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March 2013 Briefing - OBGYN & Women's Health

Multiple Strategies Are More Efficient for Cervical Cancer

FRIDAY, March 29 (HealthDay News) -- Multiple cervical cancer screening strategies that maximize early detection of high-grade disease without excessive increases in initial testing appear to be most effective, according to a study published in the March issue of the American Journal of Obstetrics & Gynecology.

Abstract
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Hormone Therapy Ups Breast Cancer Risk, Mortality

FRIDAY, March 29 (HealthDay News) -- Postmenopausal hormone therapy with estrogen plus progestin is associated with an increased risk of breast cancer, according to a study published online March 29 in the Journal of the National Cancer Institute.

Abstract
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Time to Pregnancy Is Linked to Neurological Dysfunction

FRIDAY, March 29 (HealthDay News) -- Increased time to pregnancy (TTP) and not fertility treatment is associated with suboptimal neurological dysfunction in 2-year-old children born to subfertile parents, according to research published online March 25 in the Archives of Disease in Childhood -- Fetal & Neonatal Edition.

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Many Uninsured Vets Will Be Eligible for Medicaid Under ACA

FRIDAY, March 29 (HealthDay News) -- A large proportion of uninsured veterans and their spouses will be eligible for Medicaid or new subsidies for coverage under the Affordable Care Act (ACA), according to a report published by the Robert Wood Johnson Foundation.

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Study Examines Physician Prescription of Teen IUDs

FRIDAY, March 29 (HealthDay News) -- Primary care physicians are more or less likely to prescribe long-acting reversible contraception such as intrauterine devices (IUDs) to adolescents based on their knowledge, skills, clinical environment, and attitudes, according to research published in the March/April issue of the Annals of Family Medicine.

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Viral DNA-Based Testing Can Triage Women With Abnormal Pap

THURSDAY, March 28 (HealthDay News) -- DNA-based testing with Hybrid Capture 2 (HC2) assay is more accurate than repeat cytology in identifying women with cervical cancer when their initial Pap smear shows atypical squamous cells of undetermined significance (ASCUS), according to research published online March 28 in The Cochrane Library.

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Study: Primary Care Extension Program Should Be Funded

THURSDAY, March 28 (HealthDay News) -- The Primary Care Extension Program (PCEP) has the potential to transform primary care and needs to be funded, according to a study published in the March/April issue of the Annals of Family Medicine.

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Using Internet Search Logs Can Help Identify Drug Interactions

THURSDAY, March 28 (HealthDay News) -- Search logs can be used to inexpensively mine for anonymized signals that may alert authorities to potential drug interactions and add new Web-scale pharmacovigilance capabilities, according to research published online March 6 in the Journal of the American Medical Informatics Association.

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Regional Variation Noted in Prevalence of Delayed Care

THURSDAY, March 28 (HealthDay News) -- There is considerable county-wide variation in the prevalence of delayed care, with high prevalence linked to a weaker health care infrastructure, according to a letter published in the March 28 issue of the New England Journal of Medicine.

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Breath Test Ties Hydrogen, Methane to Higher BMI

THURSDAY, March 28 (HealthDay News) -- There is a significant association between having both high methane and hydrogen results on a breath test and having a higher body mass index (BMI), according to a study published online March 26 in the Journal of Clinical Endocrinology & Metabolism.

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Birth Weight, Early Linear Growth Rate Affect Later Health

THURSDAY, March 28 (HealthDay News) -- In low- and middle-income countries, fast linear growth in the first two years of life is associated with increased adult height and completion of more schooling, while higher weight at birth and later in childhood is associated with increased risk of obesity, according to a study published online March 28 in The Lancet.

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Academic Urology Training Program in Crisis

THURSDAY, March 28 (HealthDay News) -- The current system of Graduate Medical Education (GME) funding is not adequate in funding urology residency programs and may lead to a significant shortage of urologists in the United States, according to research published in the March issue of Urology.

