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February 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 February 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.

Urologic Patient Education Reading Materials Too Difficult

THURSDAY, Feb. 28 (HealthDay News) -- Online urologic patient education materials (PEMs) are generally written above recommended reading levels, according to a study published in the March issue of The Journal of Urology.

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ACOG Joins the Choosing Wisely Program

THURSDAY, Feb. 28 (HealthDay News) -- The American College of Obstetricians and Gynecologists (The College), in coordination with the American Board of Internal Medicine's Choosing Wisely campaign, has published the top five tests and procedures to question in obstetrics and gynecology.

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Variation ID'd in Increased Demand for Primary Care Docs

THURSDAY, Feb. 28 (HealthDay News) -- Although the anticipated increased demand for primary health care providers with implementation of the Affordable Care Act is unlikely to be disruptive overall, considerable variation exists in the proportional demand for additional primary care providers, according to research published online in the February issue of Health Affairs.

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CMS Issues Final Rule on Physician Sunshine Act

THURSDAY, Feb. 28 (HealthDay News) -- The Centers for Medicare and Medicaid Services (CMS) have issued a final rule requiring drug and device manufacturers and group purchasing organizations (GPOs) to report payment or gifts of more than $10 to physicians, hospitals, and other providers, and necessitating manufacturers and GPOs to report ownership or investment interests held by physicians or their family members.

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Caffeine Linked to Low Birth Weight and SGA Babies

THURSDAY, Feb. 28 (HealthDay News) -- Maternal caffeine intake is associated with lower birth weight and increased odds of a baby being small for gestational age (SGA), but does not increase the risk of spontaneous preterm delivery (PTD), according to research published online Feb. 19 in BMC Medicine.

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Ondansetron Not Linked to Adverse Fetal Outcomes

WEDNESDAY, Feb. 27 (HealthDay News) -- Administration of ondansetron for treatment of nausea during pregnancy is not associated with any increased risk of adverse fetal outcomes, according to a study published in the Feb. 28 issue of the New England Journal of Medicine.

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Isotretinoin Not Linked to Increased Risk of IBD

WEDNESDAY, Feb. 27 (HealthDay News) -- Among women of reproductive age, isotretinoin is not associated with an increased risk for inflammatory bowel disease (IBD), including ulcerative colitis (UC) or Crohn's disease (CD), according to research published in the February issue of JAMA Dermatology.

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Low-Intensity Interventions Beneficial in Severe Depression

WEDNESDAY, Feb. 27 (HealthDay News) -- Low-intensity interventions are beneficial even for severe depression, with evidence of an interaction between depression severity and treatment effect, according to a meta-analysis published online Feb. 26 in BMJ.

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FDA Approves Osphena for Dyspareunia Post-Menopause

WEDNESDAY, Feb. 27 (HealthDay News) -- The U.S. Food and Drug Administration has approved the once-daily pill Osphena (ospemifene) to treat postmenopausal women experiencing moderate-to-severe pain during sexual intercourse.

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Advanced Breast CA Incidence Up for U.S. 25- to 39-Year-Olds

TUESDAY, Feb. 26 (HealthDay News) -- For U.S. women aged 25 to 39 years, the incidence of breast cancer with distant involvement has increased since 1976, according to research published in the Feb. 27 issue of the Journal of the American Medical Association.

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AAFP Issues Top Five Choosing Wisely Recommendations

TUESDAY, Feb. 26 (HealthDay News) -- The top five primary care issues that patients and physicians should question have been released by the American Academy of Family Physicians (AAFP) as part of the Choosing Wisely Campaign.

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Diagnostic Errors ID'd in Variety of Common Diseases

TUESDAY, Feb. 26 (HealthDay News) -- Diagnostic errors are seen in a variety of common conditions and most often relate to process breakdowns in patient-practitioner clinical encounters, according to research published online Feb. 25 in JAMA Internal Medicine.

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Sleep Restriction Impacts Gene Regulation

TUESDAY, Feb. 26 (HealthDay News) -- Insufficient sleep affects gene regulation, including genes associated with circadian rhythms, sleep homeostasis, oxidative stress, and metabolism, according to a study published online Feb. 25 in the Proceedings of the National Academy of Sciences.

