OB GYN News articles from April 2000

OB GYN News archives from April 2000

Female Depression: Unipolar vs. Bipolar.
April 1, 2000... VAIL, COLO. -- Premenstrual and postpartum depression can be either unipolar or bipolar in nature, and it's vital to recognize the difference, Dr. Steven Dubovsky warned at a conference on obstetrics and gynecology sponsored by the University...

FDA Panel Backs Approval of Saline Breast Implants.
April 1, 2000... There is 'reasonable assurance' the devices are safe, but more data are needed. GAITHERSBURG, MD. -- Two brands of saline-filled breast implants are likely to stay on the market if the Food and Drug Administration follows the...

Metronidazole Nearly Doubles Preterm Birth Risk.
April 1, 2000... Don't treat asymptomatic T. vaginalis. MIAMI BEACH -- Asymptomatic Trichomonas vaginalis in pregnant women should not be treated with metronidazole, because the therapy is associated with a significantly increased risk of preterm birth,...

Quality vs. Quantity.
April 1, 2000... I was speaking to a group of 20 women who were cancer survivors, all but two of whom had a history of breast cancer. So, as I started my talk I expected to hear an audible gasp at the mention of estrogens for menopause. But when I...

Back & Forth.
April 1, 2000... Dear Dr. Weinberg: I was reading "Do We Need Another Specialist?" the other day in the surgery lounge (From the Front Line, Feb. 1, 2000, p. 5). When I finished, I turned to a colleague of mine, Dr. Machiavelli. "Nick," I said, "what do...

Does capitation have a future?
April 1, 2000... Alex Hunter YES Capitation does have a future, but it will have to evolve as different markets continue to evolve. In markets in which it already exists, such as Orange County, Calif., it may not have to change much. But if...

LETTERS.
April 1, 2000... Postponing Preterm Delivery Since prematurity is one of the major problems in obstetrics and an area close to my heart, I read the article "Tocolytics Not Meant for Maintenance Therapy" with great interest (March 1, 2000, p. 14). As a...

Cerebral Palsy Associated With Prolonged Latency.
April 1, 2000... MIAMI -- Latency periods of 7 days or longer after preterm premature rupture of the membranes appear to be associated with a significantly elevated risk of cerebral palsy, according to a study that casts doubt on the routine practice of...

Paroxetine Barely Detectable in Nursing Infants.
April 1, 2000... Serum levels of paroxetine in a group of 16 nursing infants whose mothers were taking the drug for major depression were below the detectable limit of 2 ng/mL. The low serum levels and the fact that none of the infants experienced acute...

Avoid Triptans for Migraine in Pregnant Patients.
April 1, 2000... RANCHO MIRAGE, CALIF. -- The triptans are best avoided for treating migraines during pregnancy, Dr. Dawn A. Marcus advised at a meeting on treating the difficult headache patient. So far, these serotonin agonists have not been associated...

Low Amniotic Fluid Raises Risk of Infection in Women With PPROM.
April 1, 2000... ST. PETERSBURG, FLA. -- A patient with preterm premature rupture of membranes has a greater risk of infection if her four-quadrant amniotic fluid index is less than 5 cm, study results suggest. Even with antibiotic prophylaxis, women with a...

Circumcision Appears Safe, But Not Hugely Beneficial.
April 1, 2000... Newborn circumcision involves very little risk, but it also provides very little benefit, according to a retrospective study aimed at nailing down the tradeoffs associated with the widely performed procedure. In a study of 334,297 males...

Protease Inhibitors Don't Up Risk of Prematurity.
April 1, 2000... SAN FRANCISCO -- The use of protease inhibitor--based antiretroviral regimens during pregnancy does not appear to increase the risk of prematurity or low birth weight, compared with other antiretroviral regimens. An observational study of...

Caffeine.(during pregnancy)
April 1, 2000... The use of caffeine in pregnancy has been widely studied. What appears clear from retrospective studies is that caffeine consumption at any level during pregnancy is not associated with an increased risk of birth defects. Research also suggests...

