OB GYN News articles from February 2005

OB GYN News archives from February 2005

Insurers set criteria for VBAC coverage.(News)
February 1, 2005... The malpractice insurance crisis is prompting a small number of professional liability insurers to institute strict standards for performing vaginal birth after cesarean section. And an Oklahoma insurer last month has gone as far as...

Median compensation for ob.gyns. rises more than 8%.(VITAL SIGNS)
February 1, 2005... Median Compensation for Ob.Gyns. Rises More Than 8% Notes: Based on 1,876 medical practices nationwide in 2003. A similar number of responses was received in previous years. Source: Medical Group Management Association

Maryland to create insurance rate stabilization fund: aimed at curbing malpractice premiums.(News)
February 1, 2005... As physicians push for professional liability reform at the national level, the Maryland legislature signed off on a bill aimed at halting rising malpractice premiums. The centerpiece of the legislation is a rate stabilization fund for...

Prenatal steroids may be justified at 23 weeks.(News)
February 1, 2005... SAN FRANCISCO -- New data suggest that giving prenatal steroids to women at risk of preterm delivery might be beneficial as early as 23 weeks' gestation, said Avroy A. Fanaroff, M.B. Currently, most physicians give prenatal corticosteroids...

Survey: scientists pressured into FDA approvals.(News)
February 1, 2005... Nearly one in five Food and Drug Administration scientists in a federal survey said they were pressured to approve or recommend approval for a drug despite reservations about its safety. Half of the 400 scientists who participated in this...

Groups push to obtain OTC status for Plan B.(News)
February 1, 2005... ROCKVILLE, MD. -- A coalition of women's groups recently called for the Food and Drug Administration to approve over-the-counter marketing status for the emergency contraceptive Plan B (levonorgestrel). Waving banners and colorful signs,...

Tamoxifen-aromatase inhibitor combo improves Ca outcomes.(News)
February 1, 2005... SAN ANTONIO -- Switching postmenopausal breast cancer patients to an aromatase inhibitor following 2-3 years of adjuvant tamoxifen results in markedly better disease-free survival than the traditional 5 full years of tamoxifen, according to...

An alarming trend.(LETTERS)(Letter to the Editor)
February 1, 2005... The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and the trend toward widespread, worsening resistance with this particular organism pose a serious challenge to clinicians nationwide ("MRSA Emerging as Cause of...

Pain relief in circumcision.(LETTERS)(Letter to the Editor)
February 1, 2005... I am not surprised by the findings of Praveen Kumar, M.D., of reluctance on the part of physicians to use adequate analgesia during circumcision ("No Analgesia Given in Most Circumcisions," Nov. 15, 2004, p. 4). My experience at the...

Pain relievers.
February 1, 2005... "I'm prescribing a squiggly line, two slanted loops, and something that looks like a P or a J."

Your hardest task.(GUEST EDITORIAL)
February 1, 2005... Firing an employee is arguably the most difficult task most employers face, and it is particularly tough on physicians. We hate doing it so much that many of us prefer to tolerate poor and marginal employees rather than replace them with good...

Home visitation program benefits new mothers.(Obstetrics)
February 1, 2005... A program that sends nurses to visit economically disadvantaged, single mothers during pregnancy and for the child's first 2 years can have long-term benefits, recent data show. The analysis, which was recently commissioned by the...

Fetal origin hypothesis discounted.(Obstetrics)
February 1, 2005... Impaired fetal growth does not raise cholesterol levels in adulthood appreciably, according to Rachel Huxley, D.Phil., of the University of Sydney, and her associates. Proponents of the "fetal origins" hypothesis hold that fetal...

Obstetric applications studied for heart failure test.(Obstetrics)
February 1, 2005... NEW ORLEANS -- Measurement of B-type natriuretic peptide levels in pregnancy shows promise for the management of preeclamptic patients, Vikas Bhalla, M.D., said during the annual scientific sessions of the American Heart Association. The...

Navigating Tx of bipolar disorder in pregnancy.(Obstetrics)
February 1, 2005... BOSTON -- Managing bipolar disorder during pregnancy requires balancing the competing risks and benefits to the woman and her fetus, said Adele Viguera, M.D. "Pregnancy, and particularly the postpartum period, is associated with a high...

