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April 2013 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 April 2013. 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.

Outcomes Often Good for Extremely Premature Infants

TUESDAY, April 30 (HealthDay News) -- About three-quarters of infants born extremely prematurely who receive active care have mild or no neurodevelopmental disability at 2.5 years of age, according to a study published in the May 1 issue of the Journal of the American Medical Association, a theme issue on child health.

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Female Smokers More Susceptible to Colon Cancer

TUESDAY, April 30 (HealthDay News) -- Female smokers seem to be more susceptible to colon cancer than male smokers, particularly to proximal colon cancer, according to a study published online April 30 in Cancer, Epidemiology, Biomarkers & Prevention.

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Comprehensive Analysis Supports SERMs for Cutting Breast Cancer

TUESDAY, April 30 (HealthDay News) -- Treatment with selective estrogen receptor modulators (SERMs) is associated with a significant reduction in the incidence of breast cancer, especially for the first five years after treatment, according to research described as the first comprehensive analysis, published online April 30 in The Lancet.

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Renewed Efforts From AAFP to Repeal OTC Provision in ACA

TUESDAY, April 30 (HealthDay News) -- Members of the American Academy of Family Physicians (AAFP) and other medical associations are urging further consideration of Section 9003 of the Patient Protection and Affordable Care Act (ACA) that requires holders of tax-preferred health care accounts to obtain a physician's prescription to use funds from those accounts to pay for over-the-counter (OTC) medications. The concerns have been laid out in a letter to the chair and the ranking member of the House Committee on Ways and Means.

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Non-Inferior Response With Two-Dose HPV Vaccine

TUESDAY, April 30 (HealthDay News) -- For girls receiving two versus three doses of human papillomavirus (HPV) vaccine, antibody responses to HPV-16 and HPV-18 are non-inferior one month after the last dose, according to a study published in the May 1 issue of the Journal of the American Medical Association, a theme issue on child health.

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USPSTF Recommends Universal HIV Screening From Age 15 to 65

MONDAY, April 29 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends screening all 15- to 65-year olds, younger and older at-risk individuals, and all pregnant women for HIV, according to a Recommendation Statement published in the April 30 issue of the Annals of Internal Medicine.

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FDA Announces New Network to Focus Exclusively on Patients

MONDAY, April 29 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of a new interactive tool for educating patients, their advocates, and consumers about the processes involved in medication development.

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Explicit Sex Materials Modestly Influence Sexual Behaviors

MONDAY, April 29 (HealthDay News) -- Consumption of sexually explicit material (SEM) has a modest, but significant, effect on sexual behaviors, according to a study published online April 26 in the The Journal of Sexual Medicine.

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AAP Issues Guidelines for Care of Infants Born at Home

MONDAY, April 29 (HealthDay News) -- Every newborn infant, including those born at home, is entitled to appropriate care, according to a policy statement issued by the American Academy of Pediatrics (AAP) and published online April 29 in Pediatrics.

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Zoledronic Acid Linked to Early Increase in Sclerostin Levels

MONDAY, April 29 (HealthDay News) -- Women with postmenopausal osteoporosis treated with zoledronic acid show an early increase in serum levels of the negative regulator of bone formation, sclerostin, that return close to baseline after 360 days, according to a study published online April 17 in the Journal of Clinical Endocrinology & Metabolism.

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Teen Moms More Likely to Be Subsequently Overweight

FRIDAY, April 26 (HealthDay News) -- Teen mothers are more likely to be overweight or obese later in life compared to women who do not give birth as a teen, according to a study published online April 15 in the American Journal of Obstetrics & Gynecology.

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Medical Interns Spending Less Time With Patients

FRIDAY, April 26 (HealthDay News) -- Medical interns are spending less time with patients and more time at a computer since new rules limiting total work hours were instituted in 2011, according to a study published online April 18 in the Journal of General Internal Medicine.