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Preparation Underway for Implementation of ACA in 2014

TUESDAY, Feb. 26 (HealthDay News) -- As the implementation of the Affordable Care Act (ACA) nears, states are preparing for some of its provisions, including expanded access to Medicaid and the Children's Health Insurance Program (CHIP) and the use of information technology, according to a report issued by the Kaiser Family Foundation.

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Infant Mortality Risk Increases With Maternal Alcohol Use

MONDAY, Feb. 25 (HealthDay News) -- Maternal alcohol-use disorder increases the risk of both sudden infant death syndrome (SIDS) and non-SIDS-related infant mortality, according to a study published online Feb. 25 in Pediatrics.

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CDC: 1.5 Million New Cancers Diagnosed Annually

FRIDAY, Feb. 22 (HealthDay News) -- In 2009, approximately 1.5 million new cases of cancer were diagnosed in the United States, with an annual incidence rate of 459 cases per 100,000 population, according to research published in the Feb. 22 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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FDA Approves Kadcyla for Late-Stage Breast Cancer

FRIDAY, Feb. 22 (HealthDay News) -- The U.S. Food and Drug Administration has approved Kadcyla (ado-trastuzumab emtansine), a new treatment for patients with human epidermal growth factor receptor 2 (HER2)-positive, metastatic (late-stage) breast cancer.

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No Lasting Survival Benefit With BRCA in Ovarian Cancer

FRIDAY, Feb. 22 (HealthDay News) -- Although patients with invasive ovarian cancer carrying BRCA1/2 mutations have a short-term survival advantage compared with noncarriers, the advantage is short-lived and is no longer observed at 10 years post-diagnosis, according to a study published in the Jan. 16 issue of the Journal of the National Cancer Institute.

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Mental Health and Substance Use Disorder Benefits Expanded

FRIDAY, Feb. 22 (HealthDay News) -- In a final rule, which will make purchasing health coverage easier for consumers, mental health and substance use benefits will be expanded to 62 million Americans, according to a report published Feb. 20 by the U.S. Department of Health and Human Services.

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CMS Proposes Payment and Policy Updates for 2014

THURSDAY, Feb. 21 (HealthDay News) -- Payment and policy updates have been proposed for 2014, according to the Centers for Medicare and Medicaid Services (CMS) Advanced Notice and draft Call Letter published Feb. 15.

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Cardiometabolic Risk Factors in Teens Linked to Early Death

THURSDAY, Feb. 21 (HealthDay News) -- Smoking, central obesity, and poor glycemic control in teens and young adults correlate with an increased risk of premature death, according to a study published online Feb. 18 in Pediatrics.

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Higher Risk of Hip Implant Failure for Women Than Men

THURSDAY, Feb. 21 (HealthDay News) -- After adjustment, implant failure is more likely for women than men who undergo total hip arthroplasty (THA), according to a study published online Feb. 18 in JAMA Internal Medicine.

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Report Discusses Impact of ACGME 2011 Requirements

THURSDAY, Feb. 21 (HealthDay News) -- Although many residency program directors approve of individual components within the Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements introduced in 2011, less than half express overall approval, according to a perspective piece published in the Feb. 21 issue of the New England Journal of Medicine.

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Faster Adoption of Electronic Health Records Needed

WEDNESDAY, Feb. 20 (HealthDay News) -- The adoption of electronic health records (EHRs) by health providers for Medicare is increasing, but not quickly enough to avoid penalties in 2015, according to a letter published in the Feb. 21 issue of the New England Journal of Medicine.

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Women's Awareness of Heart Disease Improving

WEDNESDAY, Feb. 20 (HealthDay News) -- Over the past 15 years there has been an improvement in women's awareness of cardiovascular disease (CVD), but racial disparity still exists, according to a study published online Feb. 19 in Circulation.

