OB GYN News articles from August 2003

OB GYN News archives from August 2003

New subgaleal hemorrhage code.(Research Implications)
August 1, 2003... Beginning in October, physicians who deliver a baby that sustains a subgaleal hemorrhage should begin using a new diagnosis code for the injury. The new code, 767.11, will be used instead of 767.1 and was developed to separate subgaleal...

Vital signs.
August 1, 2003... PERCENT CHANGE IN PRIVATE HEALTH CARE SPENDING STABILIZES [GRAPHIC OMITTED]

Folic acid not protective in women on AEDs: users of antiepileptics did not see a reduction in major congenital anomalies.(Registry Data)
August 1, 2003... PHILADELPHIA -- Use of folic acid at the time of conception was not associated with a statistically significant reduction in the risk of having an infant with a major congenital anomaly in women taking antiepileptic drugs. That finding...

Measurement predicts postnatal renal function: AP diameter <7 mm after 32 weeks.(Mild Pyelectasis)
August 1, 2003... MONTREAL -- A renal pelvic anterior-posterior diameter of less than 7 mm after 32 weeks' gestation is predictive of normal postnatal renal function. That finding emerged from a study presented by Dr. Anthony Odibo at a meeting sponsored by...

Data watch.
August 1, 2003... THE PUBLIC SUPPORTS GOVERNMENT REGULATIONS TO LIMIT HUMAN CLONING Endorse Regulations Yes 84% No 11% Don't Know 5% Note: Based on a survey of 1,211 adults on Oct. 15-29, 2002. Source: Princeton Survey...

Enoxaparin gets favorable labeling change.(Pregnant Women With Heart Valves)
August 1, 2003... A big upsurge in enoxaparin usage by obstetricians is highly unlikely, despite newly revised, less-prohibitive labeling for the low-molecular-weight heparin, Dr. Charles Lockwood predicted in an interview with this newspaper. "Most...

OTC Prilosec to hit stores.(Concerns Remain)
August 1, 2003... The Food and Drug Administration has approved over-the-counter sales of Prilosec, and the drug is slated to hit store shelves nationwide this fall. Although the use of omeprazole (Prilosec) results in very few side effects, some physicians...

First rapid laboratory test for West Nile virus wins FDA approval.(90%-99% Sensitivity)
August 1, 2003... The first rapid laboratory test for diagnosis of West Nile virus will help physicians quickly rule out other conditions when patients present with suspicious symptoms. The Food and Drug Administration on July 8 approved the test after a...

Responding to bioterrorism.(Guest Editorial)
August 1, 2003... My experience with the nation's first anthrax case taught me that we must better prepare our medical systems to respond to bioterrorism. Only through extensive training can we become prepared. Most communities are ill prepared to handle a...

Is postmortem sperm retrieval ethical if the deceased did not leave explicit instructions?(Pro & Con)
August 1, 2003... YES Requests for postmortem sperm retrieval are becoming more common, and often they are quite compelling. The typical request comes from the wife of a recently deceased man who, before her husband's death, would have welcomed pregnancy....

Interstitial cystitis screen.(Letters)
August 1, 2003... There is an urgent need for increased awareness of interstitial cystitis among gynecologists, so I was pleased to see the topic covered in Women's Health Adviser (May 1, 2003, p. 26). Gynecologists should include the bladder in the...

The truth behind perceptions.(Letters)
August 1, 2003... Dr. Abigail Hagler deplores the unfairness of public perceptions of physicians ("We Are So Bad," Letters, July 1, 2003, p. 7). She apparently feels sorry for herself and other physicians because of the mistrust and lack of respect for members...

Talk back online.(Opinion)
August 1, 2003... Should MRI be a routine adjunct to sreening mammography in high-risk women? (July 1, 2003, p. 2) NO 27% Yes 73% To Talk Back, visit www.eobgynnews.com Note: Table made from pie chart.

Labial swelling, clear discharge? Suspect genital lymphedema.(After Pelvic, Gyn. Surgery)
August 1, 2003... MONTREAL -- Unusual gynecologic complaints of labial swelling or clear labial/vaginal discharge could be symptoms of genital lymphedema, especially if the patient has had previous pelvic or gynecologic surgery or radiation affecting lymph nodes...

