OB GYN News articles from February 2001

OB GYN News archives from February 2001

Ductal Lavage Finds Early Breast Cancer.
February 1, 2001... SAN ANTONIO -- Breast ductal lavage detected premalignant or frankly cancerous cells in one-quarter of high-risk but mammographically negative women in a multicenter trial, Dr. William C. Dooley reported at a breast cancer symposium sponsored...

Low-Dose Estrogen Linked to Lower Heart Disease Risk.
February 1, 2001... Experts say estrogen's benefits outweigh increase in stroke risk with normal dose. Postmenopausal women on low-dose estrogen have a decreased risk of developing major coronary heart disease, compared with those who never used hormones,...

Raloxifene Lowers Breast Cancer Risk by 72%.
February 1, 2001... Benefits increase with estrogen exposure. SAN ANTONIO -- Among women taking raloxifene, those with the highest lifetime exposure to estrogen had the greatest reduction in breast cancer risk. That was a key finding of an analysis of new...

Syphilis Rates Reach All-Time Low.
February 1, 2001... MILWAUKEE -- Rates of primary and secondary syphilis in the United States have reached their lowest point since reporting began in 1941, according to a new report issued by the Centers for Disease Control and Prevention. The most recent...

LETTERS.
February 1, 2001... Rules Deter Cholesterol Screening I would like to respond to the article "Cholesterol Tests Slip Past Ob. Gyns." (Oct. 15, 2000, p. 1). How can we put enough effort into screening our patients for cardiovascular disease when managed...

To Treat or Not to Treat.
February 1, 2001... I was particularly troubled by a case presentation that was made recently during our morning resident conference. The case concerned a 42-year-old woman who had complained of menometrorrhagia for approximately 3 months. Endometrial biopsy...

PRO & CON.
February 1, 2001... Should Down syndrome screening standards be changed so that amniocentesis and chorionic villus sampling are offered on the basis of maternal serum screening results, not maternal age? YES The current practice of offering routine...

Sacral Stimulation May Ease Interstitial Cystitis.
February 1, 2001... HILTON HEAD ISLAND, S.C. -- Sacral nerve stimulation used in the treatment of overactive bladder can also benefit related disorders of the pelvic floor, experts said at the annual meeting of the American Urogynecologic Society. "This...

Tolterodine Safe, Effective When Taken Over a 2-Year Period.
February 1, 2001... HILTON HEAD ISLAND, S.C. -- Tolterodine tartrate given at a dosage of 2 mg twice daily for the treatment of overactive bladder maintains its efficacy over a 2-year period and becomes more tolerable with time, according to the results of a study...

Fewer Side Effects Noted With Experimental Oxybutynin Patch.
February 1, 2001... HILTON HEAD ISLAND, S.C. -- Patients treated with oxybutynin for incontinence due to overactive bladder experience fewer side effects but similar benefits when the drug is delivered via an experimental transdermal patch rather than a pill. ...

Social Limitations Linger After Incontinence Tx.
February 1, 2001... HILTON HEAD ISLAND, S.C. -- Certain behaviors adopted by patients with urinary incontinence to cope with their disorder can often linger long after the disease has been successfully treated, Dr. Veronica Mallett said at the annual meeting of...

Chemical Exposure Can Hasten Puberty in Girls.
February 1, 2001... A chemical accident in Michigan in the early 1970s has resulted in early menarche among girls who were exposed to polybrominated biphenyls, either in utero or through their mother's breast milk. More than 4,000 Michigan residents were...

Topical Estrogen, Soaks Heal Urethral Prolapse.
February 1, 2001... BIG SKY, MONT. -- Have you ever wondered why girls' bicycles lack the top bar seen on frames for boys' bikes? "My mother used to say [it was] because of dresses," but there's another reason: to avoid bicycle straddling injuries, Dr. Lane...

Estrogen May Help Endothelial Dysfunction.
February 1, 2001... WASHINGTON -- Estrogen replacement therapy appears to improve endothelial dysfunction in postmenopausal women with hypertension, Dr. Yukhito Higashi said at the annual conference of the American Heart Association's Council for High Blood...

Laparoscopy for Obstetric Vesicovaginal Fistula.
February 1, 2001... SAN DIEGO -- Operative laparoscopy can be an alternative to laparotomy for managing high obstetric vesicovaginal fistula, Dr. Ceana Nezhat reported in a poster session at the annual meeting of the American Society for Reproductive Medicine. ...