Expectant management of HELLP: prednisolone cuts exacerbations.(Obstetrics)
February 1, 2005... VIENNA -- Prolonged prednisolone administration reduces the risk of HELLP exacerbations in women undergoing expectant management remote from term, Pieter van Runnard Heimel, M.D., said at the 14th World Congress of the International Society for...

Isolated fetal intracardiac echogenic focus doesn't increase aneuploidy risk.(Obstetrics)
February 1, 2005... PHOENIX, ARIZ. -- The presence of an isolated intracardiac echogenic focus on fetal ultrasound does not increase the risk for aneuploidy in the absence of other risk factors in women younger than 35 years of age, Kathleen Bradley, M.D.,...

Total cesarean delivery rate.(DATA WATCH)
February 1, 2005... Total Cesarean Delivery Rate 2003 27.6% 2002 26.1% Source: Centers for Disease Control and Prevention Note: Table made from bar graph.

Pitocin orders should match hospital's protocol.(Obstetrics)
February 1, 2005... SAN FRANCISCO -- Before you write an order for Pitocin administration to induce or augment labor, be sure you know your hospital's protocol for Pitocin use, Dennis J. Sinclitico, J.D., advised. In the three most recent obstetrical...

Urinary PlGF predicts early-onset preeclampsia.(Obstetrics)
February 1, 2005... VIENNA -- Decreased urinary placental growth factor at midgestation is strongly associated with the subsequent development of early-onset preeclampsia, S. Ananth Karumanchi, M.D., reported. "Low urinary PIGF antedates the clinical diagnosis...

Hydroxychloroquine 'probably safe' in pregnancy.(Obstetrics)
February 1, 2005... DUSSELDORF, GERMANY -- The anti-inflammatory compound hydroxychloroquine appears to be relatively safe during pregnancy, according to a small number of studies totaling about 250 patients. But these studies have not provided overwhelming...

Operative vaginal delivery strategies may curb risk.(Obstetrics)
February 1, 2005... SAN FRANCISCO -- Use of forceps or vacuum extractor during a vaginal delivery seldom is the sole cause of litigation, but you can reduce that risk even more, several speakers said at a conference on ob.gyn., perinatal medicine, neonatology, and...

Researchers embrace sentinel lymph node biopsy.(Gynecology)
February 1, 2005... SAN ANTONIO -- Sentinel lymph node biopsy is as accurate as the traditional surgical practice of dissecting the entire axillary lymph node chain in women with breast cancer but inflicts far less nerve damage and fewer other complications. Mark...

Refined chemo benefits ER-negative patients.(Gynecology)
February 1, 2005... SAN ANTONIO -- Twenty years of refinements in adjuvant chemotherapy have brought dramatically improved outcomes in lymph node-positive breast cancer patients, but the benefit has been confined to those with estrogen receptor-negative tumors,...

Flaxseed supplements curbed hot flashes in study.(Gynecology)
February 1, 2005... SAN ANTONIO -- Flaxseed relieved vasomotor hot flashes in postmenopausal women in a randomized blinded crossover trial, Lorraine E. Turner, Ph.D., reported at the annual breast cancer symposium sponsored by the Cancer Therapy and Research...

CAM usage climbs with education level.(Gynecology)
February 1, 2005... SAN ANTONIO -- The more years of formal education a breast cancer patient has, the more likely she is to use complementary and alternative medicine in conjunction with adjuvant chemotherapy, Eleanor Glass reported at the annual breast cancer...

Breast Ca patients need more calcium, vitamin D.(Gynecology)
February 1, 2005... SAN ANTONIO -- Inadequate calcium and vitamin D intake--and outright deficiencies--are even more common among breast cancer patients than in the general population, according to studies presented at the annual breast cancer symposium sponsored...

UAE edges myomectomy in terms of recovery.(Gynecology)
February 1, 2005... CHICAGO -- Uterine artery embolization appears to have a slight edge over myomectomy in terms of recovery after treatment of uterine fibroids, according to data presented during the annual meeting of the Radiological Society of North America....

