November 2018 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 November 2018. 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.

Several Risk Factors More Strongly Linked to MI in Women

FRIDAY, Nov. 30, 2018 (HealthDay News) -- The incidence of myocardial infarction (MI) is higher in men than women, but several risk factors are more strongly linked to MI in women, according to a study published online Nov. 7 in The BMJ.

Abstract/Full Text

Increase Seen in Amphetamine, Opioid Use in Pregnant Women

FRIDAY, Nov. 30, 2018 (HealthDay News) -- The incidence of amphetamine and opioid use has increased among pregnant women, especially in rural counties, according to a study published online Nov. 29 in the American Journal of Public Health.

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Genetic Analysis Shows Higher BMI May Up Risk for Depression

THURSDAY, Nov. 29, 2018 (HealthDay News) -- Being overweight likely plays a causal role in the development of depression, even in the absence of other health problems, according to a study published online Nov. 13 in the International Journal of Epidemiology.

Abstract/Full Text

Climate Change Ups Heat Deaths, Especially Among Elderly

THURSDAY, Nov. 29, 2018 (HealthDay News) -- Risk for heat-related disease and death is rising worldwide due to climate change, according to a report published online Nov. 28 in The Lancet.

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Editorial (subscription or payment may be required)

Age-Related Vaginal Symptoms Tied to Worse Quality of Life

THURSDAY, Nov. 29, 2018 (HealthDay News) -- Severe vulvovaginal atrophy (VVA) symptoms are associated with worse quality of life in postmenopausal women, according to a study published online Nov. 12 in Menopause.

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Large at Birth, Maternal Diabetes Up Child's Risk for Obesity

WEDNESDAY, Nov. 28, 2018 (HealthDay News) -- Large for gestational age (LGA) is a stronger marker than maternal diabetes for subsequently being overweight or obese in early childhood, according to a study published online Nov. 13 in Diabetologia.

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FDA: Kratom Products Have High Levels of Heavy Metals

WEDNESDAY, Nov. 28, 2018 (HealthDay News) -- In addition to many other health risks, kratom products can have high levels of heavy metals, according to Scott Gottlieb, M.D., commissioner of the U.S. Food and Drug Administration.

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Healthy Lifestyle Tied to Less Atherosclerosis for Women

WEDNESDAY, Nov. 28, 2018 (HealthDay News) -- A healthy lifestyle during midlife is associated with less subclinical atherosclerosis among women, according to a study published online Nov. 28 in the Journal of the American Heart Association.

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FDA: Safe to Eat Romaine Lettuce Again, but Check Labels

TUESDAY, Nov. 27, 2018 (HealthDay News) -- In a statement released late yesterday, the U.S. Food and Drug Administration Commissioner Scott Gottlieb, M.D., announced that the agency was lifting its advisory against eating romaine lettuce, first put in place last Tuesday. At that point, the agency had not been able to narrow down the source of the tainted lettuce. But now the source seems to be "end-of-season" lettuce harvested somewhere in the Central Coast regions of central and northern California. And "harvesting of romaine lettuce from this region has [already] ended for the year," Gottlieb noted.

More Information: FDA
More Information: CDC

FDA to Update Medical Device Approvals Process

TUESDAY, Nov. 27, 2018 (HealthDay News) -- A major update of the United States' system for approving medical devices was announced yesterday by the Food and Drug Administration.

CBS/AP News Article
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Four Principles Underlie Patient and Family Partnership in Care

TUESDAY, Nov. 27, 2018 (HealthDay News) -- Patient and family partnership in care should include treatment of patients and families with dignity and respect, their active engagement in all aspects of care, and their contribution to the improvement of health care systems and education of health care professionals, according to a position paper published online Nov. 27 in the Annals of Internal Medicine.

Position Paper
Editorial (subscription or payment may be required)

Pregnancy-Associated Mortality Involving Opioids Up

TUESDAY, Nov. 27, 2018 (HealthDay News) -- From 2007 to 2016, there was a sharp increase in pregnancy-associated mortality involving opioids, according to a research letter recently published in the American Journal of Obstetrics & Gynecology.

