OB GYN News articles from December 2005

OB GYN News archives from December 2005

Cochrane review eyes epidural risks.(News)
December 1, 2005... The use of epidural anesthesia during labor significantly increases the risk of instrumented delivery but does not increase the risk of a cesarean birth, according to systematic review by the Cochrane Collaboration of 21 randomized clinical...

U.S. sees increase in syphilis and chlamydia rates: gonorrhea rate falls but resistance an issue.(News)
December 1, 2005... The rate of syphilis infection in the United States continues to rise, with an 8% increase in the number of reported cases in 2004, compared with 2003, the Centers for Disease Control and Prevention reported. In 2004, the national...

Postabortion deaths spur update of Mifeprex label.(News)
December 1, 2005... Clostridium sordellii has been confirmed as the cause of sepsis in four women who died in the United States following the use of Mifeprex (mifepristone) for medical abortion, the Food and Drug Administration reported. The product's package...

Screening, adjuvant therapy both contribute to drop in breast Ca mortality.(News)
December 1, 2005... For the first time, researchers have separated the survival impacts of screening mammography and adjuvant therapy on breast cancer. From 1975 to 2000, the overall reduction in breast cancer mortality was 24%. The portion of decrease...

Bed rest for pregnancy-related hypertension: evidence is weak.(News)
December 1, 2005... Although physicians have long recommended bed rest or restricted activity for pregnant women with hypertension, a systematic review of available studies found only weak evidence that this practice benefits women or their children. In the...

Vanishing twin linked to poor perinatal outcome.(News)
December 1, 2005... MONTREAL -- A history of a vanishing twin appears strongly associated with adverse perinatal outcomes in singletons born after in vitro fertilization, results of a retrospective cohort study suggest. Contrary to previous findings, this...

Weight loss eases fibromyalgia.(News)
December 1, 2005... Behavioral weight loss treatment benefited overweight and obese women with fibromyalgia syndrome, reported Jennifer R. Shapiro, Ph.D., and her colleagues at the University of Albany, State University of New York. In a 20-week pilot study,...

Physicians make final plea to fix fee schedule: a 4.4% cut in Medicare fees could hit next year unless Congress intervenes; pay for performance at issue.(News)
December 1, 2005... WASHINGTON -- Doctors will see a 4.4% cut in their Medicare fees under rules announcing next year's fee schedule, unless legislation pending in Congress supersedes those rules. Mark D. McClellan, M.D., administrator of the Centers for Medicare...

Mobilizing for a disaster.(GUEST EDITORIAL)(Brief Article)
December 1, 2005... North Carolina had much to offer flood-ravaged states in the aftermath of Hurricane Katrina. What we weren't prepared for were the hurdles we had to face to successfully deploy our medical resources in an area of need. Our statewide trauma...

Laparoscopic cholecystectomy.(LETTERS)(Letter to the Editor)
December 1, 2005... I have had two cases of gall bladder disease treated by laparoscopic cholecystectomy ("Successful Cholecystectomy During Pregnancy," Oct. 15, 2005, p. 13). In both cases, the symptoms started in the first trimester, and patients were...

Sharp surgeons use blunt needles.(LETTERS)(Letter to the Editor)
December 1, 2005... I am delighted that the American College of Surgeons "endorses the universal adoption of blunt suture needles for all potential applications in the operating room" ("Blunt Suture Needles Advocated as Safe, Effective," Oct. 1, 2005, p. 34). ...

FDA decisions raise concerns.(LETTERS)(Letter to the Editor)
December 1, 2005... I am writing to express my admiration and support for Susan F. Wood, Ph.D., who described how the Food and Drug Administration has delayed approval of over-the-counter status for the Plan B emergency contraception ("Science, Medicine, and...

Clarification.(Correction Notice)
December 1, 2005... The case mentioned in a report about cholecystectomy during pregnancy occurred during the second trimester at 17 weeks' gestation ("Successful Cholecystectomy During Pregnancy," Oct. 15, 2005, p. 13).

Correction.(Correction Notice)
December 1, 2005... In "Study Explores Laparoscopic Ligation of Varicosities," participants underwent diagnostic hysteroscopy and endometrial sampling to exclude unsuspected endometrial pathology (Oct. 15, 2005, p. 16).

