OB GYN News articles from January 2000

OB GYN News archives from January 2000

Laparoscopic Burch Vs. Open Procedure.
January 1, 2000... LAS VEGAS -- The Burch procedure can be performed laparoscopically and achieve results identical to those achieved by the open method. That was the take-home message of a study of 87 women with genuine stress urinary incontinence (GSUI),...

Ob.Gyn. Groups to Push for Flexibility In Residencies.
January 1, 2000... One year of residency might be spent pursuing a specific educational goal. Representatives of the major ob.gyn. organizations are moving to offer more flexibility in ob.gyn. residency programs. The issue of allowing residents to modify...

Retesting Maternal Serum Can Reduce False Positives.
January 1, 2000... Do over if test is [greater than]2.2 MoM or [less than]3 MoM. SAN FRANCISCO -- Permitting select women with an elevated maternal serum alpha-fetoprotein sample to undergo repeat testing can significantly reduce the false-positive rate for...

DATA WATCH.
January 1, 2000... DATA WATCH States With the Highest and Lowest Mortality Rates for Uterine Cancer, 1992-1996 [*] States With Lowest Rates Alaska 1.6 ...

Breast-Feeding Cuts Leukemia.
January 1, 2000... Breast-feeding reduces the risk of childhood acute leukemia, especially in those who breast-feed for more than 6 months, reported Dr. Xiao Ou Shu of the University of Minnesota at Minneapolis and associates. A few small studies have...

Half a Loaf Is Less Fattening.
January 1, 2000... We all know that a significant percentage of the health problems in this country are preventable. If you subtract all of the health costs associated with smoking, overeating, excess alcohol consumption, illegal drug use, lack of exercise,...

PRO & CON.
January 1, 2000... Is it useful to vaccinate adults with the current polysaccharide pneumococcal vaccine? YES Dr. Benjamin Schwartz The 23-valent polysaccharide pneumococcal vaccine meets all the criteria for a useful vaccine. It is efficacious...

Pandering to Laziness.
January 1, 2000... Eleven years ago, when I began performing hysteroscopic endometrial ablation using a neodymium: YAG laser, I never dreamt there would be a time when instrument makers would fall all over themselves attempting to cater to the needs of...

Interstitial Cystitis Often Misdiagnosed.
January 1, 2000... ST. LOUIS -- Gynecologists and primary care physicians are seeing patients with interstitial cystitis, but many are misdiagnosed or sent to urologists for something these physicians could treat themselves, Dr. C. Lowell Parsons said. ...

Ob.Gyns. Slow to Use Tamoxifen for Prophylaxis.
January 1, 2000... In the 15 months since the Food and Drug Administration approved tamoxifen for breast cancer prevention, ob.gyns. appear to have been slow to incorporate tamoxifen into clinical practice. Overall, ob.gyns. represent less than 1% of...

Normal Vaginal Flora May Hamper IVF Success.
January 1, 2000... TORONTO -- Normal vaginal flora, which sometimes get pushed into the uterus during in vitro fertilization, may decrease pregnancy rates, according to the results of two recent studies. "This justifies the routine use of prophylactic...

Family History of Premature Menopause Puts Women at Risk.
January 1, 2000... TORONTO -- Patients who have premature menopause in their family history should be warned that they face a risk of developing the disorder themselves, according to Dr. Piergiorgio Crosignani. He reported on the familial incidence of both...

Viagra Has No Effect On Sperm Motility, Viability.
January 1, 2000... TORONTO -- Men taking sildenafil (Viagra) need not worry about its effect on their fertility, according to results of an in vitro study. "Sildenafil has no effect on normal human spermatozoa's motility, viability, and membrane integrity,"...

Sacral Nerve Stimulation Tames Urge Incontinence.
January 1, 2000... Sacral nerve stimulation using a surgically implanted device can significantly curb urinary urge incontinence in patients refractory to standard medical therapy. At a 6-month follow-up, 47% of 34 patients who used the device were...

