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M ORE THAN A third of twin births and three-quarters of births of triplets or greater multiples in the United States can be attributed to fertility treatments, accord- ing to recent fi gures published in The New England Journal of Medicine. By comparing data on multiple births from 1962 to 1966, prior to the availability of fertility treatments, with data from 1971 to 2011, Eli Y. Adashi, MD, Professor of Obstetrics and Gynecology at Brown University, and his colleagues found that 36 percent of twins and 77 percent of triplets and higher-order births by 2011 resulted from fertility treatment-assisted conception. Since 1998, when physicians were discouraged from implanting three or more embryos, there has been a 29 percent decrease in triplet and higher-order births. That reduction occurred in the same period during which transfer of three or more embryos during in vitro fertilization (IVF) decreased 70 percent and triplet and higher-order births related to IVF fell 33 percent. In the same period, however, non-IVF procedures resulted in an increasing percentage of those births — rising from 36 percent to 45 percent. ■ — Caitlin Foster P RIMARY CARE PHYSICIANS are signifi cantly more likely than obstetrician-gynecologists to address concurrent medical issues during preventive gynecologic visits, Donna Cohen, MD, and Andrew Coco, MD, reported recently in the Journal of the American Board of Family Medicine. Drs. Cohen and Coco analyzed data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey related to gynecological exams and routine cervical Pap tests between 1999 and 2008. In an analysis of 7,882 visits, they found that primary care physicians were 2.41 times more likely than OB/GYNs to include one or more medical diagnoses during a preventative gynecologic visit. The researchers concluded that this highlights the potential for the patient-centered medical home model — in which primary care physicians play a central role — to enhance the delivery, accessibility and comprehensiveness of women's health care. ■ — Caitlin Foster A GROUP OF RESEARCHERS led by Harvard University's Wyss Institute of Biologically Inspired Engineering has developed a new, noninvasive therapy that prevents or partially reverses breast cancer develop- ment in mice. The fi ndings were published recently in Science Translational Medicine. Researchers treated cancerous, lab-grown cells from mouse milk ducts with small interfering RNA (siRNA) to block the HoxA1 gene, which is strongly linked to cancer. Once treated, the cells stopped becoming malignant and started reacting like healthy cells. The siRNA treatment also halted breast cancer in mice engineered to have genes that cause cancer. Researchers hope the therapy eventually could be used in early stages of the disease in humans to heal cancerous tissue rather than kill it with surgery, chemotherapy or radiation. ■ — Caitlin Foster Therapy Holds Promise to Reverse, Prevent Breast Cancer A Boost for the Patient-Centered Medical Home High Proportion of Multiple Births Linked to Fertility Treatments + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + THAT'SNEWS ❯❯❯ 4 2 | Cleveland/Akron/Canton MD NEWS ■ M D N E W S . CO M ■ S E P T E M B E R /O C T O B E R 2 0 1 4