April 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 April 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.

Collaborative Program Reduces Unnecessary C-Section Rates

THURSDAY, April 30, 2015 (HealthDay News) -- Fewer pregnant women had cesarean section births in Canadian hospitals that took part in a C-section review program, a new study reports. The findings were published in the April 30 issue of the New England Journal of Medicine.

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Age-, Sex-Specific Thresholds Should Guide Statin Therapy

THURSDAY, April 30, 2015 (HealthDay News) -- Use of age- and sex-specific cardiovascular disease (CVD) risk thresholds could improve the sensitivity and specificity of statin treatment recommendations, according to a study published in the April 28 issue of the Journal of the American College of Cardiology.

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Sodium Nitrate, Citric Acid Effective for Anogenital Warts

THURSDAY, April 30, 2015 (HealthDay News) -- For patients with anogenital warts, high-dose topical treatment (sodium nitrite, 6 percent, with citric acid, 9 percent) is more effective than placebo, according to a study published online April 29 in JAMA Dermatology.

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Study Looks at Variability in Measures of Breast Density

THURSDAY, April 30, 2015 (HealthDay News) -- Volpara and Quantra algorithms have the lowest variability in repeated measures of breast density, according to a study published in the May issue of Radiology.

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Breastfeeding Linked to Better Breast Cancer Outcomes for Mom

WEDNESDAY, April 29, 2015 (HealthDay News) -- Women who breastfeed their babies and later develop breast cancer are less likely to have the cancer return or be terminal than women who do not breastfeed, new research shows. The study was published online April 28 in the Journal of the National Cancer Institute.

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Colon Cancer Risk Markers Appear Within Two Weeks of Diet Change

WEDNESDAY, April 29, 2015 (HealthDay News) -- Westernization of the diet induces changes in biomarkers of colon cancer risk within two weeks, according to research published online April 28 in Nature Communications.

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WHO Offers Evidence-Based Folate Concentration Guidelines

WEDNESDAY, April 29, 2015 (HealthDay News) -- Evidence-based folate concentration guidelines for the prevention of neural tube defects (NTDs) have been developed by the World Health Organization (WHO), according to a report published in the April 24 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Worse Working Memory in Women Versus Men Post Mild TBI

TUESDAY, April 28, 2015 (HealthDay News) -- New research from Taiwan uncovers more evidence that women may have a more difficult time recovering their memory after concussions. The study appears online April 28 in Radiology.

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Physician Compensation Up for Most Specialties

TUESDAY, April 28, 2015 (HealthDay News) -- Physician compensation has gone up for almost all specialties, according to a 2015 report published by Medscape.

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CDC: Surveillance System Can Help Reduce Health Care Injuries

TUESDAY, April 28, 2015 (HealthDay News) -- A surveillance system for health care facilities can be used to identify and help reduce the number of preventable injuries among health care personnel, according to research published in the April 24 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Office Visits Common Before Suicide Attempt

MONDAY, April 27, 2015 (HealthDay News) -- Many people who attempt suicide have a health care visit in the weeks or months beforehand, which suggests health visits may provide opportunities for suicide prevention, researchers report in a new study published in the May issue of Medical Care.

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Over Half of Middle-Age, Older Americans Take Daily Aspirin

MONDAY, April 27, 2015 (HealthDay News) -- Slightly more than half of middle-aged adults and seniors in the United States take aspirin daily, with most taking it for primary prevention, according to survey findings published in the May issue of the American Journal of Preventive Medicine.

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AAP: Updated Guidelines on Newborn Hospital Release

MONDAY, April 27, 2015 (HealthDay News) -- The American Academy of Pediatrics (AAP) has just released updated guidelines for judging whether or not a newborn is ready for hospital discharge. The guidelines are published online April 27 in Pediatrics.

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Early Benefits for Quadrivalent HPV Vaccine in Canadian Teens

MONDAY, April 27, 2015 (HealthDay News) -- Quadrivalent human papillomavirus (qHPV) vaccination for young girls is associated with reduced incidence of dysplasia and anogenital warts (AGW), according to a study published online April 27 in Pediatrics.

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Focus on Calories Versus Quality of Food Misdirected

FRIDAY, April 24, 2015 (HealthDay News) -- All calories are not created equal and some foods are not as bad for weight management as many believe, according to new research published online April 8 in the American Journal of Clinical Nutrition.

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National Health Alert Issued Over HIV Outbreak in Indiana

FRIDAY, April 24, 2015 (HealthDay News) -- With opioid abuse now linked to 142 cases of HIV in rural Indiana, U.S. health officials are alerting other states to watch for clusters of HIV and hepatitis C among injection drug users.