Left upper quadrant called safe alternative for umbilicus entry.(Gynecology)
February 1, 2005... SAN FRANCISCO -- The ninth intercostal space in the left upper quadrant provides a safe alternative to umbilicus entry for laparoscopy when the patient has adhesions, Neena Agarwala, M.D., reported in a poster presentation during the annual...

Nerve-sparing technique said to cut complications in deep endometriosis.(Gynecology)
February 1, 2005... SAN FRANCISCO -- A laparoscopic procedure that preserves the hypogastric and pelvic splanchnic nerves appears to reduce urinary retention after treatment of deep pelvic endometriosis, Paulo Ayroza Ribeiro, M.D., reported at the annual meeting...

Extended raloxifene use cuts risk of breast Ca.(Gynecology)
February 1, 2005... SAN ANTONIO -- Raloxifene continued to markedly reduce breast cancer incidence in postmenopausal osteoporotic women over the course of 8 years in an extension of the landmark Multiple Outcomes of Raloxifene Evaluation trial, according to...

High prevalence of fractures, reduced BMD in systemic lupus.(Gynecology)
February 1, 2005... Patients with systemic lupus erythematosus who are under the age of 50 have a high rate of fragility fractures, osteoporosis, and poor bone mineral density, according to new research. And as expected, steroid use was significantly linked to...

Routine bone scans appropriate for some premenopausal women.(Gynecology)
February 1, 2005... HARROGATE, ENGLAND -- Targeted use of bone densitometry in premenopausal women can identify a significant number of patients who would benefit from bone protection, a study has shown. Of 301 premenopausal women referred to London's Queen...

BMD early in menopause predicts 10-year bone health: findings of this study support the role of bone density measurements in the first years after menopause.(Gynecology)
February 1, 2005... HARROGATE, ENGLAND -- A single bone mineral density measurement early in menopause is a strong predictor of future bone status in women not considered at risk for osteoporosis, a study has shown. Despite various rates of bone mineral loss...

Fracture risk increases with albumin, T3 deficiencies.(Gynecology)
February 1, 2005... HARROGATE, ENGLAND -- Low serum albumin and T3 levels are independently predictive of vertebral fractures in women older than 50 years, a 10-year prospective study has shown. Because albumin and T3 deficiencies are considered markers of...

Analysis debunks age bias in bisphosphonate therapy for elderly.(Gynecology)
February 1, 2005... HARROGATE, ENGLAND -- Age and frailty should not deter physicians from offering very elderly osteoporotic patients antiresorptive therapy, despite age-associated increases in comorbid conditions, said Steven Boonen, M.D The results of a...

IUD advocated for women using antiepileptics.(Gynecology)
February 1, 2005... NEW ORLEANS -- The best contraceptive choices for women on antiepileptic medications are probably a progesterone-eluting intrauterine device or intramuscular medroxyprogesterone, with the higher doses of oral contraceptives running in second...

Outcomes of assisted reproductive technology cycles.(DATA WATCH)
February 1, 2005... Outcomes of Assisted Reproductive Technology Cycles. Single-Fetus Pregnancy 19.9% Multiple-Fetus Pregnancy 12.4% Indeterminate Number of Fetuses* 2% Ectopic Pregnancy 0.7% No Pregnancy ...

Review of 28 studies links HT to higher stroke risk.(Gynecology)
February 1, 2005... Hormone therapy is associated with a significantly increased risk of stroke, based on studies involving nearly 40,000 patients. A review of 28 studies ranging in size from 59 to 16,608 adults and with follow-up times of 0.7-6.8 years showed...

Enterococcus behind many UTIs in elderly; Tx resistance rises with age.(Gynecology)
February 1, 2005... SAN FRANCISCO -- The culprit behind most noncomplicated urinary tract infections in outpatients--Escherichia coli--plays less of a role as patients age, a study of 2,751 urine cultures showed. Other pathogens, particularly enterococcus,...

Guidelines: cut calories and salt; Exercise more.(Clinical Rounds)
February 1, 2005... The nation's newly revised dietary guidelines call on Americans to double their exercise, cut back on calories, and limit sodium consumption to 1 teaspoon or less each day. The "Dietary Guidelines for Americans 2005" document stresses the...