Lymphedema awareness called 'big problem'.(Often Goes Undiagnosed)
August 1, 2003... MONTREAL -- Lymphedema is a condition that has a high morbidity and can be fatal, but most physicians know little about its risk factors, diagnosis, or treatment, Dr. Horst Weissleder said. "Awareness is a big problem, because early...

New approaches may cut lymphedema risk after breast ca therapy.(Partial Breast Irradiation)
August 1, 2003... MONTREAL -- The risk of developing lymphedema is significant in all women who've had breast cancer treatment, but too often oncologists give it little consideration, specialists said at a meeting sponsored by the World Federation for Ultrasound...

Newer contraceptives give teens more options.(Patch Becoming Popular)
August 1, 2003... HILTON HEAD ISLAND, S.C. -- New contraceptive technologies are providing a wider array of options for sexually active adolescent girls, Dr. Linda Grant said at a meeting on clinical pediatrics sponsored by Boston University. After years of...

Emergency contraception awareness rose from 1996 to 2002.(Survey Of Teenage Girls)
August 1, 2003... PHILADELPHIA -- Teenage girls knew more about emergency contraception in 2002 than in 1996, but they still have a way to go, according to surveys done with about 100 girls each year at one medical center. Since 1996, adolescent girls have...

Myomectomy: tips for reducing adhesions.(Incisions, Suteres)
August 1, 2003... SCOTTSDALE, ARIZ. -- A surgeon's method of cutting and stitching during a myomectomy affects the patient's risk for developing adhesions that may obstruct the bowel or reduce her chances of becoming pregnant. For the best results when...

Postprocedure use of GnRH agonist doesn't boost UAE.(Study Of 26 Patients)
August 1, 2003... SCOTTSDALE, ARIZ. -- Postprocedure use of a GnRH agonist did not enhance the effects of uterine artery embolization in the treatment of fibroids in a small prospective, randomized trial. Given these results, physicians should pick one...

Low-dose mifepristone matches GnRH agonists for uterine fibroids.(Six Small Trials)
August 1, 2003... SCOTTSDALE, ARIZ. -- Low-dose mifepristone taken daily by women with uterine fibroids can significantly reduce fibroid size and symptoms, limited data suggest. The oral antiprogestin was as effective as injections of GnRH agonists, the...

3-D power Doppler may defer need for sonohysterogram.(Abnormal Uterine Bleeding)
August 1, 2003... MONTREAL -- Three-dimensional power Doppler ultrasound can be used as a screening tool to evaluate abnormal uterine bleeding in premenopausal women, thereby avoiding the need for more invasive 3-D transvaginal sonohysterography in about...

HPV-16 VLP vaccine yields consistent, durable antibody response in small trials.('Excellent' Immunogenicity)
August 1, 2003... BETHESDA, MD. -- Vaccines that contain viruslike particles from human papillomavirus types known to cause cervical cancer have produced consistent, durable antibody responses in several small trials, Doug Lowy, Ph.D., reported. Viruslike...

Endometrial thickness no real help.(Premenopausal Women)
August 1, 2003... MONTREAL -- Ultrasound measurement of a thin endometrium does not rule out pathology in premenopausal women with abnormal uterine bleeding, results of a retrospective study suggest. "We were trying to find a measurement to be able to say,...

Depo-Provera use in teens tied to bone density drop.(Reduction Of 6.8% After 2 Years)
August 1, 2003... PHILADELPHIA -- Two years of contraception with injectable medroxyprogesterone acetate in adolescent girls was associated with an average 6.8% reduction in bone mineral density, compared with controls in an observational study of 148 teens. ...

Risk of clitoral sensory loss with genitoplasty.(Review Of Six Patients)
August 1, 2003... PHILADELPHIA -- Women who underwent feminizing genitoplasty had clitoral sensory impairment in a pilot review of six patients. The findings show that the impact of genital surgery on clitoral sensation and sexual function requires further...

Patch, progesterone for young women at increased bone risk.(Endocrine Disorders)
August 1, 2003... SAN DIEGO -- Young women who face a high risk of osteoporosis due to endocrine disorders need more estrogen than they can receive through a standard 0.625-mg dose of conjugated equine estrogen or standard doses of oral contraceptives, several...

