OB GYN News articles from August 2001

OB GYN News archives from August 2001

HHS Chief Pledges Regulatory Relief.
August 1, 2001... CHICAGO -- A promise from the Bush administration to communicate with physicians on reducing regulatory burdens kicked off the 100th anniversary meeting of the American Medical Association in June. Addressing AMA's House of Delegates,...

Study May Have 'Chilling Effect' On VBAC Rate.
August 1, 2001... Uterine rupture risk was 3-15 times higher with VBAC than elective C-section. The recent finding that vaginal birth after cesarean section increases the risk of uterine rupture up to 15 times may curb patients' willingness to attempt VBAC,...

Expect Influenza Vaccine Delays Again This Fall.
August 1, 2001... Priority to physicians, high-risk patients. ATLANTA -- Distribution of the influenza vaccine will likely be delayed again this fall, but the delay should not be as problematic as it was last year, Dr. Dennis O'Mara said at a meeting of the...

Practice Revenue: Where the Money Goes *.
August 1, 2001... Practice Revenue: Where the Money Goes * Mean Total Practice Revenue in 1998 Net Income 51.8% Nonphysician Employees 16.7% Nonowner Physician Employees 2.4% Office Expenses 12.4%...

PHYSICIAN PRIVILEGE APPLICATION.
August 1, 2001... Residents should be able to apply to health plans for acceptance on their provider panel 6 months before completing training, the delegates said. Currently, it takes about 6 months for a physician to be approved by most health plans. Since many...

MAMMOGRAPHY.
August 1, 2001... Reimbursement for mammography must be increased, by law if necessary, the delegates said. Current reimbursement for mammography is about $69 an exam, while the cost ranges from $100 up to $150, a resolution passed by the House said. Some...

FLU SHOTS.
August 1, 2001... The AMA will continue to collaborate with the Centers for Disease Control and Prevention in heading off a repeat of the influenza vaccine shortage of last winter. The AMA will play a lead role in communicating with physicians during the season,...

CONSUMER ADVERTISING.
August 1, 2001... The AMA will seek to have the phrase "your physician may recommend other appropriate treatments included in all direct-to-consumer advertising. Many member organizations spoke in favor of more rigorous action by the AMA to restrict consumer...

ANTIMICROBIAL RESISTANCE.
August 1, 2001... The AMA opposes the use of antibiotics in livestock, and will press the federal government to have their nontherapeutic use banned, the House of Delegates said. The action noted that 80% of all antibiotics used by farmers--16 million pounds...

DISCRIMINATION.
August 1, 2001... The benefits of genetic testing will be medically important and patients must not be dissuaded from allowing such testing by fear of discrimination. The AMA will push for adoption of federal law to prohibit genetic discrimination, including...

STDs AND JAILED ADOLESCENTS.
August 1, 2001... Incarcerated juveniles need to be regularly screened for sexually transmitted diseases and history of abuse, the delegates said. The resolution passed calls on the AMA to work with the National Commission on Correctional Health Care to see that...

MEDICAL CANNABIS.
August 1, 2001... The AMA revised its policy on medical marijuana but stopped short of endorsing compassionate use. The new policy says physicians should be able to discuss medical marijuana use with patients without the threat of criminal sanctions, and it...

Elective C-Section Revisited.
August 1, 2001... The prophylactic use of elective cesarean section to prevent pelvic organ prolapse and urinary incontinence is gaining increased attention. Dr. W Benson Harer Jr., past president of the American College of Obstetricians and Gynecologists,...

PRO & CON.
August 1, 2001... Dr. Brett B. Gutsche is a professor emeritus of anesthesiology and of obstetrics and gynecology at the University of Pennsylvania, Philadelphia. Should an anesthesia provider be present for vaginal delivery in all patients receiving...

Ultrasound Helpful in Choosing Cerclage Patients.
August 1, 2001... MAUI, HAWAII -- Using serial transvaginal ultrasounds to decide which pregnant patients should get a cerdage may limit the use of this procedure and lower costs without increasing the risk of preterm delivery, Dr. Manuel Porto said at a...

