OB GYN News articles from December 2001

OB GYN News archives from December 2001

Blastocyst transfer not for everyone. (Less Success in ICSI Patients).
December 1, 2001... ORLANDO, FLA.--When blastocyst transfer debuted in the late 1990s, many experts predicted that it would be the wave of the future for infertility treatment. But now many of those original enthusiasts have tempered their predictions with a...

Mammogram data unlikely to change screening policy: overview analysis concludes that mammograms don't increase life expectancy. (New Analysis Called Flawed).
December 1, 2001... Mammography screening policies in the United States are unlikely to change despite a new overview analysis that concluded that mammography has not proved to cut overall mortality risk. Even if the new analysis were correct and mammography...

Parity, initial dilatation predict misoprostol success: older gestational age is also a predictor. (Labor Induction).
December 1, 2001... ASHLAND, ORE.--Labor was successfully induced and a vaginal delivery completed within 24 hours in about half of 1,373 patients who received intravaginal misoprostol, primarily within six large, randomized, controlled clinical trials. ...

Letters.
December 1, 2001... Rejects No-Mask Argument Although it is certainly true that aseptic technique under the most stringent precautions leaves a lot to be desired, there is no reason for Dr. Harry Reich to disregard time-honored techniques (Editor's Note, Oct....

Correction.
December 1, 2001... The name of the National Abortion Federation was incorrectly reported in "Mifepristone Use Expected to Rise" (Aug. 15, 2001, p. 1).

Pro & Con: is it reasonable to use ovarian tissue freezing to preserve reproductive potential? (Opinion).
December 1, 2001... YES A young woman with cancer who is about to undergo a stem cell or marrow transplant has absolutely nothing to lose in terms of her reproductive future by having one ovary taken out and the ovarian cortex properly frozen. Cancer...

Radiologists miss many vertebral fractures. (Equivocal Language also a Problem).
December 1, 2001... PHOENIX--One-third of vertebral fractures evident on lateral x-ray are missed by radiologists or reported in an ambiguous manner to the primary care physician, according to the results of a multinational study. The rate of missed findings...

Ultrasound-guided intracavitary biopsy diagnoses pelvic masses in 12 cases. (Patients with Prior Malignancies).
December 1, 2001... ASHLAND, ORE.--Ultrasound-guided intracavitary biopsies of pelvic masses can be safely and accurately performed in patients with a prior diagnosis of cancer who cannot or will not undergo a surgical biopsy Dr. Fikret Atamdede reported. Dr....

Vitamin D reduces falls in elderly by 49%. (Prospective Study).
December 1, 2001... PHOENIX--Vitamin D supplementation can reduce the risk of falling in the elderly by 49%, Dr. Heike A. Bischoff said at the annual meeting of the American Society for Bone and Mineral Research. In a randomized study of 122 women in geriatric...

Interstitial cystitis greatly underdiagnosed. (Expert Opinion).
December 1, 2001... BALTIMORE -- Physicians should become more alert to the signs and symptoms of interstitial cystitis, a condition that is significantly underdiagnosed, Dr. Marcella L. Roenneburg said at a symposium on women's health sponsored by Mercy Medical...

GnRH agonists may offer novel option for interstitial cystitis. (Cyclic Irritable Bladder Symptoms).
December 1, 2001... ASHLAND, ORE. -- Hormonal manipulation may prove to provide relief for women with chronic, cyclic irritable bladder symptoms, results of a University of Washington pilot study suggested. Eight of nine patients prescribed GnRH agonists for 6...

Drug update: interstitial cystitis.
December 1, 2001... Selecting a treatment for interstitial cystitis is a challenge. In a recent study of 581 women with the disorder, a total of 183 different treatments were prescribed (Urology 56[6]:940-45 , 2000). Ninety of the treatments were prescribed for...

Breast cancer risk rises with night-shift hours. (Melatonin Implicated).
December 1, 2001... Women who work the night shift are at increased risk of developing breast cancer, and the risk rises in a dose-dependent fashion with increasing hours per week and with increasing years spent at shift work, researchers found in two separate...

