October 2015 Briefing - OBGYN & Women's Health

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Here are what the editors at HealthDay consider to be the most important developments in OBGYN & Women's Health for October 2015. 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.

Synchronized Prescription Renewal Process Saves Time

FRIDAY, Oct. 30, 2015 (HealthDay News) -- A synchronized prescription renewal process can save physicians time and money, which can be dedicated to patient care, according to a report from the American Medical Association (AMA).

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Increasing Numbers of Med School Applicants, Enrollees

FRIDAY, Oct. 30, 2015 (HealthDay News) -- There has been a 25 percent increase in the number of medical school enrollees since 2002, with the number reaching an all-time high of 20,630 this year, according to a report published online Oct. 22 by the Association of American Medical Colleges (AAMC).

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Flu Vaccine Slightly Less Effective in Patients on Statins

THURSDAY, Oct. 29, 2015 (HealthDay News) -- Two new studies raise the possibility that statins may blunt the effectiveness of flu vaccines in seniors. The research is published online Oct. 28 in The Journal of Infectious Diseases.

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CDC: Not Enough Young Girls Getting HPV Vaccination

THURSDAY, Oct. 29, 2015 (HealthDay News) -- Human papillomavirus (HPV) vaccination rates among American girls remain too low, according to research published in the Oct. 30 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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More Prescription Opioid Addicts Are Turning to Heroin

THURSDAY, Oct. 29, 2015 (HealthDay News) -- Concurrent use of heroin and prescription opioids is increasing, according to a research letter published in the Oct. 29 issue of the New England Journal of Medicine.

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Despite Progress, Mortality Still Risk Up in Patients With T2DM

THURSDAY, Oct. 29, 2015 (HealthDay News) -- Type 2 diabetes still substantially increases mortality risk, with the degree of risk varying with age, renal complications, and glycemic control, according to research published in the Oct. 29 issue of the New England Journal of Medicine.

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CDC: E-Cigarette Use Highest Among 18- to 24-Year-Olds

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- Nearly 13 percent of American adults have tried electronic cigarettes (e-cigarettes) at least once, and 3.7 percent currently use them, according to the 2014 National Health Interview Survey by the U.S. Centers for Disease Control and Prevention.

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Women More Often Treated With Low-Dose Dabigatran

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- Women are more often treated with low-dose dabigatran, although there is a trend toward lower stroke rates with high-dose dabigatran, according to a study published online Oct. 27 in Circulation: Cardiovascular Quality and Outcomes.

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Internal Mammary Lymph Nodes ID'd on MRI Likely to Be Benign

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- Among women with breast cancer and silicone implant reconstruction, internal mammary lymph nodes (IMLNs) identified at implant-protocol breast magnetic resonance imaging (MRI) are more likely to be benign than malignant, according to a study published in the November issue of Radiology.

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Nearly 15 Percent of Plans Lack In-Network Specialists

WEDNESDAY, Oct. 28, 2015 (HealthDay News) -- A considerable proportion of federal marketplace plans lack at least one in-network specialist, according to a research letter published in the Oct. 27 issue of the Journal of the American Medical Association.

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Physician Emphasizes Importance of Saying Thank You

TUESDAY, Oct. 27, 2015 (HealthDay News) -- The importance of thanking patients for coming to see you, the physician, is described in an essay published online in Medical Economics.

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Risk of More Aggressive Ductal Carcinoma in Situ Rises With Age

TUESDAY, Oct. 27, 2015 (HealthDay News) -- Ductal carcinoma in situ (DCIS) is much more likely to be aggressive when discovered in older women, according to a report published online Oct. 27 in Radiology.

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USPSTF Urges Broader Screening for Type 2 Diabetes

TUESDAY, Oct. 27, 2015 (HealthDay News) -- Clinicians should screen overweight and obese adults between 40 and 70 years old for abnormal blood glucose levels, and should offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions, according to new recommendations from the U.S. Preventive Services Task Force. The new recommendations were published online Oct. 27 in the Annals of Internal Medicine.

