OB GYN News articles from August 2000

OB GYN News archives from August 2000

Call of the Web Beckons Physicians.
August 1, 2000... Welcome to www.wewantyou.com. More than 20 Internet companies are offering free construction and maintenance services to physicians looking to launch online medical "homes" on their sites. What's in it for you? More patients,...

Epidurals Found Not to Increase Risk of C-Section.
August 1, 2000... No significant impact on spontaneous or assisted vaginal delivery rates indicated. MONTREAL -- Epidural analgesics do not increase the risk of cesarean delivery according to the findings of two new studies presented at the annual meeting...

VITAL SIGNS.
August 1, 2000... VITAL SIGNS Internet-Using Physicians With Web Sites for Their Practices [*] Physicians With a Web Site 53% No Plans for a Web Site 30% Physicians...

HRT Use May Play Role In Knee Cartilage Health.
August 1, 2000... Could point to osteoprotective mechanism. TORONTO -- Women who use hormone replacement therapy have more knee articular cartilage than nonusers, Dr. Susan R. Davis reported at the annual meeting of the Endocrine Society. This new...

Low-Dose, `Mobile' Epidurals Reduce Operative Deliveries.
August 1, 2000... MONTREAL -- Low-dose, or "mobile," epidurals result in fewer forceps and vacuum deliveries, compared with the traditional higher-dose epidurals, British researchers reported at the annual meeting of the Society for Obstetric Anesthesia and...

Influenza Vaccine Delay Expected, Supply Shortage Possible.
August 1, 2000... The supply of influenza vaccine for the 2000-2001 season will be delayed by at least a few weeks and may be reduced as well, according to the Centers for Disease Control and Prevention. Implementation of organized influenza vaccination...

Cardiovascular Risk Factors Affect Quality of Life.
August 1, 2000... VICTORIA, B.C. -- Cardiovascular risk factors exact a quality-of-life toll in women. Results of a nationwide telephone survey of 74,000 women provide a persuasive argument for what has recently been termed "primordial prevention": that is,...

Correction.
August 1, 2000... The photograph of Dr. Thomas F. Purdon that accompanied the announcement "New ACOG Presidents Installed" (July 1, 2000, p. 4) was incorrect. The photograph was of Dr. Frank C. Miller. Dr. Purdon, president-elect of the American College of...

Cyberpractice.
August 1, 2000... Twenty-five years ago, when I had been in practice only 3 years, I overheard two colleagues talking about buying computers for their offices. To me, this made perfect sense. All those lists of differential diagnoses that I had memorized for my...

Where Do We Draw the Line?
August 1, 2000... Video camera technology has come a long way. Twenty years ago video cameras were so large that they had to be propped on your shoulder and cost so much that very few people could afford one. Today's camcorders fit into the palm of your hand,...

Behavioral Tx Beats Rx for Incontinence in Elderly.
August 1, 2000... ATLANTA -- Most physicians greatly underestimate the effectiveness of a well-designed behavioral therapy program for persistent incontinence in the elderly, Dr. Patricia S. Goode asserted at a meeting on clinical nephrology sponsored by the...

Equipment Faulted for Electrosurgical Burns.
August 1, 2000... MONTREAL -- With the rising popularity of electrosurgery electrical burns from faulty equipment are no longer a rare occurrence, Dr. George Vilos said at an international symposium on reproductive endocrinology and infertility sponsored by...

Don't Rush to Judge Pelvic Pain as A Recurrence of Endometriosis.
August 1, 2000... MONTREAL -- Although endometriosis recurs within 2 years of treatment among half of patients, don't assume that such a relapse is the cause of pelvic pain in this population, experts cautioned at an international symposium on reproductive...

Endometrial Biopsy Pain Is Greater Than Physicians Realize.
August 1, 2000... MONTREAL -- Almost a quarter of women undergoing endometrial biopsy without analgesia experience moderate to severe pain, which often is not recognized by physicians or nurses, Diana Barrigar said at the joint annual meeting of the Society of...