Vestibular bands may raise the risk of vulvovaginitis in prepubertal girls.(Pooling Of Fluid within Vagina)
August 1, 2003... PHILADELPHIA -- Vestibular bands may be an anatomic risk factor for vulvovaginitis, based on a review of 150 prepubertal girls with vaginitis at a single center. "The frequency of the association suggests a possible causal link" between...

Fetal surgery called promising for spina bifida.(Improves Short-Term Outcomes)
August 1, 2003... LISBON -- In utero surgery for spina bifida is a risky but promising procedure that appears to improve short-term outcomes, and now, thanks to a recently initiated multicenter trial, long-term results are being evaluated as well. The...

Increased maternal calcium intake may lower systolic BP in offspring.(Ongoing Study Of 712 infants)
August 1, 2003... MIAMI BEACH -- Increasing a woman's calcium intake during pregnancy may modestly lower her offspring's blood pressure, results of a study of more than 700 6-month-old infants suggest. When the babies' mothers were divided into quartiles...

Healthy behavior slips during year after delivery.(Low-Income Women)
August 1, 2003... SALT LAKE CITY -- Women tend to neglect health-promoting behaviors in the 12 months following delivery, reported Lorraine Walker, R.N., at the annual meeting of the Society of Behavioral Medicine. Results from surveys given to 259...

BMI linked to post-dural puncture headache.(Risk Increases With Lower BMI)
August 1, 2003... PHOENIX, ARIZ. -- Body mass index was inversely related to the risk of post-dural puncture headache in a study of 191 women, Dr. Fred J. Spielman reported at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. This...

Epidural pain: placement vs. infiltration.(Small Study)
August 1, 2003... PHOENIX, ARIZ. -- Women in labor who receive epidural anesthesia find Tuohy needle placement almost as painful as local anesthetic infiltration, suggesting that doctors should end the common practice of telling patients that infiltration of the...

No transabdominal scan until 18 weeks in obese women.(Fetal Heart Assessment)
August 1, 2003... MONTREAL -- Physicians should not attempt transabdominal ultrasonographic visualization of the fetal heart before 18 weeks in obese women but should consider an earlier transvaginal scan, Dr. Israel Hendler recommended. "Patients usually...

Oximeter postapproval trials go slowly.(14 Adverse Events Reported)
August 1, 2003... GAITHERSBURG, MD. -- Only one of the three postmarketing studies designed to address safety and efficacy issues related to the fetal pulse oximeter has been completed, and one is at a standstill. At a meeting of the Food and Drug...

Specific oral pathogens linked to premature delivery.(Ubiquitous In Cord Blood)
August 1, 2003... PHOENIX, ARIZ. -- Preterm labor in women with periodontitis was associated with specific oral pathogens in a recent study, a finding that adds to the growing body of evidence linking periodontitis with premature delivery, Dr. Manuel Vallejo...

Drop in HDL cholesterol seen after childbirth.(10-Year Follow-Up Study)
August 1, 2003... MIAMI BEACH -- Childbearing was associated with a significant decrease in HDL cholesterol levels in a 10-year follow-up study of almost 2,000 black and white women. A first birth was associated with a persistent decline in HDL cholesterol...

Suit seeks halt to Resident Match Day program.(Fixed Slots, Fixed Pay)
August 1, 2003... WILMINGTON, DEL. -- The Resident Match is fundamentally anticompetitive and represents an effort to depress the wages and opportunities of medical residents, according to a lawsuit filed by former and current residents. As the suit drags...

Maine's universal coverage plan could burden state physicians.(Electronic Claims Required)
August 1, 2003... A universal health care plan that promises to cover Maine's uninsured in 5 years could bring added hassles to that state's physicians. They'll have to be more prudent about their medical records, disclosing charges to patients, and...

Texas abortion law.(Policy & Practice)
August 1, 2003... Next year, women in Texas will be required to wait 24 hours to get an abortion, because of legislation signed into law by Republican Gov. Rick Perry. Under the law, physicians will be required to inform women of any medical risk associated with...

Women and medicare.(Policy & Practice)
August 1, 2003... Older women suffer from more chronic health conditions than men and have fewer resources with which to pay for their care, making Medicare more important for women, a group of female U.S. senators said at a press conference in June. Women aged...