Few placentas are delayed beyond 20 minutes.(Obstetrics)
December 1, 2005... SCOTTSDALE, ARIZ. -- Researchers stopped a randomized, controlled trial comparing strategies to prevent postpartum hemorrhage when they found a 20-minute delay in delivery of the placenta to be much rarer than reported in the medical...

Fetal alcohol spectrum draws range of diagnoses.(Obstetrics)
December 1, 2005... SAN DIEGO -- Children with fetal alcohol spectrum disorders receive a wide variety of psychiatric diagnoses and medications, Julia Murray, M.D., reported in a poster presentation at the American Psychiatric Association's Institute on...

Postpartum depression tied to incontinence.(Obstetrics)
December 1, 2005... ATLANTA -- Women with postpartum depression are more likely than are nondepressed women to have urge urinary incontinence, according to findings presented in a poster at the annual meeting of the American Urogynecologic Society. Of 146...

Magnesium sulfate fails to relieve cesarean pain.(Obstetrics)
December 1, 2005... SCOTTSDALE, ARIZ. -- Perioperative use of magnesium sulfate during cesarean delivery did not relieve short- or long-term pain for women in a double-blind, randomized controlled trial of 120 women. Neither high nor low doses produced any...

Endometriosis, wound separation don't prolong C-section.(Obstetrics)
December 1, 2005... SCOTTSDALE, ARIZ. -- A prospective observational study of 1,656 cesarean deliveries has produced a detailed portrait of factors leading to longer than usual operating times and the effects of long procedures on pregnancy outcomes. Cesarean...

Vertical hepatitis C transmission increased by HIV.(Obstetrics)
December 1, 2005... Two recently published studies demonstrate that the risk of transmission of hepatitis C from mother to infant is increased by concomitant HIV infection, but unlike HIV, the risk of vertical transmission of hepatitis C is not reduced by elective...

Periodontal disease, preterm birth link strongest in black women.(Obstetrics)
December 1, 2005... CHARLESTON, S.C. -- The association between maternal periodontal disease and increased risk for preterm birth is strongest among black women with moderate or severe periodontal disease, Kim A. Boggess, M.D., reported at the annual meeting of...

Enhanced MRI predicts Ca treatment outcome.(Gynecology)
December 1, 2005... DENVER -- Assessment of tumor microvasculature by dynamic contrast-enhanced MRI permits early prediction of treatment outcome in patients with advanced cervical cancer, Nina A. Mayr, M.D., said at the annual meeting of the American Society for...

Gum chewing speeds postop ileus resolution.(Gynecology)
December 1, 2005... SAN FRANCISCO -- A pack of chewing gum can save laparoscopic abdominal surgery patients over $500 in hospitalization costs? That's what a randomized study of postoperative ileus and "sham feeding" found. Estimates are that half of...

Get consent for the unexpected.(Gynecology)(Brief Article)
December 1, 2005... ST. LOUIS -- Physicians need to obtain comprehensive patient consent before surgery to help guide their approach to unexpected findings during the procedure, according to Ira Horowitz, M.D. In a presentation at the 15th International Pelvic...

Suspensory axis is key to pelvic reconstruction.(Gynecology)
December 1, 2005... ST. LOUIS -- Recognition of the importance of the suspensory axis of the vagina is necessary for a successful pelvic support surgery, according to Carl W. Zimmerman, M.D. If disruptions of this axis around the pericervical ring are...

Counsel the elderly about increased risks of urogynecologic procedures.(Gynecology)
December 1, 2005... ATLANTA -- Advanced age is an independent risk factor for in-hospital mortality and perioperative complications in women undergoing urogynecologic surgery, Vivian W. Sung, M.D., reported at the annual meeting of the American Urogynecologic...

Oocyte freezing protocol said to boost pregnancy rates.(Gynecology)
December 1, 2005... MONTREAL -- Preliminary results from an ongoing study of oocyte cryopreservation show "the highest pregnancy rates so far reported," making egg freezing "a viable clinical option," according to John K. Jain, M.D., the principal investigator....

