Here are what the editors at HealthDay consider to be the most important developments in OBGYN & Women's Health for May 2006. 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.
Medicare Drug Benefit Limit Linked to Mortality Risk
WEDNESDAY, May 31 (HealthDay News) -- Limiting Medicare+Choice recipients' drug benefits means lower drug costs but is associated with poorer health, according to research published in the June 1 issue of the New England Journal of Medicine.
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Decline Seen in Vaginal Birth Attempt After Caesarean
WEDNESDAY, May 31 (HealthDay News) -- Vaginal birth after Caesarean (VBAC) delivery rates have declined in California since the American College of Obstetricians and Gynecologists (ACOG) issued revised guidelines in 1999, but the associated increase in repeat Caesarean delivery has not improved neonatal and maternal mortality rates, according to a study published in the May/June issue of the Annals of Family Medicine.
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Canadians Have Better Access to Health Care Than Americans
WEDNESDAY, May 31 (HealthDay News) -- The Canadian health care system affords its citizens more equitable access to health care compared with their counterparts in the United States, thanks to universal coverage, according to a study published online May 30 by the American Journal of Public Health.
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HPV Tests More Sensitive Than Cytology for Cervical Cancer
WEDNESDAY, May 31 (HealthDay News) -- Human papillomavirus (HPV) testing may be more sensitive than cytology in detecting grade 2 or higher cervical intraepithelial neoplasia (CIN), according to a report published online in the International Journal of Cancer. The authors suggest HPV testing should replace cytology, the current standard for cervical cancer screening.
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Female Asthmatics More Likely to Be Hospitalized
TUESDAY, May 30 (HealthDay News) -- Women account for a disproportionate share of asthma-related emergency department visits and hospitalizations, suggesting a need for improved ambulatory care strategies aimed at female patients, according to a study published in the May issue of the Annals of Allergy, Asthma & Immunology.
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Few Patients Consume Major Slice of U.S. Health Care Pie
TUESDAY, May 30 (HealthDay News) -- A small percentage of the U.S. population continues to account for a disproportionate share of total U.S. health care spending for doctors, hospitals, prescription drugs and other personal health care services, according to a May report published by the U.S. Health and Human Service's Agency for Healthcare Research and Quality (AHRQ).
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Spectroscopy Plus MRI May Reduce Breast Biopsies
TUESDAY, May 30 (HealthDay News) -- Magnetic resonance (MR) spectroscopy of suspicious breast lesions may reduce the need for breast biopsy, according to a study published in the June issue of Radiology.
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Severe Chlamydia Effects Less Common Than Thought
TUESDAY, May 30 (HealthDay News) -- The incidence of severe complications of genital chlamydia in women, including ectopic pregnancy and infertility, turns out to be lower than expected, according to a study published in the May issue of Sexually Transmitted Infections.
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Assisted Reproduction Linked to Placenta Previa Risk
THURSDAY, May 25 (HealthDay News) -- Assisted reproduction technology (ART) is associated with an increased risk of placenta previa, and in some cases it is likely due to the technology itself rather than maternal factors, according to a study published online May 25 in Human Reproduction.
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Caesarean Deliveries May Cause Harm in Latin America
THURSDAY, May 25 (HealthDay News) -- In Latin America, high rates of Caesarean delivery may be associated with an increased risk of maternal and newborn illness and death, according to a study published online May 23 by The Lancet.
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Urinary FSH Appears Best for Ovarian Hyperstimulation
THURSDAY, May 25 (HealthDay News) -- Urinary follicle-stimulating hormone (FSH) appears to work better than recombinant FSH for controlled ovarian hyperstimulation in older women undergoing in vitro fertilization, according to a report in the May issue of Fertility and Sterility.
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Cystic Fibrosis Patients Show Signs of Ovarian Dysfunction
THURSDAY, May 25 (HealthDay News) -- Hormonal changes characteristic of polycystic ovary syndrome observed in women with cystic fibrosis suggest the likelihood of ovary dysfunction associated with the disease, according to a report in the May issue of Fertility and Sterility.