Women's health courses.(Policy & Practice)
August 1, 2003... Less than half of U.S. medical schools offer a women's health curriculum, according to a survey released by the Society for Women's Health Research and published online by Medscape (MedGenMed. 5[2], 2003; www.medscape.com; full text available...

'Wanted' poster ruling stands.(Policy & Practice)
August 1, 2003... The U.S. Supreme Court has upheld a ruling from a lower court that "wanted"-style posters of physicians who perform abortions are illegal. The court refused to hear the case (Planned Parenthood v. American Coalition of Life Activists) in June....

Physician depression.(Policy & Practice)
August 1, 2003... Physicians may not be seeking help for mental health problems, in part because of a fear of professional discrimination, according to the American Foundation for Suicide Prevention. The group convened a workshop of experts in October 2002 and...

Protections in clinical trials still seen as lax.(Little Change In Regulations)
August 1, 2003... WILMINGTON, DEL. -- Despite the controversy following the death of University of Pennsylvania patient Jesse Gelsinger, little has changed in the regulation of clinical trials since then, according to Arthur Caplan, Ph.D., director of the Center...

Many patients welcome discussion about their religious beliefs.(Routine Office Visits)
August 1, 2003... A third of patients are seeking spiritual as well as medical attention during routine office visits, Dr. Charles D. MacLean of the University of Vermont, Burlington, and his colleagues reported. In a survey of 456 patients seen at primary...

Education program makes doctors aware of drug costs.(Modest Improvements)
August 1, 2003... An intervention to educate physicians about the cost of drugs led to modest improvements in their awareness of the financial burden of medications on their patients, Dr. Ethan A. Halm of Mount Sinai School of Medicine, New York, and his...

Specialty hospitals raise antitrust concerns.(A Threat To General Hospitals?)
August 1, 2003... The specialty hospital boom is raising fresh concerns about patient care and competition in the health care market. Whenever there is intense competition among hospitals for a specific patient population, that's a sign that third-party...

Employers slow to latch on to consumer-driven health plans.(Fixed Copayments May Wither)
August 1, 2003... WASHINGTON -- Consumer-driven health plans may be all the buzz in the health insurance industry, but employers have been wary of them so far, according to Randall Abbott, senior consultant at Watson Wyatt Worldwide in Philadelphia. "The...

Set realistic goals for metabolic syndrome patients.(Assess Readiness For Change)
August 1, 2003... NEW ORLEANS -- Setting realistic, incremental goals for weight loss and physical activity can help patients succeed in their struggle with metabolic syndrome, Dr. Daniel Bessesen said at the annual scientific sessions of the American Diabetes...

New data challenge popular set point theory of obesity.(Physical Activity Seems Key)
August 1, 2003... DENVER -- It's high time to toss out the long-popular set point theory of obesity, according to speakers at an international conference of the Academy for Eating Disorders. The set point theory holds that obesity entails a metabolic defect...

Dieting and exercise must accompany drugs.(Obesity Therapy)
August 1, 2003... DENVER -- Weight-loss medications arguably should never be prescribed without also enrolling patients in some sort of behavioral modification program as well as a dietary intervention, Dr. Samuel Klein said at an international conference of the...

Obesity epidemic seen as a public health crisis.('Cannot Be Medicalized Away')
August 1, 2003... WASHINGTON -- The growing epidemic of obesity is not just a problem for physicians and insurers, but for all industries and policy makers, said Dr. William Caplan, director of clinical development at Kaiser Permanente's Care Management...

Regular exercise may lower C-reactive protein levels.(Anti-Inflammatory Effect)
August 1, 2003... CHICAGO -- Regular exercise may reduce levels of C-reactive protein, the inflammatory marker now recognized as a novel risk factor for coronary heart disease, Dr. Michelle A. Albert said at the annual meeting of the American College of...

Fiber may help protect against colon cancer.(Two Large Studies)
August 1, 2003... Roughage just might prevent colon cancer after all. Contradicting previous evidence, two large multicenter studies--one American, the other European--have documented a strong association between increased consumption of dietary fiber and a...