Reduce Sugar Intake in Vaginal Candidiasis.
January 1, 2000... SANTA FE, N.M. -- It's worthwhile to counsel patients who have frequent vaginal yeast infections to reduce the amount of sweets, wine, fruit, and dairy products they consume, Dr. Benson J. Horowitz advised at the International Society for the...

Look for Fibromyalgia in Resistant Vestibulitis.
January 1, 2000... SANTA FE, N.M. -- Fibromyalgia is commonly found in patients with difficult to treat vulvar vestibulitis, Dr. John J. Willems said at the International Society for the study of Vulvovaginal Disease World Congress. The vestibulitis is...

Good Surgical Response in Vulvar Vestibulitis.
January 1, 2000... SANTA FE, N.M. -- Women with severe vulvar vestibulitis that begins with the first episode of intercourse have the same good response rates to surgery as those who develop severe vestibulitis later in their sexual lives, Israeli investigators...

Distinguishing Between Osseous Complications.
January 1, 2000... SAN DIEGO -- Patients who present with pubic bone pain soon after bone anchors are placed following urethral sling surgery tend to have osteitis pubis but those who develop bone pain much later usually have periosteal irritation, results of a...

New Surgical Procedure Facilitates Removal of a Mersilene Mesh Sling.
January 1, 2000... SAN DIEGO -- Complications are rare with a Mersilene mesh sling, but if removal is needed, a new surgical technique may be of help. The most common reasons for removal include graft rejection or an infected sling, study investigator Dr....

Processing Methods Still Leave DNA Material in Human Allografts.
January 1, 2000... SAN DIEGO -- Commercial sources of some allograft material still contain DNA regardless of the method used to extract human cellular genetic material, according to Dr. Raymond Rackley. Although there have been no reported cases of anyone...

Advantages of Cryotherapy Endometrial Ablation.
January 1, 2000... LAS VEGAS -- Endometrial ablation by cryotherapy appears to be a safe and very effective means of curtailing abnormal uterine bleeding. The First Option Uterine Cryoblation therapy device reduced uterine bleeding to eumenorrhea or better 6...

Try Sharp Dissection to Navigate Vesicocervical Space.
January 1, 2000... ST. LOUIS -- Cystotomy need not be feared during vaginal hysterectomy in patients who've undergone a previous cesarean section if the correct anatomic approach is taken, Dr. S. Robert Kovac said. Knowing how to navigate the vesicocervical...

Asthma More Harmful Than Steroids in Pregnancy.
January 1, 2000... CHICAGO -- Pregnant women who have asthma and use inhaled corticosteroids do not have an increased risk of premature delivery or of giving birth to a low-birthweight baby, Dr. Michael Schatz said at the annual meeting of the American College of...

Avoid Tocolysis In Intraamniotic Infection.
January 1, 2000... TORONTO -- Tocolysis may do more harm than good when a pregnant woman has an intraamniotic infection. "In the context of infection, the onset of premature labor has survival value. The mother or fetus signals the onset of labor to take the...

Fibronectin Testing Cheaper Than Treating At-Risk Women.
January 1, 2000... MAUI, HAWAII -- Management strategies incorporating traditional fetal fibronectin testing are better at preventing neonatal respiratory distress syndrome and death due to prematurity than are those that incorporate the rapid fetal fibronectin...

Nucleated RBCs Elevated in Neonatal Seizures.
January 1, 2000... MAUI, HAWAII -- Infants with early-onset neonatal seizures often have elevated levels of nucleated red blood cells, according to a retrospective study of births at Hutzel Hospital, Detroit. This finding may soon be of crucial importance in...

Folic Acid Supplements Needed Despite Fortification.
January 1, 2000... MAUI, HAWAII -- Women who are capable of becoming pregnant still need to take a folic acid supplement despite a federal requirement that grain foods must be fortified, according to Dr. Jennifer R. Niebyl. The grain fortification effort has...