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ACA Coverage Substantial, but Did Not Impact Labor Markets

MONDAY, Nov. 26, 2018 (HealthDay News) -- Millions of workers gained insurance coverage under the Affordable Care Act (ACA) without adverse effects on labor markets, according to a report published by the Robert Wood Johnson Foundation and the Urban Institute.

Report: How Have Workers Fared Under the ACA?

Newborns Infected With Ebola in Congo Outbreak

MONDAY, Nov. 26, 2018 (HealthDay News) -- Ebola infections in newborns are being reported in the current outbreak of the deadly disease in Congo, the World Health Organization says.

AP News Article
More Information: CDC

USPSTF Suggests Universal HIV Screening, PrEP for High-Risk Patients

TUESDAY, Nov. 20, 2018 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends HIV screening for individuals aged 15 to 65 years, including all pregnant women, and pre-exposure prophylaxis (PrEP) should be offered to those at high risk of HIV. These findings form the basis of two draft recommendation statements published online Nov. 20 by the USPSTF.

Draft Evidence Review - Adolescents/Adults
Draft Recommendation Statement - Adolescents/Adults
Comment on Recommendation Statement - Adolescents/Adults
Draft Evidence Review - Pregnancy
Draft Recommendation Statement - Pregnancy
Comment on Recommendation Statement - Pregnancy
Draft Evidence Review - PrEP
Draft Recommendation Statement - PrEP
Comment on Recommendation Statement - PrEP

Insulin Needed for T2DM Tx Set to Increase >20 Percent by 2030

MONDAY, Nov. 26, 2018 (HealthDay News) -- From 2018 to 2030, the insulin required to treat type 2 diabetes is expected to increase more than 20 percent, according to a study published online Nov. 20 in The Lancet Diabetes & Endocrinology.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Obesity Tied to Increased Risk for Early-Onset CRC in Women

MONDAY, Nov. 26, 2018 (HealthDay News) -- Obesity is associated with an increased risk for early-onset colorectal cancer (CRC) among women, according to a study recently published in JAMA Oncology.

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CDC: U.S. Abortion Rate Declined 24 Percent From 2006 to 2015

WEDNESDAY, Nov. 21, 2015 (HealthDay News) -- The abortion rate in the United States fell 24 percent between 2006 and 2015, according to research published in the Nov. 23 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Switching to High-Deductible Insurance Delays Diabetes Care

WEDNESDAY, Nov. 21, 2018 (HealthDay News) -- For patients with diabetes, those switching from low-deductible to high-deductible insurance have increased delays in seeking care and diagnostic testing for macrovascular symptoms and for first procedure-based treatment, according to a study published online Nov. 20 in the Annals of Internal Medicine.

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Editorial (subscription or payment may be required)

FDA: Another E. coli Outbreak Linked to Romaine Lettuce

TUESDAY, Nov. 20, 2018 (HealthDay News) -- The U.S. Food and Drug Administration and U.S. Centers for Disease Control and Prevention along with health officials from various states are asking American consumers to avoid romaine lettuce due to an outbreak of Escherichia coli illness.

FDA Fast Facts
CDC Food Safety Alert

Prenatal Nitric Oxide Exposure Linked to Higher Risk for Autism

TUESDAY, Nov. 20, 2018 (HealthDay News) -- Prenatal exposure to nitric oxide (NO) is associated with an increased risk for autism spectrum disorder (ASD), according to a study published online Nov. 19 in JAMA Pediatrics.

Abstract/Full Text (subscription or payment may be required)

FDA Warns Against Giving Honey-Filled Pacifiers to Infants

MONDAY, Nov. 19, 2018 (HealthDay News) -- Pacifiers filled with or dipped in honey should not be given to infants, the U.S. Food and Drug Administration says.

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Opioid Misuse Varies With Sexual Orientation

MONDAY, Nov. 19, 2018 (HealthDay News) -- Opioid misuse varies with sexual orientation, with increased misuse among female bisexuals, according to a study published online Nov. 19 in the American Journal of Preventive Medicine.

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MS Relapse Drops During Pregnancy but Rises After

MONDAY, Nov. 19, 2018 (HealthDay News) -- Rates of multiple sclerosis (MS) relapse decrease during pregnancy but increase postpartum, according to a study published online Oct. 23 in Neurology.