Depression remission higher with venlafaxine than SSRIs.(Largest Pooled Analysis)
August 1, 2003... SAN FRANCISCO -- Venlafaxine outperformed selective serotonin reuptake inhibitors in achieving remission in major depression, according to a pooled analysis of data from 33 randomized, double-blind, comparative clinical trials. Venlafaxine...

Patient education improves satisfaction with chronic pain care.(Physician Involvement)
August 1, 2003... NEW ORLEANS -- When chronic pain patients felt educated by their physician about the pain, they tended to be satisfied with their care in a recent study--and those whose physician disagreed with the patient's assessment of the level of pain...

Headache.(Women's Health Adviser)
August 1, 2003... Headache is the seventh leading reason for physician visits in the United States. Women suffer disproportionately from headache. Migraine, the most debilitating form, affects about four times more women than men--1820 million American women...

Low-dose hormones.(Products)
August 1, 2003... A 0.45-mg strength of Premarin (conjugated estrogen tablets) has been approved. The tablets are indicated for the treatment of moderate to severe vasomotor symptoms and vulvar and vaginal atrophy associated with menopause. For more information,...

Free breast-feeding guide.(Products)
August 1, 2003... Parents and physicians can order a free educational guide, which offers breast-feeding tips and product information. To order, contact Medela Inc. at 800-435-8316 or customer, service@medela.com.

Reyataz approved.(Products)
August 1, 2003... Reyataz (atazanavir sulfate) is the first once-daily protease inhibitor approved for the treatment of HIV-1 infection in combination with other antiretroviral agents. For more information, contact Bristol-Meyers Squibb Co., 212-546-4000...

Push button blood collection.(Products)
August 1, 2003... The BD Vacutainer push button blood collection set retracts the needle with the push of a button when collecting blood samples. The set was designed to better protect health care workers from accidental needle sticks. For more information about...

Urine chemistry analyzer.(Products)
August 1, 2003... The DiaScreen 50 urine chemistry analyzer, used in screening for endocrine and metabolic disorders and kidney disease, has received waiver status under the Clinical Laboratory Improvement Amendments. The device is now available for use in...

Birthing aid.(Products)
August 1, 2003... The PushPal birthing aid is wrapped below each knee, providing a grip for the patient to bring her chest to her knees and improving leverage, for more effective pushing. The birthing aid is available in two sizes. For more information, contact...

Medical security cart.(Products)
August 1, 2003... The Security Cart is a vented metal-enclosed cart that can be locked to secure equipment and can also be used in an exam, operating, or laboratory room. For more information about this product, contact Anthro Corp., 800-325-3841,...

Electronic record system.(Products)
August 1, 2003... The ComChart electronic medical record program is a software package that enables physicians to eliminate traditional paper records. It can be used with or without customization. For more information, contact ComChart Medical Software LLC,...

New zocor labeling.(Products)
August 1, 2003... Zocor (simvastatin) 40 mg is now recommended, along with diet, as the starting dose for people with coronary heart disease or diabetes to reduce the risk of heart attack and stroke. Labeling changes reflect data showing that the drug is...

New HIV-1 drug dose.(Products)
August 1, 2003... Viracept (nelfinavir mesylate) has been approved in a 625-mg formulation. The new formulation reduces the number of pills that patients with HIV-1 infection take, from five 250-mg tablets twice a day to two 625-mg tablets twice a day. For more...

Feds go slowly on enforcing HIPAA: 'informal persuasion'.(News)
August 15, 2003... SAN ANTONIO -- After 3 months of required compliance for the Health Insurance Portability and Accountability Act of 1996, it appears that physicians are erring on the side of caution while the government continues to err on the side of gentle...

Regular NSAID use tied to lower risk of breast Ca: Ibuprofen associated with 49% risk reduction after 10 years in older women: women's health initiative.(News)
August 15, 2003... WASHINGTON -- Women who take moderate amounts of NSAIDs weekly for at least 10 years may significantly reduce their breast cancer risk, according to a new analysis of data from the Women's Health Initiative. Ibuprofen may be especially...

Bupropion appears safe in pregnant women: not linked to increase in major fetal dejects: first study in pregnancy.(News)
August 15, 2003... PHILADELPHIA -- Bupropion does not appear to increase the risk for major fetal malformation and seems effective in decreasing smoking in pregnant women, according to interim results of an ongoing trial. "There is always a question of...