Alternative to Routine Amniocentesis Proposed.
August 1, 2001... MAUI, HAWAII -- A three-pronged strategy to screen for fetal abnormalities using two ultrasound examinations and triple-marker serum screening may be safer and less expensive than routinely offering amniocentesis to older women, Dr. Manuel...

Many Women Treated Off Label With Antiepilepsy Drugs.
August 1, 2001... Contributing Writer NEW YORK -- Burgeoning numbers of women are being treated off label with antiepilepsy drugs for conditions such a migraine headache, bipolar disorder, and pain, and ob.gyns. need to be aware of thc drugs' adverse...

Nausea and Vomiting of Pregnancy.
August 1, 2001... Because nausea and vomiting of pregnancy peaks at about 8 weeks, right in the middle of organogenesis, some physicians worry about prescribing drugs to pregnant women, including those that have been shown to be safe in pregnancy. In my...

Top Complications of Labor and/or Delivery *.
August 1, 2001... Top Complications of Labor and/or Delivery * Meconium, Moderate/Heavy 54.7 Fetal Distress 39.6 Breech/Malpresentation 38.9 Dysfunctional Labor 27.1 Premature Rupture of Membranes 25.6...

Accelerated Salivation Common in Pregnancy.
August 1, 2001... DURBAN, SOUTH AFRICA -- Copious salivation--in medical parlance, ptyalism--is more common in pregnancy than previously recognized, Maureen Van Dinter said at WONCA 2001, the conference of the World Organization of Family Doctors. This...

Perineal Massage Doesn't Reduce Tear Rate.
August 1, 2001... Stretching and massaging the perineum during the second stage of labor does not reduce the rate of perineal tears and does not change postpartum urinary, fecal, or sexual outcomes, a recent study suggests. In what they described as the...

Minimize Risk When Using Misoprostol Off Label.
August 1, 2001... AMELIA ISLAND, FLA. -- The off-label use of misoprostol for the induction of labor is supported by good clinical evidence and the American College of Obstetricians and Gynecologists, Dr. B. Denise Raynor said at an ob.gyn. update sponsored by...

Few Hip Fracture Patients Get Osteoporosis Drugs.
August 1, 2001... VAIL, COLO. - Less than 10% of the 300,000 Americans annually who fracture their hips are subsequently placed on any form of osteoporosis therapy, Dr. Paul D. Miller declared at a conference on obstetrics and gynecology sponsored by the...

No Osteoporosis Seen When BMI Is Over 33.
August 1, 2001... SAN ANTONIO - A preliminary study examining the usefulness of dual-energy x-ray absorptiometry screening found no incidence of osteoporosis in any woman with a body mass index greater than 33. Scans were performed on 224 randomly selected...

Daily Oral Alendronate Increases BMD Better Than Intranasal Calcitonin.
August 1, 2001... WASHINGTON -- Daily oral alendronate is more effective than daily intranasal calcitonin among postmenopausal women with osteoporosis, Dr. Clifford J. Rosen said at an international symposium on women's health and menopause. Alendronate...

Simple Bone Scans OK for Some Patients.
August 1, 2001... SAN FRANCISCO -- Simple, less expensive alternatives to dual-energy x-ray absorptiometry scans for measuring bone mineral density may be sufficient if results are normal but probably are not enough if results show low density and you're...

Novel Hormone Therapy Appears Promising for HRT.
August 1, 2001... VAIL, COLO. -- Within the year, American physicians are likely to gain access to an important new type of postmenopausal hormone therapy, Dr. Kenneth Faber said at a conference on obstetrics and gynecology sponsored by the University of...

Inhaled Steroids Also Promote Osteoporosis.
August 1, 2001... SAN FRANCISCO -- The use of chronic corticosteroids has become so popular that "we might as well put it in the drinking water," Dr. Mary Frank remarked at the annual meeting of the California Academy of Family Physicians. But...