Oral Steroids Raise Risk of Hip, Vertebral Fractures.
August 1, 2000... CHICAGO -- Oral glucocorticoid use almost doubled the risk of hip fractures and tripled the risk of vertebral fractures, according to an analysis of participants in a large employer-based managed care health plan followed up for an average of...

Repeat Fractures Common With Conservative Tx.
August 1, 2000... TORONTO -- One in five postmenopausal women who have had a vertebral fracture will experience another within a year if they receive only calcium supplements and vitamin D, Dr. Nelson Watts reported at the annual meeting of the Endocrine...

Teen Contraceptive Use Won't Pack on Pounds.
August 1, 2000... VICTORIA, B.C. -- The use of oral contraceptives in adolescence doesn't result in increased body weight or percent body fat, Dr. Tom Lloyd reported at an international conference on women, heart disease, and stroke. This new information...

Consider OCs to Ease the Symptoms of Perimenopause.
August 1, 2000... MONTREAL -- Physicians should consider oral contraceptives for women who are struggling with the hormonal chaos of the perimenopause, Dr. Victoria Davis said at an international symposium on reproductive endocrinology and infertility sponsored...

Ultrasound Accurately Classifies Breast Masses in Girls.
August 1, 2000... WASHINGTON -- Ultrasound assessment correctly classifies more than 90% of palpable breast masses in girls as normal tissue, cysts, abscesses, or solid masses, Kyung-Hwa Rhee reported at the annual meeting of the American Roentgen Ray Society....

Migraine Headaches More Frequent, But Not More Severe During Menses.
August 1, 2000... MONTREAL -- Contrary to a widely held clinical belief that migraine headaches are worse during menstruation, there is actually relatively little increase in symptoms and disability during menses, compared with other times in the monthly cycle,...

Low Bone Mineral Density Linked to Depression.
August 1, 2000... CHICAGO -- Depression is strongly associated with decreased bone mineral density in the elderly, particularly among white women, Dr. John A. Robbins reported at the World Congress on Osteoporosis. The data are still too sparse to know...

Thin Women Need Annual BMD Assessment.
August 1, 2000... MONTREAL -- Consider body mass index when deciding how frequently a post-menopausal woman should have bone mineral density tests, Dr. David Morris advised at an international symposium on reproductive endocrinology and infertility sponsored by...

Nicotine Replacement in Pregnancy.
August 1, 2000... There is little information on the safety of nicotine replacement products during pregnancy. The adverse effects of smoking during pregnancy have been well defined. But it's unclear whether the reported low birth weight, prematurity, placental...

Breast-Feeding OK Even With Maternal Infection.
August 1, 2000... NEW YORK -- Babies whose mothers have infections ranging from colds to tuberculosis can in most instances be breastfed safely, Dr. Robert M. Lawrence said at a conference on the care of children and youth sponsored by New York University. ...

Fetal Surgery an Option for a Range of Diagnoses.
August 1, 2000... MONTREAL -- As prenatal diagnostic techniques become increasingly sophisticated, options for fetoscopic as well as open fetal surgery are rapidly evolving as well, Dr. Timothy Crombleholme said at the annual meeting of the Society for obstetric...

Fetal Abdominal Circumference Reliably Predicts IUGR Risk.
August 1, 2000... SAN FRANCISCO -- Ultrasound measurement of just the fetal abdominal circumference provides a reasonable estimate of the risk for intrauterine growth retardation among term babies when other measures are unavailable, Dr. Mark Williams said at...

Postpartum Good Time to Vaccinate for Hepatitis B.
August 1, 2000... SAN FRANCISCO -- The postpartum period provides an excellent opportunity for routine hepatitis B vaccination, said Dr. Marcus Jurema of Cornell University New York. It's a time of life when women are well linked to the health care delivery...

Time Primiparous Inductions for Late Evening.
August 1, 2000... MONTREAL -- Timing the induction of primiparous patients for late evening significantly reduces off-hour demands on anesthesiologists, Dr. John Harrad said at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. Dr....