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Study Redefines the 'Optimal Time for Delivery'

THURSDAY, March 28 (HealthDay News) -- The number of fetal deaths that could be avoided by delivery is greater than the number of neonatal deaths that would be anticipated by delivery around 37 to 38 weeks' gestation, according to research published in the March issue of the American Journal of Obstetrics & Gynecology.

Abstract
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Inpatient Deaths Fell by 8 Percent in Last Decade

WEDNESDAY, March 27 (HealthDay News) -- The number of inpatient hospital deaths declined by 8 percent over the last decade, although the total number of hospitalizations increased by 11 percent during the same period, according to a March data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Texts Do Not Promote Flu Vaccination During Pregnancy

WEDNESDAY, March 27 (HealthDay News) -- Text messages encouraging pregnant women to get an influenza vaccination are ineffective, according to a study published in the April issue of Obstetrics & Gynecology. A related study in the same journal examines factors predicting influenza vaccination among pregnant women.

Abstract - Henninger
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Abstract - Moniz
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Submitting Peer-Review Reports Could Expedite Process

WEDNESDAY, March 27 (HealthDay News) -- Attaching previous peer-review reports during the next submission of the same paper to a different journal could optimize the peer-review process, according to research published in the March/April issue of the Annals of Family Medicine.

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Editorial

Smoking Has Gender-Specific Effect in Urothelial Carcinoma

WEDNESDAY, March 27 (HealthDay News) -- For patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU), the impact of smoking is gender specific, with worse outcomes for females than for males, according to a study published online March 6 in BJU International.

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Residency Reforms Reduced Duty Hours, Increased Sleep

TUESDAY, March 26 (HealthDay News) -- Additional residency reforms implemented in 2011 have reduced duty hours and increased sleep duration, but with perceived reductions in quality of patient care, according to research published online March 25 in JAMA Internal Medicine.

Abstract - Sen
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Abstract - Desai
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Age of Menarche, Menopause Linked to Cardiovascular Risk

TUESDAY, March 26 (HealthDay News) -- For Chinese women, the age of menarche and menopause is not related to the risk of diabetes, but does correlate with cardiovascular disease and osteoporosis, according to a study published online March 7 in the Journal of Clinical Endocrinology & Metabolism.

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Unintended Harmful Effects of Mammography Studied

TUESDAY, March 26 (HealthDay News) -- A false-positive test result from screening mammography is not harmless and can result in negative long-term psychosocial consequences, according to research published in the March/April issue of the Annals of Family Medicine.

Abstract
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Even the Poorest Handheld Umbrellas Can Block UV Rays

MONDAY, March 25 (HealthDay News) -- Handheld umbrellas are effective at blocking ultraviolet radiation (UVR), according to a study published online March 20 in JAMA Dermatology.

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HCV Transmission Risk Is Low in Monogamous Couples

MONDAY, March 25 (HealthDay News) -- Monogamous heterosexual couples where one partner is infected with hepatitis C virus (HCV) are at very low risk of transmitting the virus to the uninfected partner, according to a study in the March issue of Hepatology. A related study in the same journal found that the prevalence of HCV infection among newly incarcerated inmates is about 1 percent.

Abstract - Kim
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Abstract - Terrault
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Maternal Grief Linked to Baby's Congenital Heart Disease Risk

MONDAY, March 25 (HealthDay News) -- Children born to mothers who lost a close relative around the time of conception have a slightly higher risk of congenital heart disease, according to a study published online March 25 in Pediatrics.

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No Overall Survival Benefit Tied to Bilateral Oophorectomy

FRIDAY, March 22 (HealthDay News) -- At no age is there an overall survival benefit associated with bilateral oophorectomy compared with ovarian conservation at the time of hysterectomy for benign disease, according to a study published online March 6 in Obstetrics & Gynecology.

Abstract
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Laparoscopic Incisional Hernia Repair Is Effective Choice

FRIDAY, March 22 (HealthDay News) -- Laparoscopic incisional hernia repair has recurrence rates comparable with open repair, according to a study published in the March issue of JAMA Surgery.