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Gender Gap Appears to Continue in Cardiovascular Care

TUESDAY, Oct. 27, 2015 (HealthDay News) -- New research suggests that doctors don't warn younger women when they're at risk for cardiovascular disease as often as they warn men. And once younger women suffer an ST-segment elevation myocardial infarction (STEMI), they are less likely to receive revascularization and more likely to die in the hospital. The findings were reported in two separate studies published in the Nov. 3 issue of the Journal of the American College of Cardiology.

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MenB Vaccine Recommended for 16- to 23-Year-Olds

MONDAY, Oct. 26, 2015 (HealthDay News) -- Serogroup B meningococcal (MenB) vaccination is recommended for adolescents and young adults aged 16 to 23 years to provide short-term protection from most strains of serogroup B meningococcal disease, according to a report published in the Oct. 23 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Cellphone System Ups Glucose Self-Monitoring in Pregnancy

MONDAY, Oct. 26, 2015 (HealthDay News) -- For pregnant women with gestational diabetes mellitus or type 2 diabetes, use of a cellphone-Internet technology (CIT) system, which collects and sends glucose readings directly to a cellphone, is associated with improved compliance in self-monitoring of blood glucose (SMBG), according to a report published in the October issue of Clinical Diabetes.

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AMA: Eight Reasons for Nonadherence to Medications

FRIDAY, Oct. 23, 2015 (HealthDay News) -- Eight reasons associated with patient's intentional nonadherence to medications have been identified in a report published by the American Medical Association (AMA).

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ACOG: Operative Vaginal Delivery Remains Appropriate

FRIDAY, Oct. 23, 2015 (HealthDay News) -- Operative vaginal delivery remains an important component of modern labor management, but obstetric care providers need to be familiar with the proper use of the instruments and the risks involved, according to a practice bulletin published in the November issue of Obstetrics & Gynecology.

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Resistance Training May Cut White Matter Lesion Progression

FRIDAY, Oct. 23, 2015 (HealthDay News) -- For older community-dwelling women, engaging in progressive resistance training (RT) seems to reduce white matter lesion (WML) progression, according to a study published in the October issue of the Journal of the American Geriatrics Society.

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'Dispositional' Mindfulness May Help Ward Off Obesity

THURSDAY, Oct. 22, 2015 (HealthDay News) -- Self-awareness may help reduce the risk of obesity, according to research published online Oct. 19 in the International Journal of Behavioral Medicine.

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Case of Ovarian Hyperthecosis Described

THURSDAY, Oct. 22, 2015 (HealthDay News) -- A case of ovarian hyperthecosis has been presented in the Oct. 22 issue of the New England Journal of Medicine.

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Smoke Exposure in Infancy Ups Sensitization to Food Allergens

THURSDAY, Oct. 22, 2015 (HealthDay News) -- Exposure to secondhand tobacco smoke (SHS) in infancy is associated with increased risk of sensitization to food allergens up to age 16 years, according to a study published online Oct. 16 in Allergy.

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Many Doctors Inconsistent With HPV Vaccine Recommendations

THURSDAY, Oct. 22, 2015 (HealthDay News) -- Many physicians are inconsistent or behind schedule in their recommendations for human papillomavirus (HPV) vaccination, according to a study published online Oct. 22 in Cancer Epidemiology, Biomarkers & Prevention.

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FDA Approves Coagadex for Rare Clotting Disorder

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- Coagadex (coagulation Factor X) has been approved by the U.S. Food and Drug Administration as the first coagulation factor replacement therapy for people with a rare blood disorder known as hereditary Factor X deficiency.

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Tdap Appears Safe in Pregnancy Even With Recent Tetanus Shot

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- Even if a woman gets a tetanus-containing shot before she conceives, it is still safe to give her the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine while she is pregnant, new research indicates. The study was published in the Oct. 20 issue of the Journal of the American Medical Association.