Data watch.
December 1, 2001... DATA WATCH Leading Causes of Death in Women, 1999 Percent of Deaths Total Deaths Diseases of Heart 373,575 30.7...

Routine screenings for vulvar cancer: low effort, high return. (Obese Women at Increased Risk).
December 1, 2001... ASHEVILLE, N.C. -- Vulvar cancers account for only 3%-5% of all gynecologic neoplasias, but routine screening is simple and worthwhile, particularly in patients at risk, Dr. William P. Irvin Jr. said at the annual Southern Obstetric and...

Ovarian Ca patients over age 75 often bypassed for Chemo. (Five Times Less Likely to Receive it).
December 1, 2001... ATLANTA -- Elderly women with advanced ovarian cancer may be less likely than younger women to receive adjuvant chemotherapy Rosemary Cress, Dr.P.H., said at a conference on cancer sponsored by the Centers for Disease Control and Prevention....

Oxybutynin patch studied for overactive bladder. (Under Review by the FDA).
December 1, 2001... CHICAGO--Transdermal oxybutynin effectively reduces symptoms of overactive bladder with minimal side effects, Dr. G. Willy Davila reported at the annual meeting of the American Urogynecologic Society. Oral oxybutynin also reduces overactive...

Pelvic floor exercises reduce incontinence risk. (1 Year Post Partum).
December 1, 2001... For women with persistent urinary and fecal incontinence after delivery, taking part in a conservative management program that focuses on pelvic floor exercises reduces the risk that they will still be incontinent at 1 year post partum, said...

Teens who breast-feed babies boost own BMD. (May Protect Against Bone Loss).
December 1, 2001... BALTIMORE--Lactation may protect against bone loss in teenaged mothers who breast-feed their infants, Dr. Caroline Chantry said at the annual meeting of the Pediatric Academic Societies. Using data on women aged 20-25, years from the third...

Does breast-feeding help prevent overweight children? (Mixed Study Findings).
December 1, 2001... Two large studies have reached inconsistent conclusions regarding the relationship between infant breast-feeding and overweight in children. One study by Dr. Matthew W Gillman of Harvard Medical School and his colleagues, concluded that...

Anti-infectives. (Drugs, Pregnancy, and Lactation).
December 1, 2001... This is the second installment of a three-part series of columns on the safety of antibiotics in pregnant and lactating women. * Lincosamides. Clindamycin (Cleocin) has been classified under pregnancy category B. There is no evidence of...

CDC OKs 1-month wait to get pregnant after rubella vaccine. (Recommendation had Been 3 Months).
December 1, 2001... ATLANTA -- Women need wait only 1 month to become pregnant after receiving the rubella vaccine, the Centers for Disease Control's Advisory Committee on Immunization Practices voted at its fall meeting. The previous recommendation, to avoid...

Higher rates of respiratory distress seen with cesareans. (Severe Preeclampsia).
December 1, 2001... PALM BEACH, FLA. -- Severe preeclampsia accounts for nearly two-thirds of cesarean deliveries, but the procedure offers no inherent benefits to patients with this condition, according to the findings of a retrospective chart review. In the...

Breast-feeding increases the risk of atopic dermatitis by 60% British study shows. (7,000 Infants Studied).
December 1, 2001... PORTLAND, ORE. -- Contrary to widely held notions, breast-feeding is associated not with a lower risk of atopic dermatitis, but with a 60% greater one, Dr. Clive B. Archer said at an international symposium on atopic dermatitis. In a...

Low levels of alcohol use may harm a fetus. (Behavioral Problems in Childhood).
December 1, 2001... Fetal alcohol exposure--even in very small amounts--is associated with significant behavioral problems during childhood, Dr. Beena Sood and associates of Wayne State University, Detroit, reported. While it has long been known that heavy...

Early cervical shortening tied to preterm birth. (History of Preterm Birth).
December 1, 2001... Shortening of the cervix early in the second trimester may signal an increased likelihood of premature birth in women who have already given birth prematurely. That was the conclusion of a recent study in which 183 women underwent serial...

Timing key to accuracy of home pregnancy test. (25% False-Negative Rate in Some Cases).
December 1, 2001... The timing of implantation varies so much in relation to the day a woman's period is expected that many pregnant women will get false-negative results on home pregnancy tests until a week or more after they have missed their periods, while many...