Laparoscopy Cost Effective For Hysterectomy.
February 1, 2001... ORLANDO, FLA. -- Laparoscopymay take longer to perform, but it is more cost effective than open surgery for pefforming hysterectomy and retropubic suspension, Dr. Gerard Pregenzer reported at the annual meeting of the American Association of...

Laparoscopic Hysteroplasty Without Hysteroscopy.
February 1, 2001... ORLANDO, FLA. -- Laparoscopic hysteroplasty is an effective alternative to hysterectomy in women with menorrhagia and myomas who want to preserve their uterus, Dr. Michael L. Moore said during the annual meeting of the American Association of...

Cavaterm Appears Safe for Menorrhagia.
February 1, 2001... ORLANDO, FLA. -- Cavaterm thermal balloon endometrial ablation appears to be safe and effective for the treatment of menorrhagia, according to several studies presented during the annual meeting of the American Association of Gynecologic...

Laparoscope Size Does Not Affect Postoperative Course.
February 1, 2001... ORLANDO, FLA. -- Laparoscope size had no effect on postoperative pain or recovery time in a small study of patients evaluated for infertility under general anesthesia, Dr. Jeffrey M. Goldberg reported at the annual meeting of the American...

FDA Approves Letrozole for Advanced Breast Ca.
February 1, 2001... BETHESDA, MD. -- Letrozole, an oral estrogen-blocking drug, has been approved as a first-line agent in treating postmenopausal women with advanced breast cancer. The Food and Drug Administration approved the drug in January for treating...

Follow-Up Poor After Negative Breast Biopsy.
February 1, 2001... CHICAGO -- Two-thirds of women with negative breast biopsies will return for follow-up assessments, and another 20% will seek follow-up after being sent a reminder letter. Follow-up assessments are needed when women have negative breast...

Elective C-Section Rates Vary by Hospital Type.
February 1, 2001... KAMUELA, HAWAII -- Corporate hospitals had the highest elective primary cesarean delivery rates, and Kaiser hospitals had the lowest in a study of hospital discharge records in California during 1995. Malpresentation was by far the most...

Indomethacin Reduces Narcotic Use by 40%.
February 1, 2001... KAMUELA, HAWAII -- Regular administration of indomethacin rectal suppositories reduced narcotic use by almost 40% in postoperative cesarean section patients treated in an Idaho community hospital, Dr. Frederick P. Ambrose reported. Dr....

Echocardiography Unreliable in Detecting Pulmonary Ailments.
February 1, 2001... KAMUELA, HAWAII -- Echocardiography miclsassfied pulmonary artery pressure in 37% of pregnant patients with suspected pulmonary hypertension in one study, Dr. Kelly Robinson reported. The noninvasive test misclassified 8 of 27 patients with...

DRUGS, PREGNANCY, AND LACTATION.
February 1, 2001... [Histamine.sub.2] Blockers and Proton Pump Inhibitors None of the four [histamine.sub.2] blockers currently available are teratogenic or carcinogenic in animals, nor are they mutagenic. They are rated pregnancy category B drugs, but there...

IV Dexamethasone Speeds Recovery From HELLP.
February 1, 2001... CHICAGO -- Intravenous dexamethasone provides more rapid recovery of liver function, arterial blood pressure, and urinary output in patients with prepartum HELLP syndrome, compared with betamethasone, Dr. Christy M. Isler said at the annual...

Bringing a Bit of Home to the Antepartum Unit.
February 1, 2001... SARASOTA, FLA. -- No one at Sarasota Memorial Hospital objected when a patient's family carried a dog in a picnic basket into the antepartum unit. "I said, 'Sounds like a good slide,' and headed over to the ward to take some photos, Dr....

Off-Label Use of Misoprostol Called Safe For Cervical Ripening, Induction.
February 1, 2001... SARASOTA, FLA. -- Misoprostol is a safe and effective agent when used off label for both cervical ripening and labor induction, according to a recently published meta-analysis of 47 studies of the drug. "It appears relatively safe for both...

Midtrimester PPROM Poses Difficult Choices.
February 1, 2001... SARASOTA, FLA. -- The gray areas of medicine are often the hardest to navigate, and midtrimester preterm premature rupture of membranes is one of them, according to Dr. Washington Hill, director of maternal-fetal medicine at Sarasota Memorial...

Avoid Misoprostol in VBAC Patients.
February 1, 2001... Caution may be the best medicine when considering misoprostol use in patients undergoing a trial of labor after a prior caesarian delivery, according to Dr. Sanchez Ramos. He and his associate reviewed 18 cohort studies looking at the...

'Deadly Quartet' in Women.
February 1, 2001... The "deadly quartet" of cardiovascular risk factors that characterize the multiple metabolic syndrome--hypertension, obesity, hyperrriglyceridemia, and diabetes--is far more lethal in women than men with known coronary disease. This was...

