April 2019 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 April 2019. 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.

Coronary Vessel Wall Thickness Surrogate for CAD in Women

TUESDAY, April 30, 2019 (HealthDay News) -- Coronary vessel wall thickness (VWT) measured with magnetic resonance imaging (MRI) is a significant surrogate of subclinical coronary artery disease (CAD) among asymptomatic women at low or intermediate risk, according to a study published online April 25 in Radiology: Cardiothoracic Imaging.

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CDC: 704 Measles Cases Reported in U.S. Through April 26, 2019

TUESDAY, April 30, 2019 (HealthDay News) -- A total of 704 cases of measles were reported in the United States from Jan. 1 to April 26, 2019, representing the largest number of cases since 1994, according to research published in the April 29 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Rare Variants Identified in DENND1A Gene in PCOS

TUESDAY, April 30, 2019 (HealthDay News) -- Rare variants have been identified in the DENND1A gene that are associated with hormonal traits of polycystic ovary syndrome (PCOS), according to research published online April 30 in the Journal of Clinical Endocrinology & Metabolism.

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Maternal Comorbidity Higher for Women With Congenital Heart Defects

TUESDAY, April 30, 2019 (HealthDay News) -- Pregnant women with congenital heart defects (CHDs) are more likely to have comorbidities and experience adverse events during delivery, according to a study published in the May 7 issue of the Journal of the American College of Cardiology.

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Ambiguous Genitalia in Newborns Not Uncommon

MONDAY, April 29, 2019 (HealthDay News) -- Ambiguous genitalia in newborns may be more common than previously thought, according to a study published online April 24 in the Journal of the Endocrine Society.

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Longer Duration of Antibiotic Use Tied to Risk for CVD in Women

FRIDAY, April 26, 2019 (HealthDay News) -- For women in middle and late adulthood, longer duration of antibiotic use is associated with an increased risk for cardiovascular disease (CVD) events, according to a study published online April 24 in the European Heart Journal.

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Dapagliflozin Improves Glucose Outcomes in Type 1 Diabetes

FRIDAY, April 26, 2019 (HealthDay News) -- In patients with type 1 diabetes, treatment with dapagliflozin for 24 weeks improves time in range, mean glucose, and glycemic variability, according to a study published online April 9 in Diabetes Care.

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Gender Differences Seen in Adverse Drug Reactions

FRIDAY, April 26, 2019 (HealthDay News) -- The risk for adverse drug reactions (ADRs) may be higher for women, even when accounting for gender differences in drug use, according to a study published online April 2 in the British Journal of Clinical Pharmacology.

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Minor Birth Defects Up in Progeny of Female Gulf War Veterans

THURSDAY, April 25, 2019 (HealthDay News) -- The odds of having a child with a minor birth defect are about five times higher for women veterans deployed during the Gulf War (DV) versus nondeployed women veterans (NDV), according to a study published in the April issue of the Journal of Occupational and Environmental Medicine.

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FDA Announces New Steps to Reduce Risks Tied to Surgical Staplers

THURSDAY, April 25, 2019 (HealthDay News) -- The U.S. Food and Drug Administration this week announced three new efforts to protect patients from malfunctions, injuries, and deaths associated with the use of surgical staplers for internal use and implantable surgical staples.

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CDC: Drinking Alcohol Not Uncommon Among Pregnant Women

THURSDAY, April 25, 2019 (HealthDay News) -- Approximately one in nine pregnant women report drinking alcohol in the past 30 days, and among those, about one-third report binge drinking, according to research published in the April 26 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Six Prognostic Factors ID'd for Invasive Disease After DCIS

THURSDAY, April 25, 2019 (HealthDay News) -- In a review published online April 25 in Cancer Epidemiology, Biomarkers & Prevention, six prognostic factors are identified that may predict invasive disease after a diagnosis of ductal carcinoma in situ (DCIS).