ABORTION RIGHTS.
August 1, 2000... The abortion debate promises to escalate, especially with a presidential election coming up, due to the Supreme Court's decision striking down a Nebraska law that banned dilation and extraction, putting access to abortion services on firmer...

MEDICARE RX BENEFIT.
August 1, 2000... The prospects for a Medicare prescription drug benefit dimmed--even as the House passed a bill calling for just that. In a raucous political battle, the Republicans pushed through a bill that would rely on the private sector aided by government...

PREGNANT SMOKER TX.
August 1, 2000... Physicians should counsel pregnant smokers more intensively to take advantage of their greater motivation to quit during pregnancy, the U.S. Public Health Service recommended in a clinical practice guideline for treating tobacco use and...

HEALTH PLANS' POWER.
August 1, 2000... Capitation is just another failed experiment. Hospitals are divesting themselves of money-losing physician practices and refocusing on core businesses. Physicians have less negotiating power with managed care companies than ever and won't get...

'Smart Card' Stores Up-to-Date Prenatal Records.
August 1, 2000... Leona Wagner, a nurse-midwife in Cookeville, Tenn., has had her share of 3 a.m. deliveries. But the one she did a few months ago was a little different from all the others. Instead of her routine of going to the office in the middle of the...

Ob.Gyn. Faculty Salaries Dip in 1999 After 3 Years of Growth.
August 1, 2000... After 3 years of steady growth, the income of obstetrician-gynecologists at academic medical centers took a nosedive in 1999. Total median compensation fell 7% to $160,176, reversing an upward trend from 1995 to 1998, during which compensation...

Drug Update: Primary Insomnia.
August 1, 2000... Insomnia strikes 30%-40% of American adults annually and 10% have insomnia that is chronic or severe. Behavioral therapy is the first step recommended by some experts. But for patients whose primary insomnia has lasted for more than 4...

Octreotide Helps Some Obese Patients Lose Weight.
August 1, 2000... TORONTO -- Long-acting octreotide is a highly effective weight loss agent in selected severely obese adults, Dr. Robert H. Lustig said at a satellite symposium held in conjunction with the annual meeting of the Endocrine Society. The drug...

Electron Beam CT Spots Subclinical Atherosclerosis.
August 1, 2000... VICTORIA, B.C. -- Subclinical atherosclerosis was evident with electron beam CT in 35% of women older than 58 years who had no coronary risk factors, Dr. Joan E. Briller reported at an international conference on women, heart disease, and...

Genes, Diet, and BP.
August 1, 2000... Certain individuals may be genetically more likely to reap cardiovascular benefits from a healthy diet, Dr. Laura Svetkey said at the annual meeting of the American Society of Hypertension. Genetic analysis of blood samples from 355...

White Coat Hypertension.
August 1, 2000... Patients with white coat hypertension have more end-organ damage than normotensive patients, based on a 15-study metaanalysis. Dr. Frank Lefevre, who presented the findings at the annual meeting of the Society for General Internal Medicine,...

Alzheimer's Dementia.
August 1, 2000... Rivastigmine, the cholinesterase inhibitor recently approved for mild to moderate Alzheimer's dementia, has a dual mechanism of action that also appears to be effective in later stages of the disease, said Dr. George T. Grossberg, director of...

Pesticides and Parkinson's.
August 1, 2000... Pesticide use was linked with Parkinson's disease in a case-control study conducted in Northern California. People who recalled using in-home pesticides on at least 160 days of their lives were 70% more likely to develop the neurologic...

Alcohol Ups Insulin Sensitivity.
August 1, 2000... Insulin sensitivity increases with rising alcohol consumption among premenopausal women, Rosemary D. Donahue, Ph.D., said at an international conference on women, heart disease, and stroke. The Miami Community Health Study is a...

Endocrinology Key to MI.
August 1, 2000... During the next 5 years, the greatest advances in survival after myocardial infarction are likely to come through the efforts of endocrinologists, Dr. Richard W Nesto predicted at a symposium on the management of risk factors for cardiovascular...