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Saturday Marks Sixth Annual Rx Drug Take-Back Day

FRIDAY, April 26 (HealthDay News) -- United States residents across the nation will have an opportunity to safely and anonymously unload expired, unwanted prescription medications on Saturday, April 27, during the sixth annual National Prescription Drug Take-Back Day.

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Post-Fracture Targeting Boosts Osteoporosis Management

FRIDAY, April 26 (HealthDay News) -- A mail-based intervention targeting patients with recent frailty fractures and their physicians is a more cost-effective means of osteoporosis management than usual care, according to a simulation-based study published online April 17 in the Journal of Clinical Endocrinology & Metabolism.

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Mindfulness-Based Cognitive Therapy Improves PTSD

FRIDAY, April 26 (HealthDay News) -- Mindfulness-based cognitive therapy (MBCT) can provide significant and clinically meaningful improvement in posttraumatic stress disorder (PTSD) symptoms, according to a pilot study published online April 17 in Depression and Anxiety.

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One-Third of Female Marathon Runners Report Breast Pain

FRIDAY, April 26 (HealthDay News) -- Approximately one-third of female marathon runners report mastalgia, according to a study published online April 19 in the British Journal of Sports Medicine.

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Risk of Delay in Response to Patient E-Mails Up Over Weekend

THURSDAY, April 25 (HealthDay News) -- The risk of delays in opening and responding to primary care patient e-mail communication is significantly worse at the weekends, according to a study published in the April/June issue of Quality Management in Health Care.

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Even Light Smoking Increases Risk of RA Among Women

THURSDAY, April 25 (HealthDay News) -- Even light smoking increases the risk of rheumatoid arthritis (RA) among women, and smoking cessation reduces but does not eliminate this risk, according to a study published online April 22 in Arthritis Research & Therapy.

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One 12-Ounce Sweet Drink a Day Ups Risk of T2DM 22 Percent

THURSDAY, April 25 (HealthDay News) -- Consumption of sweetened soft drinks correlates with the incidence of type 2 diabetes in European adults, with one 12-ounce daily increase in sweetened soft drinks correlating with a 22 percent increase in risk of the disease, according to a study published online April 25 in Diabetologia.

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Integrated 2D, 3D Mammogram Improves Cancer Detection

THURSDAY, April 25 (HealthDay News) -- Mammography with integrated two-dimensional (2D) imaging together with tomosynthesis with three-dimensional (3D) imaging is associated with improved breast cancer detection, according to a study published online April 25 in The Lancet Oncology.

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Physicians Less Empathetic in Talking to Heavy Patients

THURSDAY, April 25 (HealthDay News) -- Primary care physicians (PCPs) are less likely to bond with overweight and obese patients, according to research published online March 20 in Obesity.

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Breast CA Tx Delays Still More Common for Poor, Uninsured

WEDNESDAY, April 24 (HealthDay News) -- For young women with breast cancer, a longer treatment delay time (TDT) is associated with decreased survival, especially for African-American women, those with public or no insurance, and those with low socioeconomic status; and women with early-stage breast cancer with Medicaid are more likely to undergo mastectomy than those with private insurance, according to two studies published online April 24 in JAMA Surgery.

Abstract - Smith
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Abstract - Adepoju
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Review Looks at Best Modality for Diagnosing Ectopic Pregnancy

WEDNESDAY, April 24 (HealthDay News) -- For pregnant women with abdominal pain or vaginal bleeding, transvaginal sonography is the best modality for diagnosing ectopic pregnancy, according to research published in the April 24 issue of the Journal of the American Medical Association.

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Diagnostic Errors Are the Leading Type of Malpractice Claim

WEDNESDAY, April 24 (HealthDay News) -- In the past 25 years, diagnostic errors have been the leading type of malpractice claim and account for the highest proportion of total payments, according to a study published online April 22 in BMJ Quality & Safety.

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Maternal Use of Valproate Ups Risk of Autism in Offspring

TUESDAY, April 23 (HealthDay News) -- Prenatal exposure to valproate correlates with an increased risk of autism spectrum disorder and childhood autism in offspring, according to a study published in the April 24 issue of the Journal of the American Medical Association.