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CDC Provides Clarification of Opioid Prescribing Guideline

WEDNESDAY, April 24, 2019 (HealthDay News) -- Implementation of the U.S. Centers for Disease Control and Prevention opioid prescribing recommendations should be consistent with the guideline's intent, according to a perspective piece published online April 24 in the New England Journal of Medicine.

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Personalizing Breast Cancer Tx Could Cut Initial Costs of Care

WEDNESDAY, April 24, 2019 (HealthDay News) -- Personalizing breast cancer treatment based on Oncotype DX recurrence scores could result in small decreases in costs in the initial 12 months of care, according to a study published online April 24 in the Journal of the National Cancer Institute.

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USPSTF Urges Asymptomatic Bacteriuria Screen in Pregnancy

TUESDAY, April 23, 2019 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends screening pregnant women for asymptomatic bacteriuria (ASB) but not nonpregnant women or men. These recommendations form the basis of a draft recommendation statement published online April 23 by the USPSTF.

Evidence Review
Draft Recommendation Statement
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Individualized Medical-Nutrition Therapy Important in Diabetes

TUESDAY, April 23, 2019 (HealthDay News) -- Diabetes-focused medical nutrition therapy (MNT) is fundamental to overall diabetes management and should be adapted as needed throughout life, according to a consensus report published in the May issue of Diabetes Care.

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Risks, Benefits of Long-Term Drug Therapy for Osteoporosis Reviewed

TUESDAY, April 23, 2019 (HealthDay News) -- Long-term osteoporosis drug therapy (ODT) reduces fracture risk in women but may increase risk for rare adverse events, and research gaps surround use of long-term drug therapies for osteoporotic fracture prevention, according to a review and position paper published online April 23 in the Annals of Internal Medicine.

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Preterm Birth Linked to Periconception HbA1c in T1DM

MONDAY, April 22, 2019 (HealthDay News) -- For women with type 1 diabetes (T1D), the risk for preterm birth is strongly associated with periconceptional hemoglobin A1c (HbA1c) level, according to a study published online April 22 in the Annals of Internal Medicine.

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Diminished HRQOL More Likely Among Transgender Adults

MONDAY, April 22, 2019 (HealthDay News) -- Transgender adults are more likely to report diminished health-related quality of life (HRQOL), according to a research letter published online April 22 in JAMA Internal Medicine.

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National Hand Hygiene Initiative Successful in Australia

FRIDAY, April 19, 2019 (HealthDay News) -- The National Hand Hygiene Initiative (NHHI) has successfully sustained improvement in hand hygiene compliance, according to a study recently published in The Lancet Infectious Diseases and presented at the European Congress of Clinical Microbiology & Infectious Diseases, held from April 13 to 16 in Amsterdam.

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Conception by IVF May Increase Risk for Rare Childhood Cancer

FRIDAY, April 19, 2019 (HealthDay News) -- There is a small association between conception by in vitro fertilization (IVF) and childhood cancer, particularly hepatic tumors, according to a study published online April 1 in JAMA Pediatrics.

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Loan Forgiveness, Educational Debt May Affect Practice Patterns

FRIDAY, April 19, 2019 (HealthDay News) -- Increased educational debt appears to directly influence physician practice choice, according to a study published in the April issue of the Journal of the American Osteopathic Association.

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CDC: Recent Decline Seen in High-Grade Cervical Lesions

THURSDAY, April 18, 2019 (HealthDay News) -- The number of cervical precancers (CIN2+ cases) in the United States declined from 2008 to 2016, likely in part because of prevention with the human papillomavirus (HPV) vaccine, according to research published in the April 19 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Sixty People Charged in Massive Opioid Painkiller Investigation

THURSDAY, April 18, 2019 (HealthDay News) -- Fifty-three medical professionals, including 31 doctors, are among the 60 people charged by U.S. authorities for their alleged involvement in the illegal prescribing and distribution of opioid painkillers.

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UB-421 Monotherapy Maintains HIV Viral Suppression

THURSDAY, April 18, 2019 (HealthDay News) -- Monotherapy with UB-421 antibody, which blocks the HIV virus-binding site on human CD4+ T-cells, maintains viral suppression for up to 16 weeks in HIV-infected persons undergoing analytic treatment interruption, according to a study published in the April 18 issue of the New England Journal of Medicine.