Abstract/Full Text
Editorial (subscription or payment may be required)

HIV Transmission Risk Small With Antiretroviral Compliance

MONDAY, Nov. 19, 2018 (HealthDay News) -- The risk for sexual transmission of HIV is negligible when an HIV-positive sex partner adheres to antiretroviral therapy and maintains viral suppression, according to research published in the November issue of CMAJ, the journal of the Canadian Medical Association.

Abstract/Full Text

Higher Risk for Amputation, DKA With SGLT2 Inhibitors for T2DM

FRIDAY, Nov. 16, 2018 (HealthDay News) -- Use of sodium glucose cotransporter 2 (SGLT2) inhibitors is associated with an increased risk for lower-limb amputation and diabetic ketoacidosis compared with use of glucagon-like peptide 1 (GLP1) receptor agonists, according to a study published online Nov. 14 in The BMJ.

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CDC: 8.8 Percent Uninsured in U.S. in First Half of 2018

FRIDAY, Nov. 16, 2018 (HealthDay News) -- In the first six months of 2018, 8.8 percent of U.S. individuals of all ages were uninsured, which was not significantly different from 2017, according to a report published Nov. 15 by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

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Name-Brand Medications Driving Spike in U.S. Drug Spending

THURSDAY, Nov. 15, 2018 (HealthDay News) -- Rising drug spending in the United States is being fueled by expensive name-brand prescription medicines, a new study shows.

NBC News Article
Blue Cross Blue Shield Report

CDC: Many Americans May Have Prediabetes and Not Know It

THURSDAY, Nov. 15, 2018 (HealthDay News) -- More than one-third of Americans have prediabetes, but 90 percent of them do not know they have it, medical experts say.

Do I Have Prediabetes
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Breast Cancer Recurrence Rate Not Up With Autologous Fat Transfer

THURSDAY, Nov. 15, 2018 (HealthDay News) -- For patients with breast cancer, reconstruction with autologous fat transfer (AFT) seems not to increase the rate of locoregional recurrence versus conventional breast reconstruction, according to a study published online Oct. 10 in JAMA Surgery.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Patient Experiences Shed Light on Diagnostic Errors

THURSDAY, Nov. 15, 2018 (HealthDay News) -- Data from patient- and family-reported error narratives indicate that problems related to patient-physician interactions are major contributors to diagnostic errors, according to a study published in the November issue of Health Affairs.

Abstract/Full Text (subscription or payment may be required)

AMA to Collect Data on Suicide Among Doctors-in-Training

WEDNESDAY, Nov. 14, 2018 (HealthDay News) -- By collecting data on suicides by medical students, residents, and fellows, the American Medical Association hopes to identify ways to reduce suicides among doctors-in-training. The data collection policy was approved at a meeting yesterday.

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Heart Disease Leading Cause of Death in Low-Income Counties

WEDNESDAY, Nov. 14, 2018 (HealthDay News) -- The leading cause of death varies with income in the United States, with heart disease still the leading cause of death in low-income counties, according to a study published online Nov. 13 in the Annals of Internal Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Short Interpregnancy Intervals Tied to Adverse Outcome Risk

WEDNESDAY, Nov. 14, 2018 (HealthDay News) -- Short intervals between pregnancies are associated with increased risks for adverse pregnancy outcomes for women of all ages, according to a study published online Oct. 29 in JAMA Internal Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

USPSTF Recommends Screening Adults for Unhealthy Alcohol Use

TUESDAY, Nov. 13, 2018 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends that primary care clinicians screen all adults, including pregnant women, for unhealthy alcohol use and provide brief behavioral counseling to reduce unhealthy alcohol use. These findings form the basis of a final recommendation statement published in the Nov. 13 issue of the Journal of the American Medical Association.

Final Recommendation Statement
Evidence Report
Editorial 1
Editorial 2
Editorial 3 (subscription or payment may be required)
Editorial 4 (subscription or payment may be required)

Denosumab Promising for TDT-Induced Osteoporosis Treatment

TUESDAY, Nov. 13, 2018 (HealthDay News) -- Denosumab (DNM), a fully human monoclonal antibody against the receptor activator of nuclear factor kappa-B ligand (RANKL), may be beneficial for managing transfusion-dependent thalassemia (TDT)-induced osteoporosis, according to a study published online Oct. 31 in Blood Advances.