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Computer Screening Boosts Domestic Violence Disclosure
TUESDAY, May 23 (HealthDay News) -- A computer-based screening method may increase the odds that a female victim of domestic violence will talk to a health professional about the topic when in the emergency department, according to a report in the May 22 issue of the Archives of Internal Medicine.
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Breast MRI Cost-Effective for Some High-Risk Women
TUESDAY, May 23 (HealthDay News) -- The addition of breast magnetic resonance imaging (MRI) to mammography screening is most cost-effective for women 35 to 54 years old who carry mutations in the BRCA1 or BRCA2 genes, according to a report in the May 24/31 issue of the Journal of the American Medical Association.
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Unnecessary Tests During Physicals Could Cost Millions
TUESDAY, May 23 (HealthDay News) -- Unnecessary medical interventions during routine office visits for preventive medical exams could be costing $47 million to $194 million a year in the United States, according to a report in the June issue of the American Journal of Preventive Medicine.
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Male Partner Over 40 Contributes to IVF Failure
TUESDAY, May 23 (HealthDay News) -- Couples who choose to postpone childbearing should not only consider the age of the woman but that of the man as well, according to a report in the May issue of Fertility and Sterility that finds that when the male partner is aged 40 and older, couples are less likely to achieve a pregnancy with in vitro fertilization.
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Postmenopausal Weight Gain Linked to Breast Cancer
TUESDAY, May 23 (HealthDay News) -- Postmenopausal weight gain is associated with an increased risk of all types of breast cancer, even for women who have not used hormone replacement therapy, according to a report published online May 22 in Cancer.
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Maternal Stress Linked to Child Development
FRIDAY, May 19 (HealthDay News) -- Contrary to popular wisdom, maternal anxiety, depression and stress during pregnancy at mild-to-moderate levels may aid rather than hinder fetal maturation, according to a study published in the May/June issue of Child Development.
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Overactive Bladder Differs in Multiple Sclerosis Patients
THURSDAY, May 18 (HealthDay News) -- The urodynamics of bladder dysfunction differ in patients with multiple sclerosis compared with patients with idiopathic detrusor overactivity, according to a report in the May issue of Urology. Women with multiple sclerosis have overactive bladder contractions of a greater amplitude than other patients, which has a high predictive value in identifying multiple sclerosis, the authors say.
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Multiple HER2 Copies Affect Response to Anthracyclines
WEDNESDAY, May 17 (HealthDay News) -- Amplification of the HER2 gene or overexpression of the HER2 protein in breast cancer cells is associated with a better clinical response to anthracycline-containing chemotherapy regimens, according to a randomized study in the May 18 issue of the New England Journal of Medicine.
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Early Hearing-Impairment Detection Improves Language
WEDNESDAY, May 17 (HealthDay News) -- Language skills, but not necessarily speech, are better in school-age children if their bilateral hearing impairment is confirmed by 9 months of age (usually after detection during universal newborn screening) compared with children whose hearing impairment is confirmed after that age, according to a study published in the May 18 issue of the New England Journal of Medicine.
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Proteins Predict Breast Cancer Survival After Tamoxifen
WEDNESDAY, May 17 (HealthDay News) -- Women whose breast cancers have high expression of the estrogen receptor and low expression of p21-activated kinase 1 (Pak1) protein, which activates estrogen receptors, have better recurrence-free survival after treatment with tamoxifen, according to a report in the May 17 issue of the Journal of the National Cancer Institute.
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Three Questions Can Identify Type of Incontinence
WEDNESDAY, May 17 (HealthDay News) -- Three simple questions can enable primary care practitioners to distinguish between urge and stress incontinence in women, obviating the need for extensive evaluation, according to a study published in the May 16 issue of the Annals of Internal Medicine.
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Brain Scans Measure Lesbian Response to Pheromones
WEDNESDAY, May 17 (HealthDay News) -- A brain imaging study suggests that women who are lesbians respond to putative human pheromones with some similarity to heterosexual men rather than to heterosexual women, according to a report published online May 16 in the Proceedings of the National Academy of Sciences Early Edition.
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Statin Use Not Linked to Increased Breast Cancer Risk
TUESDAY, May 16 (HealthDay News) -- In postmenopausal women, statin use is not associated with an increased risk of breast cancer, while one class of drugs -- hydrophobic statins -- may actually reduce the risk, according to a study in the May 17 issue of the Journal of the National Cancer Institute.