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Late-Pregnancy US Could Prevent Undiagnosed Breech Presentation

THURSDAY, April 18, 2019 (HealthDay News) -- Universal ultrasound at 36 gestational weeks could virtually eliminate undiagnosed breech presentation in nulliparous women, according to a study published online April 16 in PLOS Medicine.

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Perinatal Complications Tied to Childhood Social Anxiety

THURSDAY, April 18, 2019 (HealthDay News) -- Perinatal complications are associated with behavioral inhibition and social anxiety in children, according to a study published online March 19 in Infant and Child Development.

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Infections May Up Risk for Developing Sjögren Syndrome

THURSDAY, April 18, 2019 (HealthDay News) -- Individuals with a history of infection have double the risk for developing Sjögren syndrome, according to a study published online March 20 in the Journal of Internal Medicine.

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Most Diabetes Phone Apps Lack Education, Support Functions

WEDNESDAY, April 17, 2019 (HealthDay News) -- Most diabetes apps miss opportunities to improve care and health outcomes by not providing real-time decision support or situation-specific education on blood glucose self-management, according to a research letter published in the April 16 issue of the Journal of the American Medical Association.

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Some Patients With Imminently Fatal Cancer Undergo Treatment

WEDNESDAY, April 17, 2019 (HealthDay News) -- Some patients with imminently fatal de novo metastatic cancer undergo treatment, according to a study published online April 15 in JNCI: Cancer Spectrum.

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FDA Halts All Sales of Pelvic Mesh Products Tied to Injuries in Women

TUESDAY, April 16, 2019 (HealthDay News) -- The U.S. Food and Drug Administration on Tuesday announced a ban on the sale of all pelvic mesh products.

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Mixed Effects Observed for Workplace Wellness Program

TUESDAY, April 16, 2019 (HealthDay News) -- A workplace wellness program improves certain self-reported health behaviors but does not impact clinical measures of health or health care spending, according to a study published in the April 16 issue of the Journal of the American Medical Association.

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Cognitive Behavioral Therapy Effective for Prenatal Insomnia

TUESDAY, April 16, 2019 (HealthDay News) -- Cognitive behavioral therapy is an effective nonpharmacologic treatment for insomnia during pregnancy, according to a study published online April 5 in Obstetrics & Gynecology.

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Standardizing Demographics Ups Accuracy of Patient Matching

MONDAY, April 15, 2019 (HealthDay News) -- Standardizing demographic data can improve the accuracy of patient matching, according to a study published in the May issue of the Journal of the American Medical Informatics Association.

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Telehealth Video Visits Risk Fragmenting Care

MONDAY, April 15, 2019 (HealthDay News) -- Although telehealth video visits offer users greater convenience, they risk fragmenting care without greater coordination with usual care providers, according to a study recently published in the Journal of the American Medical Informatics Association.

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Gestational Diabetes Linked to Incident Diabetes in Offspring

MONDAY, April 15, 2019 (HealthDay News) -- Gestational diabetes mellitus is associated with incident diabetes in offspring throughout childhood and adolescence, according to a study published online April 15 in CMAJ, the journal of the Canadian Medical Association.

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Metformin May Cut Risk for Prematurity, Miscarriage in PCOS

MONDAY, April 15, 2019 (HealthDay News) -- In pregnant women with polycystic ovary syndrome (PCOS), metformin treatment from the late first trimester until delivery might reduce the risk for late miscarriage and preterm birth but does not prevent gestational diabetes, according to a study published in the April issue of The Lancet Diabetes & Endocrinology.

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In Pregnancy, Buprenorphine Use Up, Methadone Use Down

FRIDAY, April 12, 2019 (HealthDay News) -- From 2009 to 2015, the prevalence of methadone use decreased and buprenorphine use increased among Medicaid-enrolled pregnant women with opioid use disorder, and the 4Ps Plus and Substance Use Risk Profile-Pregnancy (SURP-P) scale are sensitive for identifying illicit drug use, according to two studies published online April 5 in Obstetrics & Gynecology.