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Less Urinary Incontinence After Total Abdominal Hysterectomy

FRIDAY, April 24, 2015 (HealthDay News) -- At five years after surgery, women undergoing subtotal abdominal hysterectomy (SAH) were more likely to have urinary incontinence (UI) than those undergoing total abdominal hysterectomy (TAH), according to a study published in the May issue of BJOG: An International Journal of Obstetrics and Gynaecology.

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Oophorectomy Linked to Better Survival in BRCA1 Breast Cancer

THURSDAY, April 23, 2015 (HealthDay News) -- Oophorectomy is associated with a decrease in mortality in women with breast cancer and a BRCA1 mutation, and women with estrogen receptor-negative breast cancer and a BRCA1 mutation should undergo the procedure shortly after diagnosis, according to research published online April 23 in JAMA Oncology.

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Self-Reported Health Predicts Survival in Breast Cancer

THURSDAY, April 23, 2015 (HealthDay News) -- For older women with breast cancer, low self-rated health (SRH) and limited walking ability predict worse all-cause survival at five and 10 years, according to a study published in the April issue of the Journal of the American Geriatrics Society.

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Abridged Standards of Care for Diabetes Developed for PCPs

THURSDAY, April 23, 2015 (HealthDay News) -- An abridged version of the 2015 Standards of Medical Care in Diabetes has been produced for primary care physicians. The condensed guidelines were published in the April issue of Clinical Diabetes.

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EHR Data Mining Helps With Quality Improvement

WEDNESDAY, April 22, 2015 (HealthDay News) -- Electronic health records (EHRs) are a valuable source of data that can be mined to help practices with quality improvement performance, according to a study published in Medical Economics.

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Eating Disorders Common in Girls With Type 1 Diabetes

WEDNESDAY, April 22, 2015 (HealthDay News) -- For girls and young women with type 1 diabetes, eating disorders are common and persistent, according to a study published online April 17 in Diabetes Care.

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Review Examines Salpingectomy Alone for Cutting Ovarian CA Risk

WEDNESDAY, April 22, 2015 (HealthDay News) -- Salpingectomy alone may be a risk management option for women at hereditary risk of ovarian cancer, according to a review published in the May issue of Cancer Prevention Research.

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EHR Decision Support Ups Radiologic Test Appropriateness

TUESDAY, April 21, 2015 (HealthDay News) -- Computerized clinical decision-support (CCDS) capabilities of electronic health records may improve appropriate use of diagnostic radiologic test ordering and reduce test use, according to a review published in the April 21 issue of the Annals of Internal Medicine.

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AHA Issues Guidelines for Adults With Congenital Heart Dz

TUESDAY, April 21, 2015 (HealthDay News) -- The American Heart Association (AHA) has issued guidelines for health care providers treating patients older than 40 with congenital heart disease. The guidelines were published online April 20 in Circulation.

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USPSTF Revisits Mammography Guidelines

TUESDAY, April 21, 2015 (HealthDay News) -- Women in their 40s should talk with their doctors and then decide for themselves whether they need regular mammograms to screen for breast cancer before age 50, according to draft U.S. federal health guidelines.

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Guidance Offered for Managing Conflict With Patients

MONDAY, April 20, 2015 (HealthDay News) -- Good communication is key to managing conflict with patients, according to an article published April 1 in Medical Economics.

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Suboptimal Prescribing Attitudes Could Signal Personal Distress

FRIDAY, April 17, 2015 (HealthDay News) -- Medical students in personal distress may be more likely to have suboptimal attitudes about self-prescribing and personal responsibility for reporting impaired colleagues, according to a study published in the April issue of Academic Medicine.

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Apple HealthKit App Facilitates Doctor-Patient Communication

THURSDAY, April 16, 2015 (HealthDay News) -- The latest version of Apple's operating system iOS 8 allows physicians to connect with patients in many ways using the HealthKit app that collects user health and fitness data, according to an article published in Medical Economics.

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Ethical Implications for Looking Up Applicants on Facebook

THURSDAY, April 16, 2015 (HealthDay News) -- Looking up students on Facebook and other social networking sites (SNS) is associated with ethical concerns, according to a perspective piece published in the March issue of the Journal of Graduate Medical Education.

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Medicare Spending Down in Year One of Pioneer ACO

THURSDAY, April 16, 2015 (HealthDay News) -- Medicare spending is down in year one of the Pioneer accountable care organization (ACO) program, according to a study published online April 15 in the New England Journal of Medicine.

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AMA Announces End of Sustainable Growth Rate Formula

WEDNESDAY, April 15, 2015 (HealthDay News) -- Recently adopted legislation has repealed the sustainable growth rate (SGR) formula, according to a report published by the American Medical Association (AMA).