Abstract
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Mobility Impaired May Have Difficulty Accessing Docs

FRIDAY, March 22 (HealthDay News) -- Many U.S. subspecialty practices cannot accommodate patients with mobility impairment, according to a study published in the March 19 issue of the Annals of Internal Medicine.

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Impact of Budget Sequestration on Health Care Discussed

THURSDAY, March 21 (HealthDay News) -- The impact of sequestration will have far-reaching consequences in health care, according to a perspective piece published online March 20 in the New England Journal of Medicine.

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Study Examines Impact of Minimally Invasive Surgery

THURSDAY, March 21 (HealthDay News) -- For specific types of surgery, minimally invasive procedures correlate with significantly lower health plan spending and fewer days of absence from work, compared with standard surgery, according to a study published online March 20 in JAMA Surgery.

Abstract
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Endocrine Society Urges Better Standards for Estradiol Testing

THURSDAY, March 21 (HealthDay News) -- A new position statement published by The Endocrine Society recommends that estradiol measurement assays and reference ranges be standardized and that the health care community work toward improving the accessibility of accurate estradiol testing methods; the position statement was published online March 5 in the Journal of Clinical Endocrinology & Metabolism.

Abstract
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Annual BP Checks May Improve Hypertension Identification

THURSDAY, March 21 (HealthDay News) -- For previously normotensive adults, an annual office-based hypertension screening strategy is associated with improved specificity while maintaining sensitivity, according to a study published in the March/April issue of Annals of Family Medicine.

Abstract
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Hypospadias Not Related to Organic Diet During Pregnancy

THURSDAY, March 21 (HealthDay News) -- Although no obvious relationship between organic diet during pregnancy and hypospadias has been found, frequent consumption of non-organic high-fat dairy products during pregnancy might be associated with increased odds of hypospadias, according to research published in the March issue of Urology.

Abstract
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Heart-Healthy Lifestyle Can Also Reduce Cancer Risk

THURSDAY, March 21 (HealthDay News) -- Subjects who are enrolled in the Atherosclerosis Risk in Communities (ARIC) study and are meeting goals for six to seven ideal health metrics have a 51 percent lower risk of incident cancer than those not meeting any goals for ideal health metrics, according to research published online March 18 in Circulation.

Abstract
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Effect of Immigration Status on Medicaid Eligibility Discussed

WEDNESDAY, March 20 (HealthDay News) -- Under the Affordable Care Act, a considerable proportion of low-income uninsured adults will be ineligible for Medicaid coverage due to their immigration status, and their main providers are likely to be safety-net health care providers, according to a March report published by the State Health Access Data Assistance Center.

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Molluscum Contagiosum Virus Linked to Pubic Hair Removal

WEDNESDAY, March 20 (HealthDay News) -- The incidence of sexually transmitted molluscum contagiosum virus (STMC) may be linked to hair removal in the genital area, according to a letter published online March 18 in Sexually Transmitted Infections.

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HIV Prevalence Is High Among High-Risk Heterosexuals

WEDNESDAY, March 20 (HealthDay News) -- The prevalence of HIV infection is high among low socioeconomic heterosexuals living in areas with high rates of AIDS in 2010, according to research published in the March 15 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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ER Discharge Dx/Disposition Discordant With Chief Complaint

TUESDAY, March 19 (HealthDay News) -- A considerable proportion of patients with emergency department visits with the same presenting complaint as those ultimately given a primary care-treatable diagnosis require immediate emergency care or hospital admission, according to a study published in the March 20 issue of the Journal of the American Medical Association.

Abstract
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Maternal Vitamin D Not Linked to Child Bone Mineral Content

TUESDAY, March 19 (HealthDay News) -- There is no association between maternal 25-hydroxyvitamin D (25[OH]D) concentration and bone mineral content (BMC) in offspring at age 9 to 10 years, according to a study published online March 19 in The Lancet.

Abstract
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Conflict-of-Interest Disclosures Common at 2011 AAOS Meeting

TUESDAY, March 19 (HealthDay News) -- At the 2011 American Academy of Orthopaedic Surgeons (AAOS) annual meeting, voluntarily disclosed conflicts of interest were common, especially for featured symposia, according to a study published in the March 6 issue of The Journal of Bone & Joint Surgery.