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Drop in Genital Warts in Young Women Since HPV Vaccination

TUESDAY, April 23 (HealthDay News) -- For Australian women aged 30 years or younger there has been a decrease in the proportion found to have genital warts following the introduction of the human papillomavirus (HPV) vaccine program, according to research published online April 18 in BMJ.

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Breast Density Linked to Breast Cancer-Specific Survival

TUESDAY, April 23 (HealthDay News) -- For women with breast cancer receiving adjuvant tamoxifen treatment, a decrease in mammographic density appears to be associated with improved breast cancer-specific survival, according to a study published online April 22 in the Journal of Clinical Oncology.

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Outcomes No Worse With Home Call for Surgical Interns

MONDAY, April 22 (HealthDay News) -- For surgical interns, being on call from home is not associated with increased rates of postoperative morbidity or mortality, according to a study published in the April issue of JAMA Surgery.

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Mammogram Rates Unchanged Since USPSTF Recommendations

MONDAY, April 22 (HealthDay News) -- There has been no change in mammography screening rates among women aged 40 years or older following publication of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendations, according to research published online April 19 in Cancer.

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One-Year Survival Up for Critical Congenital Heart Defects

MONDAY, April 22 (HealthDay News) -- For infants with critical congenital heart defects (CCHDs), one-year survival has improved over time, with an increased risk of mortality associated with earlier diagnosis, low birth weight, and maternal age, according to a study published online April 22 in Pediatrics.

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More Than Two-Thirds of Surgeons Are 'Employed'

FRIDAY, April 19 (HealthDay News) -- There is a substantial shift in practice environment occurring among surgeons in the United States, with more surgeons becoming employees, according to a study published in the April issue of JAMA Surgery.

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Patient Satisfaction Poor Indicator of Quality Surgical Care

FRIDAY, April 19 (HealthDay News) -- For surgical patients, satisfaction is not associated with performance on process measures or on overall hospital safety culture scores, according to a study published in the April issue of JAMA Surgery.

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Patient-Centered Decision Making Ups Health Outcomes

FRIDAY, April 19 (HealthDay News) -- Patient-centered decision making (PCDM) is associated with improved health care outcomes, according to a study published in the April 16 issue of the Annals of Internal Medicine.

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Guidelines Issued Relating to Online Medical Professionalism

THURSDAY, April 18 (HealthDay News) -- Physicians should be aware of the benefits on online media and should recognize the implications for patient confidentiality and public perception, according to a position paper published in the April 16 issue of the Annals of Internal Medicine.

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Family-Centered Teaching Rounds Good for Patients, Students

THURSDAY, April 18 (HealthDay News) -- Teaching and conducting rounds in the presence of patients and their families can be beneficial for patients and learners, according to research published online April 15 in Pediatrics.

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Relative Proportion of MRSA Increasing in S. aureus Isolates

THURSDAY, April 18 (HealthDay News) -- The relative proportion of methicillin-resistant Staphylococcus aureus (MRSA) is increasing in S. aureus isolates, and methicillin-sensitive S. aureus (MSSA) is becoming increasingly resistant to antibiotics, according to a study published in the April issue of JAMA Dermatology.

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Happiness Influenced by One's Own, Others' Sexual Activity

THURSDAY, April 18 (HealthDay News) -- Happiness is positively associated with an individual's sexual frequency and negatively associated with the sexual frequency of others, according to a study published in the February issue of Social Indicators Research.

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Essay Questions Conventional Etiology of Obesity

THURSDAY, April 18 (HealthDay News) -- To progress in the fight against obesity it is necessary to accept that there may be alternative hypotheses underlying its etiology and be prepared to invest the necessary time and resources to understand the underlying causes, according to an essay published online April 16 in BMJ.

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Community Benefit Spending Varies for Tax-Exempt Hospitals

WEDNESDAY, April 17 (HealthDay News) -- There is considerable variation in the level of community benefit expenditure by tax-exempt hospitals, according to a study published in the April 18 issue of the New England Journal of Medicine.