Standard ovulation induction may promote Ca in predisposed women.(Gynecology)
December 1, 2005... MONTREAL -- Ovulation induction for in vitro fertilization may promote the growth of breast cancer in patients who are predisposed to the disease, suggest results of a case series of seven IVF patients later diagnosed with the disease. "A...

Unexpected complications with TOT reported.(Gynecology)
December 1, 2005... MONTREAL -- Although the complication rate remains low with the use of transobturator tape to treat stress urinary incontinence, unexpected complications are beginning to emerge as this treatment becomes more widely used, according to Sarah...

Multimodal Tx for vulvar vestibulitis studied.(Gynecology)
December 1, 2005... CHARLESTON, S.C. -- A combination of intralesional steroids, antifungal therapy, and physical therapy may be effective for the treatment of vulvar vestibulitis syndrome, Carolyn Gardella, M.D., reported in a poster at the annual meeting of the...

Smoking may up risk of pelvic organ prolapse.(Gynecology)
December 1, 2005... ATLANTA -- Tobacco smoking is an independent risk factor for pelvic organ prolapse, data from the Pelvic Organ Support Study suggest. The findings from this multicenter, cross-sectional, observational study--known as POSST--contrast with...

Activity limits often don't help pelvic ills.(Gynecology)
December 1, 2005... ATLANTA -- Most activity restrictions recommended for preventing the progression or recurrence of pelvic floor disorders are unwarranted, results of a small study suggest. Several daily activities, such as lifting and exercising, are often...

Anal sphincter injury has lasting impact on sex life.(Gynecology)
December 1, 2005... MONTREAL -- Obstetric anal sphincter injuries can cause fecal incontinence for decades, and also may wreak havoc on a couple's sex life, according to Jan Willem de Leeuw, M.D., a consultant ob.gyn. from the Ikazia Ziekenhuis hospital in...

Review pegs anal incontinence rate in women at 4.5%; age key factor.(Gynecology)
December 1, 2005... MONTREAL -- Anal incontinence is four times more prevalent than previously thought, and it affects older men and women almost equally, according to what British researchers describe as the first systematic review of the prevalence of this...

Severe IBS symptoms tied to psychosocial problems.(Clinical Rounds)
December 1, 2005... MONTREAL -- Comorbid psychosocial disorders are an important consideration in patients presenting with severe symptoms of irritable bowel syndrome, Douglas A. Drossman, M.D., said at the 13th World Congress of Gastroenterology. Such...

Non-GI symptoms can help differentiate bowel disorders.(Clinical Rounds)
December 1, 2005... MONTREAL -- Non-GI symptoms can help distinguish irritable bowel syndrome from inflammatory bowel disease, Noel B. Hershfield, M.D., said during the 13th World Congress of Gastroenterology. Patients with irritable bowel syndrome (IBS) are...

Response to PPI uncertain after first week of treatment.(Clinical Rounds)
December 1, 2005... COPENHAGEN -- Some patients with dyspepsia not caused by reflux or a peptic ulcer who don't respond to a proton pump inhibitor in the first week of treatment will respond after a few more weeks of ongoing treatment, based on results from two...

Biofeedback for chronic constipation works for at least a year, study shows.(Clinical Rounds)
December 1, 2005... HONOLULU -- Biofeedback proved superior to standard therapy for long-term management of patients with the most common cause of chronic constipation in the first-ever randomized trial featuring a full year of follow-up. Previous short-term...

IVIG for postexposure varicella prophylaxis: use this approach if there's a shortage of varicella zoster immune globulin, CDC advisory panel says.(Clinical Rounds)
December 1, 2005... ATLANTA -- Intravenous immune globulin should be the primary means of post-exposure prophylaxis among persons at high risk of severe varicella complications if there is a shortage of varicella zoster immune globulin, according to a vote by the...

Tdap should replace Td for adults, says CDC committee.(Clinical Rounds)
December 1, 2005... ATLANTA -- The recommendation for using the new tetanus-diphtheria-acellular pertussis vaccine has been expanded to adults aged 19-64 years, according to a vote by the Centers for Disease Control and Prevention's Advisory Committee on...

