US Pharm. 2007;32(6):HS-38.

Breast-Feeding Cuts HIV Mortality
A South African study published in Lancet found that HIV-positive mothers who exclusively breast-fed their babies could likely cut HIV transmission in half. According to researcher Hoosen Coovadia, MD, from the University of KwaZulu-Natal in South Africa, and colleagues, babies who are exclusively breastfed have a lower risk of HIV infection compared to those children who received other food or liquids in addition to breast milk before they were six months old.

Mixed feeding before or after 14 weeks nearly doubled the HIV transmission risk, and the addition of solids increased the risk 11-fold. In fact, Dr. Coovadia and the researchers reported that mortality by three months for replacement-fed babies was more than double that of those who were exclusively breast-fed. The findings suggest that infant feeding guidelines for HIV-positive women be revised.

Obesity May Alter Prostate Biopsy Readings
According to a study conducted by Stephen Freedland, MD, Duke University, and colleagues, published in the journal Urology obese men were significantly more likely than men of normal weight to have cancers of a higher grade. The findings were based on biopsy results from more than 1,000 men who had their prostates surgically removed.

"We already know that it's more difficult to diagnose prostate cancer in obese men because they have lower levels of prostate-specific antigen," commented Dr. Freedland. He said overweight men also have a larger-sized prostate, making it more likely for a biopsy to miss the cancer. "These findings further suggest that we could be missing even more high-grade disease among obese men."

Mammography Rates Down Nationwide
Results from a National Cancer Institute study show a significant decline in the number of mammograms given annually. Surveying some 35,000 women across the U.S., lead researcher Nancy Breen, PhD, and colleagues found that mammography rates dropped by 4% in a recent five-year period, down from the peak rate of 70% in 2000 to 66% in 2005.

This trend represents a reversal in mammogram screening rates. Between 1987 and 2000, the percentage of women ages 40 and older who were getting screened for breast cancer grew steadily. Between 2000 and 2003, however, the mammography rates leveled off. The researchers reported that mammography use dropped the most in the population with the highest rates of breast cancer, women in the 50 to 64 age-group, dropping by nearly 7%. 

The researchers are unsure why mammogram rates are on the decline and are developing studies to help explain the alarming trend. "We really need to know why it is that screening isn't happening before we can talk about developing strategies that are going to work," said Dr. Breen.

Ovarian Cancer Undertreated
According to an analysis of hospital data from nine states done by Barbara Goff, MD, 66.9% of all women admitted with a diagnosis of ovarian cancer received optimal treatment, but one in three American women with the disease may not be getting the recommended comprehensive surgical treatment.

Dr. Goff and her colleagues said that among those who may be undertreated are women ages 71 or older, women of African-American race or Hispanic ethnicity, or those covered by Medicaid. The study also revealed that women with advanced cancer were nearly five times as likely to get comprehensive care compared to women with early state disease; and women treated at non-teaching hospitals by a medium-or high-volume surgeon were 35% to 57% more likely to receive optimal treatment for ovarian cancer.

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