Migraine called major risk factor for hyperemesis. (Retrospective Study).
December 1, 2001... STANFORD, CALIF. -- A history of migraine headaches appears to be a powerful risk factor for hyperemesis gravidarum, Dr. W. LeRoy Heinrichs said at a conference on perinatal and pediatric nutrition. He reported on a retrospective record...

Home BP sharpens gestational hypertension dx. (Beter than Office Monitoring?).
December 1, 2001... SAN FRANCISCO -- Blood pressure measurements taken at home identified gestational hypertension more accurately than did measurements taken in physicians' offices, two European studies showed. In a study of 363 women, 63 with undetected...

Early low cytokine levels may flag later infection. (May Signal Need for Intervention).
December 1, 2001... QUEBEC CITY--Low levels of proinflammatory cytokines collected from the cervixes of pregnant women early in gestation may be a precursor to intra-amniotic infection later in pregnancy, Dr. Hyagriv N. Simhan reported. Poor maternal and...

Pass the cereal. (GI Disorders).
December 1, 2001... Diets with the highest content of cereal fiber are associated with a significantly lower risk for gastric cardia adenocarcinoma, reported Dr. Paul Terry of the Karolinska Institute, Stockholm, and his associates. The strong, dose-dependent...

Proton pump inhibitor safety. (GI Disorders).
December 1, 2001... Patients have used proton pump inhibitors to stop gastric acid production for up to 17 years without increasing their risk of developing gastric carcinoids. This finding is "reassuring for patients regularly using a proton pump inhibitor...

Nailing the diagnosis. (Dermatology).
December 1, 2001... Primary care physicians need to pay more attention to their patients' fingernails and toenails, Dr. Clay Cockerell said at the annual meeting of the Texas Academy of Family Physicians. Nail diseases are interesting, but they "are often...

Once-daily topical for acne. (Dermatology).
December 1, 2001... A once-daily topical clindamycin gel is a "viable alternative" to the standard twice-daily formulation for acne treatment, with equivalent efficacy and fewer side effects. This conclusion emerged from a multicenter, randomized,...

Early violence, later depression. (Mental Health).
December 1, 2001... Women who were victimized in childhood are more likely to develop major depressive disorder as adults, said Lauren A. Wise of Harvard Medical School, Boston, and her colleagues. The researchers conducted a population-based, case-control...

Panic attacks with HT drugs. (Mental Health).
December 1, 2001... Patients with multiple episodes of intolerance to antihypertensive medications had a high incidence of panic attacks and symptoms of anxiety and depression, compared with matched patients who tolerated the drugs, Dr. Simon J. Davies reported....

Feds to bolster physician-public health partnership. (Emphasis on Local Health Departments).
December 1, 2001... In response to anthrax bioterrorism, the federal government is strengthening partnerships between physicians and public health departments at the local level, Tommy G. Thompson, secretary of health and human services, announced. "I've...

Medicaid expansion. (Policy & Practice).
December 1, 2001... An additional 13 states have been given approval by the Department of Health and Human Services to extend Medicaid benefits to uninsured women with breast or cervical cancer. The 13 states are Alaska, Arizona, Arkansas, California, Connecticut,...

Wal-mart lawsuit. (Policy & Practice).
December 1, 2001... Wal-Mart Stores Inc., the largest private sector employer in the United States, has been sued in a class action lawsuit alleging sex discrimination for denying its employees insurance coverage of prescription contraceptives and devices. The...

Emergency contraception. (Policy & Practice).
December 1, 2001... California Gov. Gray Davis has signed legislation authorizing pharmacists to dispense emergency contraceptive pills without a prescription. Only California and Washington state have passed such legislation, says a spokeswoman for the...

Regulatory relief ahead? (Policy & Practice).
December 1, 2001... Physicians remain hopeful that Congress will pass Medicare regulatory relief legislation, even as Congress concentrates on war and homeland security issues. "We hope [regulatory relief] will be resolved very shortly," Dr. Donald Palmisano,...