Balance efficacy, tolerability in ordering retinoids.(Clinical Rounds)
December 1, 2005... BLAINE, WASH. -- Topical retinoids can be highly effective treatments for acne, but they come in a bewilderingly wide variety of strengths and formulations. Clinicians should consider effectiveness, tolerability, and the type of vehicle...

Change in color can be earliest sign of melanoma.(Clinical Rounds)
December 1, 2005... VANCOUVER, B.C. -- Color change, in addition to color variegation, often heralds melanoma, thus bolstering the need for adding an E to the ABCD mnemonic for melanoma detection, Robert J. Friedman, M.D., said at the Sixth World Congress on...

Panel seeks citizen input on health care reform.(Practice Trends)
December 1, 2005... WASHINGTON -- American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system. "In order to make health care work...

Parental notification fails.(POLICY & PRACTICE)
December 1, 2005... An attempt to require parental notification for minors seeking an abortion in California failed last month in a special election. The vote on Proposition 73 was 52.6% against and 47.4% for the measure, according to the California Board of...

Yates conviction overturned.(POLICY & PRACTICE)(Andrea Yates)(Brief Article)
December 1, 2005... The Texas Court of Appeals last month upheld a lower court ruling that overturned the murder conviction of Andrea Yates in the drowning deaths of three of her children. The case is likely to go to trial again unless the district attorney's...

Groups demand action on Plan B.(POLICY & PRACTICE)
December 1, 2005... The Food and Drug Administration should abandon the current proposed rulemaking process for Plan B emergency contraception and approve over-the-counter status for the product for women of all ages, according to a letter from the American...

Costs of intimate partner violence.(POLICY & PRACTICE)
December 1, 2005... The average cost for a woman who is the victim of intimate partner violence is about $948 per incident, according to researchers from the Centers for Disease Control and Prevention (CDC). The cost includes the cost of medical care, mental...

Teenage birth rate drops.(POLICY & PRACTICE)(Brief Article)
December 1, 2005... The birth rate among teenage girls continued to decline in 2004, according to the CDC's National Center for Health Statistics. The birth rate for girls aged 15-19 years dropped to the historic low of 41 births per 1,000 last year. Births rose...

Physicians of note share their love for music.(THE REST OF YOUR LIFE)
December 1, 2005... In 1964, when C. Wright Pinson, M.D., was just 11 years old, he bought his first set of Ludwig drums. The price tag was $300, "which was 100% of my net worth at the time," quipped Dr. Pinson, professor of surgery and chief medical officer...

The comfort of a banjo on Thursdays.
December 1, 2005... A recent survey asked the readers of a scientific trade magazine what they do for fun. More than half said that they play a musical instrument. I am among them, and I've been thinking about why the whole business is so gripping. I started...

Treating ectopic pregnancy.(MASTER CLASS)
December 1, 2005... As editor of Master Class columns on gynecologic surgery, I am especially pleased to have Togas Tulandi, M.D., contribute this article on the current treatment of ectopic pregnancy. Dr. Tulandi is a professor of ob.gyn. and the Milton Leong...

Surgical treatment calls for minimally invasive techniques.(ectopic pregnancy)
December 1, 2005... As in many other areas of medicine, we are treating more patients with ectopic pregnancy medically than surgically. But not all women are good candidates for medical therapy; some undergo surgical therapy by necessity, and some by choice. ...

Thermoablation: 73% have reduced dysmenorrhea at 3 years.(Practice Trends)
December 1, 2005... SAN DIEGO -- Thermal balloon endometrial ablation is a safe and effective option for the treatment of women with idiopathic menorrhagia, results from a 3-year study of 330 women have shown. "The procedure is simple, does not require...

Blotter strips stop the bleeding.(PRODUCTS)(Brief Article)
December 1, 2005... Seal-On blotters use a microdispersed oxidized cellulose to stop bleeding from minor wounds, scrapes, and razor nicks. When the strips come in contact with blood, a soft gel-like layer is formed to stop the bleeding. For more information,...

New supplement for joint health.(PRODUCTS)
December 1, 2005... CH-Alpha joint health supplement contains 10 g collagen hydrolysate and may improve joint function, strength and mobility. The supplement comes in monthly packs of 30 ready-to-drink vials, retailing for $60. For more information, contact GELITA...