Device Tied to More Deaths, Injuries.
April 1, 2000... MIAMI BEACH -- The rate of injuries or deaths associated with vacuum-assisted delivery devices reported to the Food and Drug Administration increased by 22-fold in the 6 months immediately following a 1998 FDA advisory on the subject, according...

Screen Fetuses For Severe Anemia.
April 1, 2000... Doppler ultrasonography accurately and noninvasively enables physicians to identify fetuses at risk for severe anemia due to maternal red-cell alloimmunization, Dr. Giancarlo Marl of Yale University, New Haven, and other members of the...

Consequences of Poor Maternal PKU Control.(phenylketonuria)
April 1, 2000... Poor metabolic control before conception and early in pregnancy causes cognitive impairment and developmental delay in the children of women with phenylketonuria, said Susan E. Waisbren, Ph.D., of Children's Hospital, Boston, and her...

Minimal-Stimulation IVF Best for Young Patients.(in vitro fertilization)
April 1, 2000... ST. PETERSBURG, FLA. -- Minimal-stimulation in vitro fertilization may be a cost-effective option for young women who want to conceive, Dr. Gary DeVane said. While conventional in vitro fertilization (IVF) procedures yield better pregnancy...

IUI in Spontaneous Cycles Proves More Cost Effective.(Intrauterine insemination)
April 1, 2000... Intrauterine insemination during spontaneous ovulation cycles should be considered the first-line treatment for couples with idiopathic or male subfertility, according to researchers from the Netherlands. In a trial involving 248 couples...

No Higher-Order Multiples With Blastocyst Transfer.
April 1, 2000... ST. PETERSBURG, FLA. -- No higher-order multiples occurred with blastocyst transfer in a large study involving women undergoing in vitro fertilization, Dr. Andrew Toledo said at the annual meeting of the Southern Atlantic Association of...

Behavioral Tx Beats Drugs for Incontinence.(therapy)
April 1, 2000... SAN FRANCISCO -- Intensive behavioral therapy worked better than medication or placebo to improve urinary incontinence in a study of 197 older women, Dr. Leslee Subak said at an ob.gyn. update sponsored by the University of California, San...

Combo Surgery Effective for Dual Incontinence.(laparoscopic Burch colpopexy and external sphincteroplasty)
April 1, 2000... LAS VEGAS -- Concomitant urinary stress and fecal incontinence can be successfully treated using a combination of laparoscopic Burch colpopexy and external sphincteroplasty, according to Dr. James W. Ross. The Salinas, Calif.,...

Evening Primrose Oil May Ease PMS Symptoms.(premenstrual syndrome)
April 1, 2000... SAN FRANCISCO -- Evening primrose oil appears to reduce some of the symptoms of premenstrual syndrome, especially cyclical mastalgia, Dr. Ellen Hughes said at a meeting on women's health sponsored by the University of California, San Francisco....

Estrogen Plus Androgen Best Tx for Low BMD.(treatment, bone mineral density)
April 1, 2000... Low-dose estrogen-androgen therapy is safe and more effective than estrogen alone in building bone mineral density among surgically menopausal women, said Dr. Elizabeth Barrett-Connor of the University of California, San Diego, and her...

Overuse, Reimbursement Issues Plague Peripheral Bone Densitometry.
April 1, 2000... COLORADO SPRINGS - Peripheral bone densitometry is a problematic and overused test, Dr. Michael T. McDermott asserted at a meeting of the Colorado chapter of the American College of Physicians-American Society of Internal Medicine. "I'm...

Promising Advances in Osteoporosis Therapy.
April 1, 2000... COLORADO SPRINGS -- Intravenous pamidronate is a good alternative in osteoporotic women who can't take oral bisphosphonates, estrogen, or calcitonin, Dr. Michael T. McDermott said at a meeting of the Colorado chapter of the American College of...

Genetic Screening, Counseling Advised Before ICSI.(intracytoplasmic sperm injection)
April 1, 2000... WAIKOLOA VILLAGE, HAWAII -- Couples who plan to conceive using intracytoplasmic sperm injection should be encouraged to have genetic counseling and screening before the procedure, according to Dr. Aubrey Milunsky. And if pregnancy is...