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Anti-Müllerian Hormone Levels Can Predict IVF Success

WEDNESDAY, Feb. 20 (HealthDay News) -- A woman's plasma level of anti-Müllerian hormone (AMH), produced in the ovaries, is strongly associated with the rate of live birth after in vitro fertilization (IVF) and may serve as a prognostic factor for the chance of pregnancy and live birth, according to a study published online Feb. 13 in the Journal of Clinical Endocrinology & Metabolism.

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Robot-Assisted Hysterectomy Use Up From 2007 to 2010

TUESDAY, Feb. 19 (HealthDay News) -- The use of robotically-assisted and laparoscopic hysterectomy increased from 2007 to 2010; and despite similar complication rates, robotic procedures result in considerably higher costs than laparoscopic hysterectomy, according to a study published in the Feb. 20 issue of the Journal of the American Medical Association.

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CMS: Unnecessary Medicare Regulations to Be Reformed

TUESDAY, Feb. 19 (HealthDay News) -- Medicare regulations which are unnecessary, obsolete, or excessively burdensome on hospital or health care providers will be reformed, according to a rule proposed by the Centers for Medicare & Medicaid Services (CMS) in response to the President's instructions in Executive Order 13563.

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Multimodality Approach Needed to Reengineer Health Care

TUESDAY, Feb. 19 (HealthDay News) -- A multimodality approach focusing on reengineering the U.S. health care system may provide a way to improve quality and reduce costs, according to a viewpoint published in the Feb. 20 issue of the Journal of the American Medical Association.

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Most Moms Stop Breastfeeding Earlier Than They Desire

TUESDAY, Feb. 19 (HealthDay News) -- Concerns about maternal or child health and lactation or milk-pumping problems are the major reasons why mothers stop breastfeeding earlier than desired, according to a study published online Feb. 18 in Pediatrics.

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Artificial Intelligence Can Improve Patient Care

TUESDAY, Feb. 19 (HealthDay News) -- Use of an artificial intelligence (AI) framework can improve patient outcomes at one-third of the costs of the current standard of care, according to a study published online Jan. 2 in Artificial Intelligence in Medicine.

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Vitamin D Dosing Should Be Same in Black, White Women

MONDAY, Feb. 18 (HealthDay News) -- Black and white women respond similarly to vitamin D supplements and should be dosed similarly, according to a study published online Feb. 5 in the Journal of Clinical Endocrinology & Metabolism.

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CDC: Cephalosporin-Resistant Gonorrhea Imminent in U.S.

MONDAY, Feb. 18 (HealthDay News) -- Neisseria gonorrhoeae has developed antimicrobial resistance since the 1930s and may be developing resistance to cephalosporins, according to research published in the Feb. 15 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Gender Influences Ischemic Time, Outcomes After STEMI

FRIDAY, Feb. 15 (HealthDay News) -- After ST-segment elevation myocardial infarction (STEMI) and primary percutaneous coronary intervention (PCI), women have longer ischemic times and are at a higher risk than men of early all-cause and cardiac mortality, according to research published in the Feb. 1 issue of The American Journal of Cardiology.

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Preterm Birth Risk Down With Introduction of Smoking Bans

FRIDAY, Feb. 15 (HealthDay News) -- Following the introduction of smoking restrictions in Belgium there was a consistent reduction in the risk of preterm delivery, according a study published online Feb. 14 in BMJ.

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Health Care-Associated Infections Decreased in 2011

FRIDAY, Feb. 15 (HealthDay News) -- In 2011, decreases were noted for some health care-associated infections (HAIs), according to a report prepared by the U.S. Centers for Disease Control and Prevention.

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Alcohol Contributes to About 3.5 Percent of Cancer Deaths

FRIDAY, Feb. 15 (HealthDay News) -- Alcohol consumption remains a major contributor to cancer mortality and years of potential life lost (YPLL), according to research published online Feb. 14 in the American Journal of Public Health.