Artificial Bowel Sphincter Treats Fecal Incontinence.
August 1, 2001... SAN DIEGO -- An investigational artificial bowel sphincter provides major clinical improvement in those patients with severe fecal incontinence who can tolerate the device and its substantial morbidity, Dr. W. Douglas Wong reported at the...

Sacral Nerve Stimulation Works, but Beware of Adverse Events.
August 1, 2001... SCOTTSDALE, ARIZ. -- Implanted sacral nerve stimulators can work wonders in patients with bladder overactivity or urinary retention, but the treatment comes with its share of problems, Dr. Jeffrey L. Cornella said. The procedure is...

Try Intravaginal Boric Acid for Candida glabrata.
August 1, 2001... DURBAN, SOUTH AFRICA -- Physicians seeking reliably effective therapy for Candida glabrata vaginitis must dust off a treatment that was in its heyday in the Crimean War era, Dr. Jack D. Sobel said at a satellite conference held in conjunction...

Black Cohosh No Better Than Placebo.
August 1, 2001... Black cohosh, a popular herbal product, was no more effective than placebo in relieving most menopausal symptoms in women with a history of breast cancer, Dr. Judith S. Jacobson of Columbia University, New York, and her associates reported. ...

Breast, Lung Cancer Rates Increasing in Women.
August 1, 2001... The overall incidence and mortality from cancer in the United States are decreasing. Yet lung and breast cancer rates are increasing in women, as are the incidences of 10 less common cancers, according to an annual report on national cancer...

Test IDs Cancers From BRCA1, BRCA2, Sporadic Mutations.
August 1, 2001... A gene-expression profiling technique that yields a "fingerprint" of genetic activity in tissue samples can distinguish among breast cancers that arise from BRCA1, BRCA2, and sporadic gene mutations, according to investigators at the National...

Chemotherapy's Goals Often Not Conveyed.
August 1, 2001... SAN FRANCISCO -- Physicians and their patients are more likely than not to disagree about the goals and the benefits of chemotherapy, demonstrating possible shortcomings in the informed-consent process, Dr. Geetha N. Varma reported at the...

Use Oral Desmopressin Judiciously for Nocturia.
August 1, 2001... ANAHEIM, CALIF. -- Oral desmopressin is useful in the treatment of nocturia in men and women, according to two studies presented at the annual meeting of the American Urological Association. A third study indicated that the pathogenesis of...

FISH Alternative Promising for Aneuploidy Search.
August 1, 2001... RANCHO MIRAGE, CALIF. -- A relatively new technique called comparative genomic hybridization may soon replace fluorescent in situ hybridization as the method of choice for obtaining preimplantation genetic diagnoses for aneuploidy in...

Antifibrinolytics First Line for Teen Menorrhagia.
August 1, 2001... TORONTO -- Physicians should consider antifibrinolytic therapy plus standard estrogen therapy as first-line treatment for acute menorrhagia in adolescents, Canadian experts said. "We have to be more aggressive in treating these patients....

Constipation Not Always Easy to Spot.
August 1, 2001... TORONTO -- Chronic pelvic pain in a teenage girl could be nothing more than chronic constipation. But physicians may really have to coax details out of these young patients to make the diagnosis, Dr. Cynthia Holland said during the annual...

Premature Adrenarche May Mean Adrenal Hyperplasia, PCOS.
August 1, 2001... TORONTA -- Premature adrenarche in girls, even in the absence of tumors, is no longer thought to be benign, said Dr. Kristi Muichahey said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology. "It...

Cardiology.
August 1, 2001... The Exercise Paradox The risk of sudden death is 14-45 times greater during vigorous exertion than during rest or light exertion, but paradoxically that risk is blunted in people who exercise regularly, reported Dr. Christine M. Albert of...

Hypertension.
August 1, 2001... Salt Restriction The low-salt, low-fat DASH diet failed to remedy the blunting of the nocturnal decline in blood pressure that has been observed in blacks, Dr. Lawrence J. Appel reported at the annual conference of the American Heart...