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Cancers Differ in Indigenous, Non-Indigenous Populations

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- In Australia, New Zealand, Canada, and the United States, indigenous populations exhibit clear differences in the scale and profile of cancer compared to non-indigenous populations, according to a study published online Oct. 14 in The Lancet Oncology.

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Midlife Cardiovascular Fitness Tied to Lower Health Costs Later

WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- Higher cardiorespiratory fitness in middle age is strongly associated with lower health care costs later in life, according to a study published in the Oct. 27 issue of the Journal of the American College of Cardiology.

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Gestational, Post-Delivery Weight Gain Linked to Child's Weight

TUESDAY, Oct. 20, 2015 (HealthDay News) -- Maternal gestational weight gain (GWG) and post-delivery weight gain are independently associated with a child's weight development, according to a study published online Oct. 19 in Pediatrics.

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Preeclampsia Tied to Congenital Heart Defects

TUESDAY, Oct. 20, 2015 (HealthDay News) -- Preeclampsia may increase risk of congenital heart defects, according to research published in the Oct. 20 issue of the Journal of the American Medical Association.

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ACS: Annual Mammograms Should Start at Age 45

TUESDAY, Oct. 20, 2015 (HealthDay News) -- The American Cancer Society is delaying the recommended age when a woman should start receiving annual mammograms, based on new research that shows the average risk for breast cancer increases near menopause. The new guidelines are published in the Oct. 20 issue of the Journal of the American Medical Association.

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AAP: Alcohol Leading Preventable Cause of Birth Defects, Disability

TUESDAY, Oct. 20, 2015 (HealthDay News) -- No amount of alcohol should be considered safe to drink during any trimester of pregnancy, according to a clinical report published online Oct. 19 in Pediatrics.

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Not All Large Breast Tumors Warrant Mastectomy

MONDAY, Oct. 19, 2015 (HealthDay News) -- A combination of breast conservation surgery and radiation is as effective as breast removal for some women with large, localized invasive breast tumors, according to a study published online Oct. 19 in Cancer.

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Greater Breast CA-Specific Distress for Girls With Family Hx

MONDAY, Oct. 19, 2015 (HealthDay News) -- Girls from families with a history of breast cancer experience greater breast cancer-specific distress, according to a study published online Oct. 19 in Pediatrics.

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Review: Maternal Flu Shot Doesn't Up Congenital Anomalies

FRIDAY, Oct. 16, 2015 (HealthDay News) -- Maternal influenza vaccination is not associated with increased risk of congenital anomalies, according to a review published online Oct. 7 in Obstetrics & Gynecology.

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Hormonal Contraceptives Safe After Complete Hydatidiform Mole

FRIDAY, Oct. 16, 2015 (HealthDay News) -- The use of current hormonal contraceptives (HC) can safely prevent new conception after complete hydatidiform mole (CHM) irrespective of human chorionic gonadotropin (hCG) level, according to a study published online Oct. 7 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Treatment Patterns for DCIS Shift From 1991 to 2010

FRIDAY, Oct. 16, 2015 (HealthDay News) -- There were substantial shifts in treatment patterns for ductal carcinoma in situ (DCIS) from 1991 to 2010, with more women opting for lumpectomy and radiation therapy rather than single mastectomy, according to a study published online Sept. 30 in the Journal of the National Cancer Institute.

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Lower-Income Cancer Patients Less Likely to Participate in Trials

THURSDAY, Oct. 15, 2015 (HealthDay News) -- Lower-income patients with cancer are less likely to participate in clinical trials, according to a research letter published online Oct. 15 in JAMA Oncology.

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Safety-Net Hospitals Have Higher Costs, Worse Outcomes

THURSDAY, Oct. 15, 2015 (HealthDay News) -- Intrinsic qualities of safety-net hospitals, rather than patient characteristics, lead to inferior surgical outcomes and increased costs across nine elective surgical procedures, according to a study published online Oct. 14 in JAMA Surgery.