Fetal Injuries Are Worse if Seat Belt Is Not Used.
January 1, 2000... MAUI, HAWAII -- Pregnant women who worry that wearing a seat belt will crush their fetus in an automobile accident should be told that not wearing a seat belt is much more dangerous, according to Dr. Mark D. Pearlman. An analysis of 42...

Unified Dietary Guidelines.
January 1, 2000... Unified dietary guidelines have been issued by a consortium of health advocacy and research organizations, including the American Heart Association, American Cancer Society, American Dietetic Association, American Academy of Pediatrics, the...

Herbs and Patient Income.
January 1, 2000... Herbal healing is not just for the well heeled. In a survey of 185 predominantly low-income patients visiting a county health clinic, 60% reported using herbal remedies or dietary supplements and 53% said that they had not informed their...

Gingko Tied to Hemorrhage.
January 1, 2000... Ginkgo herbal therapy is best avoided by patients taking an anticoagulant, high-dose aspirin, or those with a bleeding predisposition, said Sally K. Guthrie, Pharm.D. A small number of disturbing case reports of hemorrhage are cropping up...

White Coat Hypertension.
January 1, 2000... White coat hypertension may not be a benign condition, but it probably isn't as ominous as sustained hypertension, according to studies conducted by two separate groups of European investigators. In one study, investigators used Doppler...

Pseudoephedrine-Colitis Link.
January 1, 2000... In unexplained cases of suspected ischemic colitis, be sure to ask about recent pseudoephedrine use, Dr. David Bailey urged at the annual meeting of the American College of Physicians-American Society of Internal Medicine in New Orleans. ...

Depression Screening.
January 1, 2000... Primary care patients with signs of comorbid depression and anxiety on initial screening are more likely to receive a diagnosis of major depression than are those who screen positive only for depression, Dr. Mary Kay Smith said at the annual...

Estrogen for Alzheimer's.
January 1, 2000... Estrogen replacement therapy appears to enhance the cognitive gains associated with the acetylcholinesterase inhibitor donepezil for some women with Alzheimer's disease, Dr. Thomas McRae said at the 11th World Congress of Psychiatry. In...

ULTRASOUND PRIVILEGING.
January 1, 2000... Hospital medical staffs should grant privileges for performing ultrasounds to any physicians who have proper education and training in use of the technology, the delegates said. "Some radiologists have adopted policies at local hospitals that...

PAP SMEAR LITIGATION.
January 1, 2000... The delegates reiterated their support for the use of nonbinding arbitration in all malpractice cases, including those brought for false-negative Pap smear results. Warning that a flood of lawsuits could threaten the test's availability,...

STEM CELL RESEARCH.
January 1, 2000... The delegates agreed to support a National Bioethics Advisory Commission recommendation that federal funding be allowed for research using human pluripotent stem cells derived from embryos originally created for infertility treatment. The AMA...

ANESTHESIA AND NEONATAL CIRCUMCISION.
January 1, 2000... Ob.gyns., pediatricians, and family physicians who perform circumcision should be better trained at pain control, the delegates said. Surveys show that 84% of pediatric residents, 80% of family practice residents, and 60% of ob.gyn. residents...

HERBAL REMEDIES.
January 1, 2000... Herbal product and dietary supplement labels should warn consumers about possible drug interactions and advise them to tell their physicians if they're taking supplements, the delegates said. The delegates also called for the establishment of...

DOMESTIC VIOLENCE.
January 1, 2000... All state and county medical societies should launch domestic violence programs like one pioneered by Baltimore physicians, the delegates said. The Baltimore County Medical Association produced a slide that local movie theaters show as a public...

SEX EDUCATION.
January 1, 2000... The AMA should continue to study whether increasingly popular abstinence-only sex education programs actually help prevent teen pregnancies and sexually transmitted diseases, the delegates said. They also reaffirmed AMA policy that sex...

EMERGENCY CONTRACEPTION.
January 1, 2000... The AMA will study whether it should take the position that emergency contraception be considered an essential emergency service and that federal funding therefore should be withheld from hospitals that don't provide it, as is the case in an...