Mental Health.
August 1, 2001... Geriatric Depression Although depressive symptoms are common among the elderly depression is not a normal part of aging and should be vigorously treated, Dr. Carl Salzman said at the annual meeting of the American Association for Geriatric...

Pain.
August 1, 2001... Palliative Surgery Palliative surgery can improve quality of life for cancer patients, even when the patient's cancer is advanced and even when the necessary surgery is quite aggressive. Betty R. Ferrell, Ph.D., reported at the annual...

Td Vaccine No Longer Being Shipped to Offices.
August 1, 2001... ATLANTA -- The nation's only manufacturer of tetanus-diphtheria (Td) vaccine has temporarily halted shipments to physicians' offices in order to maintain sufficient supplies for critical needs during the shortage. That announcement came...

Agency Mulls Easing Pessary Reimbursement Rules.
August 1, 2001... WASHINGTON -- The Centers for Medicare and Medicaid Services is considering a move to ease reimbursement for physicians who want to dispense pessaries in their offices to Medicare beneficiaries. The agency, formerly known as the Health Care...

DR. SATCHER'S SEX REPORT.
August 1, 2001... Deviating from the common message of abstinence until marriage, U.S. Surgeon General David Satcher is calling for strategies in teenage sex education that are based on personal responsibility, culture, and science. "The Surgeon General's Call...

MEDICARE EXPANDS SERVICES.
August 1, 2001... Medicare has expanded its coverage of screening tests for breast, cervical, and colorectal cancers. The new benefits are part of the Beneficiary Improvements and Protections Act enacted by Congress in December 2000. Women who are not at high...

BEWARE BAD BILLING ADVICE.
August 1, 2001... Some consultants' advice may lead to improper payment of insurance claims, the General Accounting Office says. The GAO discovered this when it investigated, several health care consultants who conduct seminars or workshops on ways to avoid...

CONTRACEPTIVE COVERAGE POLL.
August 1, 2001... The majority of Americans want their insurance plans to pay for contraceptives, new poll from the National Abortion and Reproductive Rights Action League says. Their survey of 853 registered voters nationwide found that 67% of voters strongly...

CONDOM ADS OK.
August 1, 2001... Most American viewers do not oppose condom ads on TV, a study conducted by the Henry J. Kaiser Family Foundation says. This finding runs in direct conflict with the current policies of many broadcast television networks, which historically have...

Apology, Explanation Can Diffuse Patient Anger.
August 1, 2001... DENVER - It's an unpleasant situation that busy physicians face all the time: striding into an examining room only to find a patient who is steamed over a prolonged office wait. What's the best way to handle this situation? A new study...

Patients Can Bypass Doctors for Medical Testing.
August 1, 2001... Clinical laboratory companies have begun to offer a wide option of self-selected medical tests to consumers. The largest such company is Quest Diagnostics, whose QuestDirect service is currently available in Colorado, Montana, Missouri, and...

Mifepristone Use Expected to Rise.
August 15, 2001... Mifepristone does not appear to be widely embraced by women seeking abortion, but some experts say the drug is gradually gaining broader acceptance. Although exact prescription numbers are not available from the drug's manufacturer, Danco...

Risedronate Acts Quickly to Reduce Fracture Risk.
August 15, 2001... Patients who had the highest fracture risk were most likely to benefit from treatment. SAN ANTONIO -- Five studies involving more than 13,500 patients now verify that the bisphosphonate risedronate quickly reduces fracture risk in patients...

Metformin as Effective as Clomiphene in PCOS.
August 15, 2001... Ovulation, pregnancy rates similar. DENVER -- Two new studies add to previous data supporting the use of metformin as a fertility drug in women with polycystic ovary syndrome. The insulin-sensitizing agent dramatically cut the elevated...