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Radiation Therapy Benefits Elderly Breast Cancer Patients
TUESDAY, May 16 (HealthDay News) -- Radiation therapy can reduce the risk of cancer recurrence and mastectomies in women at least 70 years old with early-stage breast cancer, according to a report in the May 17 issue of the Journal of the National Cancer Institute.
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Working Women Report Better Health in Middle-Age
TUESDAY, May 16 (HealthDay News) -- Stay-at-home mothers tend to be heavier and to report poorer health in middle-age than working mothers, according to a study in the June issue of the Journal of Epidemiology and Community Health.
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Not All Black Cohosh Supplements Contain the Plant
MONDAY, May 15 (HealthDay News) -- Black cohosh supplements, which have become increasingly popular in the United States for the treatment of menopause symptoms, are highly variable in terms of the active compounds they contain, and even the presence of the herb itself, according to a study published in the May 17 issue of the Journal of Agricultural & Food Chemistry.
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Women with Lung Cancer Less Likely to Have COPD
FRIDAY, May 12 (HealthDay News) -- Women with newly diagnosed lung cancer are less likely to have chronic obstructive pulmonary disease (COPD) than their male counterparts with lung cancer, according to a study published in the May issue of Chest. The findings suggest that screening for lung cancer in "high risk" patients, or those with COPD, may miss cases in women.
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Frivolous Claims Account for Small Fraction of Costs
WEDNESDAY, May 10 (HealthDay News) -- The majority of resources involved in malpractice claims go toward resolving and paying those that involve errors, indicating it may be more cost-effective to streamline claims processing rather than discourage claims, according to a study in the May 11 issue of the New England Journal of Medicine.
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U.S. Hispanic Population Growing in Southern States
WEDNESDAY, May 10 (HealthDay News) -- Arkansas, Georgia, North Carolina and Tennessee have the fastest growing Hispanic populations and the highest number of live births to Hispanic mothers, according to a report published this week by the U.S. Centers for Disease Control and Prevention. Birth and fertility trends among the U.S. Hispanic population varies widely from state to state and between population subgroups.
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Tailored Chemo More Effective with Amplified Cancer Genes
WEDNESDAY, May 10 (HealthDay News) -- Breast cancer patients whose tumors have amplifications of two genes have better relapse-free survival if treated with individually tailored and dose-escalated adjuvant anthracycline-based chemotherapy, according to a report published online May 8 in the Journal of Clinical Oncology.
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Lobular Breast Cancer Can Be Managed Like Ductal Cancer
TUESDAY, May 9 (HealthDay News) -- Women with infiltrating lobular breast carcinoma who undergo breast-conserving therapy have similar outcomes as patients with the more common invasive ductal breast carcinoma and do not require more extensive preoperative evaluation, according to a study in the June 15 issue of Cancer.
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Higher Breast Cancer Risk for Long-Term Estrogen Users
TUESDAY, May 9 (HealthDay News) -- Postmenopausal women with hysterectomies who undergo long-term estrogen use have an increased risk of developing breast cancer, according to a study in the May 8 issue of the Archives of Internal Medicine.
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Off-Label Prescribing Common in Doctors' Offices
TUESDAY, May 9 (HealthDay News) -- Office-based physicians frequently prescribe drugs off-label, with approximately one-fifth of drugs prescribed in this way, often without scientific support, according to a study in the May 8 issue of the Archives of Internal Medicine.
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Many Breast Cancer Survivors Skip Mammograms
MONDAY, May 8 (HealthDay News) -- During the five years after breast cancer treatment there is a steady decline in the number of patients who receive annual mammograms, according to a study published online April 24 in the journal Cancer.
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Sentinel Lymph Nodes Can Give False Positives
FRIDAY, May 5 (HealthDay News) -- Using sentinel lymph nodes for diagnosis of invasive breast carcinoma may lead to false positive results because of the presence of benign or iatrogenically introduced epithelial cells, according to a report in the May 1 issue of the Journal of Clinical Oncology.