ON-CALL PHYSICIANS.
January 1, 2000... The delegates asked the AMA to establish a task force with the American Hospital Association, the American College of Emergency Physicians, and other groups to tackle a growing shortage of physicians who are willing to be on-call for hospital...

PUBLIC TRUSTEE.
January 1, 2000... The delegates asked the AMA to continue to study the feasibility of adding a public member to the AMA's 15-member board of trustees. While debate was mixed, Dr. Richard Hollis, a delegate from the American College of Obstetricians and...

AMA Union Leadership Targets Residents.
January 1, 2000... SAN DIEGO -- Leaders of the doctor union sponsored by the American Medical Association are attempting to recruit residents in several communities across the country. In what union president Dr. Susan Hershberg Adelman described as "a...

Report on Medical Errors Highlights Ailing System.
January 1, 2000... WASHINGTON -- The government needs to make reporting of medical errors mandatory and establish a center for studying patient care mistakes, but errors won't be substantially reduced until doctors who err stop thinking of themselves as...

Med Schools Set to Improve Doctor Communication.
January 1, 2000... Diagnosing and treating disease is no longer enough. Physicians have to be better communicators. That's the upshot of a new report from the Association of American Medical Colleges in Washington, D.C. The report, entitled "Contemporary...

Quality of Visit Matters More Than Quantity of Time.
January 1, 2000... CHICAGO -- Patients care more about bedside manner than they do about the amount of time that their doctor spends with them. Dr. Marvin J. Bittner found in his survey of 97 patients treated by medical interns that the patients were more...

BREAST IMPLANT SETTLEMENT.
January 1, 2000... Women who claim they were injured by Dow Corning Corp.'s silicone breast implants will receive a collective settlement of S3.2 billion under an agreement approved in November by a U.S. bankruptcy court judge in Bay City, Mich. Dow declared...

ABORTION BAN BLOCKED.
January 1, 2000... The U.S. Supreme Court has temporarily stopped Illinois and Wisconsin from enforcing bans on so-called "partial-birth abortions." Although the 7th Circuit Court of Appeals in Chicago has ruled that such bans are legal, the ruling has been...

MEDICARE SPENDING.
January 1, 2000... For the first time in the program's 35-year history, Medicare spending actually declined by approximately 1% last year. Medicare spending dropped from more than $213 billion in fiscal year 1998 to $212 billion in fiscal year 1999, which ended...

MEDICAL MALPRACTICE PREMIUMS.
January 1, 2000... States that have enacted tort reforms in an effort to reduce medical malpractice claim amounts and premium rates are finding that the strategy doesn't always work. A new comparison of premium rates in the District of Columbia, Maryland, and...

MINORITY HEALTH RESEARCH.
January 1, 2000... The National Institutes of Health would receive $100 million to create a new Center for Research on Minority Health and Health Disparities under legislation introduced in November by Sen. Edward M. Kennedy (D-Mass.). Citing racial and ethnic...

HIV/AIDS Web Site.
January 1, 2000... A new Web site at www.hivcme.com is designed for health care providers and focuses on HIV/AIDS issues, including immune reconstitution, early diagnosis, salvage therapy and treatment of special populations such as children, adolescents, women,...

Resources Catalog.
January 1, 2000... The Health Care Resources catalog lists publications on medical conditions and treatments by federal agencies, including manuals, guides, guidelines, encyclopedias, and reference books, both in print and on CD-ROM.

Brochure on Dietary Fat.
January 1, 2000... A new brochure, "Facts on Preventing Cancer: Fats and Oils," explains the cancer risk associated with a diet high in saturated fat, offers practical suggestions for reducing dietary fat, and discusses low-fat foods and those containing...

Substance Abuse Programs.
January 1, 2000... The updated National Directory of Drug Abuse and Alcoholism Treatment Programs lists thousands of facilities at the federal, state, and local levels, as well as licensed private facilities.