Sentinel Node Biopsy Discouraged in DCIS.(ductal carcinoma in situ)
April 1, 2000... SAN ANTONIO -- Axilary staging by any method is inappropriate for ductal carcinoma in situ, Dr. David Brenin said at a breast cancer symposium sponsored by the San Antonio Cancer Institute. Several studies have recently concluded that...

Tamoxifen Tied To 12% Risk of Ocular Toxicity.
April 1, 2000... Women with breast cancer who take low-dose tamoxifen should have a detailed ophthalmic assessment when therapy is initiated, advised Dr. Baha N. Noureddin and associates at the American University of Beirut. They also should be cautioned to...

Timing is Critical in Postexposure Prophylaxis Against HIV Infection.
April 1, 2000... SARASOTA, FLA. -- Postexposure prophylaxis significantly reduces the risk of HIV seroconversion, Dr. Patrick Duff said at a perinatal symposium sponsored by Symposia Medicus. That finding, reported in a recent study, reinforces the central...

Arthritis Before Age 30 May Signal Disseminated Gonorrhea.
April 1, 2000... NEW YORK -- A hot, swollen, arthritic joint in a sexually active young adult is disseminated gonorrhea until proven otherwise, Dr. Diane Birnbaumer said at a meeting on primary care emergencies sponsored by Symposia Medicus. "This is easy...

Gender Steers Spread Of HIV Variants.
April 1, 2000... Gender matters in HIV transmission: A man who has multiple variants will pass all of them to a woman, but he would pass only one variant to a man. This finding suggests that creating a vaccine that works in women will be especially...

Sentinel Node Mapping for Vulvar Ca Supported.(cancer)
April 1, 2000... SAN DIEGO -- Sentinel lymph node mapping proved highly accurate in diagnosing vulvar cancer metastases in two studies presented at the annual meeting of the Society of Gynecologic Oncologists. But the data do not yet answer lingering...

Pap Smears Often Miss Adenocarcinoma Precursor Lesions.
April 1, 2000... SAN DIEGO -- Pap smears are a good screen for squamous cell carcinoma, but they appear to be missing a disturbing portion of adenocarcinoma precursor lesions, Dr. Michael F. Tiffany said at the annual meeting of the Society of Gynecologic...

Few Data Guide When to Begin, End Pap Smears.
April 1, 2000... SAN FRANCISCO -- There are not enough good data to determine the best ages to start and stop Pap smear screening for cervical cancer, Dr. George F. Sawaya said at an ob.gyn. update sponsored by the University of California, San Francisco. ...

Teens Get an 'F' on STD Knowledge Test.(sexually transmitted diseases)
April 1, 2000... NEW ORLEANS -- If an average teenager took a test on sexually transmitted diseases, she would likely score an F. That's what happened when a 13-question exam on STDs was given to 66 adolescents and young adults from the Birmingham, Ala.,...

Many HMO Docs Ignore Chlamydia Guidelines.
April 1, 2000... Many HMO-affiliated physicians in the Birmingham, Ala., region are not following the longstanding recommendation of the Centers for Disease Control and Prevention to offer Chlamydia screening to sexually active teenage girls and young women,...

Atkins or Ornish?(reducing diets)
April 1, 2000... Whichever dietary road a patient goes down, weight loss is similar on the Atkins and Ornish regimens. The Atkins diet is going to cause diuresis initially, and that may make it seem to be more effective than other diets, Dr. F. Xavier...

To Diet, Perhaps to Die.
April 1, 2000... Many obese people are willing to accept extreme risks, including the risk of death, to lose weight, according to the results of a small study. A survey of 72 obese patients at Washington University St. Louis, showed that on average,...

Plant-Based Heart Health.
April 1, 2000... High blood levels of the soy phytoestrogen daidzen are associated with favorable lipid levels in women with suspected myocardial ischemia, Dr. C. Noel Bairey Merz reported at the annual scientific sessions of the American Heart Association. ...