HMO decline. (Policy & Practice).
December 1, 2001... The number of HMOs continues to drop despite stabilizing enrollment in the second half of 2000, according to the most recent Competitive Edge HMO directory, published by InterStudy Publications. As of Jan. 1, 2001, 541 full-service HMOs were in...

Peer review groups enlisted in bioterrorism fight. (Getting Timely Information to Doctors).
December 1, 2001... WASHINGTON -- The Centers for Disease Control and Prevention is enlisting the aid of peer review organizations to speed the delivery of accurate clinical information on bioterrorism. "Special Alert" is the insignia of the new rapid...

Doctors often don't ask about patients' sexual orientation. (Some Rely on Self-Disclosure).
December 1, 2001... SAN FRANCISCO -- Many healthcare providers aren't asking women about their sexual orientation, according to a survey of 1,161 lesbian and heterosexual women. Fifty-seven percent of the surveyed women said their health care provider did not...

Resources for the elderly. (FYI).
December 1, 2001... The "Resource Directory for Older People" is a listing of almost 300 public and private services and organizations that assist the elderly. Compiled by the National Institute on Aging and the Administration on Aging, the directory includes a...

Antibiotic resistance site. (FYI).
December 1, 2001... The Food and Drug Administration has created a Web page on antibiotic resistance, providing information on the problem of disease-causing microbes that are resistant to drug therapy. To access it, go to...

Answering menopause questions. (FYI).
December 1, 2001... "Menopause -- One Woman's Story Every Woman's Story: A Resource for Making Healthy Choices" is a 32-page brochure that answers questions that the average woman might have when facing menopause. The brochure, offered by the National Institute on...

Tools to combat obesity. (FYI).
December 1, 2001... "The Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults" provides a 10-step plan aimed at aiding in the treatment of overweight and obesity. It has a detailed section on diet therapy exercise,...

Spanish drug abuse brochure. (FYI).
December 1, 2001... "Juventud Latina--Hable con Sus Hijos Sobre las Drogas y Sus Peligros" (Latino Youth: Speak to Your Children About Drugs and Their Dangers) is a brochure with information on the health effects of inhalants and illegal drugs. It informs readers...

Calcium education campaign. (FYI).
December 1, 2001... "The Lowdown on Lactose Intolerance: Making the Most of Milk" is a free brochure that seeks to show people with lactose intolerance that they can enjoy milk and dairy products. It includes tips on gradually adding dairy foods to the diet to...

Infertility awareness campaign. (FYI).
December 1, 2001... Protecting fertility is the message at www.freerangegraphics.com/clients/ asrm/beta/information.html, a Web site that also offers advice on risky behaviors to avoid and options for infertile couples. Sponsored by the American Society for...

UAE follow-up riles gynecologists. (Working with Radiologists).
December 15, 2001... Uterine artery embolization puts gynecologists in a tough spot: While laying out all a patient's options for treating symptomatic fibroids is clearly the right thing to do, most ob.gyns. have a long way to go in building better working...

Singleton IVF pregnancies carry far higher risks: perinatal mortality, other adverse outcomes increased two- to threefold. (Metaanalysis Results).
December 15, 2001... ORLANDO, FLA. -- Singleton pregnancies conceived through in vitro fertilization have between double and triple the risk of several adverse outcomes, compared with spontaneously conceived pregnancies, according to results of a large...

CDC issues battle plan for confronting smallpox: feds to stockpile available vaccine. (Containing Outbreaks).
December 15, 2001... Teams of specialists from the Centers for Disease Control and Prevention were vaccinated against smallpox and began training in November to prepare for rapid deployment in the event a suspected case of smallpox is reported. "There has been...

Vital Signs: Average Compensation of Top Executives in for-Profit Health Plans, 2000 *.
December 15, 2001... VITAL SIGNS Average Compensation of Top Executives In For-Profit Health Plans, 2000 * Average Average Value of Compensation Unexercised Stock Options UnitedHealth...

Diabetes risk after gestational diabetes rises with DMPA use. (Progestin Increases Insulin Resistance).
December 15, 2001... ASHLAND, ORE. -- Women with a history of gestational diabetes were significantly more likely to develop subsequent diabetes if they used depot medroxyprogesterone acetate rather than combination oral contraceptives, a University of Arizona...