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Women's Hostile Attributions Up Odds of Child Maltreatment

WEDNESDAY, April 17 (HealthDay News) -- Pregnant women's hostile attributions about infants correlate with an increased risk of early child maltreatment and harsh parenting, according to a study published online April 15 in JAMA Pediatrics.

Abstract
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Low-Carb Diet Doesn't Improve Gestational Diabetes Outcomes

WEDNESDAY, April 17 (HealthDay News) -- A low carbohydrate (CHO) diet does not alter insulin needs or pregnancy outcomes in women with gestational diabetes mellitus (GDM), according to a study published online April 5 in Diabetes Care.

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Presenting Fee Data to Docs Cuts Number of Tests Ordered

WEDNESDAY, April 17 (HealthDay News) -- Presenting fee data to providers at the time of laboratory test orders is associated with a small reduction in the number of tests ordered, according to a study published online April 15 in JAMA Internal Medicine.

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Induced Abortion Rate Lower With Methotrexate Tx in RA

WEDNESDAY, April 17 (HealthDay News) -- For women with rheumatoid arthritis (RA), exposure to methotrexate is associated with a reduced risk of induced abortions, according to a study published online April 16 in Arthritis Care & Research.

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U.S. Infant Mortality Rates Down From 2005 Through 2011

WEDNESDAY, April 17 (HealthDay News) -- Infant mortality rates in the United States decreased from 2005 through 2011, according to an April data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Routine CT Imaging Can Be Used to Identify Osteoporosis

TUESDAY, April 16 (HealthDay News) -- Abdominal computed tomography (CT) imaging, conducted for other indications, can be used to identify patients with osteoporosis, according to a study published in the April 16 issue of the Annals of Internal Medicine.

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USPSTF: Offer Preventive Meds to Women at Risk of Breast Cancer

TUESDAY, April 16 (HealthDay News) -- The U.S. Preventive Services Task Force recommends that women who are at increased risk of primary breast cancer consider taking preventive medications such as tamoxifen. This Recommendation Statement is based on an evidence review published in the April 16 issue of the Annals of Internal Medicine.

Draft Recommendation Statement
Comment on Recommendations
Background Review

Family Doc Counseling Fails to Lift QoL for Abused Women

TUESDAY, April 16 (HealthDay News) -- For women identified as positive for fear of partner, counseling from trained family doctors is not associated with improved quality of life, but may reduce depression, according to a study published online April 16 in The Lancet.

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Computer-Aided Detection Tied to Increase in DCIS Diagnoses

TUESDAY, April 16 (HealthDay News) -- The use of computer-aided detection (CAD) for screening mammography has increased in prevalence and is associated with increased diagnosis of ductal carcinoma in situ (DCIS), according to a study published in the April 16 issue of the Annals of Internal Medicine.

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Endometriosis Surgery Linked to Lower Ovarian Cancer Risk

TUESDAY, April 16 (HealthDay News) -- Women who undergo surgical treatment for endometriosis have a significantly lower risk of developing ovarian cancer, according to a study published online April 8 in Acta Obstetricia et Gynecologica Scandinavica.

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Endocrine Therapy Often Incomplete after Breast Cancer

TUESDAY, April 16 (HealthDay News) -- About 25 percent of women with breast cancer either never initiate adjuvant endocrine treatment or stop treatment prematurely, according to a study published in the March issue of Breast Cancer Research and Treatment.

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Review Addresses Need for 'Sharps' Injury Prevention Efforts

TUESDAY, April 9 (HealthDay News) -- Injuries caused by needles and other sharp instruments are a major occupational hazard for health care providers, particularly surgeons, with significant health risks and cost impact, and there is a need for enhanced preventive efforts, according to a special article published in the April issue of Plastic and Reconstructive Surgery.

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4.4 mmol/L Is Optimal Fasting Glucose Cutoff for GDM Screening

MONDAY, April 15 (HealthDay News) -- A fasting plasma glucose value of 4.4 mmol/L is the optimal cut point for determining which pregnant Chinese women need a 75-g 2-h oral glucose tolerance test offered at 24 to 28 weeks' gestation, according to a study published online March 27 in Diabetes Care.