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Pros and Cons of Annual Physical Discussed

THURSDAY, Oct. 15, 2015 (HealthDay News) -- The pros and cons of the annual physical are discussed in two perspective pieces published online Oct. 14 in the New England Journal of Medicine.

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Community-Based Intervention Ups HIV Testing in Pregnancy

THURSDAY, Oct. 15, 2015 (HealthDay News) -- A community-based intervention that includes health education and on-site laboratory testing can increase uptake of HIV testing in pregnant women in southeast Nigeria, according to a study published online Oct. 14 in the The Lancet Global Health.

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Hysteroscopic Sterilization Tied to Higher Reoperation Risk

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Patients undergoing hysteroscopic sterilization have more than a 10-fold higher risk of undergoing reoperation compared with patients undergoing laparoscopic sterilization, though the risk of unintended pregnancy is similar, according to a study published online Oct. 13 in BMJ.

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Epidural-Related Complications Down for C-Sections

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Complications from epidural and spinal anesthetic procedures during cesarean deliveries dropped 25 percent over a recent 10-year period, according to a study published online Sept. 29 in Anesthesiology.

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Coadministering Tdap, Flu Vaccines Safe in Pregnancy

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Coadministering tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccines appears safe in pregnancy, according to a study published online Oct. 5 in Obstetrics & Gynecology.

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Cannabis Not Recommended to Prevent Post-op Nausea

WEDNESDAY, Oct. 14, 2015 (HealthDay News) -- Cannabis should not be used to prevent postoperative nausea and vomiting (PONV) because of unacceptable side effects and low effectiveness, according to a study published online Sept. 30 in Anesthesia & Analgesia.

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Racial Disparity Seen in Childbirth-Related Readmission

TUESDAY, Oct. 13, 2015 (HealthDay News) -- Black and Hispanic women have significantly higher readmission rates than white women after childbirth, according to a study published online Oct. 5 in Obstetrics & Gynecology.

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Maternal Glucose Levels Linked to Two CHD Phenotypes

TUESDAY, Oct. 13, 2015 (HealthDay News) -- Maternal midpregnancy measures of glucose and insulin are associated with two different congenital heart disease (CHD) phenotypes, according to a study published online Oct. 12 in JAMA Pediatrics.

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Advanced-Stage Breast CA More Likely in Certain Racial Groups

TUESDAY, Oct. 13, 2015 (HealthDay News) -- Women in certain racial/ethnic groups are more likely to be diagnosed with more advanced breast cancer, according to a study published online Oct. 13 in Cancer Epidemiology, Biomarkers & Prevention.

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Cancer Survivors Often Have Poor Dietary Quality

TUESDAY, Oct. 13, 2015 (HealthDay News) -- Cancer survivors tend to have worse dietary quality than the general population, according to a study published online Oct. 13 in Cancer.

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Minimally Invasive Hysterectomy May Be Underused

MONDAY, Oct. 12, 2015 (HealthDay News) -- In 2012, minimally invasive hysterectomy was underused for gynecologic cancers, according to a study published online Oct. 7 in Obstetrics & Gynecology.

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Few Physical, Socio-Emotional Outcomes for C-Section

MONDAY, Oct. 12, 2015 (HealthDay News) -- Cesarean section seems to be associated with few physical and socio-emotional outcomes, and the correlations are not consistent through childhood, according to a study published online Oct. 12 in Pediatrics.

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Hospital Factors Can Overcome 'Weekend Effect'

MONDAY, Oct. 12, 2015 (HealthDay News) -- More nurses and electronic medical records can help hospitals overcome the "weekend effect" (WE) associated with urgent general surgery procedures performed on weekends, according to a study published in the October issue of the Annals of Surgery.