Sporadic Workouts and CV Deaths.
February 1, 2001... A little bit of exercise can be a dangerous thing. Nearly half of all cardiovascular (CV) deaths over a 2-year period at one of the nation's largest commercial health club chains occurred in members who exercised less than once per week....

'Connectedness' and Suicide Risk.
February 1, 2001... The gender disparity in suicide--women are less likely to commit suicide than men--may be explained by such "protective factors" as the social connectedness of women, Dr. George Murphy said at the annual meeting of the American Academy of...

Sertraline vs. Imipramine.
February 1, 2001... If given a choice between sertraline and imipramine for treating chronic depression, physicians should prescribe the former for women and the latter for men, according to results of a randomized, double-blind study. Of 400 women and 235...

Obesity Ups Arthritis Risk.
February 1, 2001... Women who are obese at age 18 have up to a 7.3-fold increased risk of severe hip osteoarthritis later in life compared with leaner women, Dr. Elizabeth Karlson said at the annual meeting of the American College of Rheumatology in Philadelphia....

Valvular Abnormalities and Fen-Phen.
February 1, 2001... The natural history of valvular heart abnormalities in patients treated with dexfenfluramine or the fenfluramine and phenterimine combination called "fen-phen" appears more reassuring than earlier feared, according to the results of the largest...

Perennial Allergic Rhinitis.
February 1, 2001... Patients with perennial allergic rhinitis are more likely than those with seasonal allergic rhinitis to have asthma and to use an intranasal steroid in addition to a second-generation antihistamine, according to an analysis of information in a...

The Hazards of Henna Use.
February 1, 2001... Women who use henna for cosmetic purposes are at risk for allergic reactions ranging from contact dermatitis to angioedema. A case report presented in a poster session at the ninth Congress of the European Academy of Dermatology and Venereology...

New Medical Privacy Rules May Pose Significant Challenges.
February 1, 2001... Sweeping new rules were issued to protect the privacy of Americans' medical records in the final days of the Clinton administration. Several years in the making, the final privacy rules apply to health care providers, hospitals, health...

Managing Your Receivables Key to Fiscal Fitness.
February 1, 2001... LANCASTER, PA. -- Maintain an "accounts receivable" mind-set to help maintain the optimum financial health of your practice, Elizabeth Clark advised at a meeting on family practice management. Accounts receivable is usually the largest...

Confidentiality and Treating the Adolescent Patient.
February 1, 2001... HILTON HEAD ISLAND, S.C. -- Adolescent patients and their parents deserve a straightforward explanation about a patient's right to confidentiality and the circumstances under which that confidentiality may be breached, Dr. Tomas Silber said at...

Value of Annual Pap Smears Questioned.
February 15, 2001... Many postmenopausal U.S. women are needlessly screened with an annual cervical smear. When postmenopausal women have a cervical smear taken within 2 years of a previously normal smear, the problem is not just that the second smear wastes...

State Abortion Laws May Apply to Mifepristone Use.
February 15, 2001... Office-based physicians who perform medical abortions may be affected. Now that the abortive agent mifepristone is on the market, some physicians who are interested in offering medical abortion but who weren't previously offering surgical...

RDAs for Iron, Vitamin A, Other Nutrients Revised.
February 15, 2001... More iron needed for women under age 50. WASHINGTON -- New dietary goals for iron include increased requirements for women aged 50 and under--a change that reflects concern about the risk of iron deficiency in women. An Institute of...

FDA Advises Pregnant, Nursing Women to Avoid Certain Fish.
February 15, 2001... WASHINGTON -- Pregnant and lactating women should exclude shark, swordfish, king mackerel, and tilefish from their diets, the Food and Drug Administration said in a warning issued last month. The warning also applies to women of...

Protocols for Administering Mifepristone Can Be Modified.
February 15, 2001... ALBUQUERQUE--NOW that mifepristone is available for use in medical abortion, physicians who intend to offer the procedure face some practical issues in patient care, Dr. Linda W Prine said at a conference on patient education sponsored by the...

Lactic Acidosis With HIV Drugs Reported.
February 15, 2001... Three cases at fatal lactic acidosis have been reported in pregnant women using stavudine and didanosine with other anti-HIV drugs, the Food and Drug Administration noted in a warning. "The combination of stavudine (Zerit) and didanosine...