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Many Women Have Not Heard of Ovarian Cancer Before Dx

FRIDAY, Nov. 9, 2018 (HealthDay News) -- Many women are not knowledgeable about ovarian cancer before diagnosis despite most women experiencing prediagnosis symptoms, according to a report published online Oct. 18 by the World Ovarian Cancer Coalition.

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Urinary Incontinence Common in Women Over 50 Years

FRIDAY, Nov. 9, 2018 (HealthDay News) -- Nearly half of women older than 50 years report having urinary incontinence, according to the results of the National Poll on Healthy Aging, published on Nov. 1.

National Poll on Healthy Aging

Progress Toward Goals in Global Health Is Slowing

FRIDAY, Nov. 9, 2018 (HealthDay News) -- Global progress in health has slowed, and improvements in health have been unevenly distributed, according to a series of articles published in a special issue of The Lancet, highlighting the fact that global progress in health is not inevitable.

The Lancet - The Global Burden of Disease Study 2017

Soy Feeding in Infancy Linked to Menstrual Pain in Blacks

FRIDAY, Nov. 9, 2018 (HealthDay News) -- Soy formula feeding in infancy is associated with an increased risk for menstrual pain in young African-American women, according to a study published online Nov. 9 in Human Reproduction.

Abstract/Full Text

CDC: Increases in Yoga, Meditation for Children in 2012-2017

THURSDAY, Nov. 8, 2018 (HealthDay News) -- The use of yoga and meditation have increased in recent years among children and adults, while use of chiropractors has also increased among adults, according to two November data briefs published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

Abstract/Full Text - Black
Abstract/Full Text - Clark

Trump Administration Finalizes Birth Control Coverage Opt-Out

THURSDAY, Nov. 8, 2018 (HealthDay News) -- A birth control coverage opt-out for employers was finalized by the Trump administration on Wednesday.

AP News Article

Zoliflodacin Seems Effective for Some Gonococcal Infections

THURSDAY, Nov. 8, 2018 (HealthDay News) -- Oral zoliflodacin, which inhibits DNA biosynthesis, seems effective for urogenital and rectal gonococcal infections but is less effective for pharyngeal infections, according to a study published in the Nov. 8 issue of the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Quantity of Opioids Prescribed Postop Linked to Consumption

THURSDAY, Nov. 8, 2018 (HealthDay News) -- The quantity of opioids prescribed after surgery is associated with patient-reported opioid consumption, according to a study published online Nov. 7 in JAMA Surgery.

Abstract/Full Text (subscription or payment may be required)

Improved Long-Term Pregnancy Outcomes for Goserelin + Chemo

THURSDAY, Nov. 8, 2018 (HealthDay News) -- For premenopausal women with stage I to IIIA estrogen receptor-negative, progesterone receptor-negative breast cancer, goserelin plus chemotherapy is associated with an increased likelihood of becoming pregnant without an increased risk for adverse effects, according to a study published online Oct. 29 in the Journal of the National Cancer Institute.

Abstract/Full Text (subscription or payment may be required)

Medicaid Expansion Approved in Three Republican-Leaning States

WEDNESDAY, Nov. 7, 2018 (HealthDay News) -- Hundreds of thousands more low-income Americans could get health insurance after voters in three Republican-leaning states approved Medicaid expansion in the midterm elections.

CNBC Article

Excess Gestational Weight Gain Not Better for Child Bone Health

WEDNESDAY, Nov. 7, 2018 (HealthDay News) -- Among women who are under/normal weight, gestational weight gain (GWG) is associated with slightly increased bone measures in offspring at age 7 years, but there is no effect for overweight/obese mothers, according to a study published online Nov. 7 in the Journal of Bone and Mineral Research.

Abstract/Full Text (subscription or payment may be required)

Abx-Resistant Enterobacteriaceae Tied to Clinical Failure in UTI

WEDNESDAY, Nov. 7, 2018 (HealthDay News) -- Community-onset urinary tract infection (UTI) due to extended-spectrum cephalosporin-resistant (ESC-R) Enterobacteriaceae (EB) is significantly associated with clinical failure, according to a study published online Oct. 30 in Infection Control & Hospital Epidemiology.