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Use of Emergency Contraception Has More Than Doubled

THURSDAY, Feb. 14 (HealthDay News) -- The use of emergency contraception has more than doubled in recent years, primarily due to large increases in use by women in their early twenties, according to a February data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Snoring Tied to Increased Cardiovascular Risk in Women

THURSDAY, Feb. 14 (HealthDay News) -- For women, snoring is associated with a modest increased risk of stroke, coronary heart disease (CHD), and cardiovascular disease (CVD), according to a study published in the Feb. 15 issue of The American Journal of Cardiology.

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Activated Platelets Linked to White Matter Hyperintensity

THURSDAY, Feb. 14 (HealthDay News) -- Platelet-derived thrombogenic microvesicles correlate with increased white matter hyperintensity (WMH) load in recently menopausal women, according to a study published online Feb. 13 in Neurology.

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Estrogen May Improve Pathway-Selective Insulin Resistance

THURSDAY, Feb. 14 (HealthDay News) -- Estrogen treatment at the time of surgical menopause may reverse aspects of pathway-selective insulin resistance in the liver associated with a high-fat diet (HFD) in mice by promoting insulin action on glucose metabolism but limiting hepatic lipid deposition, according to a study published in the February issue of Diabetes.

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IOM Urges International Action to Eradicate Fake Drugs

THURSDAY, Feb. 14 (HealthDay News) -- Falsified and substandard medications pose public health problems around the world, and international action should be taken to combat the phenomenon, according to a report published Feb. 13 by the Institute of Medicine (IOM).

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Psychological, Sexual Impact of Female Breadwinners Explored

THURSDAY, Feb. 14 (HealthDay News) -- For couples in which the wife earns more than the husband, there may be psychological and sexual implications, according to a study published in the March issue of the Personality and Social Psychology Bulletin.

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Post-Pregnancy Deterioration in Glycemic Control in T1DM

WEDNESDAY, Feb. 13 (HealthDay News) -- Women with type 1 diabetes experience post-pregnancy deterioration in glycemic control and sustained weight gain, according to research published online Dec. 18 in Diabetes Care.

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Oregon Experiment Will Provide Insight Into ACO-Based Reform

WEDNESDAY, Feb. 13 (HealthDay News) -- The outcome of the Oregon experiment, an ambitious program centered on a model of an accountable care organization (ACO), will offer important lessons for the wider implementation of ACOs as cost-saving mechanisms, according to a perspective piece published online Feb. 13 in the New England Journal of Medicine.

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High Calcium Intake Linked to Increased Mortality in Women

WEDNESDAY, Feb. 13 (HealthDay News) -- For women, high intake of calcium (>1,400 mg/day) is associated with a significantly increased risk of all-cause and cardiovascular mortality, according to a study published online Feb. 12 in BMJ.

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IBCERCC: Prioritize Prevention to Reduce Breast Cancer

WEDNESDAY, Feb. 13 (HealthDay News) -- Seven recommendations have been proposed highlighting the need for coordinated efforts to identify and mitigate the environmental causes of breast cancer, according a report from the Interagency Breast Cancer and Environmental Research Coordinating Committee (IBCERCC).

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Health Insurance Exchanges Are Top Priority on U.S. Agenda

WEDNESDAY, Feb. 13 (HealthDay News) -- The public's health care agenda places creation of a health insurance exchange or marketplace as a top priority, according to a report published by the Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health.

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Potency of OTC Vitamin D Supplements Varies Widely

TUESDAY, Feb. 12 (HealthDay News) -- The potency of over-the-counter (OTC) and compounded vitamin D (cholecalciferol) supplements vary widely, according to a research letter published online Feb. 11 in JAMA Internal Medicine.

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Gradual Dietary Sodium Reductions Will Save Lives

TUESDAY, Feb. 12 (HealthDay News) -- Substantial health benefits can likely be achieved if Americans gradually reduce their daily dietary sodium intake over the next decade, according to research published online Feb. 11 in Hypertension.

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Maternal Folic Acid Use Linked to Reduced Autism Risk

TUESDAY, Feb. 12 (HealthDay News) -- Maternal use of folic acid supplements around the time of conception is associated with a reduced risk of having children with autistic disorder, according to a study published in the Feb. 13 issue of the Journal of the American Medical Association.