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Exercise Improves Quality of Life in Type 2 Diabetes

MONDAY, March 18 (HealthDay News) -- For people with type 2 diabetes mellitus (T2DM), a nine-month aerobic and resistance training program significantly improves quality of life (QOL) compared with no exercise, according to research published online Feb. 12 in Diabetes Care.

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USPSTF: Insufficient Evidence for ABI Screening for PAD, CVD

MONDAY, March 18 (HealthDay News) -- The U.S. Preventive Services Task Force has found that there is currently insufficient evidence to determine whether the ankle brachial index (ABI) is beneficial for screening for peripheral artery disease (PAD) and predicting the risk of cardiovascular disease.

Draft Recommendation Statement
Comment on Recommendations

Older Women Can Safely Undergo Mammography Biennially

MONDAY, March 18 (HealthDay News) -- Women 50 to 74 years old can safely undergo mammography every two years instead of annually, while women 40 to 49 years old should only undergo annual mammography if they have extremely dense breasts, according to a study published online March 18 in JAMA Internal Medicine.

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Reasons for Refusal of HPV Differ From Other Vaccines

MONDAY, March 18 (HealthDay News) -- Parents who do not have their teenagers immunized against human papillomavirus (HPV) most often say that they have safety concerns or that their child is not sexually active, which differs from their refusal of other vaccines, according to a study published online March 18 in Pediatrics.

Abstract
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Evidence Indicates Link for Shift Work, Ovarian Cancer

MONDAY, March 18 (HealthDay News) -- Shift work may be associated with an increased risk of ovarian cancer, according to a study published in the April issue of Occupational & Environmental Medicine.

Abstract
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Data Insufficient to Link Declines in Breast Cancer, HRT Use

MONDAY, March 18 (HealthDay News) -- Evidence does not definitively link the decline in the use of hormone replacement therapy (HRT) to a fall in the incidence of breast cancer, according to the last in a series of critiques published in the April issue of the Journal of Family Planning & Reproductive Health Care.

Abstract
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Commentary

Key Variables Examined in Gestational Diabetes Advance

MONDAY, March 18 (HealthDay News) -- For women with gestational diabetes mellitus (GDM), clinical and genetic factors including higher pre-pregnancy body mass index are associated with development of type 2 diabetes mellitus (T2DM), according to a study published online March 7 in the Journal of Clinical Endocrinology.

Abstract
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Robotic Surgery Not Best for Hysterectomy, ACOG Says

FRIDAY, March 15 (HealthDay News) -- Robotic surgery is not the only, the best, or the most cost-efficient method for a minimally invasive hysterectomy, according to a statement published March 14 by the American College of Obstetricians & Gynecologists (ACOG).

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Final Rule in Notice of Benefit, Payment Parameters Issued

FRIDAY, March 15 (HealthDay News) -- The final rule of the Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2014, which expands on existing standards, has been released.

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About 14 Percent of Moms Face Postpartum Depression

FRIDAY, March 15 (HealthDay News) -- About 14 percent of mothers are depressed postpartum, with a postpartum onset in most cases, and with the most common diagnosis being major depressive disorder with comorbid anxiety disorders, according to a study published online March 13 in JAMA Psychiatry.

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High-Fat Dairy Linked to All-Cause, Breast Cancer Mortality

FRIDAY, March 15 (HealthDay News) -- For women with a breast cancer diagnosis, high-fat dairy consumption is associated with a higher mortality risk, according to a study published online March 14 in the Journal of the National Cancer Institute.

Abstract
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Pharmaceutical Companies Are Reducing Promotional Spending

FRIDAY, March 15 (HealthDay News) -- Pharmaceutical companies have been reducing the amount of money they spend on promotion to consumers and providers over the past decade and spend much less to promote biologics compared with small molecule drugs, according to a study published online March 4 in PLOS ONE.

