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May 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 May 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.

Spectroscopy Technique Accurate in Breast Lesion Diagnosis

FRIDAY, May 31 (HealthDay News) -- A Raman spectroscopy technique can very accurately diagnose breast lesions and detect microcalcifications in core needle biopsies, according to a study published in the June 1 issue of Cancer Research.

Abstract
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Patients Like Commercial Programs for Weight Loss

FRIDAY, May 31 (HealthDay News) -- Patients view being overweight in a nonmedical context, and the use of commercial providers to manage weight loss mirrors this perspective, according to research published in the May/June issue of the Annals of Family Medicine.

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New Statement Released by Anticoagulation Forum

FRIDAY, May 31 (HealthDay News) -- The Anticoagulation Forum has endorsed a new consensus statement aimed at optimizing the delivery of anticoagulation therapy to inpatients; the statement has been published in the May issue of the Annals of Pharmacotherapy.

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Economics, Health Explain U.S. Women's Mortality Inequalities

THURSDAY, May 30 (HealthDay News) -- The widening gap in mortality across education levels seen among U.S. white women can largely be explained by economic circumstances and health behaviors, according to a study published online May 30 in the Journal of Health and Social Behavior.

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Lactobacilli May Inhibit Pathogen for Vaginal Infections

THURSDAY, May 30 (HealthDay News) -- Organisms found in the natural microbiota of the vagina, particularly lactobacilli, may influence the virulence of the pathogen that causes trichomoniasis, according to research published online May 29 in Sexually Transmitted Infections.

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Patients Who Share in Care Decisions May Up Costs of Care

THURSDAY, May 30 (HealthDay News) -- Patient preference for participating in shared decision making regarding care may increase length of hospital stays and costs of care, according to research published online May 27 in JAMA Internal Medicine.

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Editorial (subscription or payment may be required)

Odds of Mortality Up With Elective Surgery on Friday, Weekend

THURSDAY, May 30 (HealthDay News) -- For patients undergoing elective surgery, the odds of death are significantly increased for those who undergo the procedure on Friday or at the weekend, compared with Monday, according to research published online May 28 in BMJ.

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For Women, Calcium Intake Tied to Reduced Mortality Risk

THURSDAY, May 30 (HealthDay News) -- Women taking up to 1,000 mg/day of calcium supplements and with increased consumption of dietary calcium may have a reduced risk of mortality, according to a study published online May 23 in the Journal of Clinical Endocrinology & Metabolism.

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2012 AMA Report Highlights Progress Toward Better Future

THURSDAY, May 30 (HealthDay News) -- Given the changes in America's health care system and challenges facing physicians, in 2012, the American Medical Association (AMA) focused on creating a better future for the nations' patients, physicians, and medical students, according to their annual report.

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One-Third of Medical Students Have Implicit Anti-Fat Bias

THURSDAY, May 30 (HealthDay News) -- More than one-third of medical students have a significant implicit anti-fat bias that few are aware of, according to a study published in the July issue of Academic Medicine.

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Doc Passengers Assist in Half of In-Flight Medical Emergencies

WEDNESDAY, May 29 (HealthDay News) -- Physician passengers provide medical assistance in about half of in-flight medical emergencies, which are most commonly related to syncope, respiratory symptoms, or gastrointestinal symptoms, according to a study published in the May 30 issue of the New England Journal of Medicine.

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Modified Genes Present After Maternal Bariatric Surgery

WEDNESDAY, May 29 (HealthDay News) -- Children born after their mothers had bariatric surgery have gene modifications that are consistent with their reduced cardiometabolic risk, according to a study published online May 28 in the Proceedings of the National Academy of Sciences.

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Billions Can Be Saved With Pharmacy Benefit Management

WEDNESDAY, May 29 (HealthDay News) -- Efficient pharmacy benefit management, including increasing use of generic drugs and negotiation of market-based pharmacy dispensing fees, could save Medicaid programs billions of dollars nationwide in the next 10 years, according to a report prepared by the Menges Group and sponsored by the Pharmaceutical Care Management Association.