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Most Ob-Gyns Still Perform Bimanual Exam But Reasons Vary

TUESDAY, Feb. 12 (HealthDay News) -- The majority of obstetrician-gynecologists perceive bimanual pelvic examinations as important for adult women of all ages, although the reasons cited for performing the exam vary widely, according to a study published in the February issue of the American Journal of Obstetrics & Gynecology.

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Red Meat Intake May Raise Risk of Gestational Diabetes

TUESDAY, Feb. 12 (HealthDay News) -- Higher consumption of red meat is associated with an increased risk of gestational diabetes mellitus (GDM), according to research published online Feb. 1 in Diabetes Care.

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Report Emphasizes Physicians' Role in Gun Policy Discussions

MONDAY, Feb. 11 (HealthDay News) -- Physicians can play important roles in discussions of gun policy and prevention of gun violence, according to a report published online Feb. 12 in the Annals of Internal Medicine.

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Increasing Patient Activation Tied to Lower Health Care Costs

MONDAY, Feb. 11 (HealthDay News) -- Patient activation is associated with improved outcomes and lower health care costs, according to a review published in the February issue of Health Affairs.

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Obstetric Outcomes for Women With Asthma Evaluated

MONDAY, Feb. 11 (HealthDay News) -- Women with asthma have significantly higher odds for nearly all obstetric complications, according to a study published in the February issue of the American Journal of Obstetrics & Gynecology.

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Final HIPAA Omnibus Rule Goes Into Effect March 26

FRIDAY, Feb. 8 (HealthDay News) -- The final omnibus rule, which makes changes to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, goes into effect March 26, and physicians must be in compliance by Sept. 23.

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Study Explores Link Between UV-B Light Exposure, RA Risk

FRIDAY, Feb. 8 (HealthDay News) -- In a cohort of older women, exposure to ultraviolet-B (UV-B) light is associated with a significantly reduced risk of rheumatoid arthritis (RA), but this relationship is not seen among younger women, according to research published online Feb. 4 in the Annals of the Rheumatic Diseases.

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Most Dietary Supplement Use Not Recommended by Docs

FRIDAY, Feb. 8 (HealthDay News) -- Adults frequently use dietary supplements, including multivitamins, calcium, and omega-3 or fish oil, to improve or maintain their health, and less than one-quarter of this use is on the basis of health care provider recommendation, according to research published online Feb. 4 in JAMA Internal Medicine.

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CDC: Breastfeeding Increasingly Prevalent for U.S. Infants

THURSDAY, Feb. 7 (HealthDay News) -- The prevalence of breastfeeding, considered by the American Academy of Pediatrics as the normative standard for infant feeding, has grown in the United States, but in 2008, most infants were not being breastfed for the recommended 12 months, according to research published in the Feb. 8 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Doctors' Perceptions of Psoriasis Therapies Vary

THURSDAY, Feb. 7 (HealthDay News) -- Doctors who treat patients with psoriasis show wide variation in their beliefs about the safety and effectiveness of psoriasis treatments, according to a study published in the February issue of the Journal of the American Academy of Dermatology.

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Support for Biennial Over Annual Mammography in Older Women

WEDNESDAY, Feb. 6 (HealthDay News) -- For older women, biennial screening mammography is associated with similar rates of advanced disease and lower rates of false-positive recall, irrespective of comorbidity, according to a study published online Feb. 5 in the Journal of the National Cancer Institute.

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Diet Soda-Mixed Drinks Result in Higher Breath Alcohol Levels

WEDNESDAY, Feb. 6 (HealthDay News) -- Mixing alcohol with diet soft drinks results in higher breath alcohol concentrations (BrACs) than equivalent amounts of alcohol mixed with sugar-sweetened beverages, according to a study published online Dec. 6 in Alcoholism: Clinical & Experimental Research.

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Physicians' Pay for Existing Patients Dropped in 2012

TUESDAY, Feb. 5 (HealthDay News) -- Physicians' pay for existing patients dropped considerably in 2012, according to the results of the Fee Schedule Survey published Jan. 31 in Physicians Practice.