LETTERS.
February 15, 2001... Let the Sun Shine on Babies? My husband is the physician in the family, but I enjoy OB.GYN. NEWS as well. However, I found the article on rickets misleading ("Breast-Fed Infants Require Vitamin D Supplements," Dec. 15, 2000, p.5). Dr....

Chlamydia, HPV Rates Skyrocket in Young People.
February 15, 2001... MILWAUKEE -- The rates of Chlamydia trachomatis and human papillomavirus are skyrocketing among young people, in part because health care providers are missing opportunities for counseling them about their risk, said Dr. Judith Wasserheit of...

Persistent Chlamydia May Go Undetected.
February 15, 2001... Persistent chlamydia infection was identified in seven women with three or more recurrences over a 2- to 5-year time span, in a 10-year retrospective analysis of STD clinic samples. Four of the women harbored the same genotype of Chlamydia...

Ultrasound Under Study as Treatment for Breast Ca.
February 15, 2001... CHICAGO -- An ultrasound technique could become a treatment option for breast cancer patients, according to researchers at St. Luc Hospital, Montreal. Dr. David Gianfelice reported that 17 of 22 breast cancer patients (77%) are tumor free...

GnRH Agonist Regimen May Reduce Breast Cancer Risk.
February 15, 2001... SAN ANTONIO -- A GnRH agonist-based hormonal chemo-prevention regimen shows early promise in young women who are at high risk for breast cancer, Dr. Jeffrey N. Weitzel reported at a breast cancer symposium sponsored by the San Antonio Cancer...

Microwave Ablation Appears Safe for Menorrhagia.
February 15, 2001... ORLANDO, FLA. -- Microwave endometrial ablation continues to show promise for the safe and effective treatment of menorrhagia, Dr. Kevin G. Cooper said at the annual meeting of the American Association of Gynecologic Laparoscopists. The...

Repeat Resection Of Endometrium Safe and Effective.
February 15, 2001... ORLANDO, FLA. -- Repeat resection of the endometrium following a failed resection is safe and worthwhile in most cases, Dr. Olav Istre said at the annual meeting of the American Association of Gynecologic Laparoscopists. Of 750 women who...

Bone Anchors Present Small Osteomyelitis Risk.
February 15, 2001... HILTON HEAD ISLAND, S.C. -- Osteomyelites following bone-anchor procedures is rare but can be easily missed, so physicians should be on the lookout for it, according to one expert. "The risk is small, but there's serious morbidity with...

Fluoroscopic Guidance Improves Accuracy of Durasphere Injection.
February 15, 2001... HILTON HEAD ISLAND, S.C -- Fluoroscopic guidance can help physicians more accurately inject Durasphere, a bulking agent used to treat women with stress urinary incontinence due to intrinsic sphincter deficiency, according to Dr. James Lukban....

Try Multiple Strategies Simultaneously To Treat Stress Urinary Incontinence.
February 15, 2001... CHICAGO -- Shotgun approaches to the treatment of stress urinary incontinence are a surefire way to fail. That's because no single modality can address enough aspects of this complex, multifactorial disorder, and, after several failed...

Sacroiliac Dysfunction May Worsen Cystitis.
February 15, 2001... HILTON HEAD, S.C. -- Sacroiliac dysfunction, a malalignment of the sacrum and innominate bones of the hip and pelvis, may be an underrecognized component in some cases of interstitial cystitis. In a pilot study, 16 women with interstitial...

Most Forceps Deliveries Carry Acceptable Risks.
February 15, 2001... SAN JUAN, P.R. -- Operative vaginal deliveries involving forceps don't necessarily deserve their bad rap, but those involving rotations over 45 degrees should probably be avoided, according to one expert. The risks of morbidity that are...

Document Management Efforts in Asphyxia Cases.
February 15, 2001... SAN JUAN, P.R. -- Recent data suggest that only 6% of cerebral palsy cases are associated with birth asphyxia, yet when medical malpractice cases involving the disorder go to trial, plaintiffs' lawyers blame most of them on birth asphyxia,...

Training, Comfort Guide Dystocia Management.
February 15, 2001... SAN JUAN, P.R. -- When it comes to managing shoulder dystocia, do what works for you, Dr. Gary D.V Hankins said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law. The most appropriate maneuvers are...

Urogynecologists More Likely to Have a C-Section.
February 15, 2001... HILTON HEAD ISLAND, S.C. -- Doctors who have seen what vaginal birth can do to the pelvic floor are more likely than other physicians to choose cesarean delivery for themselves or their partner, study results suggest. "These physicians are...

High Caffeine Intake Raises Miscarriage Risk.
February 15, 2001... Daily ingestion of at least 500 mg of caffeine, which is equivalent to about three 8-ounce cups of coffee, can almost double a nonsmoker's risk of miscarriage in the first trimester, Swedish investigators reported. A case group of 562...