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Enrollment in U.S. Medical Colleges Is Increasing

WEDNESDAY, May 29 (HealthDay News) -- Enrollment in U.S. medical colleges is increasing, but there is concern about the adequacy of training opportunities, according to a report published by the Association of American Medical Colleges (AAMC).

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Transparency Key to Improving Value Care for Patients

WEDNESDAY, May 29 (HealthDay News) -- In order to ensure the provision of higher quality care and cost control in a post-Affordable Care Act health care system, data on price, utilization, and quality should be made publicly available unless there is a compelling publicly-acceptable justification for keeping it confidential, according to a study published online May 28 in the Annals of Internal Medicine.

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HHS: End-of-2013 Targets for EHR Use Already Reached

TUESDAY, May 28 (HealthDay News) -- The U.S. Department of Health & Human Services (HHS) has already met and exceeded its goal for 50 percent of physician offices and 80 percent of eligible hospitals to have electronic health records (EHRs) by the end of 2013, according to a report published by the department.

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USPSTF Recommends Gestational DM Screening After 24 Weeks

TUESDAY, May 28 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends use of the 50-g oral glucose challenge test (OGCT) for screening pregnant women for gestational diabetes mellitus (GDM) after 24 weeks of gestation. This Recommendation Statement is based on an evidence review published online May 28 in the Annals of Internal Medicine.

Draft Recommendation Statement
Comment on Recommendations
Background Review

ACOG Endorses CDC Vaccine Recommendations in Pregnancy

TUESDAY, May 28 (HealthDay News) -- The American College of Obstetricians and Gynecologists (ACOG) has endorsed the U.S. Centers for Disease Control and Prevention's updated guidelines for the administration of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) during pregnancy, according to a Committee Opinion published in the June issue of Obstetrics & Gynecology.

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Docs Anticipating Changes Ahead As ACA Progresses

MONDAY, May 27 (HealthDay News) -- Most physicians expect the Affordable Care Act (ACA) to continue as planned and expect further integration in the coming years, according to a report published by Deloitte.

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In Utero Smoke Exposure Ups Subsequent Health Risks

FRIDAY, May 24 (HealthDay News) -- In utero exposure to cigarette smoking puts women at higher risk of subsequently developing gestational diabetes or obesity in adulthood, according to a study published online May 23 in Diabetologia.

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Digital Breast Tomosynthesis May Improve Cancer Detection

FRIDAY, May 24 (HealthDay News) -- Digital breast tomosynthesis, which produces three-dimensional images of the breast, may be more accurate than mammography in detecting breast cancer but may also expose women to more radiation, according to a technology assessment published in the June issue of Obstetrics & Gynecology.

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Bulletin Provides Guidelines for Second-Trimester Abortion

FRIDAY, May 24 (HealthDay News) -- New evidence-based guidelines provide guidance on medical and surgical methods for second-trimester abortion and management of associated complications, according to a practice bulletin published in the June issue of Obstetrics & Gynecology.

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Overweight and Obese Are More Likely to Doctor Shop

FRIDAY, May 24 (HealthDay News) -- Doctor shopping is more likely among overweight and obese individuals and is associated with a significantly increased rate of emergency department visits, according to research published online May 13 in Obesity.

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About One in Four Uninsured Could Be Excluded From ACA

FRIDAY, May 24 (HealthDay News) -- More than one in four of those eligible for new premium assistance tax credits under the Affordable Care Act (ACA) do not have a checking account and will not be able to receive premiums from insurance companies, according to a report published by Jackson Hewitt.

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Data Support Basing Health Decisions on Both Benefit, Cost

FRIDAY, May 24 (HealthDay News) -- Person-level health care expenditures per month of health status-adjusted life expectancy are much higher for adults aged 85 years and older than for 0- to 14-year-olds, but despite spending much more on health care, the aging population gets substantially less value for that spending in terms of quality and quantity of life expectancy, according to a study published in the Spring issue of the Michigan Journal of Public Affairs.