Migraine Rx Tied to Ulcers.
August 1, 2000... Think anogenital ergotism an patients with perianal ulcerations--especially in those who don't respond to antiherpetic treatments, Dr. E. Eggi-Tyl said at a meeting on clinical dermatology sponsored by the University of Vienna. She...

Health Improvements With Just a 10% Weight Loss.
August 1, 2000... DENVER -- Treatment of obesity is not the near-hopeless proposition many physicians think. "Our success rate is not terrible: We can produce and maintain a 10% weight loss. We know that can significantly improve health," James O. Hill,...

Migraine Guidelines: History, Physical Exam Key.
August 1, 2000... Migraine is one problem that everyone seems to agree deserves more attention. In fact, seven medical organizations have jointly issued evidence-based guidelines for diagnosing and treating migraine headache, a condition that affects 1 in...

Phone Message Software.
August 1, 2000... Phoneslips version 4.0 software manages phone messages, e-mail, memos, card files, schedules, and to-do lists. Optional links to the Timeslips time-billing program, and to the Palm Computing line of hand-held computers are also offered,...

Power Exam Table.
August 1, 2000... The adjustable Midmark 411 Power Examination Table allows all patients, including the infirm, pregnant, obese, and elderly, to easily mount and dismount the table without assistance. The table's height ranges from 22.5 inches to 40 inches and...

Baby Emergency Kit.
August 1, 2000... The New Baby/New Parent Emergency Kit can be used as a teaching tool to help parents recognize and respond to a medical emergency, and to organize medical instructions and the baby's medical history It's useful for parents with limited...

IV Multivitamins.
August 1, 2000... Multi-12 (Multivitamins for Infusion) has been approved as a daily intravenous mu1tivitamin maintenance supplement for adults and children (11 years and older) who are receiving parenteral nutrition. The supplement also can be used in other...

Breast Milk Fortifier.
August 1, 2000... Similac human milk fortifier mixes with expressed breast milk to promote weight gain and overall growth in low-birth-weight infants. Minerals such as calcium, phosphorus, and zinc are added to the formula to meet the special needs of premature...

Laparoscopic Scissors.
August 1, 2000... Microline Re-New II 5-mm Laparoscopic Scissors feature an ergonomic pistol grip handle with a coaxial threaded distal shaft and lumen that accepts disposable tips. Constructed in stainless steel and fully insulated, the Laparoscopic Scissors...

Postop Pain Management.
August 1, 2000... Chirocaine (levobupivacaine injection) anesthesia is now indicated for postoperative pain management and can be used locally and regionally in surgery and obstetrics. A pure levoisomer, Chirocaine has an efficacy similar to bupivacaine at equal...

SERMs: The Year in Review.
August 1, 2000... THE FOLLOWING presentations from a symposium on May 23, 2000, in San Francisco, California, address some of the major issues confronting physicians in the clinical management of menopausal and postmenopausal patients. Skeletal health...

SERMs and Skeletal Health: The Prevention and Treatment of Osteoporosis.
August 1, 2000... EARLY IDENTIFICATION and treatment of women at risk for osteoporotic fractures can dramatically reduce the risk by use of therapies that promote the restoration and maintenance of bone density and integrity. "Osteoporosis is basically a...

SERMs: Breast and Endometrial Concerns in Women.
August 1, 2000... CONCERN ABOUT the risk of endometrial cancer in women treated with tamoxifen has sparked interest in potential alternatives for breast cancer prevention, especially the selective estrogen receptor modulator (SERM) raloxifene. "Tamoxifen...

Expanding Horizons: SERMs, Cardiovascular Disease, and Cognitive Function in Postmenopausal Women.
August 1, 2000... CONTRARY TO what many laypersons and health professionals still believe, cardiovascular disease (CVD), not cancer, is the leading cause of death in women, with cardiovascular mortality having increased between 1984 and 1997, according to Dale...