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Divorce Tied to Increased Risk of Acute Myocardial Infarction

WEDNESDAY, April 15, 2015 (HealthDay News) -- People who divorce face a higher risk of acute myocardial infarction (AMI) than those who remain married, but remarriage may not be the remedy, at least not for women, according to a new study published online April 14 in Circulation: Cardiovascular Quality and Outcomes.

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Survey Looks at Patient Attitudes Regarding Informed Consent

WEDNESDAY, April 15, 2015 (HealthDay News) -- Most U.S. adults would prefer to be asked for permission to participate in studies assessing usual medical practices, according to a study published online April 14 in the Annals of Internal Medicine.

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Gestational Diabetes May Increase Risk of Autism

TUESDAY, April 14, 2015 (HealthDay News) -- Gestational diabetes may increase the risk a child will develop autism, according to research published in the April 14 issue of the Journal of the American Medical Association.

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Security Breaches of Health Records Up Over Past Decade

TUESDAY, April 14, 2015 (HealthDay News) -- Breaches in data security exposed more than 29 million health records to potential criminal misuse between 2010 and 2013, according to a new study. Security breaches involving hacking have nearly doubled in recent years, rising to 8.7 percent in 2013 compared with 4.7 percent in 2010, according to the study, published as a research letter in the April 14 issue of the Journal of the American Medical Association.

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Placebo Response May Depend on Individual DNA

TUESDAY, April 14, 2015 (HealthDay News) -- The strength of the placebo effect may depend on particular DNA, according to a report published online April 13 in Trends in Molecular Medicine.

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USPSTF Review: T2DM Screening Doesn't Cut Mortality

TUESDAY, April 14, 2015 (HealthDay News) -- Type 2 diabetes screening is not associated with improved mortality rates after 10 years of follow-up, according to a U.S. Preventive Services Task Force (USPSTF) review published online April 14 in the Annals of Internal Medicine.

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Single-Dose Injection Rx Ups Bone Density in Frail Elderly

MONDAY, April 13, 2015 (HealthDay News) -- Frail, older women may only need a single dose of the osteoporosis drug zoledronic acid (Reclast) to build bone strength, a new study suggests. But greater bone density did not translate into fewer fractures among these high-risk women, who were living in nursing homes and assisted-living facilities during the study. The research was published online April 13 in JAMA Internal Medicine.

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Most Hospitalists Would Not Order Inpatient Mammography

MONDAY, April 13, 2015 (HealthDay News) -- Most hospitalists feel that they should not be involved in breast cancer screening, according to a study published in the April issue of the Journal of Hospital Medicine.

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Medical Debt Burden Higher in Texas, Florida

FRIDAY, April 10, 2015 (HealthDay News) -- Significantly more adults in Florida and Texas struggle to pay medical bills or pay off medical debt over time compared with residents of New York and California, according to a new Commonwealth Fund report released Friday.

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Many Doctors Haven't Started Dealing With ICD-10 Revision

FRIDAY, April 10, 2015 (HealthDay News) -- Most physicians have barely begun to deal with issues relating to documentation associated with the transition to the International Classification of Diseases, 10th Revision (ICD-10), according to an article published in Medical Economics.

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Art Program Hones Med Students' Visual Observation Skills

FRIDAY, April 10, 2015 (HealthDay News) -- An innovative interdisciplinary program, Art Rounds, is effective for improving medical and nursing students' physical observation skills, according to a study published in the April issue of the Journal of Nursing Education.

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Maternal C-Type Natriuretic Peptide Tied to Pre-Eclampsia

FRIDAY, April 10, 2015 (HealthDay News) -- Levels of maternal plasma amino terminal propeptide of C-type natriuretic peptide (NTproCNP) may be useful in defining phenotypes associated with pre-eclampsia in late pregnancy, according to a study published online April 5 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Three-Drug Combo Cream Effective for Melasma

FRIDAY, April 10, 2015 (HealthDay News) -- A cream formula containing 4 percent hydroquinone, 10 percent glycolic acid, and 0.01 percent hyaluronic acid is very effective in the treatment of melasma, according to a study published online April 6 in the Journal of Cosmetic Dermatology.

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Migraine Medication Linked to Eating Disorders in Teens

THURSDAY, April 9, 2015 (HealthDay News) -- Topiramate (Topamax) used for migraine headaches has been linked to increased odds of eating disorders in some teens. The report was published online April 6 in Pediatrics.