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ACOG: Hormone Therapy Not Recommended to Prevent CHD

THURSDAY, May 23 (HealthDay News) -- Menopausal hormone therapy should not be used for prevention of coronary heart disease, according to a Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG) published in the June issue of Obstetrics & Gynecology.

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CDC: Teen Birth Rates Down From 2007 to 2011

THURSDAY, May 23 (HealthDay News) -- The rates of teenage births decreased considerably from 2007 to 2011, with the steepest decline noted among Hispanic teenagers, according to a May data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Midlife Hysterectomy Doesn't Increase Cardiovascular Risk

THURSDAY, May 23 (HealthDay News) -- A hysterectomy in midlife with or without ovarian conservation is unlikely to accelerate women's cardiovascular disease (CVD) risk, according to a study published online May 22 in the Journal of the American College of Cardiology.

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Systematic Screening of Med Adherence Will ID Barriers

WEDNESDAY, May 22 (HealthDay News) -- Implementation of systematic monitoring for medication adherence will allow for identification of barriers to adherence and tailoring of interventions, according to a viewpoint piece published in the May 22/29 issue of the Journal of the American Medical Association.

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Iodine Deficiency Has Negative Impact on Child Cognition

WEDNESDAY, May 22 (HealthDay News) -- Even mild iodine deficiency during pregnancy is associated with adverse child cognitive development, according to a study published online May 22 in The Lancet.

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CDC Presents Recent Trends in Health Behaviors of U.S. Adults

TUESDAY, May 21 (HealthDay News) -- In 2008 to 2010, the prevalence of key health behaviors among U.S. adults varied, with about one in five adults current smokers and 62.1 percent overweight or obese, according to a report presented by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

Report

Digital Divide Exists With Physician EHR Adoption

MONDAY, May 20 (HealthDay News) -- The majority of physicians remain reluctant to adopt health information technology (HIT), according to a report by Deloitte Touche Tohmatsu.

Report

Review: Exercise Indeed Beneficial for Major Depression

FRIDAY, May 17 (HealthDay News) -- For patients with major depressive disorder (MDD), exercise is beneficial as monotherapy or as an adjunct therapy, according to a review published in the May issue of the Journal of Psychiatric Practice.

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Depression Doubles Stroke Risk in Middle-Aged Women

FRIDAY, May 17 (HealthDay News) -- In middle-aged women, depression is associated with a significantly increased risk of stroke, even after adjustment for lifestyle and physiological variables, according to a study published online May 16 in Stroke.

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Many Patients Would Switch Doc to Cut Health Care Costs

THURSDAY, May 16 (HealthDay News) -- Many Americans feel that keeping out-of-pocket health care costs is more important than staying with the same primary care physician.

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Docs and Nurse Practitioners Have Different Role Perceptions

WEDNESDAY, May 15 (HealthDay News) -- There is considerable disagreement between physicians and nurse practitioners regarding the role of nurse practitioners in primary care, according to research published in the May 16 issue of the New England Journal of Medicine.

Full Text - Donelan (subscription or payment may be required)
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Overinterpretation Common in Diagnostic Accuracy Studies

WEDNESDAY, May 15 (HealthDay News) -- Roughly three in 10 diagnostic accuracy studies published in journals with impact factors of four or higher have overinterpretation, according to a review published in the May issue of Radiology.

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Combination Osteoporosis Rx Further Improves Bone Density

WEDNESDAY, May 15 (HealthDay News) -- Combination therapy with teriparatide and denosumab may be most effective in treating postmenopausal women with osteoporosis at risk for fracture, according to a study published online May 15 in The Lancet.

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Pelvic Organ Prolapse Surgery Loses Effectiveness

TUESDAY, May 14 (HealthDay News) -- In women with pelvic organ prolapse who undergo abdominal sacrocolpopexy, the failure rates increase with longer follow-up, according to a study published in the May 15 issue of the Journal of the American Medical Association.