Stroke Red Flags.
April 1, 2000... A number of warning posts can signal that a headache is not just a headache but the manifestation of cerebrovascular disease. Conditions such as subarachnoid hemorrhage, subdural hematoma, arteriovenous malformation, temporal arteritis, and...

Past Is Prologue in Stroke.
April 1, 2000... How long a patient has been hypertensive is more important than the patient's current blood pressure in estimating the risk of stroke, Dr. Sudha Seshadri said at the 25th International Stroke Conference sponsored by the American Stroke...

Lung Cancer In HIV.
April 1, 2000... The risk of lung cancer is twice as high in HIV-infected women as in women who are at risk for HIV but are seronegative, based on the results of a small, prospective study presented at a conference on Retroviruses and Opportunistic Infections....

When Less Is More.(preventive treatment for health care workers accidentally exposed to HIV)
April 1, 2000... More is not necessarily better when offering prophylaxis to health care workers accidentally exposed to HIV, Dr. Julie L. Gerberding said. Regimens of three antiretrovirals are much more toxic when used for postexposure prophylaxis than for...

Hybrid Capture II Gonorrhea Test.
April 1, 2000... (Digene) A nucleic acid probe--based assay for detecting Neisseria gonorrhoeae in cervical specimens in women with or without symptoms. * Recommended Usage: For use with an endocervical brush and swab specimen collection kit, also...

Lotronex.
April 1, 2000... (alosetron, Glaxo Weilcome) * Recommended Dosage: 1 mg twice a day. A 5-[HT.sub.3] antagonist for women with irritable bowel syndrome (IBS) whose predominant symptom is diarrhea. The first drug approved specifically for IBS. *...

Protonix.
April 1, 2000... (pantoprazole, American Home Products) A proton pump inhibitor (PPI) for erosive esophagitis associated with gastroesophageal reflux disease (GERD). The fourth PPI approved. * Recommended Dosage: 40 mg once a day for up to 8 weeks;...

Smoking Raises Psoriasis Risk, Especially in Women.
April 1, 2000... The more women smoke, the higher their risk of psoriasis, based on results of a case-control study of more than 1,000 people. The dose-response relationship between smoking and psoriasis severity was stronger for women than for men, and was...

Drug Update: Antibiotics for Atopic Dermatitis.
April 1, 2000... Although no antibiotic has been specifically approved for treating atopic dermatitis (atopic.eczema), intermittent antibiotic therapy is one of the four pillars of atopic dermatitis treatment. The other three are continuous moisturization of...

Fear of Audits Leads to Medicare 'Downcoding'.
April 1, 2000... WASHINGTON -- The Health Care Financing Administration's efforts to fight fraud should not make providers feel that they have to "downcode" their services, Gail Wilensky, Ph.D., said at a meeting on Medicaid and Medicare sponsored by the...

Conducting Clinical Drug Trials Can Raise Income.
April 1, 2000... MIAMI -- Conducting clinical drug studies can boost your income and add spice to the routine of daily practice. Drug studies are particularly remunerative to physicians in private practice, who don't have to pay overhead costs to a hospital...

FUNDING CANCER THERAPIES.(for low-income women)
April 1, 2000... President Bill Clinton has proposed spending $220 million to pay for breast and cervical cancer treatment for low-income women. The money would go to provide full Medicaid benefits for women diagnosed with those diseases. According to a White...

INDUCTIONS DOUBLE.(induced labor)(Statistical Data Included)
April 1, 2000... The percentage of pregnant women whose labor was induced doubled over an 8-year period, according to the National Center for Health Statistics. The percentage of women induced grew from 9% in 1989 to 18% in 1997, the last year studied. The use...

DRUG TESTING OB PATIENTS.
April 1, 2000... The U.S. Supreme Court has agreed to decide whether hospitals can legally test pregnant women for drugs and report the results to the police for prosecution. The court agreed to review the case of Ferguson v. City of Charleston, in which...

INTERNET HEALTH PRIVACY.
April 1, 2000... Many health Web sites transmit user information to third parties in direct violation of their stated privacy policies, according to the California HealthCare Foundation. The foundation studied 21 health Web sites and found many inconsistencies...