Primary care physicians assigned front line in obesity Tx.(Clinical Rounds)
February 1, 2005... LAS VEGAS -- In theory, team management of obese patients makes a lot of sense. But in the real world, it may not be possible, because the obesity epidemic is too big, trained specialists too few, and resources too scarce, Arthur Frank,...

Calories count despite debate on best weight-loss plans.(Clinical Rounds)
February 1, 2005... NEW ORLEANS -- Calorie restriction, rather than the carbohydrate or fat content or the glycemic index of the diet, is of great importance in losing weight, Ernst J. Schaefer, M.D., said at the annual scientific sessions of the American Heart...

Uncomplicated obesity linked to compromised aortic elasticity.(Clinical Rounds)
February 1, 2005... NEW ORLEANS -- Obese individuals with no other complicating diseases have an abnormally stiff aorta, predisposing them to heart failure and other cardiovascular diseases, Monique Robinson, M.B., said at the annual scientific sessions of the...

Exercises to speed breast Ca surgery recovery: slow is definitely the way to go when it comes to exercise after surgery to prevent muscle atrophy.(EXERCISE RX)
February 1, 2005... A major problem in patients who are undergoing rehabilitation after cancer surgery or chemotherapy is that platelet counts go down, and patients develop thrombopenia and bleed easily. In addition, the peripheral nervous system may be...

Pumping iron hones glycemic control in type 2 diabetes.(Clinical Rounds)
February 1, 2005... KEYSTONE, COLO. -- Weight lifting is an attractive option to improve glycemic control in patients with type 2 diabetes, Richard Weil said at a conference on management of diabetes in youth. The great majority of research on the metabolic...

New DNA test: prescription for genetic precision.(Clinical Rounds)
February 1, 2005... Food and Drug Administration approval of the first DNA microarray test will allow physicians to consider patient-specific genetic information before prescribing medications for a variety of conditions such as cardiac disease, psychiatric...

CV risks rise among Native Americans.(Clinical Rounds)
February 1, 2005... ATLANTA -- The prevalence of cardiovascular risk factors and cardiovascular disease is alarmingly high and continues to rise in Native Americans, according to several reports at a prevention conference on heart disease and stroke sponsored by...

Post-MI depression most common in younger women.(Clinical Rounds)
February 1, 2005... NEW ORLEANS -- Younger women with acute MI are a particularly high-priority target population in terms of screening for and treatment of postinfarct depression, Susmita Mallik, M.D., said at the annual scientific sessions of the American Heart...

Medicare poised to help seniors kick the habit.(Clinical Rounds)
February 1, 2005... Medicare is investigating ways to help its beneficiaries quit smoking. The Centers for Medicare and Medicaid Services proposed to extend smoking cessation coverage to beneficiaries who smoke and have been diagnosed with a smoking-related...

Smoking, salt increase risk of GERD.(Clinical Rounds)
February 1, 2005... Smoking and high salt intake increase the risk of developing gastroesophageal reflux disease, while a high-fiber diet and regular physical exercise decrease it, a study of two large Norwegian surveys suggests. The study, conducted by...

Smoking cessation.(WOMEN'S HEALTH ADVISER)
February 1, 2005... About 21% of American women, or more than 20 million, smoke cigarettes, with prevalence being the highest, about 32%, among Native American women. According to the Office of the Surgeon General, smoking is probably the most important...

Injectable sumatriptan works after oral form fails.(Clinical Rounds)
February 1, 2005... VANCOUVER, B.C. -- When migraine patients who need sumatriptan to abort their headaches fail to respond to it, they should try the injectable form, Seymour Diamond, M.D., said at the annual meeting of the American Headache Society. In an...

Study: migraine underdiagnosed in HMO population.(Clinical Rounds)
February 1, 2005... VANCOUVER, B.C. -- Even in a health maintenance organization, few patients with migraine are identified, diagnosed, and treated--even fewer than previous epidemiologic studies of the population have suggested, Marcelo E. Bigal, M.D., reported...

FDA approves a new, nonnarcotic sleep aid.(Clinical Rounds)
February 1, 2005... The Food and Drug Administration has approved a new, nonnarcotic therapy for insomnia, eszopiclone. Most sleep aids are approved for only short-term use of a week to 10 days, but eszopiclone can be safely prescribed for longer, according to the...