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Domestic Responsibilities Tied to Physician Mothers' Satisfaction

THURSDAY, April 11, 2019 (HealthDay News) -- For physician mothers in procedural specialties, being responsible for five or more domestic tasks is associated with an increased likelihood of career dissatisfaction, according to a study published online April 10 in JAMA Surgery.

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Very Low LDL-C, Triglycerides Tied to Hemorrhagic Stroke Risk in Women

THURSDAY, April 11, 2019 (HealthDay News) -- Women with very low low-density lipoprotein cholesterol (LDL-C) or low triglycerides have an increased risk for hemorrhagic stroke, according to a study published online April 10 in Neurology.

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Inflammatory Arthritis Linked to Sexual Dysfunction

THURSDAY, April 11, 2019 (HealthDay News) -- Sexual dysfunction appears to be highly prevalent in both men and women with inflammatory arthritis (IA), according to a review published online April 3 in Arthritis Care & Research.

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SSI Risk Up After C-Section for Medicaid Beneficiaries

THURSDAY, April 11, 2019 (HealthDay News) -- The risk for surgical site infection (SSI) after cesarean delivery is increased for women covered by Medicaid versus private health insurance, according to a study published online April 9 in Infection Control & Hospital Epidemiology.

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FDA: Patients Should Not Abruptly Stop Taking a Prescribed Opioid

WEDNESDAY, April 10, 2019 (HealthDay News) -- Because of the danger of "serious harm" to patients, the U.S. Food and Drug Administration is advising doctors not to suddenly stop patients from taking opioid painkillers, or drastically lower the dose.

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Review Links Adverse Events to Use of Herbal Meds in Pregnancy

WEDNESDAY, April 10, 2019 (HealthDay News) -- The use of herbal medicinal products during pregnancy and the postnatal period is associated with increased risk of adverse events, according to a review published online April 9 in Obstetrics & Gynecology.

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People With Obesity Are Blatantly Dehumanized

WEDNESDAY, April 10, 2019 (HealthDay News) -- People with obesity are not only commonly stigmatized, but are blatantly dehumanized, according to research published online April 2 in Obesity.

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Same Services More Expensive in Outpatient Than Office Settings

WEDNESDAY, April 10, 2019 (HealthDay News) -- The same services are more expensive when performed in outpatient versus office settings, according to a blog post from the Health Care Cost Institute.

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Haptoglobin Expression Tied to Outcomes in Preterm Newborns

WEDNESDAY, April 10, 2019 (HealthDay News) -- The absence of haptoglobin (Hp) may be a marker of poor neonatal outcomes among preterm newborns exposed to in utero inflammation, according to a secondary analysis of a randomized controlled trial published online March 22 in EClinicalMedicine.

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Recurrence Score May Cut Costs for High-Risk Breast Cancer Care

WEDNESDAY, April 10, 2019 (HealthDay News) -- Genomic recurrence score (RS) testing using a 21-gene assay is associated with decreased cancer care costs in real-world practice among certain patients with breast cancer who would otherwise receive standard chemotherapy, according to a study published in the March issue of the Journal of the National Comprehensive Cancer Network.

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Genetic Testing Underused in Breast, Ovarian Cancer

TUESDAY, April 9, 2019 (HealthDay News) -- Only one-quarter of those with breast cancer and one-third with ovarian cancer undergo genetic testing, according to a study published online April 9 in the Journal of Clinical Oncology.

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FDA Approves Osteoporosis Tx for High-Risk Postmenopausal Women

TUESDAY, April 9, 2019 (HealthDay News) -- Evenity (romosozumab-aqqg) was approved for the treatment of osteoporosis in postmenopausal women with a high risk for fracture, the U.S. Food and Drug Administration announced.