MEDICAID FOR HIV PATIENTS.
April 1, 2000... The Health Care Financing Administration has approved a plan by Maine Medicaid officials to offer Medicaid coverage to low-income HIV patients. Under the plan, HIV patients who make less than $25,000 annually will receive a full benefits...

Proposed Privacy Rules Raise Concerns About Minors' Rights.
April 1, 2000... WASHINGTON -- Minors' privacy rights and administrative burdens on physicians are a few of the concerns that physician groups have about the Clinton administration's proposed privacy regulations regarding electronic medical records. ...

Physicians Ignore Request For More Data.
April 1, 2000... WASHINGTON -- Physicians need better incentives before they will start turning in patient encounter data to Medicaid managed care plans, several speakers said at a meeting on Medicaid and Medicare sponsored by the National Managed Health Care...

Canada Faces Shortage of Radiation Therapists.
April 1, 2000... A shortage of radiation therapists has prompted several Canadian provinces to send their overflow cancer patients south of the border to be treated in the United States. A shortage of manpower and technology in Britain has cancer patients...

Relationships Key to Better Professional Satisfaction.
April 1, 2000... CHICAGO -- The typical medical practice is "the perfect recipe" for professional burnout, Dr. Mark O'Halloren said at the annual meeting of the American College of Allergy, Asthma, and Immunology. Physicians face escalating workloads, loss...

Electronic Medical Record.
April 1, 2000... Practice Partner Patient Records version 7.1 features an embedded Web browser, a library of HTML files, a list of prewritten clinical notes, and the option to copy content from the Web to the system's library.

Vascular Probe.
April 1, 2000... A new 8-MHz pointed-style probe, suitable for focused vessel assessment and for use in smaller areas, has been added to the Elite series of hand-held Doppler vascular probes. The other probes are a 3-MHz broad-beam obstetrical probe, a 3-MHz...

Combined HRT Tablets.(hormone replacement therapy )
April 1, 2000... A hormone replacement therapy formulation called femhrt (norethindrone acetate/ethinyl estradiol tablets) can prevent osteoporosis and treat moderate to severe vasomotor symptoms associated with menopause in women with intact uteri. This is the...

Antioxidant Skin Products.
April 1, 2000... Primacy skin care products include Serum 20 (a 20% concentration of vitamin C), C+AHA, C+E, and Phyto+ (a skin-lightening formula). They contain some of the highest levels of antioxidants on the market.

Tissue Retraction Hook.
April 1, 2000... The Model 3338 6.5-mm solid blade retractor hook is designed for deeper tissue retraction through a small incision and can be used when there is limited maneuverability in the surgical field. The hook is made of stainless steel and latex-free...

Role-Playing Game.
April 1, 2000... The Assert With Love game teaches children and adults how to interact assertively and respond appropriately to aggression. Players explore 48 different situations, such as a roommate conflict, pressure to use drugs, and a disagreement with a...

Blood Pressure Monitor.
April 1, 2000... The Baum Wall Aneroid blood pressure monitor is highly accurate and has a high-contrast scale and red pointer for optimum visibility. It comes with a 1-year guarantee.

Mediolateral Episiotomy Best in High-Risk Women.
April 1, 2000... MIAMI BEACH -- Nulliparous women with large fetuses who require pudendal analgesia and undergo a forceps-assisted delivery face some of the highest risks for severe perineal tears, according to a recent study. Add a midline episiotomy and...

Midline Episiotomy Risks Anal Continence.
April 1, 2000... Midline episiotomy raises the risk for postpartum anal incontinence independently of its association with instrument-assisted delivery, high birth weight, and long labor, Boston investigators reported. They studied the incidence of fecal...

Higher Rate of Abnormalities in ICSI Children.(intracytoplasmic sperm injection)
April 1, 2000... MIAMI BEACH -- A high rate of congenital abnormalities among children conceived through intracytoplasmic sperm injection may be due to the fact that many of these children were part of a multiple gestation, Dr. Ulla-Britt Wennerholm said at the...