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Candy Twists Alternative to Glucola Drink for GDM Screening

THURSDAY, April 9, 2015 (HealthDay News) -- Candy twists can be used as an alternative to glucola beverage in gestational diabetes mellitus screening, according to a study published in the April issue of the American Journal of Obstetrics & Gynecology.

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Pharmacists Raise Concerns for Patient Access to Generic Drugs

THURSDAY, April 9, 2015 (HealthDay News) -- Nearly all pharmacists have experienced upswings in the acquisition costs of generic drugs, with price spikes reported to be worse since 2013, according to a report published by the National Community Pharmacists Association (NCPA).

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Higher Risk of Heart Disease Seen With Shorter Stature

THURSDAY, April 9, 2015 (HealthDay News) -- Short people may be more likely to have coronary artery disease (CAD), and that increased risk could be linked to the genetics that also determine height, new research suggests. The study was published online April 8 in the New England Journal of Medicine.

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High Costs for False-Positive Mammograms, Overdiagnosis

THURSDAY, April 9, 2015 (HealthDay News) -- Mammography screening is associated with considerable costs linked to false-positive mammograms and breast cancer overdiagnosis, with national expenditure estimated at $4 billion annually, according to a study published in the April issue of Health Affairs.

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Internet-Based CBT Helps Women With Fear of Childbirth

WEDNESDAY, April 8, 2015 (HealthDay News) -- An Internet-based cognitive behavioral therapy (ICBT) program can improve attitudes among nulliparous women with severe fear of childbirth, according to a study published online March 27 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Less Depression Reported by Black Women

WEDNESDAY, April 8, 2015 (HealthDay News) -- Black women are much less likely to report suffering from depression than white women, a new study suggests. The findings were published online April 8 in JAMA Psychiatry.

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CDC: Long-Acting Contraceptive Use Rising Among U.S. Teens

WEDNESDAY, April 8, 2015 (HealthDay News) -- The use of long-acting, reversible forms of contraception remains low among sexually active teen girls, though that trend seems to be changing, according to research published in the April 7 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Websites Offer Poor Information About C-Section

WEDNESDAY, April 8, 2015 (HealthDay News) -- The quality and completeness of Internet information about cesarean sections is poor, according to a Brazilian study published in the April issue of BJOG: An International Journal of Obstetrics and Gynaecology.

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Limited Time Available to Review Sunshine Act Data

WEDNESDAY, April 8, 2015 (HealthDay News) -- Physicians have only 45 days to review and dispute reports regarding their financial ties to drug and medical device manufacturers reported under the Physician Payments Sunshine Act, according to the American Medical Association (AMA).

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Breast, Ovarian CA Risk Varies With BRCA Mutation Location

TUESDAY, April 7, 2015 (HealthDay News) -- The risk of breast and ovarian cancer varies with the type and location of BRCA1/2 mutations, according to a study published in the April 7 issue of the Journal of the American Medical Association.

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Breast CA Patients Want, but May Not Get, Genetic Risk Discussion

TUESDAY, April 7, 2015 (HealthDay News) -- Although many women with breast cancer are concerned about their genetic risk for other cancers -- as well as their relatives' risk for breast cancer -- almost half of these patients don't get information about genetic testing, according to a study published online April 6 in the Journal of Clinical Oncology.

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More Expensive Breast Cancer Tx Tied to Improved Survival

TUESDAY, April 7, 2015 (HealthDay News) -- More expensive breast cancer treatments are linked to a greater chance of survival, new research suggests. The study was published in the April issue of Health Affairs.

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Two Commercial Weight Loss Plans Come Out on Top

TUESDAY, April 7, 2015 (HealthDay News) -- Only two out of 32 major commercial weight-loss programs marketed nationwide -- Weight Watchers and Jenny Craig -- can boast scientific evidence showing their clients maintain weight loss for at least a year, according to a new study published in the April 7 issue of the Annals of Internal Medicine.

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Med Students, Residents Rarely Perform Stethoscope Hygiene

TUESDAY, April 7, 2015 (HealthDay News) -- Stethoscope hygiene is rarely performed by trainee physicians, according to a research letter published online April 2 in the Journal of Hospital Medicine.

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Hx of Depression Tied to Higher Risk of Gestational Diabetes

TUESDAY, April 7, 2015 (HealthDay News) -- Women with gestational diabetes mellitus (GDM) are more likely to have a history of depression, according to a study published in the March/April issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing.

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Semen Quality Linked to Fruit, Veggie Pesticide Residue

TUESDAY, April 7, 2015 (HealthDay News) -- High-pesticide residue fruit and vegetable intake correlates with poorer semen quality, according to a study published online March 30 in Human Reproduction.