Aromasin approved as adjuvant.(PRODUCTS)(Brief Article)
December 1, 2005... Aromasin (exemestane tablets) is approved as an adjuvant treatment for post-menopausal women with estrogen receptor-positive breast cancer who have received 2-3 years of tamoxifen and are switched to Aromasin for completion of a total of 5...

Follistim in single-use vials.(PRODUCTS)(Brief Article)
December 1, 2005... Follistim AQ (follitropin [beta] injection) 75 IU and 150 IU are now available in single-use, premixed 0.5 mL vials for subcutaneous and intramuscular injection for patients undergoing assisted reproductive technology procedures. For more...

Single-clinician closure.(PRODUCTS)
December 1, 2005... The Insorb 1 single user forceps works with the Insorb 20 subcuticular skin stapler to allow a single clinician to close a surgical incision without help. For more information, contact Incisive Surgical Inc. by calling 877-246-7672 or by...

Drink mix for PMS symptoms.(PRODUCTS)
December 1, 2005... PMS Escape is a powdered drink mix blending simple and complex carbohy-drates and select vitamins and minerals and is designed to reduce PMS-related mood disturbances and food cravings. The drink mix is available in raspberry-lime and...

Improved CF carrier screening.(PRODUCTS)
December 1, 2005... The CFplus cystic fibrosis mutation analysis has been upgraded to test for 97 mutations, for improved detection in Hispanic and African American patients. The inclusion of a new mutation CFTRdele2,3 (21kb) is expected to improve detection for...

Stark Laws and Regulations CD.(PRODUCTS)
December 1, 2005... The American Health Lawyers Association has developed a Stark-related tool to aid in compliance efforts. "The Complete 'Connected' Stark Laws and Regulations" is available on CD-ROM. For more information, contact Lexis-Nexis by visiting...

Handheld ultrasound system.(PRODUCTS)
December 1, 2005... The MicroMaxx ultrasound system weighs less than 8 pounds and is roughly the size of a laptop computer. The system can operate on battery power for up to 4 hours and comes with a standard 5-year warranty. For more information, contact SonoSite...

Color-coded BP indicator.(PRODUCTS)
December 1, 2005... A new color-coded indicator to use with LifeSource blood pressure monitors was approved by the Food and Drug Administration. The indicator categorizes results based on the guidelines of the seventh report of the Joint National Committee on...

Updated label for ParaGard IUD.(PRODUCTS)
December 1, 2005... The label for ParaGard T 380A intrauterine copper contraceptive includes new prescribing information. Nulliparity or a history of sexually transmitted diseases is no longer a contraindication, nor is pelvic inflammatory disease unless a patient...

Hope for physical deformities.(FYI)
December 1, 2005... Fresh Start Surgical Gifts is offering a patient outreach program to inform U.S. families of children with physical deformities about free reconstructive plastic surgery and medical services made available by the nonprofit group. The program...

Next Steps After a Diagnosis.(FYI)
December 1, 2005... The Agency For Healthcare Research and Quality has released a brochure to help patients following the diagnosis of an illness. "Next Steps After Your Diagnosis: Finding Information and Support" includes a list of 10 questions that patients...

Stroke information for seniors.(FYI)
December 1, 2005... The National Institutes of Health Senior Health Web site now offers information for older Americans on strokes, including how to reduce stroke risks, recognize symptoms, and act quickly when warning signs appear. For more information, visit...

Guide to hormone therapy.(FYI)
December 1, 2005... The National Heart, Lung, and Blood Institute has issued a booklet with up-to-date information on hormone trials of the Women's Health Initiative. The booklet also addresses the risks and benefits of hormone therapy. "Facts About Menopausal...

Spanish-language stroke video.(FYI)
December 1, 2005... The National Institute of Neurological Disorders and Stroke has released a Spanish-language video aimed at educating Hispanic communities about stroke prevention and treatment. "Ataque Cerebral: Conozca los Sintomas y Actue a Tiempo" is divided...

Seniors' guide to smell and taste.(FYI)
December 1, 2005... The National Institutes of Health now offer information about the sense of smell and taste in a senior-friendly format. Seniors can learn how smell and taste decline with age or illness, and what older adults can do to cope with the loss of...