Abstract/Full Text (subscription or payment may be required)

Over Two Million People Living With Hep C From 2013 to 2016

TUESDAY, Nov. 6, 2018 (HealthDay News) -- During 2013 to 2016, more than two million people in the United States had current hepatitis C virus (HCV) infection, according to a study published online Nov. 6 in Hepatology.

Abstract/Full Text (subscription or payment may be required)

Older Paternal Age Linked to Adverse Perinatal Outcomes

MONDAY, Nov. 5, 2018 (HealthDay News) -- Advanced paternal age is associated with adverse infant and maternal outcomes, according to a study published online Oct. 31 in The BMJ.

Abstract/Full Text
Editorial

Most Meds Affecting Neurotransmitters Not Linked to Autism Risk

MONDAY, Nov. 5, 2018 (HealthDay News) -- Prenatal exposure to most medications affecting neurotransmitter systems is not associated with estimates of autism spectrum disorder (ASD) risk, according to a study published online Oct. 31 in JAMA Psychiatry.

Abstract/Full Text
Editorial (subscription or payment may be required)

Age to Stop Cervical Cancer Screening Depends on Test Used

FRIDAY, Nov. 2, 2018 (HealthDay News) -- Continuing regular cytology screening up to age 75 years or performing an exit human papillomavirus (HPV) test to confirm the absence of oncogenic HPV strains past the age of 55 years offers preventive benefit for older women with a cervix, according to a study published online Nov. 1 in The Lancet Oncology.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Sign-Up Season Begins on HealthCare.gov

FRIDAY, Nov. 2, 2018 (HealthDay News) -- The federal government website where Americans can sign up for health insurance under the Affordable Care Act is up and running, officials said yesterday.

AP News Article
HealthCare.gov

CDC: Prevalence of Gestational Diabetes 6.0 Percent in 2016

FRIDAY, Nov. 2, 2018 (HealthDay News) -- The prevalence of gestational diabetes was 6.0 percent in 2016, with a slight increase seen from 2012 to 2016, according to research published in the Nov. 2 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Abstract/Full Text

HPV Vaccination Uptake Increasing, but Still Too Low

FRIDAY, Nov. 2, 2018 (HealthDay News) -- Although progress has been made in increasing human papillomavirus (HPV) vaccination, coverage is still too low to achieve full cancer prevention potential, according to a report from the President's Cancer Panel published Nov. 1.

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Second Hypertension Drug Recalled Due to Contamination

THURSDAY, Nov. 1, 2018 (HealthDay News) -- Another hypertension drug is being recalled due to contamination that could pose a cancer risk, the U.S. Food and Drug Administration says.

CNN Article
FDA Recall Alert

Minimally Invasive Sx May Up Mortality in Early Cervical Cancer

THURSDAY, Nov. 1, 2018 (HealthDay News) -- For patients with early-stage cervical cancer, minimally invasive surgery is associated with increased mortality and worse survival than open surgery, according to two studies published online Oct. 31 in the New England Journal of Medicine.

Abstract/Full Text - Melamed
Abstract/Full Text - Ramirez
Editorial

Fewer Parents Have Sexuality, Gender Concerns About HPV Shot

THURSDAY, Nov. 1, 2018 (HealthDay News) -- Parents' concerns about sexuality and gender as reasons for lack of HPV vaccine initiation in their children decreased substantially from 2010 to 2016, according to a study published in the November issue of the Journal of Adolescent Health.

Abstract/Full Text (subscription or payment may be required)

Infant Ab Levels Highest With Tdap Vax in Early 3rd Trimester

THURSDAY, Nov. 1, 2018 (HealthDay News) -- Tetanus, diphtheria, and acellular pertussis (Tdap) vaccines given to pregnant women early in the third trimester may offer the most protection against infant pertussis, according to a study published in the Oct. 9 issue of the Journal of the American Medical Association.

Abstract/Full Text (subscription or payment may be required)

Financial Conflicts of Interest Prevalent Among CPG Authors

THURSDAY, Nov. 1, 2018 (HealthDay News) -- There is a high prevalence of financial conflicts of interest among authors of clinical practice guidelines (CPGs) related to high-revenue medications and in gastroenterology, according to two research letters published online Oct. 29 in JAMA Internal Medicine.

Abstract/Full Text - Khan (subscription or payment may be required)
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Editorial (subscription or payment may be required)

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