OB/GYN Clinical Alert articles from October 2004

OB/GYN Clinical Alert archives from October 2004

Cesareans for all?(Special Report)
October 1, 2004... Cesarean Section Rate Trends IT IS CLEAR THAT THE UNITED STATES' CESAREAN SECTION RATE (CSR), while tailing off in the late 1990's, is now again rapidly heading upward. For example, the CSR in 1988 reached 24.7% after rising steadily from...

YKL-40 and ovarian cancer.(Abstract & Commentary)
October 1, 2004... Synopsis: YKL-40 may represent a novel marker for the detection of early-stage ovarian cancer. YKL-40 levels in early stage patients may also predict disease recurrence and survival. The use of YKL-40 in detection of early stage ovarian cancer...

Assessing blood estradiol levels.(Abstract & Commentary)
October 1, 2004... Synopsis: Topical estradiol application can be associated with falsely high blood estradiol measurements. ********** VIHTAMAKI AND COLLEAGUES FROM FINLAND MEASURED the circulating levels of estradiol 12 hours after the topical,...

Surgical staging of ovarian low malignant potential tumors.(Abstract & Commentary)
October 1, 2004... Synopsis: Routine pelvic and para-aortic lymph node dissection is not necessary in the majority of women with ovarian low malignant potential tumors. ********** PATIENTS WITH OVARIAN TUMORS OF LOW MALIGNANT potential have an excellent...

CME questions.
October 1, 2004... 6. The following statements are true regarding measuring blood estradiol levels in women receiving hormone therapy except: a. Differences among individuals in the metabolism of estrogen accounts for variability in clinical response to a...

Folate therapy and in-stent restenosis and coronary stenting.(Brief Article)
October 1, 2004... Source: Lange H, et al. N Engl J Med. 2004;350:2673-2681. OBSERVATIONAL DATA HAVE SUPPORTED the role of homocysteine (HCS) as a cause of or contributor atherosclerosis. Randomized trials of interventions to reduce HCS have provided...

Quinapril reduces markers of oxidative stress in the metabolic syndrome.(Brief Article)
October 1, 2004... Source: Khan B, et al. Diabetes Care. 2004;27:1712-1715. THE METABOLIC SYNDROME (MBS) MAY be defined as 3 or more of: increased waist circumference (men > 40 inches, women > 35 inches), triglycerides > 150, reduced HDL (men 130/85, and...

Donepezil in patients with Alzheimer's.(Brief Article)
October 1, 2004... Source: AD2000 Collaborative Group Lancet. 2004;363:2105-2115. BECAUSE USE OF CHOLINESTERASE inhibitors is neither inexpensive nor without significant potential adverse effects, their long-term impact on patients with dementing disorders...

Effect of the dietary approaches to stop hypertension diet and reduced sodium intake on blood pressure control.(Brief Article)
October 1, 2004... Source: Svetkey LP, et al. J Clin Hypertens. 2004;6:373-381. THE DIETARY APPROACHES TO STOP Hypertension (DASH) diet, which suggests high intake of fruits, vegetables, and low-fat diary products, has been shown to favorably affect blood...

Methylprednisolone, valacyclovir, or the combination for vestibular neuritis.(Brief Article)
October 1, 2004... Source: Strupp M, et al. N Engl J Med. 2004;351:354-361. VESTIBULAR NEURITIS (VN) IS characterized by acute onset of vertigo, a positive Romberg's sign, nystagmus, and nausea. It is second only to benign paroxysmal positional vertigo as a...

Improved plasma glucose control, whole-body glucose utilizations, and lipid profile on a low-glycemic index diet in type 2 diabetic men.(Brief Article)
October 1, 2004... Source: Rizkalla SW, et al. Diabetes Care. 2004;27:1866-1872. AT THE SAME LEVEL OF GRAMS OF Carbohydrate, different foods vary in their rate of rise of plasma glucose, and in the subsequent amount and timing of insulin response they elicit....

Linking COX-2 inhibitors and cardiovascular event risk.
October 1, 2004... A new, and as of yet unpublished study, has raised increased concern about the relationship between rofecoxib (Vioxx), Merck's blockbuster COX-2 inhibitor, and cardiovascular events. The study, which was presented at a meeting in Bordeaux...

Viagra: maximum capacity at high-altitudes?
October 1, 2004... High-altitude hikers may soon be requesting sildenafil (Viagra) prescriptions based on the results of a new study. The drug, which is a phosphodiesterase-5 inhibitor, is known to cause pulmonary vasodilation. German researchers postulated that...

FDA actions.
October 1, 2004... Eli Lilly has received FDA approval to market duloxetine (Cymbalta) for the treatment of major depression. The drug is a serotonin and norepinephrine reuptake inhibitor (SNRI), similar to venlafaxine (Effexor-Wyeth). The drug is also being...