Harmonized Adult Immunization Schedule in the Works.
August 15, 2001... ATLANTA -- For years, the routine childhood immunization schedule has decorated the walls of pediatricians' and family physicians' offices. Now, it's the grown-ups' turn. Work has begun on the development of a harmonized immunization...

Challenges of Genetic Testing.
August 15, 2001... We need to think about some of the ethical issues of genetic testing today since regular routine clinical testing does not appear to be very far in the future. First we need to consider the difference between testing for somatic cell...

Medicare Panel Advises Coverage of FDG-PET.
August 15, 2001... TORONTO -- A Medicare advisory committee has agreed that there. is enough evidence to support their coverage of [18] fluorodeoxyglucose-PET scans for women with suspected invasive breast cancer. The recommendation, which must still be...

Extent of Metastatic Breast Cancer Accurately Reflected in FDG-PET Scan.
August 15, 2001... TORONTO -- [blank.sup.18]Fluorodeoxyglucose-PET scans are more sensitive than conventional imaging at discerning the nature and extent of suspected. metastatic breast cancer and for guiding the therapeutic approach, Dr. Mohei M. Abou-Zied said...

PET Excels at Reflecting Breast Cancer Prognosis.
August 15, 2001... TORONTO -- Whole-body [blank.sup.18]fluorodeoxyglucose-PET scans were superior to conventional imaging techniques for predicting the posttrearment outcomes of women at high risk for recurrent breast cancer, Dr. Duska Vranjesevic said at the...

Report Says Breast Self-Exam Shows No Benefit.
August 15, 2001... Doctors should stop advising women between the ages of 40 and 69 to perform breast self-examination, and education about breast self-examination should be limited to women who specifically ask for it, according to a controversial Canadian...

Tamoxifen Tied to Aggressive Contralateral Disease.
August 15, 2001... Tamoxifen use by breast cancer patients increases the risk that aggressive contralateral tumors will develop, a small retrospective study suggests. Dr. Christopher I. Li and his colleagues at[the Fred Hutchinson Cancer Research Center in...

Estrogen May Exacerbate Hypothyroidism.
August 15, 2001... Estrogen therapy in postmenopausal, hypothyroid women elicits a clinically significant decrease in serum free thyroxine, results of a small study suggest. These findings suggest that doctors who prescribe estrogen for postmenopausal,...

Self-injected PTH, New SERM Target Osteoporosis.
August 15, 2001... DENVER -- Emerging approaches to osteoporosis include self-injected recombinant parathyroid hormone and a new third-generation selective estrogen-receptor modifier, according to reports at the annual meeting of the Endocrine Society. With...

Secondary Causes May Explain Bone Loss in Breast Ca Patients.
August 15, 2001... WASHINGTON -- Osteoporotic women who have a history of breast cancer are at increased risk for hidden disorders of bone and mineral metabolism that also contribute to their bone loss, Dr. C. Tannenbaum said at an international symposium on...

Karyotyping May Be Warranted for isolated Talipes.
August 15, 2001... ST. JOHN'S, NFLD, -- Fetal karyotyping may still be warranted when isolated talipes is found on ultrasound, Dr. Tina Delaney said at the annual meeting of the Society of Obstetricians and Gynaecologists of Canada. Historically, the...

Congenital Syphilis Down.
August 15, 2001... Congenital syphilis in the United States has dropped to the point that elimination is now feasible, the Centers for Disease Control and Prevention said (MMWR 50[27]:537-77, 2001). In 2000, a total of 529 congenital syphilis cases were...

Risks, Benefits of Prenatal Steroids Questioned.
August 15, 2001... SAN FRANCISCO -- Current knowledge about the risks and benefits of giving multiple courses of prenatal corticosteroids to women at risk for preterm delivery can be summed up in one word: confusion. Clinicians must rely on conflicting data...

Higher-Than-Normal Doses OK During Methadone Maintenance Therapy.
August 15, 2001... LOS ANGELES -- Babies born to women who take higher-than-recommended doses of methadone during the third trimester are no more likely to experience withdrawal than are the children of women who take the standard dose, Dr. Peter Selby said at...