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Online Human Milk Samples May Contain Cow's Milk

MONDAY, April 6, 2015 (HealthDay News) -- About 10 percent of online human milk samples tested were contaminated with cow's milk in a recent study published online April 6 in Pediatrics.

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Clinical Practice Changing for Node Lymph Mgmt in Breast CA

FRIDAY, April 3, 2015 (HealthDay News) -- Women with breast cancer undergoing lumpectomy and sentinel node biopsy (SNB) may now be less likely to then have completion axillary lymph node dissection (ALND), according to research published online March 25 in the Journal of the American College of Surgeons.

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Article Highlights Legal Issues Linked to Physician Extenders

FRIDAY, April 3, 2015 (HealthDay News) -- The use of physician extenders (PEs; mainly physician assistants and nurse practitioners) may bring added legal risks to a practice, according to an article published in Medical Economics.

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Women Overweight in Youth May Face Higher CRC Risk

THURSDAY, April 2, 2015 (HealthDay News) -- Women who were overweight as children and teens may have a greater risk of colorectal cancer (CRC), no matter what their current weight, a new study cautions. The findings were published in the April issue of Cancer Epidemiology, Biomarkers & Prevention.

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Fish Oil Could Possibly Interfere With Chemotherapy

THURSDAY, April 2, 2015 (HealthDay News) -- Fish oil supplements, and even certain fish, may hinder the effectiveness of chemotherapy, according to new research published online April 2 in JAMA Oncology.

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Cardiovascular Disease Deaths Increasing Worldwide

THURSDAY, April 2, 2015 (HealthDay News) -- Despite medical advances, new research indicates that more people are dying of heart disease and stroke worldwide than did a quarter century ago because the global population is growing, and growing older. The study is published in the April 2 issue of the New England Journal of Medicine.

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Review: Vegan-Vegetarian Diets Seem Safe in Pregnancy

THURSDAY, April 2, 2015 (HealthDay News) -- Vegan-vegetarian diets appear to be safe in pregnancy, according to a review published in the April issue of BJOG: An International Journal of Obstetrics and Gynaecology.

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Sonographic Follow-Up May Be Adequate for Teen Breast Masses

THURSDAY, April 2, 2015 (HealthDay News) -- Sonographically benign-appearing solid breast masses in adolescents may undergo sonographic follow-up based on combined criteria of size and volume change per month, according to a study published in the April 1 issue of the Journal of Ultrasound in Medicine.

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DNA-Based Blood Test More Accurate in ID of Down Sx

THURSDAY, April 2, 2015 (HealthDay News) -- A DNA-based blood test appears to be more effective in detecting possible Down syndrome in unborn children than other screening methods, researchers say. The findings have been published in the April 2 issue of the New England Journal of Medicine.

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Recommendations Issued for Prevention of Ovarian Cancer

THURSDAY, April 2, 2015 (HealthDay News) -- Recommendations for prevention of ovarian cancer include oral contraceptive use and tubal sterilization, as well as genetic counseling and testing for women from high-risk families, according to a report from the Society of Gynecologic Oncology published online March 27 in Cancer.

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Patients May Be Modifying Meds Due to Trouble Swallowing

THURSDAY, April 2, 2015 (HealthDay News) -- Some patients experience difficulties swallowing and modify medication dosage forms, without necessarily consulting health professionals, according to research published in the March issue of the Journal of Pharmacy Practice and Research.

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Legal Issues of Removing Patient From Practice Explored

WEDNESDAY, April 1, 2015 (HealthDay News) -- The legal and ethical responsibilities of removing a patient from practice are discussed in an article published March 16 in Medical Economics.

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Ob-Gyns Say Use Ultrasound First for Pelvic Symptoms

WEDNESDAY, April 1, 2015 (HealthDay News) -- Ultrasound should be the first type of imaging used to assess pelvic symptoms in women, a team of obstetricians and gynecologists write in an article published in the April issue of the American Journal of Obstetrics & Gynecology.

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Serious Adverse Drug Reactions Still Occur With Bromocriptine

WEDNESDAY, April 1, 2015 (HealthDay News) -- Serious adverse drug reactions (ADRs) can occur after bromocriptine use in lactation inhibition, most of which could be avoided, according to a study published online March 11 in BJOG: An International Journal of Obstetrics & Gynecology.

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Plasma B12 Levels Tied to Anorexia Nervosa Severity

WEDNESDAY, April 1, 2015 (HealthDay News) -- In patients with anorexia nervosa, plasma levels of vitamin B12 might be an early marker of liver dysfunction and are possibly related to more severe psychopathological aspects, according to a study published in the April issue of the International Journal of Eating Disorders.

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