SERMs: Case Studies Illustrate Clinical Applications.
August 1, 2000... MOST WOMEN do not take hormone replacement therapy (HRT) for any significant period of time, and many never even get initial prescriptions filled. One possible reason for women's avoidance of long-term HRT is that the treatment is not tailored...

High-Dose Chemo Trials in Jeopardy.
August 15, 2000... Few experimental therapies have demonstrated the power of politics and emotion to trump science and clinical research as blatantly as high-dose chemotherapy with autologous bone marrow transplantation for breast cancer. And the procedure's...

Salary Trends for Medical Faculty.
August 15, 2000... Salary Trends for Medical Faculty Median Pay Percent Change 1999 1998-1999 1995-1998 All Primary Care $120,000 0.0 14.3 All Specialists $157,269 ...

Oral Combo HRT Better Than Dermal Form for Diabetics.
August 15, 2000... Estrogen / progestogen lowered total and LDL cholesterol, triglycerides, and [HbA.sub.1c]. SAN ANTONIO -- Oral combination hormone replacement therapy appears to confer metabolic benefits to women with type 2 diabetes--benefits that are...

Hot Flashes in Menopausal Women Uneased by Soy.
August 15, 2000... Endogenous estradiol levels reduced. ATLANTA -- Soy supplements do not appear to decrease the number of hot flashes in menopausal women, Margo Woods, D.Sc., reported at a meeting on breast cancer sponsored by the Department of Defense. ...

Brief Bed Rest Improves IUI Success Rates.
August 15, 2000... MONTREAL -- Patients who remain lying down for at least 10 minutes after an intrauterine insemination have a significantly higher pregnancy rate than patients who get up immediately after the procedure, according to the results of a study...

Prophylactic Oophorectomy.
August 15, 2000... Prophylactic oophorectomy in the population of women who are carriers of the BRCA mutations offers a dramatic increase in life expectancy and while we do not yet have long-term follow-up data, the preponderance of evidence leads me to strongly...

LETTERS.
August 15, 2000... Statistical Skepticism The conclusion reached by Dr. J. Chris Carey should be viewed with skepticism as it contradicts established medical opinion that Trichomonas vaginalis is associated with increased risk of preterm birth...

Interest in Androgen Supplementation Grows.
August 15, 2000... TORONTO -- Androgen supplementation may soon be as commonly prescribed in both men and women as estrogen replacement therapy is today in women, Dr. Bradley D. Anawalt predicted at the annual meeting of the Endocrine Society. The list of...

Nonhormonal Vaginal Moisturizer Eases Dryness.
August 15, 2000... SAN FRANCISCO -- A nonhormonal vaginal moisturizer can ease discomfort from external vaginal dryness in postmenopausal women who can't or won't use an estrogen cream, Dr. Lila E. Nachtigall said in a poster presentation at the annual meeting of...

No Rise in Ca, Hyperplasia Risk With Raloxifene.
August 15, 2000... TORONTO -- Five years of daily raloxifene in postmenopausal women doesn't increase their risk of endometrial hyperplasia or carcinoma, Dr. Elaine E. Jolly said at the annual meeting of the Endocrine Society. She reported on 331...

'Pill' Guidelines for Those With Underlying Disease.
August 15, 2000... Armed with new recommendations, the American College of Obstetricians and Gynecologists aims to clear up what it calls the "substantial confusion" among some doctors about whether to prescribe oral contraceptives to women with underlying...

The 'Next Step' In Endometrial Evaluation.
August 15, 2000... WASHINGTON -- Sonohysterography is the appropriate next step in the evaluation of an abnormal endometrium seen on transvaginal ultrasound, Dr. J.R. Jorizzo advised at the annual meeting of the American Roentgen Ray Society. "While...

New Technique Eases Painful Vertebral Fractures.
August 15, 2000... CHICAGO -- Painful vertebral compression fractures respond quickly and well to a new technique that employs the percutaneous insertion of an inflatable balloon tamp followed by cement injection, investigators from two centers reported at the...