Strategies to avoid HIV transmission: new CDC guidelines.(News)
August 15, 2003... New guidelines from the Centers for Disease Control and Prevention are designed to help health care providers promote strategies to prevent HIV transmission. The guidelines come on the heels of a CDC report of increasing HIV transmission...

Destigmatize physician depression.(Guest Editorial)
August 15, 2003... Physicians are not immune to depression and suicidal ideation. Yet we often deny our vulnerability to the same illnesses that we treat in our patients, and further deny that getting help for depression will, in fact, fix the problem. It is...

Should women be allowed to eat and drink while in labor?(Pro & Con)
August 15, 2003... YES We don't allow laboring women to eat or drink for fear they might aspirate should they need general anesthesia. What we call aspiration deaths today, however, are really due to badly managed airway problems that would result in death...

Education before economics.(Letters)
August 15, 2003... Dr. Lawrence G. Smith appears to admit that limitations of resident work hours are necessary. He also "strongly oppose[s] micromanagement" of work hours ("Limiting Resident Work Hours," Guest Editorial, May 15, 2003, p. 6). His objection...

Talk back online.(Opinion)
August 15, 2003... TALK BACK ONLINE 'Have the results of the Women's Health Initiative changed the way you prescribe hormone therapy?' (July 15, 2003, p. 9) NO 6% YES 94% To Talk Back, visit www.eobgynnews.com

Alternative therapies popular with ART patients: may affect hemostasis, outcomes.
August 15, 2003... PHOENIX, ARIZ. -- Complementary and alternative therapies are popular among patients undergoing assisted reproduction procedures and could affect hemostasis and reproductive outcomes, according to Dr. Lawrence Tsen. In a survey of 1,038...

Stress amenorrhea responds to psychotherapy: effective in small randomized trial.
August 15, 2003... DENVER -- Cognitive-behavioral therapy is an effective treatment for women with stress-induced anovulation, Rebecca M. Ringham reported at an international conference of the Academy for Eating Disorders. The psychological intervention...

COX-2 inhibitors advocated for dysmenorrhea: expert opinion.(Gynecology)
August 15, 2003... CHARLOTTETOWN, P.E.I. -- Although nonsteroidal anti-inflammatory drugs are currently the first-line treatment for primary dysmenorrhea, physicians should consider replacing them with cyclooxygenase-2 inhibitors, advised Dr. Fay Weisberg of the...

Menstrual woes may accompany bipolar illness: precede psychiatric DX.(Gynecology)
August 15, 2003... SAN FRANCISCO -- Menstrual abnormalities are quite common among women with bipolar disorder, and in most cases precede diagnosis and treatment of the psychiatric disorder, Dr. Natalie L. Rasgon reported at the annual meeting of the American...

Long-term data on subserosal fibroid resection: 206 patients studied up to 18 years.(Gynecology)
August 15, 2003... SCOTTSDALE, ARIZ. -- After subserosal fibroid resection, 11%-14% of patients will still have uncontrolled menstrual bleeding; 15%-20% will need a hysterectomy, mostly to treat pain; and 17%-24% will develop intrauterine adhesions that could...

Laparoscopic approach works for most fibroids: one doctor's experience.(Gynecology)
August 15, 2003... SCOTTSDALE, ARIZ. -- A large majority of women with fibroids can be offered minimally invasive myomectomy through laparoscopy, according to Dr. Charles E. Miller. "I can take care of virtually 99% of my practice laparoscopically," said Dr....

Missed Ca diagnosis top cause of gyn. lawsuits: breast cancer listed in 59% of these cases.(Gynecology)
August 15, 2003... Breast Cancer Listed In 54% Of These Cases CHARLOTTETOWN, P.E.I. -- Gynecologic issues are cited in 41% of all lawsuits against ob.gyns., with failure to diagnose cancer the top cause, representing 63% of these cases, according to Dr. Larry...

Ideal spectroscopy device for CIN screening remains elusive: ongoing trials.
August 15, 2003... Measuring the way light is reflected or fluoresced off a woman's cervix may provide a means to objectively detect pre-cancerous cells. It's an attractive way to refine current methods--Pap smears, colposcopy, and biopsy--for screening,...