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Sex May Boost Female Immune System to Aid Fertility

MONDAY, Oct. 12, 2015 (HealthDay News) -- Sex at any time in a woman's menstrual cycle may trigger immune system changes that boost the likelihood of getting pregnant, a new study suggests. The findings were published recently in the journals Fertility and Sterility and Physiology and Behavior.

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Americans Spend More on Health Care, but Fare Worse

MONDAY, Oct. 12, 2015 (HealthDay News) -- When compared to 12 other industrialized nations, Americans spend more on health care services, but they fare worst in terms of life expectancy, according to recent findings from The Commonwealth Fund.

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Occupational Risk of Bladder Cancer on the Rise

FRIDAY, Oct. 9, 2015 (HealthDay News) -- Despite efforts by lawmakers and manufacturers to protect workers and provide safe working environments, the risk of bladder cancer is still rising in certain industries, according to a review published online Oct. 8 in JAMA Oncology.

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Young Cancer Survivors May Need Lifelong Screenings

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Teen and young adult cancer survivors are at increased risk for other cancers later in life, according to a study published online Oct. 6 in Cancer.

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Substantial Proportion of Revisits Post Ambulatory Sx Occur in ER

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Acute care revisits occur with considerable frequency among low-risk patients undergoing ambulatory operations, with a substantial proportion of revisits occurring in emergency departments, according to a research letter published in the Oct. 6 issue of the Journal of the American Medical Association.

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Bariatric Surgery Can Lead to Increased Suicide Risk

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Some patients who have bariatric surgery may be more likely to attempt suicide following the procedure, according to a study published online Oct. 7 in JAMA Surgery.

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Early Detection Still Key to Breast Cancer Survival

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Even with recent strides in breast cancer treatment, a woman's chances of surviving the disease still partly depend on early detection, according to research published online Oct. 6 in The BMJ.

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Being Overweight Helps Women With Heart Failure, but Not Men

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Overweight and mildly obese women with heart failure may live significantly longer than similarly heavy men with the progressive disease, according to a study published Oct. 7 in JACC: Heart Failure.

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Most Cancer Patients Believe Surgery Will Be Curative

THURSDAY, Oct. 8, 2015 (HealthDay News) -- Most patients undergoing surgery for lung or colorectal cancer believe that the surgery is likely to be curative, according to a study published in the Oct. 15 issue of Cancer.

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Ovarian Tissue Transplant Can Up Fertility Post Cancer Tx

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- For cancer survivors, ovarian tissue transplants are safe and effective and pose little risk of cancer recurrence, according to a report published online Oct. 6 in Human Reproduction.

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CDC: Hospitals Doing Better Job of Promoting Breastfeeding

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- U.S. hospitals have made significant improvements to breastfeeding support programs in recent years, providing better help to new mothers, federal health officials reported Tuesday.

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Prognostic Disclosure Improves Life Expectancy Estimates

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- Prognostic disclosure is associated with more realistic patient expectations of life expectancy (LE) in advanced cancer, according to a study published online Oct. 5 in the Journal of Clinical Oncology.

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Low Income, Minority Status Affect Medical Care Wait Times

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- Blacks and Hispanics spend approximately 25 percent more time seeking health care than whites, and patients also spend more time in a doctor's waiting room if they're unemployed, in a low-paying job, or never attended college, according to research published online Oct. 5 in JAMA Internal Medicine.

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3D Modeling Assists Evaluation of Complex Fetal Anatomy

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- For the first time, three-dimensional (3D) printing technology has been used in utero to diagnose facial deformity and severity of airway risk with a newborn, according to a report published online Oct. 5 in Pediatrics.

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Ultrasound Diagnosis of Fetal Teratoma Very Accurate

WEDNESDAY, Oct. 7, 2015 (HealthDay News) -- Ultrasonography (US) has very high sensitivity and low false-positive rates in identifying fetal teratoma prenatally, according to a study published online Oct. 1 in the Journal of Clinical Ultrasound.