Folic Acid Fortification Tied to a 19% Decline In Neural Tube Defects.
August 15, 2001... The prevalence of neural tube defects at birth has declined by 19% since the mandatory addition of folic acid to fortified grain products began in January 1998. In a comparison of birth certificate data for live births to women in a total...

Don't Overlook Reticularis Implications.
August 15, 2001... SAN FRANCISCO -- It's no secret that livedo reticularis can be a symptom of antiphospholipid syndrome, yet many clinicians still miss the diagnostic implications of this peculiar rash, Dr. T. Murphy Goodwin said. The netlike rash virtually...

Colon Exams and MI Rates.
August 15, 2001... Screening flexible sigmoidoscopy does not put people at higher than general risk of cardiovascular disease events, Dr. Theodore R. Levin said at the annual Digestive Disease Week. Some have theorized that flexible sigmoidoscopy may be...

Bulimia Outcomes.
August 15, 2001... Outcomes for bulimia patients were more positive than those for anorexia patients 5 years after diagnosis, said Dr. David I. Ben-Tovim and his colleagues at Flinders Medical Centre, Adelaide, Australia. In a study of 220 women aged 15 years...

Colorectal and Breast Cancer.
August 15, 2001... The risk for colorectal cancer is higher in women with a history of breast cancer, but that finding does not appear to influence the age at which to start colorectal cancer screening in these women, Dr. Andrejs Avots-Avotis said at the annual...

Eating Disorders in High School.
August 15, 2001... Nearly one-third of girls who participated in the first-ever nationwide survey of eating disorders among high school students had significant eating disorder symptoms. Of those, almost none had received treatment, S. Bryn Austin, Sc.D.,...

Pinpointing Bacterial Sinusitis.
August 15, 2001... In cases of suspected acute bacterial sinusitis, diagnostic certainty increases from 50% to 90% focusing on a specific handful of clinical clues, Dr. Morten Lindbaek said during WONCA 2001, the conference of the World Organization of Family...

Not Just a Childhood Illness.
August 15, 2001... Of 442 adolescents and adults with prolonged cough, 20% had laboratory evidence of pertussis, said Dr. Linda D. Senzilet of the Laboratory Centre for Disease Control in Ottawa and her colleagues. The mean duration of cough in the study was...

FDA Plans to Phase Out Unapproved Thyroid Products.
August 15, 2001... ROCKVILLE, MD. -- The Food and Drug Administration has issued details about how it plans to phase out distribution of synthetic thyroid replacement products that were not being formally reviewed by the agency as of Aug. 14. The FDA set...

Prospective Trial Shows Walking May Deter Cognitive Decline in Women.
August 15, 2001... PHILADELPHIA -- Regular exercise may help prevent cognitive decline in elderly women, according to the results of a large prospective study presented by Dr. Kristine Yaffe at the annual meeting of the American Academy of Neurology. Several...

Valtrex.
August 15, 2001... (valacyclovir GlaxoSmithKline) A shorter course (3 days) of therapy of the antiviral for treating recurrent episodes of genital herpes. Previously, a 5-day course of the antiviral was approved for this indication. * Recommended Dosage:...

Amplicor HCV Test.
August 15, 2001... (Roche Diagnostics Corp.) A polymerase chain reaction (PCR) test to be used as a supplementary assay to directly detect the presence of hepatitis C virus (HCV) in people with evidence of liver disease and HCV antibodies. This is the first...

CONTRACEPTIVE COVERAGE.
August 15, 2001... The House Appropriations Committee has voted to reinstate a provision in the fiscal year 2002 budget requiring federal employees' health benefit plans to cover contraceptives. The provision was removed earlier by the House Appropriations...

REPORT ON CONDOMS AND STDs.
August 15, 2001... Male latex condoms can help prevent the transmission of HIV/AIDS, but there is not enough evidence to show that they help prevent the spread of other sexually transmitted diseases, a controversial National Institutes of Health report says. At...