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Health Insurance Exchanges Will Mainly Be Run by Feds

FRIDAY, March 15 (HealthDay News) -- More than half of the states within the United States will allow the federal government to establish health insurance exchanges, according to a report issued by the Henry J. Kaiser Family Foundation.

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AMA Files Brief Contesting Insurer's Payment Practices

WEDNESDAY, March 13 (HealthDay News) -- A landmark case examining the question of whether physicians can bring a class arbitration against a health insurer who has underpaid them is currently before the U.S. Supreme Court, in a brief filed by the Litigation Center of the American Medical Association and State Medical Societies and the Medical Society of New Jersey.

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Wide Variation in Cesarean Rates Across U.S. Hospitals

WEDNESDAY, March 13 (HealthDay News) -- Rates of cesarean delivery vary about 10-fold across a sample of U.S. hospitals nationwide, according to a study published in the March issue of Health Affairs.

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Breastfeeding Does Not Reduce Obesity Risk at Age 11.5

TUESDAY, March 12 (HealthDay News) -- While promoting breastfeeding increases breastfeeding rates, it has no effect on the risk of overweight or obesity in children at 11.5 years of age, according to a study in the March 13 issue of the Journal of the American Medical Association.

Abstract
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Worldwide, Contraceptive Prevalence Up Since 1990

TUESDAY, March 12 (HealthDay News) -- Since 1990, contraceptive prevalence has increased worldwide and the unmet need for family planning has decreased, but the absolute number of women with a demand for contraception is likely to increase by 2015, according to a study published online March 12 in The Lancet.

Abstract
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$120 Million to Be Sequestered From Health Centers in 2013

TUESDAY, March 12 (HealthDay News) -- Budget sequestration, which is expected to reduce federal spending, is likely to result in a $120 million loss in grant funding for the nation's 1,200 community health centers in 2013, according to a report published by the Geiger Gibson/ RCHN Community Health Foundation Research Collaborative.

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PTSD Symptoms Common After Breast Cancer Diagnosis

FRIDAY, March 8 (HealthDay News) -- Following a diagnosis of breast cancer, nearly one-quarter of women report symptoms of posttraumatic stress disorder (PTSD), according to a study published online Feb. 21 in the Journal of the National Cancer Institute.

Abstract
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New Pap Guidelines May Delay Adenocarcinoma Diagnosis

FRIDAY, March 8 (HealthDay News) -- Recent revisions in national guidelines for cervical cancer screening may affect clinicians' ability to diagnosis adenocarcinoma in situ (AIS), particularly in young patients, according to a study published online March 6 in Obstetrics & Gynecology.

Abstract
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Neonatal Size Unaffected by Gestational Diabetes Drugs

FRIDAY, March 8 (HealthDay News) -- Women with gestational diabetes mellitus treated with metformin or insulin have similar changes in markers of metabolic status and no differences in offspring birth weight, according to a study published in the March issue of Diabetes Care.

Abstract
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Link for Intravaginal Insertion of Products, Bacterial Vaginosis

FRIDAY, March 8 (HealthDay News) -- Intravaginal insertion of over-the-counter products is linked to an increased risk of bacterial vaginosis, according to a study published online March 6 in Obstetrics & Gynecology.

Abstract
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Study Compares Procedures for Postmastectomy Reconstruction

WEDNESDAY, March 6 (HealthDay News) -- For patients undergoing autologous postmastectomy breast reconstruction, the rates of complications vary with different procedures, according to research published in the February issue of the Journal of the American College of Surgeons.

Abstract
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Symptom-Specific Quality of Life Up in Repeat Sling Procedure

WEDNESDAY, March 6 (HealthDay News) -- Women undergoing repeat midurethral sling procedure have a significantly increased risk of stress urinary incontinence (SUI) failure, but experience greater improvement in urinary symptom-specific quality of life (QOL) than women undergoing a primary procedure, according to research published in the February issue of Obstetrics & Gynecology.