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Guidelines Developed for Managing Conflicts of Interest

TUESDAY, Oct. 6, 2015 (HealthDay News) -- The Guidelines International Network has developed principles for disclosure and management of conflicts of interest (COIs) during the clinical practice guideline development process, according to a report published in the Oct. 6 issue of the Annals of Internal Medicine.

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USPSTF Recommends CRC Screening for 50- to 75-Year-Olds

TUESDAY, Oct. 6, 2015 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends colorectal cancer (CRC) screening starting at age 50 years and continuing through age 75 years. These findings form the basis of a draft recommendation statement, published Oct. 5 by the USPSTF.

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β-Blockers May Up Risk of Surgical Complications for Some

MONDAY, Oct. 5, 2015 (HealthDay News) -- Patients taking β-blockers may face heightened risks of cardiovascular complications during non-cardiac surgeries, according to a large study published online Oct. 5 in JAMA Internal Medicine.

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Flu Vaccine Benefits Extend to Fewer Pneumonia Admissions

MONDAY, Oct. 5, 2015 (HealthDay News) -- Influenza vaccination can substantially reduce the risk of hospitalizations for influenza pneumonia, according to research published online Oct. 5 in the Journal of the American Medical Association.

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Menstrual Preconditioning May Prevent PCOS-Tied Complications

MONDAY, Oct. 5, 2015 (HealthDay News) -- Menstrual preconditioning could prevent major obstetrical syndromes in women with polycystic ovary syndrome (PCOS), according to a clinical opinion piece published in the October issue of the American Journal of Obstetrics & Gynecology.

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Modified SOAP Ups Student Awareness of Health Care Costs

MONDAY, Oct. 5, 2015 (HealthDay News) -- Modification of the traditional Subjective-Objective-Assessment-Plan (SOAP) presentation to consider value (SOAP-V) can help medical students learn to practice high-value, cost-conscious care, according to a study published online Sept. 28 in the Journal of Hospital Medicine.

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Providers Must Understand Legal Limits of Telemedicine

FRIDAY, Oct. 2, 2015 (HealthDay News) -- In order to minimize risk when practicing telemedicine, providers should ensure they hold the proper medical licenses, have medical liability insurance coverage, and communicate with patients regarding the potential risks of telemedicine, according to a report published in Medical Economics.

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Strategies Provided for Improving EHR Efficiency

THURSDAY, Oct. 1, 2015 (HealthDay News) -- Several strategies can be implemented in order to better use electronic health records (EHRs) for patient care and efficiency, according to an article published in Medical Economics.

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'Low-Nicotine' Cigarettes May Help Smokers Quit, Smoke Less

THURSDAY, Oct. 1, 2015 (HealthDay News) -- Smokers are more likely to cut back or quit if they switch to cigarettes made from tobacco containing very low levels of nicotine, new research shows. The findings were published in the Oct. 1 issue of the New England Journal of Medicine.

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Too Few Women Getting Counseling Before BRCA Test

THURSDAY, Oct. 1, 2015 (HealthDay News) -- Only about one-third of women receive genetic counseling before they undergo testing for BRCA mutations, and patients who receive genetic counseling beforehand display better knowledge of the process and possible results, according to a study published online Oct. 1 in JAMA Oncology.

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Integrative Model Is Advised for Cancer Control in Primary Care

THURSDAY, Oct. 1, 2015 (HealthDay News) -- An integrative model incorporating cancer care into primary care is recommended for addressing the increasing burden of cancer control, according to a commission piece published online Sept. 29 in The Lancet Oncology.

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Adjuvant Hormone Tx Ups Survival in Epithelial Ovarian CA

THURSDAY, Oct. 1, 2015 (HealthDay News) -- For women with epithelial ovarian cancer, adjuvant hormone therapy (AHT) for five years is associated with improved survival, according to a study published online Sept. 28 in the Journal of Clinical Oncology.

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