burns as a result of wearing medicated patches, such as those used for smoking cessation or pain relief, during MRI scans.

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Some Tocolytics Carry High Risk of Adverse Reactions

FRIDAY, Mar. 6 (HealthDay News) -- Pregnant women who are treated with tocolytics to postpone preterm labor may be at high risk of a serious adverse reaction to the drugs, according to research published online Mar. 5 in BMJ.

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Arm Fracture Raises Risk of Hip Fracture in Elderly Women

THURSDAY, Mar. 5 (HealthDay News) -- Elderly women who fracture their arm are at greater risk of fracturing their hip within a year, researchers report in the Mar. 1 issue of the Journal of Bone & Joint Surgery.

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Unnecessary Laparotomies Prevented in Pregnant Women

THURSDAY, Mar. 5 (HealthDay News) -- MRI can help to prevent unnecessary laparotomies in pregnant patients with suspected acute appendicitis, according to research published in the March issue of Radiology.

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Obama Wants to Spend $630 Billion on Health Care Reform

THURSDAY, Mar. 5 (HealthDay News) -- Achieving health care reform is one of President Barack Obama's major challenges, and his newly released spending plan calls on Congress to commit $630 billion over the next decade to finance that reform, according to an article published online Mar. 4 in the New England Journal of Medicine.

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Defects in Hormone Cycling After Prenatal Testosterone

THURSDAY, Mar. 5 (HealthDay News) -- Female sheep that were exposed to excess testosterone in utero have defects in reproductive hormone cycling, particularly if they become obese, researchers report in the March issue of Endocrinology. The observations may explain the anovulation observed in obese women with polycystic ovary syndrome, where excess prenatal steroid exposure may play a role in the disease.

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Testosterone Not Beneficial for Female Sexual Dysfunction

WEDNESDAY, Mar. 4 (HealthDay News) -- Hypoactive sexual desire disorder is a common condition in Western women, but evidence suggests that treatment with transdermal testosterone patches is ineffective and potentially risky, according to an article published in the March issue of the Drug and Therapeutics Bulletin.

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Marked Disparity in Incidence of Severe Maternal Morbidity

WEDNESDAY, Mar. 4 (HealthDay News) -- Significant disparity exists in the incidence of maternal morbidity among women in the United Kingdom, particularly affecting black African and Caribbean ethnic groups, according to research published Mar. 3 in BMJ Online First.

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US Motor Vehicle-Related Death Rates Vary Geographically

MONDAY, Mar. 2 (HealthDay News) -- Although the mortality rate related to motor vehicles remained almost unchanged from 1999 to 2005 in the United States, on closer inspection the data reveals wide variations from state to state, as well as by gender and ethnicity, according to a report published in the Feb. 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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