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IOM: Health Effects of Further Lowering Sodium Unclear

TUESDAY, May 14 (HealthDay News) -- Lowering sodium levels to moderate (2,300 mg/day) seems to result in improved health outcomes, but the evidence is insufficient to assess the benefits and harms of further lowering levels, according to a review published by the Institute of Medicine.

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USPSTF Recommends Screening Adults for Alcohol Misuse

MONDAY, May 13 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends primary care screening for alcohol misuse for all adults aged 18 years and older, and further recommends providing brief counseling interventions for those who engage in risky or hazardous behavior, according to a Recommendation Statement published in the May 14 issue of the Annals of Internal Medicine.

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New FDA Survey to Assess Doc Attitudes on DTC Advertising

MONDAY, May 13 (HealthDay News) -- The U.S. Food and Drug Administration plans to conduct a new survey involving 2,000 health care professionals to examine their views on direct-to-consumer (DTC) advertising of prescription medications. The survey has been approved by the White House Office of Management and Budget.

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Even Mild Iodine Deficiency Can Affect Child's Cognition

MONDAY, May 13 (HealthDay News) -- Even mild iodine deficiency during pregnancy can have long-term adverse effects on a child's cognition, according to a study published in the May 1 issue of the Journal of Clinical Endocrinology & Metabolism.

Abstract
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'Eating More Protein' Strategy Helps Women Lose Weight

FRIDAY, May 10 (HealthDay News) -- Women who report "eating more protein" as a weight loss strategy achieve weight loss over two years, according to a study published in the May issue of the Journal of Nutrition Education and Behavior.

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Poor Service, Bedside Manner Top Patients' Online Complaints

FRIDAY, May 10 (HealthDay News) -- On "rate-your-doctor" websites, patients complain more about poor bedside manner and unprofessional office staff than inadequate medical skills, according to a recent multi-city study published by Vanguard Communications.

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Menopause Education Lacking in U.S. Residency Programs

FRIDAY, May 10 (HealthDay News) -- Formal menopause medicine training is inadequate in many American obstetrics and gynecology residency programs, according to a study published online April 29 in Menopause.

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User Satisfaction With Electronic Health Records Down

FRIDAY, May 10 (HealthDay News) -- Since 2010, there has been a decrease in the satisfaction and usability ratings for certified electronic health records (EHRs), according to survey results presented by the American College of Physicians (ACP) and AmericanEHR Partners.

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In Most States, Primary Care Medicaid Payments to Increase

THURSDAY, May 9 (HealthDay News) -- Under a health reform provision of the Affordable Care Act (ACA), primary care doctors who provide services to Medicaid patients will experience fee increases starting January 2013 for two years.

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Smartphones, Smartphone Apps Increasingly Used by Docs

THURSDAY, May 9 (HealthDay News) -- Smartphones and smartphone applications are increasingly being used in a professional capacity among physicians, according to two reports published in the March issue of Kantar Media Sources & Interactions Study-Medical/Surgical Edition.

Report 1
Report 2

HHS Releases Data on Inpatient Charges for Hospital Services

THURSDAY, May 9 (HealthDay News) -- To promote transparency in the health care system, the first part of a three-part initiative has been released by the U.S. Department of Health and Human Services (HHS). The report provides consumers with information on hospital charges and highlights the considerable variation across the country for common inpatient services.

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AAFP Member Urges Investment in Primary Care

WEDNESDAY, May 8 (HealthDay News) -- In testimony to Congress, a member of the American Association of Family Physicians (AAFP) addressed the importance of primary care and emphasized the value of increasing investment in primary care training programs.

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Application for Health Coverage Has Been Simplified, Shortened

WEDNESDAY, May 8 (HealthDay News) -- The application for health insurance coverage has been simplified and shortened, with the application reduced to three pages for individuals, according to a report released April 30 by the Centers for Medicare & Medicaid Services (CMS).

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In-Utero Exposure to Migraine Drugs May Lower Offspring IQ

TUESDAY, May 7 (HealthDay News) -- Pregnant women should steer clear of certain migraine prevention medications which have been associated with decreased IQ scores in children exposed to them in utero, according to a May 6 news release issued by the U.S. Food and Drug Administration.