Abstract
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Nonheme Iron Intake Linked to Reduced Risk of PMS

WEDNESDAY, March 6 (HealthDay News) -- Intake of specific minerals seem to be associated with the risk of premenstrual syndrome (PMS), with high intake of nonheme iron linked to reduced risk of PMS, according to research published online Feb. 26 in the American Journal of Epidemiology.

Abstract
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Most Docs Report Information Overload in EHR-Setting

WEDNESDAY, March 6 (HealthDay News) -- Primary care practitioners (PCPs) using electronic health records (EHRs) are susceptible to information overload and feel that the EHR notification system makes it possible to miss test results, according to a research letter published online March 4 in JAMA Internal Medicine.

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Clinical Trials Published Almost Two Years After Completion

WEDNESDAY, March 6 (HealthDay News) -- Clinical trials are published, on average, almost two years after completion, with time to publication affected by the funding source, number of trial participants, and journal impact factor, according to a research letter published online March 4 in JAMA Internal Medicine.

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Mortality Index Can Accurately Identify 10-Year Mortality Risk

TUESDAY, March 5 (HealthDay News) -- For U.S. adults older than 50 years, a 12-item mortality index can accurately detect 10-year mortality risk, according to a research letter published in the March 6 issue of the Journal of the American Medical Association.

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Diagnostic Testing Does Little to Reassure Patients

TUESDAY, March 5 (HealthDay News) -- Although further primary care visits may be reduced, diagnostic tests for symptoms with a low risk of serious illness actually do little to reassure patients, decrease their anxiety, or resolve their symptoms over the short or long term, according to research published online Feb. 25 in JAMA Internal Medicine.

Abstract
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U.K. Health Performance Worse Than Comparable Countries

TUESDAY, March 5 (HealthDay News) -- The United Kingdom has worse health performance than other comparable countries, according to a study published online March 5 in The Lancet.

Abstract
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Newborns of Obese Mothers Have Thicker Aortic Walls

TUESDAY, March 5 (HealthDay News) -- Maternal adiposity correlates with thickening of the aortic wall in newborns, according to a letter published online Feb. 27 in the Archives of Diseases of Childhood: Fetal Neonatal Edition.

Abstract
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Proportion of Black Males in U.S. Medical Schools Dropping

MONDAY, March 4 (HealthDay News) -- The proportion of black males in medical school is decreasing, according to a report published by the Association of American Medical Colleges (AAMC).

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Panel Recommends 10 Patient Safety Strategies

MONDAY, March 4 (HealthDay News) -- An expert panel is strongly encouraging the immediate adoption of 10 patient safety strategies and encouraging the adoption of a further 12, according to a supplement published in the March 5 issue of the Annals of Internal Medicine.

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Computerized Provider Order Entry System Cuts Rx Errors

MONDAY, March 4 (HealthDay News) -- Electronic prescribing through computerized provider order entry (CPOE) systems can substantially reduce medication errors in inpatient acute-care settings, according to a study published online Feb. 20 in the Journal of the American Medical Informatics Association.

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CMS Reports on Progress Toward Improved Health Care

MONDAY, March 4 (HealthDay News) -- Considerable progress has already been made toward improving the quality and delivery of health care, according to a Centers for Medicare and Medicaid Services (CMS) bulletin published online Feb. 28.

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Postpartum Anxiety More Common Than Depression

MONDAY, March 4 (HealthDay News) -- Postpartum anxiety is more common than depression in the days and months following delivery, and is associated with adverse maternal heath outcomes and reduced duration of breastfeeding, according to a study published online March 4 in Pediatrics.

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Personalized Patient-Risk Info Enhances Informed Choice

FRIDAY, March 1 (HealthDay News) -- When patients are given personalized versus generic risk information, they are better able to make genuinely informed choices about undergoing screening tests, according to research published online Feb. 28 in The Cochrane Library.

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Sequestration to Impact Health Care-Related Programs

FRIDAY, March 1 (HealthDay News) -- The $85 billion of mandatory cuts in federal spending that take effect March 1 as part of sequestration will be felt across health care and related programs, with cuts to Medicare providers and to the budgets of federal agencies.

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