Journal of women's health
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Journal of women's health · Mar 2014
Patterns of postpartum depot medroxyprogesterone administration among low-income mothers.
Depot medroxyprogesterone acetate (DMPA) is often administered immediately postpartum to reduce the risk of short-interval repeat or unintended pregnancies, but little is known about the actual patterns of postpartum DMPA use. This article examines the patterns of DMPA administered among low-income new mothers in an upstate New York State community. ⋯ This study of postpartum DMPA administration among a convenience sample of low-income mothers demonstrated rates of 26% overall, but there was between-hospital variability. Additional study may identify approaches to ensure timely administration to appropriate candidates.
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Journal of women's health · Mar 2014
U.S. Preventive Services Task Force recommendations and cancer screening among female Medicare beneficiaries.
Medicare covers several cancer screening tests not currently recommended by the U.S. Preventive Services Task Force (Task Force). In September 2002, the Task Force relaxed the upper age limit of 70 years for breast cancer screening recommendations, and in March 2003 an upper age limit of 65 years was introduced for cervical cancer screening recommendations. We assessed whether mammogram and Pap test utilization among women with Medicare coverage is influenced by changes in the Task Force's recommendations for screening. ⋯ Although there is evidence that many Medicare beneficiaries adhere to screening guidelines, some women may be receiving non-recommended screening services covered by Medicare.
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Journal of women's health · Mar 2014
Enrollment and monitoring of women in post-approval studies for medical devices mandated by the Food and Drug Administration.
Disease presentation, prevalence, and treatment effects vary by sex, thus it is important to ensure adequate participation of both sexes in medical device post-approval studies (PAS). ⋯ Data on sex was not routinely assessed in FDA reviews. Based on these findings, FDA implemented new procedures to ensure participation by sex is evaluated in PAS reviews. FDA will continue working with applicants to develop PAS that enroll and retain proportions of women consistent with the sex-specific prevalence for the disease or condition the device is used to treat.
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Journal of women's health · Feb 2014
Does removal of the primary tumor in metastatic breast cancer improve survival?
Although relative survival for breast cancer has improved in recent years, patients who present with metastatic disease have a less than 30% 5-year survival. Thus, improvements in treatment for these patients have the potential to have a significant impact on outcomes. ⋯ Here, we review the theories and data at the center of the debate, the landmark studies that historically guided treatment, the retrospective data that revisited the role of removal of the primary tumor, as well as the latest advances in basic science and the accruing clinical studies to provide for future directions in this field. Although the definitive role of removal of the primary tumor in metastatic breast cancer is not settled, it is critical to understand the complexities of this debate in order to make further gains in breast cancer survivorship.