New electronic drug labels.(FYI)
December 1, 2005... The Food and Drug Administration has begun requiring manufacturers to submit prescription drug label information in an electronic format. The labels are the key element and primary source of medication information for DailyMed, a new...

Helping elderly talk with physicians.(FYI)
December 1, 2005... The National Institute on Aging has updated the "Talking With Your Doctor" publication, with worksheets and tips on patient communication. For a free copy, visit www.niapublications.org/pubs/talking/index.asp or call 800-222-2225.

New rules apply after NovaSure.(News)
December 15, 2005... CHICAGO -- The exact state of the uterus 1 year after global endometrial ablation with Nova-Sure is largely unknown, but certain characteristics are beginning to emerge, Robert Sabbah, M.D., reported at the annual meeting of the AAGL. Even...

Many patients 'strongly favor' physicians' use of new medical technologies.(VITAL SIGNS)
December 15, 2005... Many Patients 'Strongly Favor' Physicians' Use of New Medical Technologies Home monitoring 51% E-mail with patient 49% Imaging by e-mail 44% Electronic records 42% Personal digital device 37% Note:...

2004 C-section rate is all-time U.S. high at 29%: medical, legal, and choice issues combine.(News)
December 15, 2005... Cesarean sections constituted 29% of all births in the United States in 2004--a record high for the country, government officials have said. The increase reflects an 8% hike in primary cesareans and a 13% decrease in vaginal birth after...

Patch's sustained estrogen levels prompt warning.(News)
December 15, 2005... The Ortho Evra contraceptive patch exposes women to higher steady state estrogen levels than do most birth control pills, and concerns that such exposure could increase the risk for blood clots prompted an update to the product's label. ...

NSABP's tamoxifen results confirmed.(News)
December 15, 2005... Tamoxifen substantially cuts the risk of invasive and noninvasive breast cancer, researchers confirmed in an extended follow-up of the National Surgical Adjuvant Breast and Bowel Project that was initially reported in 1998. This update of...

AMA opposes Medicare physician voluntary reporting program.(News)
December 15, 2005... DALLAS -- Predicting more administrative burdens and an eventual mandate on performance measures, delegates at the interim meeting of the American Medical Association's House of Delegates voted to oppose the federal government's plans to...

Ensuring equitable care in your practice.(GUEST EDITORIAL)
December 15, 2005... Eliminating health disparities in this country requires a multi-pronged approach that includes action by government, communities, medical institutions, and each of us as physicians. While death rates have declined across the board in the...

Patients exposed to unnecessary risk.(LETTERS)(Letter to the Editor)
December 15, 2005... Dr. James A. McGregor, a well-known gynecologist and specialist in infectious diseases, opined that mifepristone in medical abortion interferes with the patient's immune response to infection, causing death because of Clostridium sordellii in...

Obstetric medicine is a team effort.(LETTERS)(Letter to the Editor)
December 15, 2005... I am writing to thank your newspaper for the attention it has brought to obstetric medicine, but also to provide some clarifications ("Obstetric Medicine Niche Builds Slowly," Oct. 15, 2005, p. 1). As the article stated, obstetric medicine...

Low-trauma fractures lack needed follow-up.(Gynecology)
December 15, 2005... QUEBEC CITY -- Women who have had a low-trauma fracture are not getting the follow-up they need for osteoporosis, Sonia Singh, M.D., reported in a poster at the annual meeting of the North American Primary Care Research Group. History of a...

Vitamin D's effect exceeds calcium's on bone health.(Gynecology)
December 15, 2005... Vitamin D sufficiency appears to be more important for bone health than is high calcium intake, according to Laufey Steingrimsdottir, Ph.D., of the Public Health Institute of Iceland, Reykjavik, and associates. Both nutrients are known to...

Hysteroscopic sterilization device nears market.(Gynecology)
December 15, 2005... The Adiana transcervical sterilization system appears to be easy to use, safe, and effective, according to phase III data, Alan Johns, M.D., reported at the annual meeting of the AAGL. The Adiana Complete system is available only for...