FDA issues new warning for ADHD drug.(Clinical Rounds)
February 1, 2005... The Food and Drug Administration has issued a new warning for atomoxetine HCI concerning the potential for severe liver injury. The drug, indicated for the treatment of attention-deficit hyperactivity disorder in adults and children, has been...

Program aims to treat disruptive physicians.(Practice Trends)
February 1, 2005... More than 4 years ago, Raymond M. Pomm, M.D., started to see a pattern of disruptive behavior occurring in physicians across Florida, where he is the medical director for the state's Impaired Professionals Program. Hospitals were reporting...

Health disparities in minority women vary by ethnic group.(Practice Trends)
February 1, 2005... WASHINGTON -- More programs need to be developed to address the specific health needs of minority women, Elena Cohen said during the annual meeting of the American Public Health Association. "Racial minorities are projected to make up...

Does Medicaid managed care deliver savings?(Practice Trends)
February 1, 2005... WASHINGTON -- Medicaid managed care doesn't appear to be living up to its reputation for cost savings, at least not in South Carolina, Walter Jones, Ph.D., said at the annual meeting of the American Public Health Association. Dr. Jones and...

Plan B decision delay spawns lawsuit.(POLICY & PRACTICE)
February 1, 2005... An advocacy group is suing the Food and Drug Administration for delaying its decision on over-the-counter status for the emergency contraceptive Plan B (levonorgestrel). "Half of the 3 million pregnancies in the U.S. are unintended each year....

Emergency contraception omitted.(POLICY & PRACTICE)
February 1, 2005... A coalition of abortion rights advocates and health care professionals is urging the U.S. Department of Justice to add information about emergency contraception to its "National Protocol for Sexual Assault Medical Forensic Examination." The...

Misleading ads.(POLICY & PRACTICE)
February 1, 2005... The Food and Drug Administration recently warned Barr Research that one of its advertisements for the oral contraceptive Seasonale (levonorgestrel/ethinyl estradiol) was misleading consumers. "By omitting and minimizing the risks associated...

HIV prevention.(POLICY & PRACTICE)
February 1, 2005... Although current law allows for the delivery and financing of HIV-prevention programs through Medicaid and the Ryan White Comprehensive AIDS Resources Emergency Act grants, neither program delivers a significant level of services, according to...

The malpractice debate.(POLICY & PRACTICE)
February 1, 2005... President Bush hit the road in January to drum up support for his medical liability reform legislation. The president traveled to Illinois to draw attention to the problem of frivolous lawsuits and called on Congress to enact a $250,000 cap on...

Full-time work no protection from medical debt.(Practice Trends)
February 1, 2005... WASHINGTON -- Medical debt is more common among families with full-time workers than among families whose members work part-time, according to University of Iowa researchers at the annual meeting of the American Public Health Association. ...

Pharmaceutical industry issues its plan for voluntary clinical trials registry.(Practice Trends)
February 1, 2005... In the face of bad publicity and impending restrictions, trade groups representing pharmaceutical companies have proposed a voluntary plan for using a clinical trials registry as well as results databases by midyear. The "Joint Position on...

Office staff embrace patient e-mailing.(Practice Trends)
February 1, 2005... SAN FRANCISCO -- Nonphysician staff in 10 primary care clinics initially were leery of giving patients the ability to e-mail their clinics, but they became more enthusiastic 6 months after using an electronic communication system, a study of 76...

PPAC: pricing system needs correction plan.(Practice Trends)
February 1, 2005... WASHINGTON -- Physicians should be reimbursed retroactively for any payment miscalculations that occurred under Medicare's new system for in-office infusions, the Practicing Physicians Advisory Council recommended. The average sales price...

Patient history electronic service.(PRODUCTS)
February 1, 2005... The Care360 system allows physicians to compare a patient's current and past test results, view prescriptions, share lab and prescription histories with other Care360 physicians, make electronic prescriptions, and check benefit eligibility and...

Hydrogen peroxide swab.(PRODUCTS)
February 1, 2005... The Popule hydrogen peroxide self-saturating swab incorporates a sealed 3% hydrogen peroxide solution that can be snapped open to saturate the swab and apply to a wound. For more information, contact Puritan Medical Products Co. by calling...

