OB/GYN Clinical Alert articles from September 2004

OB/GYN Clinical Alert archives from September 2004

Frequency of symptoms of ovarian cancer in women presenting to primary care clinics.(Abstract & Commentary)
September 1, 2004... IT HAS BEEN RECENTLY RECOGNIZED AND INCREASINGLY REPORTed that ovarian cancer patients frequently manifest symptoms, predominately related to their gastrointestinal or urinary tracts, a significant period of time ahead of their diagnosis. Goff...

Biophysical profile with amniotic fluid volume assessments.(Abstract & Commentary)
September 1, 2004... Synopsis: The AFI offers no advantage in detecting adverse outcomes compared with the single deepest pocket when performed with the BPP. The AFI may cause more interventions by labeling twice as many at-risk pregnancies as having...

Analyzing reproductive performance before and after abdominal myomectomy.(Abstract & Commentary)
September 1, 2004... Synopsis: Abdominal myomectomy might improve reproductive outcome in cases of intramural or subserosal fibroids especially if the patient is less than 30 years of age and the myoma is single. Source: Marchionni M, et al. Fertil Steril....

Long-term use of phytoestrogens and the endometrium.(Abstract & Commentary)
September 1, 2004... Synopsis: Long-term treatment (up to 5 years) with soy phytoestrogens was associated with an increased occurrence of endometrial hyperplasia. These findings call into question the long-term safety of phytoestrogens with regard to the...

Patient preferences for treatment of dysfunctional bleeding.(Abstract & Commentary)
September 1, 2004... Synopsis: A majority of patients scheduled for endometrial ablation or a levonorgestrel-releasing IUD were willing to accept a 50% likelihood of treatment failure to avoid hysterectomy. Source: Bourdez, et al. Fertil Steril....

Should gynecologists screen for hypothyroidism?(Special Feature)
September 1, 2004... IT IS HARD TO BELIEVE, BUT WHOM, HOW, AND WHEN TO screen for thyroid disease is a highly controversial topic. The controversy is fueled by uncertainty about which populations are at risk, short-term cost vs benefit considerations, lack of...

CME question.
September 1, 2004... 5. The following statements are true regarding the association between endometrial cancer and postmenopausal estrogen therapy except: a. With standard doses of estrogen, unopposed by a progestin, a substantial number of women develop...

Prostate cancer among men with a prostate-specific antigen level < 4.0 ng/ml.(Brief Article)
September 1, 2004... Source: Thompson IM, et al. N Engl J Med. 2004;350:2239-2246. THE PROSTATE CANCER PREVENTION trial enrolled 18,882 men to evaluate whether an alpha-reductase inhibitor, finasteride, could prevent incident prostate cancer in men with normal...

Mirtazapine for reducing nocturnal itch in patients with chronic pruritus.(Brief Article)
September 1, 2004... Source: Hundley JI, Yosipovitch G. J Am Acad Dermatol. 2004;50:889-891. PRURITUS IS A COMMONPLACE COMplaint of persons with dermatological disorders like psoriasis, atopic dermatitis, and chronic urticaria. Nocturnal itch interrupts sleep...

Interventions for the prevention of postoperative nausea and vomiting.(Brief Article)
September 1, 2004... Source: Apfel CC, et al. N Engl J Med. 2004;350:2441-2451. AS MANY AS 1 OUT F 3 POST-SURGIcal patients suffer nausea and vomiting (N&V), unless prophylaxed with antiemetic pharmacotherapy. Worldwide, 75 million persons per year undergo a...

Multivitamin supplements and HIV disease progression and mortality.(Brief Article)
September 1, 2004... Source: Fawzi WW, et al. N Engl J Med. 2004;351:23-32. THE GREATEST BURDEN OF THE HIV epidemic resides outside the United States. Especially in economically lesser-privileged nations, not all individuals who might benefit from...

The long-term outcomes of Sibutramine effectiveness on weight (LOSE weight) study.(Brief Article)
September 1, 2004... Source: Porter JA, et al. Am J Manag Care. 2004;10:369-376. CLINICAL TRIALS IN RESEARCH SETtings may not reflect accuratelys what clinicians in a non-academic milieu may anticipate, despite using the same fundamental pharmacologic tools....

Trial of atorvastatin in rheumatoid arthritis (TARA).(Brief Article)
September 1, 2004... Source: McCarey DW, et al. Lancet. 2004;363:2015-2021. MODULATION OF LIPID LEVELS Appears to be the primary mechanism for beneficial effects of statins upon cardiovascular disease. At the same time, statins have been demonstrated in-vitro...

New clinical guidelines on cholesterol management.
September 1, 2004... The National Cholesterol Education Program (NCEP), a product of a collaboration of the National Heart, Lung, and Blood Institutes, the American College of Cardiology, and the American Heart Association, has updated its clinical practice...

Hypothyroidism and pregnancy.(Brief Article)
September 1, 2004... A new study clarifies thyroid replacement therapy during pregnancy. Researchers at Harvard followed 19 women with hypothyroidism through 20 pregnancies, of which 17 resulted in full-term births. Thyroid function, HCG levels, and estradiol were...

Anti-depressants sad the risk of suicide.(Brief Article)
September 1, 2004... The risk of suicidal behavior is relatively high after starting anti-depressants, however, there is no statistical difference between anti-depressants used, according to a new study. Researchers reviewed data from the UK General Practice...

FDA actions.(Brief Article)
September 1, 2004... The FDA has approved acamprosate (Campral-Merck) for the maintenance of abstinence in patients in alcohol recovery programs. The drug, which has been available in Europe for several years, may not work if patients are still drinking or abusing...

Brief notes.(Ginseng)
September 1, 2004... The over-the-counter cough medications, dextromethorphan and diphenhydramine, are no better than placebo in suppressing cough in children (Pediatrics. 2004;114:e85-e90). Many women are turning to phytoestrogens in lieu of hormone...