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Proximity to Major Roadways Impacts Child Development

TUESDAY, April 9, 2019 (HealthDay News) -- Proximity to major roadways and prenatal/early life exposure to particulate matter <2.5 µm (PM2.5) and ozone (O3) are associated with childhood developmental delays, according to a study published online April 9 in Environmental Research.

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New, Revised Topics Released in ACR Appropriateness Criteria

TUESDAY, April 9, 2019 (HealthDay News) -- The latest edition of the American College of Radiology (ACR) Appropriateness Criteria has been released and includes 188 diagnostic imaging and interventional radiology topics, with 908 clinical variants covering more than 1,670 clinical scenarios.

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Dietary Supplement Use Not Linked to Mortality Benefits

TUESDAY, April 9, 2019 (HealthDay News) -- For U.S. adults, dietary supplements are not associated with mortality benefits, according to a study published online April 9 in the Annals of Internal Medicine.

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Guidance Statements Issued for Breast Cancer Screening

MONDAY, April 8, 2019 (HealthDay News) -- Four evidence-based guidance statements on breast cancer screening have been developed by the American College of Physicians and published online April 9 in the Annals of Internal Medicine.

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Preventive Drugs Often Used in Last Year of a Cancer Patient's Life

MONDAY, April 8, 2019 (HealthDay News) -- Preventive drugs are frequently used in the last year of life among older adults with cancer, according to a study published online March 25 in Cancer.

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Alcohol, Drug Misuse Tied to Long-Term Health Problems

MONDAY, April 8, 2019 (HealthDay News) -- More than one-third of U.S. adults in recovery for alcohol and other drug (AOD) use have health problems related to previous substance use, according to a study published online March 16 in the Journal of Addiction Medicine.

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Draft Recommendation Promotes Screening Women for Anxiety

MONDAY, April 8, 2019 (HealthDay News) -- Adolescent and adult women, including those who are pregnant and postpartum, should be assessed for anxiety as a routine preventive health service, according to a draft recommendation statement published online April 1 by the Women's Preventive Services Initiative (WPSI).

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Female Infertility Specialists Make Less Than Male Specialists

FRIDAY, April 5, 2019 (HealthDay News) -- Although women outnumber men as obstetrician/gynecology clinicians, they still make significantly less money even in subspecialties like reproductive endocrinology and infertility (REI), according to a study published online March 25 in Fertility and Sterility.

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Histologic Clearance of CIN2/3 Seen With HPV Therapeutic Vaccine

FRIDAY, April 5, 2019 (HealthDay News) -- For women with cervical intraepithelial neoplasia (CIN) grade 2 or 3 associated with high-risk human papillomavirus (HPV), an immunotherapeutic tipapkinogen sovacivec (TS) HPV vaccine is effective for achieving histologic resolution, according to a study published online April 4 in Gynecologic Oncology.

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Pregnancy History Not Likely Tied to Later Cognitive Function

FRIDAY, April 5, 2019 (HealthDay News) -- There is no clinically meaningful long-term association between pregnancy history and age-related change in cognitive function, according to a study published online March 18 in Menopause.

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Digital Breast Tomosynthesis Boosts Metrics in Older Women

FRIDAY, April 5, 2019 (HealthDay News) -- In older women, digital breast tomosynthesis (DBT) is associated with improved performance metrics versus digital mammography (DM), although the cancer detection rate is similar, according to a study published online April 2 in Radiology.

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Depressive Symptoms May Up Risk for Death in HIV+ Veterans

FRIDAY, April 5, 2019 (HealthDay News) -- Among U.S. veterans with HIV infection, depressive symptoms are associated with a significantly increased risk for mortality, but depression is not, according to a study published online March 29 in HIV Medicine.

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FDA: High Levels of Heavy Metals Found in Kratom Products

THURSDAY, April 4, 2019 (HealthDay News) -- Dangerously high levels of heavy metals have been found in dozens of kratom products, the U.S. Food and Drug Administration said Wednesday.