Valtrex label change: nursing.(PRODUCTS)
February 1, 2005... GlaxoSmithKline is changing the label of Valtrex (valacyclovir) caplets to reflect new data on nursing mothers. After oral administration of 500 mg of the drug, five nursing mothers had peak acyclovir concentrations in breast milk ranging from...

Urinary incontinence workshops.(PRODUCTS)
February 1, 2005... CooperSurgical Inc. is hosting a series of regionally based training workshops on urinary incontinence and urodynamics. In particular, the sessions will focus on the use of the company's Lumax pro fiberoptic cystometry system and SURx radio...

Custom medical lighting.(PRODUCTS)
February 1, 2005... Custom modular lighting is available in various configurations, including flexible gooseneck arms, spotlights, and different light intensities, for medical exam rooms. For more information, contact Sunnex Inc. by visiting www.sunnexonline.com...

Wall storage for charts.(PRODUCTS)
February 1, 2005... The Vertical Chart Stacker is a wall-mounted storage unit that can accommodate five charts--low-profile privacy clipboards, springloaded charts, emergency department clipboards, or 1-inch side- or top-opening ring binders. For more information...

Chart security bag.(PRODUCTS)
February 1, 2005... The chart security bag has a clear sleeve for inserting paper notations, a zipper closure, and a carrying handle. The bag can accommodate up to a 3-inch chart. For more information about the bag, contact Carstens Inc. by calling 800-782-1524 or...

A practical perspective on a complicated problem.(THE MASTER CLASS)
February 1, 2005... The health of any country is judged by the survival of its infants. The United States spends 15% of its gross national product on health care, yet it ranks 21st in the world in its infant mortality rate of 8 deaths per 1,000 live births,...

Managing preterm labor in multiple gestations.(THE MASTER CLASS)
February 1, 2005... Preterm labor is one of the most important and vexing challenges complicating pregnancy. Premature babies account for an estimated 6%-10% of births, yet they account for 70%-85% of neonatal morbidity and mortality. In multiple gestations,...

Panel rejects OTC version of statin.(News)
February 15, 2005... BETHESDA, MD. -- Concerns about unintended pregnancy exposures and the ability of consumers to correctly select themselves for treatment without the advice of a health care professional were among those cited by Food and Drug Administration...

General Ob.Gyns. worked about 38 clinical hours per week in 2003.(VITAL SIGNS)
February 15, 2005... General Ob.Gyns. Worked About 38 Clinical Hours per Week in 2003 Mean Hours per Week Reproductive Endocrinology (n = 32) 39.34 Maternal & Fetal Medicine (n = 75) 39.10 Gynecologic Oncology (n = 26) 38.62 General Ob.Gyn...

Cochrane review favors vaginal hysterectomy: shorter hospital stays, faster recovery cited.(News)
February 15, 2005... Vaginal rather than abdominal hysterectomy should be performed "whenever technically feasible" to reduce complications and to speed hospital discharge and patients' return to normal activities, according to a review of randomized controlled...

Study confirms estrogen raises gallbladder risks.(News)
February 15, 2005... Oral estrogen therapy significantly increases the risk of gallbladder disease and gallbladder-related procedures, according to an analysis of the Women's Health Initiative. The results "demonstrate for the first time in a randomized,...

Most abnormal cervical cytology regresses in teens.(News)
February 15, 2005... WHITE SULPHUR SPRINGS, W.VA. -- Most abnormal cervical cytology in adolescent women will be low-grade squamous intraepithelial lesions, and will regress to normal by the follow-up exam, Andrea Wininger, M.D., said at the annual meeting of the...

Membrane stripping.(LETTERS)(Letter to the Editor)
February 15, 2005... I find it ironic that a recent issue contained four separate stories regarding the malpractice crisis, along with a Pro & Con titled. "Is membrane stripping appropriate in modern obstetrics?" (Nov. 1, 2004, p. 7). James A. McGregor, M.D.,...

Limit medical abortions.(LETTERS)(Letter to the Editor)
February 15, 2005... The Food and Drug Administration's addition of a revised black box section of the prescribing information for mifepristone is not enough ("Three Deaths Prompt New Warnings for Mifepristone," Dec. 15, 2004, p. 1). Medical abortion with the...