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Potentially Toxic Metals Present in Lip Cosmetics

FRIDAY, May 3 (HealthDay News) -- Potentially toxic metals are present in cosmetic lip products at levels that could raise health concerns, according to a study published online May 2 in Environmental Health Perspectives.

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Self-Medicating With Alcohol Linked to Later Dependence

FRIDAY, May 3 (HealthDay News) -- Use of alcohol to self-medicate mood symptoms correlates with increased odds of subsequent alcohol dependence and persistence of dependence, according to a study published online May 1 in JAMA Psychiatry.

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Patients Most Annoyed by Long Waits, Unclear Test Results

FRIDAY, May 3 (HealthDay News) -- Long waiting times and unclear test results are the top patient grievances when it comes to visiting the doctor, according to a report published in the June issue of Consumer Reports.

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Ethical, Legal Aspects of Docs' Discrimination Discussed

FRIDAY, May 3 (HealthDay News) -- Recent examples of doctors refusing to treat certain patients on questionable grounds, including their weight, have triggered discussion of discrimination among doctors, according to a perspective piece published in the May 2 issue of the New England Journal of Medicine.

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CDC: About One in Five U.S. Adults Meets Exercise Guidelines

FRIDAY, May 3 (HealthDay News) -- In 2011, about 20 percent of U.S. adults met guidelines for both aerobic and muscle-strengthening physical activity, according to research published in the May 3 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Low Birth Weight Accounts for Part of Intellectual Disability

THURSDAY, May 2 (HealthDay News) -- Low birth weight is associated with about 10 to 15 percent of the total prevalence of intellectual disability (ID) among children who received a life-saving intervention in their first five years of life, according to a review published online April 29 in JAMA Pediatrics.

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Medicaid Coverage Doesn't Lead to Better Physical Health

THURSDAY, May 2 (HealthDay News) -- Medicaid coverage does not seem to produce improvements in measured physical health outcomes within two years, but does have some effects, including increased use of health care services and reduced financial strain, according to research published in the May 2 issue of the New England Journal of Medicine.

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Editorial (subscription or payment may be required)

Micro-, Macrovascular Changes Observed in Binge Drinkers

THURSDAY, May 2 (HealthDay News) -- Young binge drinkers have alterations in the macrocirculation and microcirculation compared with age-matched abstainers, according to a study published online May 1 in the Journal of the American College of Cardiology.

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Health Industry Payment Details to Be Publicly Available

THURSDAY, May 2 (HealthDay News) -- As part of the National Physician Payment Transparency Program and in compliance with a provision in the Affordable Care Act (ACA), the government will make information about financial relationships between doctors, teaching hospitals, and drug and device manufacturers publicly available on a new Centers for Medicare and Medicaid Services website, according to a report published by Kaiser Health News.

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Nearly One-Third Don't Pick Up New Osteoporosis Rx

THURSDAY, May 2 (HealthDay News) -- More than 30 percent of women fail to pick up new prescriptions for osteoporosis medications, according to a study published in the April issue of Osteoporosis International.

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SAMHSA: Sharp Rise in ER Visits Due to Zolpidem

WEDNESDAY, May 1 (HealthDay News) -- Issues related to the prescription sleep medication zolpidem are landing an increasing number of people in emergency departments, according to research conducted by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

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Breast Implants May Impair Breast CA Diagnosis, Prognosis

WEDNESDAY, May 1 (HealthDay News) -- Women who have received cosmetic breast implants may have an increased risk of diagnosis at a non-localized stage of breast cancer, and seem to have worse breast cancer survival, according to research published online April 30 in BMJ.

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Plan B Approved for Women 15 Years and Older Without Rx

WEDNESDAY, May 1 (HealthDay News) -- The U.S. Food and Drug Administration has approved Plan B One-Step emergency contraceptive for over-the-counter sales to women 15 years of age and older.

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