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Drop Seen in Preinvasive Cervical Disease With HPV Vaccination

THURSDAY, April 4, 2019 (HealthDay News) -- Routine vaccination of young girls aged 12 to 13 years with human papillomavirus (HPV) vaccine results in a reduction in preinvasive cervical disease, according to a study published online April 3 in The BMJ.

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Adherence to Prenatal Screening Recommendations Varies by Lab

THURSDAY, April 4, 2019 (HealthDay News) -- Laboratories vary in the extent to which they adhere to recommendations from the American College of Medical Genetics and Genomics (ACMG) for noninvasive prenatal screening (NIPS), according to a study published online April 3 in Genetics in Medicine.

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Most Osteoporosis Guidelines Do Not Discuss Patient Choices

THURSDAY, April 4, 2019 (HealthDay News) -- Less than 40 percent of osteoporosis clinical practice guidelines include any mention of patients' beliefs, values, or preferences (BVPs), according to a study published online March 11 in Osteoporosis International.

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Minerals Not Linked to Multiple Sclerosis Risk in Women

WEDNESDAY, April 3, 2019 (HealthDay News) -- Mineral intake seems not to be associated with the risk for multiple sclerosis (MS) among women, according to a study published online April 3 in Neurology.

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Late Preterm Steroid Therapy Found to Be Cost-Effective

WEDNESDAY, April 3, 2019 (HealthDay News) -- In women at high risk for late preterm delivery, antenatal treatment with betamethasone is a cost-effective strategy, according to a study published online March 11 in JAMA Pediatrics.

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Americans Borrowed $88 Billion in Past Year to Pay for Health Care

TUESDAY, April 2, 2019 (HealthDay News) -- About one in eight Americans borrowed a total of $88 billion in the past year to pay for health care, a new West Health-Gallup survey shows.

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Sex Hormone Levels May Impact Development of Asthma

TUESDAY, April 2, 2019 (HealthDay News) -- Sex hormones may impact the risk for asthma, with elevated sex hormone-binding globulin (SHBG) demonstrating a protective effect in females, according to research recently published in Thorax.

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Cesarean Delivery May Up Risk for Severe Maternal Morbidity

TUESDAY, April 2, 2019 (HealthDay News) -- Cesarean delivery is associated with an increased risk for severe maternal morbidity, according to a study published online April 1 in CMAJ, the journal of the Canadian Medical Association.

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Dolutegravir Feasible for HIV Tx in Women of Childbearing Age

TUESDAY, April 2, 2019 (HealthDay News) -- Dolutegravir should be considered for antiretroviral therapy (ART) in treating HIV in women of childbearing potential in resource-limited settings, despite its associated risk for neural tube defects, according to a study published online April 2 in the Annals of Internal Medicine.

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Guidelines for Asymptomatic Bacteriuria Updated

TUESDAY, April 2, 2019 (HealthDay News) -- Recommendations have been updated for the management of asymptomatic bacteriuria (ASB); the Infectious Diseases Society of America clinical practice guideline was published online March 21 in Clinical Infectious Diseases.

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Over-the-Counter Meds Save Health Care System Money

TUESDAY, April 2, 2019 (HealthDay News) -- On average, each dollar spent on over-the-counter (OTC) medicines saves the U.S. health care system $7.20, totaling nearly $146 billion in annual savings, according to a report released March 18 by the Consumer Healthcare Products Association (CHPA).

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Doctors Unclear on Legal Obligations in Caring for Patients With Disability

MONDAY, April 1, 2019 (HealthDay News) -- Practicing physicians might not understand their legal responsibilities when caring for people with disability, which may contribute to inequalities in their care, according to a study published online April 1 in Health Affairs.

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Undiagnosed Gestational Diabetes Ups Risk for Stillbirth

MONDAY, April 1, 2019 (HealthDay News) -- Women at risk for gestational diabetes mellitus (GDM) who are not screened or diagnosed are more likely to experience stillbirth than women who undergo screening, according to a study published online March 19 in BJOG, an international journal of obstetrics and gynecology.

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