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Laparoscopic Hysterectomy Rates on Rise Over Past Decade

MONDAY, April 15 (HealthDay News) -- The rate of laparoscopic hysterectomy has greatly increased over the past decade and is now higher than that of abdominal hysterectomy, according to a study in the April issue of the American Journal of Obstetrics & Gynecology.

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Full-Term Gestational Age Tied to Development at 12 Months

MONDAY, April 15 (HealthDay News) -- For healthy full-term infants, development at age 12 months is associated with gestational age, with scores increasing for each additional week of gestation, according to a study published online April 15 in Pediatrics.

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Review Suggests Breast Cancer Screens Should Be Personalized

FRIDAY, April 12 (HealthDay News) -- Optimal breast cancer screening should be personalized for each woman and may go beyond mammography, according to a review published online April 4 in the American Journal of Medicine.

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Ectopic Pregnancy Rates Higher in Medicaid Population

FRIDAY, April 12 (HealthDay News) -- The ectopic pregnancy rate is higher among Medicaid beneficiaries than the privately insured, according to a study published in the April issue of the American Journal of Obstetrics & Gynecology.

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Blood Clot Risk in Pregnancy Is Highest With Stillbirth

THURSDAY, April 11 (HealthDay News) -- The risk of venous thromboembolism (VTE) among pregnant women is highest if they have had a stillbirth and also increases if they are obese or have conditions such as varicose veins, inflammatory bowel disease, obstetric hemorrhage, preterm delivery, or cesarean section, according to a study published online April 2 in Blood.

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ACS: Room for Improvement in Cancer Prevention, Detection

THURSDAY, April 11 (HealthDay News) -- Despite improvements in aspects of cancer prevention and early detection, more systematic efforts to reduce tobacco use and obesity, and expand the use of screening tests could prevent much of the suffering and death of cancer, according to a report published online April 11 by the American Cancer Society.

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Speech Details Practices to Improve U.S. Health Systems

THURSDAY, April 11 (HealthDay News) -- There are specific steps health care providers and policymakers should take to create high-quality, patient-centered care at lower costs, according to remarks made in an April 9 speech to the National Press Club.

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Sales Representatives Provide Inadequate Safety Information

THURSDAY, April 11 (HealthDay News) -- Pharmaceutical sales representatives (PSRs) rarely inform primary care physicians about drug safety information during sales visits, according to research published online April 10 in the Journal of General Internal Medicine.

Abstract
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Fish Oil Has No Effect on Depression in Pregnancy

THURSDAY, April 11 (HealthDay News) -- Fish oil supplements do not prevent depression in late pregnancy and postpartum in women at risk of depression, according to a study in the April issue of the American Journal of Obstetrics & Gynecology.

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LQTS Susceptibility Mutations ID'd in Intrauterine Death

WEDNESDAY, April 10 (HealthDay News) -- Missense mutations associated with long QT syndrome (LQTS) susceptibility may explain some cases of intrauterine fetal death, according to a study published April 10 in the Journal of the American Medical Association.

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Collaborative Program Can Cut Early-Term Deliveries

WEDNESDAY, April 10 (HealthDay News) -- A multistate collaborative process improvement program can reduce the rate of elective scheduled singleton early-term deliveries, according to a study published online April 5 in Obstetrics & Gynecology.

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Patients Using Different Rx Strategies to Save Money

TUESDAY, April 9 (HealthDay News) -- Adults in the U.S. who are poor or uninsured are more likely to ask for lower-cost alternatives or not to take their prescribed medications, according to research published in the April NCHS Data Brief.

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Diclegis Approved for Nausea/Vomiting in Pregnancy

TUESDAY, April 9 (HealthDay News) -- Diclegis (doxylamine succinate and pyridoxine hydrochloride) has been approved by the U.S. Food and Drug Administration to treat nausea and vomiting during pregnancy.

