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Six Researchers To Receive Prestigious Awards From The American Society Of Hematology
The American Society of Hematology (ASH), the world"s largest professional society of blood specialists, will honor six scientists who have made significant contributions to the understanding of hematologic diseases. These awards, including the newly created Ernest Beutler Lecture and Prize, will be presented at the 51st ASH Annual Meeting taking place December 5-8 in New Orleans.
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Tummy Troubles -- Gastrin Key In Bacterial-Induced Stomach Cancer
Current research suggests that levels of gastrin play a key role in the development of Helicobacter-induced stomach cancer. The related report by Takaishi et al, "Gastrin is an essential cofactor for Helicobacter-associated gastric corpus carcinogenesis in C57BL/6 mice," appears in the July 2009 issue of The American Journal of Pathology.
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U.S. Must Do More To Address Maternal Mortality In Developing Countries, Rep. Moore Writes In Opinion Piece
President Obama and first lady Michelle Obama"s visit to Africa this weekend "will send a powerful message to the world about their commitment to ensuring Africa"s continued progress," Rep. Gwen Moore (D-Wis.) writes in an opinion piece in The Hill. She continues that "for Africa to make this long-forestalled progress, a renewed promise must be made to provide highly cost-effective solutions to ensure that women are healthy before, during and after pregnancy."According to Moore, "More than 500,000 women worldwide die from pregnancy each year, and millions more endure life-threatening complications." For example, in Ghana, women"s risk of pregnancy-related death is one in 45, compared with one in 4,800 in the U.S., she writes. "In some of the world"s poorest countries, including Afghanistan, the maternal death risk is as high as one in eight," Moore adds. Access to health care is a significant part of the problem, she writes, noting that "[o]nly 40% of births worldwide take place in a health facility" and that "[s]ix of the seven countries with the highest levels of maternal mortality have less than one doctor per every 10,000 people."Moore continues that she is "encouraged" that the House Appropriations Committee recently approved increased funding for family planning and maternal and child health as part of the fiscal year 2010 Foreign Operations Appropriations bill (HR 3081). "However, more remains to be done by the United States and our partners around the world if we are truly going to fulfill the promise of the Millennium Development Goals by 2015, one of which is to reduce maternal mortality by three-quarters and achieve universal access to reproductive health," she adds. Although there has been progress in fighting HIV/AIDS and working toward other Millennium Development Goals, "[w]e must recognize the appalling lack of progress that has been made in the area of maternal mortality, child mortality and family planning as major barriers to progress on all of the other goals," according to Moore."Pregnancy, childbirth and motherhood should not be a death sentence," Moore writes. She concludes, "Improving impoverished women"s chances of survival before, during and after pregnancy is an issue of rights and social justice. It is also a sound economic and social investment, given the importance of women to the well-being of their children, families and societies" (Moore, The Hill, 7/7).
Diagnostics

ACOG Issues Revision Of Labor Induction Guidelines

Revised guidelines on when and how to induce labor in pregnant women were issued by The American College of Obstetricians and Gynecologists (ACOG). The guidelines provide physicians with guidance regarding which induction methods may be most appropriate under particular circumstances, as well as the safety requirements, and risks and benefits of the different methods. ACOG"s Practice Bulletin "Induction of Labor" is published in the August 2009 issue of Obstetrics & Gynecology. The rate of labor induction in the US has more than doubled since 1990. In 2006, more than 22% (roughly 1 out of every 5) of all pregnant women had their labor induced. The goal of labor induction is to artificially stimulate uterine contractions so that pregnant women can deliver vaginally. As with all procedures, the risks must be weighed against the benefits to the woman and the fetus. "There are certain health conditions, in either the woman or the fetus, where the benefit of inducing labor is clear-cut," says Susan Ramin, MD, from the University of Texas Medical School in Houston who helped lead the development of ACOG"s Practice Bulletin. "And, there are some nonmedical situations in which induction also may be prudent, for instance, in rural areas where the distance to the hospital is just too great to risk waiting for spontaneous labor to happen at home." In circumstances like these, the ACOG recommendations say the gestational age of the fetus should be determined to be at least 39 weeks or that fetal lung maturity must be established before induction. Cervical ripening is the first component to labor induction. If the cervix is not sufficiently dilated, then drugs or mechanical cervical dilators should be used to ripen the cervix before labor is induced. Once the cervix is dilated, labor can be induced with oxytocin, membrane stripping, rupture of the amniotic membrane, or nipple stimulation. Misoprostol, a medication for peptic ulcers, is a commonly used off-label drug that both ripens the cervix and induces labor. The ACOG guidelines indicate that inducing labor with misoprostol should be avoided in women who have had even one prior cesarean delivery due to the possibility of uterine rupture (which can be catastrophic). According to ACOG, there are a number of health conditions that may warrant inducing labor but physicians should take into account maternal and infant conditions, cervical status, gestational age, and other factors. Some examples in which labor induction is indicated include (but are not limited to) gestational or chronic hypertension, preeclampsia, eclampsia, diabetes, premature rupture of membranes, severe fetal growth restriction, and postterm pregnancy. "There are certain situations where labor induction is contraindicated," says Dr. Ramin. These situations include (but are not limited to) transverse fetal position, umbilical cord prolapse, active genital herpes infection, placenta previa, and women who have had a previous myomectomy (fibroid removal) from the inside of the uterus, according to ACOG. "A physician capable of performing a cesarean should be readily available any time induction is used in the event that the induction isn"t successful in producing a vaginal delivery," notes Dr. Ramin. Although rare, there are potential complications with some methods of labor induction. "These guidelines will help physicians utilize the most appropriate method depending on the unique characteristics of the pregnant woman and her fetus." Practice Bulletin #107, "Induction of Labor," is published in the August 2009 issue of Obstetrics & Gynecology. American College of Obstetricians and Gynecologists


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