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Guidelines Updated for Young CA Survivors' Fertility Follow-Up

TUESDAY, Feb. 5 (HealthDay News) -- Current recommendations for the assessment and management of female reproductive complications following treatment of cancers in childhood, adolescence, and young adulthood have been updated, according to a review published online Feb. 4 in the Journal of Clinical Oncology.

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Health-Plan, Employer-Based Programs Studied for Diabetes

TUESDAY, Feb. 5 (HealthDay News) -- Health plan-initiated, employer-based wellness programs are being implemented to test new approaches to help reduce diabetes risk and, more broadly, to prevent chronic illness, according to research published online Jan. 31 in Preventing Chronic Disease.

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Cancer Mortality Decreasing for African-American Men, Women

TUESDAY, Feb. 5 (HealthDay News) -- Although African-Americans experienced decreases in cancer death rates from 2000 to 2009, the five-year survival rates are still lower than for whites, according to research published online Feb. 5 in CA: A Cancer Journal for Clinicians.

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Breast CA Diagnostic Errors Major Cause of Malpractice Suits

MONDAY, Feb. 4 (HealthDay News) -- The most common reason for medical malpractice suits against radiologists in the United States is diagnostic errors, particularly breast cancer and non-vertebral and spinal fractures, according to research published in the February issue of Radiology.

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Higher Midlife Fitness Linked to Lower All-Cause Dementia Risk

MONDAY, Feb. 4 (HealthDay News) -- Individuals with higher midlife cardiorespiratory fitness levels are significantly less likely to develop all-cause dementia later in life, according to research published in the Feb. 5 issue of the Annals of Internal Medicine.

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Contraception Coverage Rules Issued for Public Comment

MONDAY, Feb. 4 (HealthDay News) -- Reflecting public feedback and concerns of some religious organizations, a Notice of Proposed Rulemaking has been issued for public comment regarding contraceptive coverage with no cost sharing under the health law.

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FSMB: Approaches Explored for Expediting Multi-State Licenses

MONDAY, Feb. 4 (HealthDay News) -- New approaches are being explored for streamlining physician multi-state licensure to accommodate the use of telemedicine in the delivery of health care, according to a report from a meeting held from Jan. 16 to 17 by the Federation of State Medical Boards (FSMB).

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Low Adiponectin in First Trimester Linked to GDM

FRIDAY, Feb. 1 (HealthDay News) -- Low adiponectin levels during the first trimester of pregnancy correlate with a higher level of insulin resistance and an increased risk of developing gestational diabetes mellitus (GDM), according to research published online Jan. 8 in Diabetes Care.

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One-Third of Physician Assistants Work in Primary Care

FRIDAY, Feb. 1 (HealthDay News) -- Roughly one-third of physician assistants (PAs) choose to work in primary care, according to a study published in the January/February issue of the Annals of Family Medicine.

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Serum Calcium Is a Possible Biomarker of Ovarian Cancer

FRIDAY, Feb. 1 (HealthDay News) -- High serum calcium levels are associated with a greater risk of developing ovarian cancer, according to a study published online Jan. 9 in Gynecologic Oncology.

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Sex Differences in Return to Work for Cancer Survivors

FRIDAY, Feb. 1 (HealthDay News) -- Significant differences have been identified in the return-to-work (RTW) process for male and female cancer survivors, according to research published online Jan. 28 in the Journal of Clinical Oncology.

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Knowing Cost of Imaging Tests Doesn't Cut Utilization

FRIDAY, Feb. 1 (HealthDay News) -- Physicians do not order fewer imaging tests if they are aware of the costs, according to a study published online Jan. 2 in the Journal of the American College of Radiology.

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Medroxyprogesterone Acetate Linked to Immune Suppression

FRIDAY, Feb. 1 (HealthDay News) -- Use of the injectable contraceptive depot medroxyprogesterone acetate (MPA), common in areas such as sub-Saharan Africa with high HIV-1 prevalence, is associated with suppression of the immune response, according to a study published online Jan. 25 in Endocrinology.

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