OB/GYN Clinical Alert – April 1, 2004

April 1, 2004

• Swedish HABITS Is Cancelled

  Hormonal replacement therapy after breast canceris It Safe? (HABITS) began in May 1997, to compare breast cancer survivors treated for at least 2 years with hormone therapy with treatment other than hormones. By September 2003, a total of 434 women had been randomized and, in December 2003, the steering committee of the HABITS study made the decision to stop the trial because there were 26 women in the treated group and 7 in the non-treated group with new breast cancer diagnoses.

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• Cervical Adenocarcinoma and Squamous Cell Carcinoma Incidence Trends Among White and Black Women in the United States

  Changes in screening, endocervical sampling, nomenclature, and improvements in treatment likely explain the increased in situ cervical SCC incidence in white and black women. Increasing AIS incidence over the past 20 years in white women has not yet translated into a decrease in invasive AC incidence.

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• BRCA Germline Mutations in Jewish Women with Uterine Serous Papillary Carcinoma

  The loss of heterozygosity in the tumor tissue of carriers coupled with the high frequency of patient and family history of breast and ovarian malignancies suggest that USPC might be part of the manifestation of familial breast-ovarian cancer in Ashkenazi Jews.

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• Microchimerism: An Investigative Frontier in Autoimmunity and Transplantation

  In this article, Adams and Nelson integrate results from several disparate fields to advance the concept that autoimmune conditions resemble host vs graft disease and that the graft in many cases may be fetal or maternal cells that lodge in the host, namely the mother or fetus, respectively.

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• Abdominal and Vaginal Colpopexy Comparable for Vault Prolapse

  Ninety-five patients with vaginal vault prolapse were randomly assigned to having either an abdominal sacral colpopexy with Prolene mesh or unilateral sacrospinous colpopexy. All patients in both groups with stress incontinence also had Burch colposuspension. The abdominal approach was associated with longer operating room time, higher cost, and longer convalescence.

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• Special Feature: What is the Best Way to Monitor Maternal Temperature in Labor?

  To answer the title question a team of british investigators (Banerjee S, et al. Obstet Gynecol. 2004;103:287-293) inserted an intrauterine temperature sensor in 18 laboring patients with epidural anesthesia at the time they were inserting intrauterine pressure catheters. These patients then were monitored with periodic oral thermometer sampling, continuous skin temp assessment (taped to the inner thigh) and the commonly used ear canal temperature assessments.

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• Pharmacology Watch: Estrogen Found to Not Affect Heart Disease, Breast Cancer

  Antibiotics Associated With Cancer Risk; Topiramate Effective Against Migraine; Statin Therapy For Heart Failure; FDA Actions.

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• Clinical Briefs in Primary Care Supplement

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