Microbicidal Research Still Alive Despite Setbacks.
August 15, 2000... Study results linking nonoxynol-9 to an increased risk of HIV transmission dealt a blow to hopes that the topical microbicide would prevent sexually transmitted diseases. But microbicide research efforts aren't over. A ramping up of...

Spill All on Great Vessel Injury Risk in Laparoscopy.
August 15, 2000... MONTREAL -- Laparoscopic injury of the great vessels, while rare, carries up to a 20% mortality rate and a high rate of malpractice, Dr. George Vilos warned at the joint annual meeting of the Society of Obstetricians and Gynaecologists of...

Laparoscopic Surgery Provides No Cost Break Over Laparotomy.
August 15, 2000... Laparoscopic surgery for early endometrial cancer costs the same as laparotomy, a review of 36 cases at one institution showed. Cost savings from shorter hospital stays after laparoscopic surgery were offset by longer surgical times and...

Accelerated Radiation Okay For Lumpectomy Patients.
August 15, 2000... NEW ORLEANS -- An accelerated, 3-week schedule of radiation therapy appeared to be as effective as the standard 5-week schedule for women with breast cancer treated by lumpectomy. "The shorter schedule reduces the days of radiation...

HRT: Finding the Right Combination for Best Results.
August 15, 2000... DESPITE TUE IMPRESSIVE DATA demonstrating the health benefits of hormone replacement therapy (HRT)--including, aside from symptom relief, a reduced risk of cardiovascular disease and of osteoporotic bone loss that may lead to fractures--some...

How to Talk to Your Patients About Breast Cancer.
August 15, 2000... IS HORMONE REPLACEMENT therapy (HRT) associated with an increased risk of breast cancer? Seemingly reliable epidemiologic evidence shows that it is. However, other seemingly reliable evidence indicates that HRT use carries no increased risk of...

Optimizing Bone Health After Menopause.
August 15, 2000... BONE DENSITY is an important part of the equation in planning peri- and postmenopausal health care, including deciding whether hormone replacement therapy (HRT) is indicated. Two techniques are currently recommended to measure bone mineral...

Management of Bleeding Problems Associated with HRT.
August 15, 2000... ANNUAL MORBIDITY and mortality statistics continue to show that two of the most costly conditions are cardiovascular disease and osteoporotic fractures, both of which can be reduced by the use of postmenopausal hormone replacement therapy...

High Prolactin Levels Associated With Breast Ca.
August 15, 2000... ATLANTA -- Postmenopausal women with high levels of prolactin may be at increased risk of breast cancer, Susan Elizabeth Hankinson, Sc.D., said at a meeting on breast cancer sponsored by the Department of Defense. In what Dr. Hankinson...

When Mammography Is Equivocal, US Is Critical.
August 15, 2000... WASHINGTON -- Ultrasound of the breast is essential in symptomatic patients when mammography shows dense tissue or when other findings are equivocal, Dr. M.R. O'Reilly urged at the annual meeting of the American Roentgen Ray Society. ...

High Bone Mineral Density May Flag An Increased Risk for Breast Cancer.
August 15, 2000... MONTREAL -- Bone mineral density measures may reveal more than a just a patient's risk of osteoporosis. "BMD [bone mineral density] can be regarded as a surrogate marker for estrogen exposure over a lifetime, which in turn is a strong...

VBAC Safe for Women With Twin Pregnancies.
August 15, 2000... SAN FRANCISCO - Vaginal birth after cesarean section is a viable option for women with twin pregnancies, Dr. Thomas D. Myles said at the annual meeting of the American College of Obstetricians and Gynecologists. Many physicians avoid...

VCUG Not Required for Mild Hydronephrosis.
August 15, 2000... WASHINGTON -- Mild hydronephrosis detected by prenatal ultrasound does not warrant subjecting the neonate to voiding cysrourethrography because it doesn't correlate with the presence or the severity of vesicoureteral reflux, Dr. Andrea...