Prenatal Cigarette, Cocaine Exposure Tied To Language Problems.
April 1, 2000... MIAMI BEACH -- Children who were prenatally exposed to cocaine are more than twice as likely as unexposed children to have language development problems by age 6, according to data presented at the annual meeting of the Society for...

Biophysical Profiling May Lower ADD Rate.(attention-deficit disorder)
April 1, 2000... MIAMI BEACH -- Use of biophysical profiling to enable swift delivery at the first sign of fetal asphyxia appears to be associated with a reduced risk of attention-deficit disorder and several other disorders later in life. In fact, in a...

Hypoxic Ischemia Doubles Risk of Later Psychosis.
April 1, 2000... The occurrence of fetal and neonatal complications that are related to hypoxic ischemia doubles the risk that the neonate will develop schizophrenia or other psychoses later in life, according to Dr. Gwen L. Zornberg and her associates at the...

Greater Maternal Hydration Cuts Prolonged Labor.
April 1, 2000... MIAMI BEACH -- Hiking up the amount of maternal hydration during labor cuts the incidence of prolonged labor by half, Dr. Thomas Garite said at the annual meeting of the Society for Maternal-Fetal Medicine. In a study that challenges some...

A Single Course of Prenatal Steroids Helps Up to 14 Days Before Delivery.
April 1, 2000... MIAMI BEACH -- Exposure to a single dose of prenatal corticosteroids does not have to be within a week of delivery to aid fetal lung development, according to data presented at the annual meeting of the Society for Maternal-Fetal Medicine. ...

Mortality Tied to Fetal Weight in Diabetic Moms.
April 1, 2000... ST. PETERSBURG, FLA. -- Fetal mortality increases as fetal weight increases in diabetic mothers, according to the results of a retrospective study. The finding suggests that increased fetal surveillance for macrosomic fetuses of diabetic...

Get Expert Advice on Drugs in Pregnancy, Lactation.
April 1, 2000... OB.GYN. NEWS is committed to helping you treat and advise pregnant women. With that goal in mind, we are pleased to announce the debut of our new column, "Drugs, Pregnancy and Lactation," which appears on the opposite page. This...

Flexible Residency Proposal Under Fire.
April 15, 2000... NEW ORLEANS -- The mere possibility of more flexibility being built into ob.gyn. residency training has elicited cries of opposition from many program directors. The target of their frustration: a proposal under review by the Residency...

HRT Fails to Slow Progression of Established CAD.
April 15, 2000... Make use of therapies proven to slow CAD, such as cholesterol-lowering drugs. ANAHEIM, CALIF. -- Hormone replacement therapy does not slow the progression of coronary artery disease in postmenopausal women with established coronary...

Membrane Rupture Spurs HIV Vertical Transmission.
April 15, 2000... The risk of infection rises 2% each hour. SAN FRANCISCO -- The risk that an HIV-infected mother will transmit the virus to her infant rises by about 2% each hour after her membranes rupture and before she delivers her infant. The...

Obesity Rate Balloons in Educated, Middle-Aged Women.
April 15, 2000... LA JOLLA, CALIF. - The prevalence of obesity rose dramatically among educated middle-aged and older women as they aged between 1980 and 1994, according to new data from the Nurses' Health Study. In a more welcome trend, the age-adjusted...

HRT Isn't Cardioprotective in Female Diabetics.
April 15, 2000... LA JOLLA, CALIF. -- Hormone replacement therapy appears to have no effect on MI risk in women with diabetes, Dr. Assiamira Ferrara reported at the annual conference on cardiovascular disease epidemiology and prevention sponsored by the American...

RRC Considers Moving Primary Care Training Into Ob.Gyn.
April 15, 2000... The RRC's ambitions to build more flexibility into ob.gyn. residency programs grabbed the most attention at this year's CREOG/APGO meeting, but it is a proposal to place primary care training within the ob.gyn. departments that could have a...

Preventing Medical Errors.
April 15, 2000... In February, President Clinton announced an initiative to improve patient safety and reduce the number of medical errors by 50% over the next 5 years. The plan was developed by the Quality Interagency Coordination Task Force, which was...