Distinguishing smallpox from other infections: a primer. (Initial Lesions Resemble Chickenpox).
December 15, 2001... Unless you've got your radar way up, smallpox early in its course is easy to confuse with other things, says Dr. Christopher J. Harrison of the University of Louisville (Ky). The incubation period for smallpox averages 10-14 days, although...

Risedronate lowers risk of vertebral fracture in 6 months. (Bone Turnover is Reduced).
December 15, 2001... PHOENIX -- Risedronate therapy reduces the risk of vertebral fractures among osteoporotic patients in as little as 6 months, according to an analysis of data from two large studies. The analysis, which included 2,442 women, showed a...

Letters.
December 15, 2001... The Laparoscopic Advantage Dr. Mickey Karram was correct that there are few clinical trials comparing laparoscopic procedures with conventional treatment and that there is a significant learning curve ("Is It Really a Surgical Advance?"...

To be fully alive. (Guest Editorial).
December 15, 2001... Patients with advanced cancer are typically offered surgery chemotherapy radiation-or "there is nothing we can do for you." The last option seems not to be a choice, and yet I have often observed that this realization is the most liberating...

Childhood ca survivors at risk for osteoporosis. (Heightened Awareness Urged).
December 15, 2001... HOUSTON -- Of 93 young adult survivors of childhood cancer, 11 had bone mineral densities in the osteoporotic range and 33 had osteopenia, Dr. Jyotika K. Fernandes reported at a conference on adolescent and young adult leukemias. ...

Triamcinolone inhaler associated with bone loss. (Premenopausal Women).
December 15, 2001... Premenopausal women using triamcinolone inhalers experience a small but statistically significant amount of bone loss that is dose dependent, a prospective cohort study suggests. The investigators predicted that a 30-year-old woman who uses...

Data back bacterial vaginosis testing before surgery. (Low Infection Rates Misleading).
December 15, 2001... ST. LOUIS -- The data supporting the value of screening for and treating bacterial vaginosis before ob.gyn. surgery are not merely indicative of a trend or an association. "They're fact," Dr. Sebastian Faro maintained at the 11th...

Breast cancer patients advised to avoid soy. (Phytoestrogens at Issue).
December 15, 2001... ARLINGTON, VA. -- Caution is the word for now on soy consumption for women with a history of breast cancer. Epidemiologic evidence clearly demonstrates a significantly lower risk for breast cancer among women whose diets routinely contain...

Be prompt in treating hidradenitis suppurativa. (Don't Delay Surgery When Antibiotics Fail).
December 15, 2001... ST. Louis -- In the past year, Dr. Sebastian Paro has treated a dozen cases of hidradenitis suppurativa, once considered a relatively rare disease. And when it strikes, if patients don't respond to antibiotic therapy, don't delay surgery...

Skin disease tied to greater squamous cell cancer risk. (Hidradenitis Suppurativa).
December 15, 2001... MUNICH -- Hidradenitis suppurativa is associated with a markedly increased risk of squamous cell carcinoma, Dr. JeanPaul Ortonne said at the 10th Congress of the European Academy of Dermatology and Venereology. This chronic inflammatory...

Birth control patch as effective as oral therapy. (Better Compliance).
December 15, 2001... ORLANDO, FLA. -- A birth control patch recently approved by the Food and Drug Administration shows similar efficacy to the oral contraceptive pill and better patient compliance, according to several studies sponsored by the patch's...

Estimated fetal weight not a guide for cesareans. (Preventing Shoulder Dystocia).
December 15, 2001... ASHLAND, ORE. -- Estimated fetal weight can be used as a guidepost in directing obstetric management of diabetic and nondiabetic patients but should not be used to dictate cesarean sections, researchers determined in a 4-year study. The...

Host of skin changes plague pregnant patients. (Obstetricians Should Know Possibilities).
December 15, 2001... PALM BEACH, FLA. -- Hair loss, hyperpigmentation, striae, and other pregnancy-related physiologic changes may be of little consequence to physicians, but they generate considerable patient concern, dermatologist Kenneth Tomecki said. Women...