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Overall Alcohol Intake Not Tied to Breast CA-Specific Survival

TUESDAY, April 9 (HealthDay News) -- Moderate alcohol consumption before diagnosis of breast cancer is associated with modest improvement in disease-specific survival, although overall consumption before and after diagnosis are not linked to disease-specific survival, according to a study published online April 8 in the Journal of Clinical Oncology.

Abstract
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Federal Judge Rules FDA Must Lift Restrictions on Plan B

FRIDAY, April 5 (HealthDay News) -- The U.S. Food and Drug Administration (FDA) must lift any age and sale restrictions on Plan B One-Step and its generic versions within 30 days, a federal judge ruled today.

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Walking Reduces CHD Risk Factors as Much as Running

FRIDAY, April 5 (HealthDay News) -- Equivalent energy expenditure by moderate- or vigorous-intensity exercise is associated with similar risk reductions in coronary heart disease risk factors, according to a study published online April 4 in Arteriosclerosis, Thrombosis, and Vascular Biology.

Abstract
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Integrated Model Can Predict Preeclampsia in First Trimester

WEDNESDAY, April 3 (HealthDay News) -- An integrated model for first-trimester screening of preeclampsia (PE) seems effective in a routine care setting, according to a study published in the March issue of the American Journal of Obstetrics & Gynecology.

Abstract
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One in 5 Teen Births Is Now a Repeat Birth, Study Finds

TUESDAY, April 2 (HealthDay News) -- Despite a decline in the prevalence of repeat teen births in recent years, nearly 20 percent of all teen births are a repeat birth with significant racial/ethnical and geographical variations, according to research published April 2 in Vital Signs, a section of the Mortality and Morbidity Weekly Report, published by the U.S. Centers for Disease Control and Prevention (CDC).

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Decreased Melatonin Secretion Tied to Risk for Type 2 Diabetes

TUESDAY, April 2 (HealthDay News) -- In women, lower melatonin secretion is independently associated with a higher risk of developing type 2 diabetes, according to a study published published online April 2 in the Journal of the American Medical Association.

Abstract
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USPSTF: BRCA Testing for Women With Family History

TUESDAY, April 2 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends that BRCA1 and BRCA2 genetic testing be limited to women whose family histories are associated with an increased likelihood of having BRCA mutations.

Draft Recommendation Statement
Comment on Recommendations

Study Tracks Patterns of U.S. Cases of Anal Canal Carcinoma

TUESDAY, April 2 (HealthDay News) -- Available screening and identification of human papillomavirus likely contributed to the increased incidences of squamous cell carcinoma of the anal canal (SCCA) and anal carcinoma in situ (CIS) after 1997, according to research published online March 18 in Journal of Clinical Oncology.

Abstract
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Study Examines Timing of Sexual Activity in U.S. Teens

TUESDAY, April 2 (HealthDay News) -- For the youngest teenagers, sexual activity and pregnancy are rare, but most older teens are sexually active, according to a study published online April 1 in Pediatrics.

Abstract
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Physical Activity Improves Sleep for Menopausal Women

MONDAY, April 1 (HealthDay News) -- For women with vasomotor symptoms, greater leisure time activity and greater household physical activity are associated with more favorable sleep characteristics, according to a study published online March 25 in Menopause.

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Runners Achieve Greater Weight Loss Than Walkers

MONDAY, April 1 (HealthDay News) -- Runners lose more weight than walkers, according to a large study published in the April issue of Medicine & Science in Sports & Exercise.

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In-Person Recruitment Most Effective to Reach Moms-to-Be

MONDAY, April 1 (HealthDay News) -- In-person recruitment at hospital-based prenatal clinics produces the highest yield of early stage pregnant study participants, according to a study published online March 7 in Preventing Chronic Disease.

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Most Partners of U.S. Docs Satisfied in Their Relationships

MONDAY, April 1 (HealthDay News) -- Most spouses/partners of U.S. physicians report being satisfied with their relationships, with satisfaction linked to time spent together each day, according to research published in the March issue of the Mayo Clinic Proceedings.

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