Community Hospital Lowers C-Section Rate to 11%.
February 15, 2001... KAMUELA, HAWAII -- Ten willing obstetricians and a supportive nursing staff reduced the cesarean section rate at their community hospital from 16.59% to 10.92% over a 10-year period by implementing active management of labor guidelines,...

Starlix.
February 15, 2001... (nategilnide, Novartis) An oral antidiabetic agent for use as monotherapy, with diet and exercise to improve glycemic control in people with type 2 diabetes. Also approved for use in combination with metformin (Glucophage) when that drug...

Remicade.
February 15, 2001... (infliximab, Centocor) A tumor necrosis factor-[alpha] (TNF-[alpha]) blocker to inhibit progression of joint damage when used with methotrexate, in people with moderately to severely active rheumatoid arthritis with inadequate response to...

DHEA Effective for Lupus.
February 15, 2001... A natural human hormone looks like it's on track to be the first new treatment approved for systemic lupus erythematosus in 40 years. Prasterone, which is the hormone dehydroepiandrosterone (DHEA), was safe and effective for improving...

Smoking, Rheumatoid Arthritis.
February 15, 2001... Cigarette smoking appears to boost a woman's risk of elderly onset rheumatoid arthritis, Dr. Kenneth G. Saag said at the annual meeting of the American College of Rheumatology. Dr. Saag of the University of Alabama, Birmingham, and his...

You Are What You Eat.
February 15, 2001... Poor nutrition is the leading cause of immune deficiency in the elderly and is surprisingly common, even among those who live independently and have no chronic diseases. The foods we eat influence specific acquired immunity, which declines...

Prolonging the Flu.
February 15, 2001... Flu patients who took antipyretic drugs stayed sick an average of 3.5 days longer than patients who did not take fever medication, according to Karen I. Plaisance, Pharm. D., of the University of Maryland, College Park, and her associates. ...

RA Ups Depression Risk.
February 15, 2001... For many patients with rheumatoid arthritis who also have major depression, selective serotonin reuptake inhibitors are the treatment of choice, Karen L. Smarr reported at the annual meeting of the American College of Rheumatology. Studies...

Isotretinoin and Suicide Risk.
February 15, 2001... The use of isotretinoin tar acne does not raise a patient's risk for depression, suicide, or neurotic and psychotic symptoms, reported Susan S. Jick, Sc.D., of the Boston Collaborative Drug Surveillance Program, Lexington, Mass., and her...

TISSUE REGISTRATION REQUIRED.
February 15, 2001... Reproductive tissues and stem cells derived from umbilical cord blood and other blood sources are regulated for the first time in a final rule issued by the Food and Drug Administration. This regulation is part of an FDA rule requiring all...

SUPERVISING NURSE ANESTHETISTS.
February 15, 2001... The Health Care Financing Administration has removed the federal requirement for physician supervision of nurse anesthetists. The final rule, which was published in the Federal Register, defers to the states to determine which health care...

PHYSICIAN SELF-REFERRAL.
February 15, 2001... Final rules addressing self-referrals by physicians have been released by the Department of Health and Human Services. The final rules, which are published in part in the Jan. 4 Federal Register, prohibit physicians from referring Medicare...

MORE MEDICAID FLEXIBILITY.
February 15, 2001... A new rule from the Department of Health and Human Services will allow states more discretion in using Medicaid funds to assist medically needy individuals. The new rule, which is published in the Federal Register, will assist people with...

OBESITY PLAN ANNOUNCED.
February 15, 2001... The U.S. government has begun a year-long effort aimed at reducing the prevalence of overweight and obesity, Surgeon General David Satcher announced. The federal government plans to involve the public in its effort through open public comment...

Make Better Customer Service a Primary Goal.
February 15, 2001... KANSAS CITY, Mo. -- Today's primary care offices need an improved culture of customer service, Dr. Bruce Bagley declared at the annual National Congress of Family Practice Residents and National Congress of Student Members. Many offices...

National Networks Try to Attract Infertility Patients.
February 15, 2001... An increasing number of reproductive endocrinologists are banding together to offer infertility treatments--often with financing and money-back guarantees--in the hope of building on the $2 billion infertility market and gaining new patients....

CLINICAL PEARLS.
February 15, 2001... FLAMM, BRUCE L. CESAREAN DELIVERY The cesarean section rate is about 22% and rising. This means that almost 1 million cesareans are performed in this country each year. When a procedure is performed this frequently, it can become...