Higher VEGF levels tied to ectopic pregnancy. (Vascular Endothelial Growth Factor).
December 15, 2001... ORLANDO, FLA. -- Serum levels of vascular endothelial growth factor are significantly higher in women with ectopic pregnancies, compared with those with arrested intrauterine pregnancies, Dr. Togas Tulandi reported. Moreover, this marker...

GBS screening: perianal cultures prove effective. (Lab Tests at Issue).
December 15, 2001... PALM BEACH, FLA. -- Anorectal sampling for group B streptococcus screening late in pregnancy is not necessary for accurate results, but the laboratory procedure recommended by the Centers for Disease Control and Prevention to detect...

Maternal vaccine for infant RSV clears hurdle. (Babies Born Healthy).
December 15, 2001... SAN FRANCISCO -- An investigational vaccine designed to prevent serious respiratory syncytial virus infection in infants by immunizing their mothers during pregnancy has passed its first clinical safety hurdle. The Wyeth-Lederle...

Colorectal cancer screening. (Cancer).
December 15, 2001... Screening patients over age 50 for colarectal cancer is becoming the standard of care, but the decision about which screening method to use depends in part on patient preference, Dr. Paul S. Frame said at the annual meeting of the American...

Flexible sigmoidoscopy. (Cancer).
December 15, 2001... Flexible sigmoidoscopy findings are poor predictors of proximal colon findings in asymptomatic women. That conclusion emerged from an ongoing trial of women being conducted at four military hospitals nationwide, Dr. Philip Schoenfeld...

Celiac disease ups malignancies. (GI Disorders).
December 15, 2001... Patients with celiac disease have twice the risk of cancer seen in the general population, Dr. Peter Green reported at the annual meeting of the American College of Gastroenterology. European studies have previously documented an...

Treat GERD, end coughs. (GI Disorders).
December 15, 2001... Successful treatment of gastroesophageal reflux disease may put an end to some patients' hoarseness, chronic cough, throat clearing, and sore throat, according to results of a controlled trial presented at the annual Digestive Disease Week. ...

MI mortality has declined. (Cardiology).
December 15, 2001... The size and the lethality of initial myocardial infarctions appears to be declining among people who are younger than age 75. But among those aged 75 years or older at the time of their first MI, the death rate did not change between 1979...

Warfarin cuts post-MI events. (Cardiology).
December 15, 2001... Daily treatment with warfarin and aspirin was more effective than daily aspirin alone or warfarin alone for preventing a second cardiovascular event. Based on the findings of a Norwegian study of 3,630 myocardial infarction patients...

Adult flu shots need a push. (Infectious Diseases).
December 15, 2001... Little recent progress has been made toward improving influenza vaccination rates among elderly and high-risk adults, particularly those in minority populations, James Singleton said in a poster presentation at the National Immunization...

Routinely screen for acute HIV. (Infectious Diseases).
December 15, 2001... Routine screening of selected patients for acute HIV infection is edging closer toward becoming standard practice. "Primary care physicians should immediately begin to integrate routine screening for acute HIV infection" for patients with a...

Low-tech strategies can help reduce medical errors. (Checklist for Patients).
December 15, 2001... ALEXANDRIA, VA. -- Use of several low-tech, simple strategies can make a major difference in patient safety, Dr. Gregg S. Meyer said at a conference on sleep research sponsored by the National Heart, Lung, and Blood Institute. "Read-back"...

New guidelines limit resident duty hours. (Maximum of 80 Hours/Week).
December 15, 2001... The American Association of Medical Colleges has issued new guidelines on graduate medical education that include limits on resident duty hours. According to the new guidelines, residents should be on duty no more than 80 hours per week...

Stem cell list ready. (Policy Practice).
December 15, 2001... The National Institutes of Health has unveiled the registry of human embryonic stern cell lines that may he used in federally funded research. The list may be found on the NH-I Web site at www.nih.gov. According to the registry eleven...

Gag rule repeal sought. (Policy Practice).
December 15, 2001... Thirty-six organizations, including the American College of Obstetricians and Gynecologists, have sent a letter to President Bush asking him to lift the so-called global "gag rule," which prohibits U.S. financial assistance to overseas groups...