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High Folate Levels Increase Likelihood of Twins After IVF
FRIDAY, May 5 (HealthDay News) -- High levels of folate are associated with an increased likelihood of a twin birth after in vitro fertilization (IVF) with multiple embryo transfer, suggesting that fortifying foods with folic acid could lead to an increase in twin births after fertility treatment, according to a report in the May 6 issue of The Lancet.
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HIV Therapy Doesn't Affect Blood Glucose in Pregnancy
THURSDAY, May 4 (HealthDay News) -- HIV-infected pregnant women, whether or not they are taking protease inhibitors, are no more likely to develop glucose intolerance than HIV-negative women, according to a report published in the May issue of the Obstetrics & Gynecology.
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Vulvar, Vaginal Tumor Risk Higher in Women with HIV
THURSDAY, May 4 (HealthDay News) -- Women infected with HIV have a much higher risk of getting vulvar, vaginal or perianal cancer than women without HIV, according to a report published in the May issue of Obstetrics & Gynecology.
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Lower Cancer Recurrence for Young Women on Fenretinide
THURSDAY, May 4 (HealthDay News) -- Younger women who take the vitamin A-related drug fenretinide have a significantly reduced risk of breast cancer recurrence, according to a study published online May 4 in the Annals of Oncology.
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Teens Likely to Deny Making Virginity Pledges After Sex
THURSDAY, May 4 (HealthDay News) -- Adolescents who take virginity pledges are likely to deny having made a pledge if they break their promise of sexual abstinence, according to a study in the June issue of the American Journal of Public Health.
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Emergency Rooms Report Dire Shortage of Specialists
THURSDAY, May 4 (HealthDay News) -- About three in four emergency department directors report inadequate on-call specialist coverage at their facilities in 2005, compared with two in three directors who reported the problem in 2004, according to a new report from the American College of Emergency Physicians (ACEP).
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Persistent Disease Risk Low with Triploid Molar Pregnancy
WEDNESDAY, May 3 (HealthDay News) -- Patients with triploid molar pregnancies are at very low risk of developing persistent trophoblastic disease, according to a study published in the May issue of Obstetrics & Gynecology.
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Study Suggests 3.2 Million Annual Stillbirths Worldwide
WEDNESDAY, May 3 (HealthDay News) -- The first systematic worldwide study of stillbirth incidence indicates that there were over 3 million in 2000 alone but the number is likely an underestimate, according to a report published online May 2 in The Lancet. For various reasons, these deaths go largely unaccounted for in health surveys.
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Prior Miscarriages Up Risk for Down Syndrome, Aneuploidy
WEDNESDAY, May 3 (HealthDay News) -- Women with a history of miscarriage may have an increased risk for fetal aneuploidy including Down syndrome in subsequent pregnancies, according to a report in the May issue of Obstetrics & Gynecology.
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Better Outcomes for Sentinel Node Biopsy for Breast Cancer
WEDNESDAY, May 3 (HealthDay News) -- For women with early-stage breast cancer, a sentinel node biopsy rather than lymph node removal is associated with better arm function and quality of life, according to a study in the May 3 issue of the Journal of the National Cancer Institute.
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Incidence of In Situ Vulvar Carcinoma Rising in the U.S.
WEDNESDAY, May 3 (HealthDay News) -- There is an increasing incidence of in situ vulvar carcinoma, and incidence of the invasive form of the disease is also on the rise albeit at a slower rate, according to a study published in the May issue of Obstetrics & Gynecology.
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Risk Perception Influences Attitudes to Prenatal Testing
WEDNESDAY, May 3 (HealthDay News) -- Women's risk perception and attitudes affect their decision-making process in prenatal testing for Down syndrome and mediate the effect of racial or ethnic and socioeconomic differences, according to a study published in the May issue of Obstetrics & Gynecology.
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Non-Hormonal Options for Hot Flashes Have Drawbacks
TUESDAY, May 2 (HealthDay News) -- Non-hormonal therapies for menopausal hot flashes appear to show some efficacy, but are not as effective as estrogen and have other drawbacks, according to a meta-analysis of 43 trials published in the May 3 issue of the Journal of the American Medical Association.
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