Online Patient Records.
January 1, 2000... Patients can put medical information online for access by emergency personnel or physicians who treat them while they're traveling. The free Internet site prompts users for information about insurance, physician and emergency contacts, and...

Cancer Cargegivers.
January 1, 2000... The Strength for Caring program is a free half-day workshop administered by nurses or social workers and directed toward caregivers of cancer patients. The program, which is sponsored by the National Family Caregivers Association, covers issues...

Incontinence Support Group.
January 1, 2000... The National Association for Continence's Take Control Support Group for people with incontinence provides members with social support and opportunities to discuss their experiences with others.

Domestic Violence Screening.
January 1, 2000... Guidelines for domestic violence screening, tips for intervention, and suggestions for organizing a clinic to screen for abuse are available free from the National Health Resource Center on Domestic Violence, at 888-RX-ABUSE.

Fetal MRIs Pick Up Where US Stops.
January 15, 2000... CHICAGO -- New ultrafast techniques are intensifying the role of fetal magnetic resonance imaging in clarifying equivocal ultrasound results, planning fetal surgery, and devising plans for the care of ill newborns after birth. Studies...

Premenopausal Diet, Exercise Yield Long-Term Benefits.
January 15, 2000... Lifestyle changes limit weight gain, LDL, other coronary heart disease risk factors. ATLANTA -- Middle-aged women can largely avoid menopausal weight gain and adverse lipid changes through premenopausal adoption of a low-fat diet coupled...

Irregular Menses Flags Higher Coronary Risk.
January 15, 2000... Lifestyle changes, close follow-up urged. ATLANTA -- Women with consistently irregular menstrual periods have about a 50% increased risk of coronary events, based on results from a large epidemiologic study. The elevation in coronary...

Whites, Nonsmokers, Low Baseline HDL Get Best Lipid Response to HRT.
January 15, 2000... ATLANTA -- Portraits are emerging of the postmenopausal women who are the most likely and least likely to derive cardiovascular benefit from hormone replacement therapy. This predictive information will be clinically valuable because...

FDA Proposes New Rules on Reusing Single-Use Medical Devices.
January 15, 2000... GAITHERSBURG, MD. -- The Food and Drug Administration is seeking input on its proposed strategy for reuse of medical devices that are currently labeled or otherwise intended for only one use. Panel discussions about the FDA's draft...

Delivery Modes Carry Similar Intracranial Risks.
January 15, 2000... Rates of intracranial hemorrhage are similar whether infants are delivered using vacuum extraction, forceps, or cesarean section once labor has started. All are higher than the injury rate with spontaneous vaginal delivery, but are still...

Betamethasone May Cut Periventricular Leukomalacia.
January 15, 2000... Prenatal exposure to betamethasone, but not dexamethasone, significantly reduced the risk of cystic periventricular leukomalacia, a major cause of cerebral palsy, reported Dr. Olivier Baud of Antoine Beclere University Hospital in Clamart,...

ACOG Committee Advises Major Practice Changes.
January 15, 2000... Ob.gyns. should offer HIV, diabetes, and hepatitis C screening to a wider population of patients; start routinely screening for gonorrhea in certain women; and ask all patients about the use of complementary and alternative therapies. ...

Maternal Mortality Rate Grossly Underestimated.
January 15, 2000... MAUI, HAWAII -- Maternal mortality figures in this country may be underreported by as much as a half, according to a study conducted in Michigan. The study found that while figures in Michigan's vital statistics reports would have...

Managed Care Is Not the Problem.
January 15, 2000... We have a problem in American medicine. Aside from the 48 million Americans lacking health insurance, the safety of health care provided in the country is the single most important issue in health care today. Quality of care is the...

LETTERS.
January 15, 2000... Medical Perspective Needed The article "Court Overturns 'Partial Birth' Abortion Ban" focused entirely on the legal and political arguments and comments offered by lawyers for the National Right to Life Committee and the Center for...

Posterior Colporrhaphy Bests Transanal Repair.
January 15, 2000... SAN DIEGO -- Posterior colporrhaphy is superior to transanal repair for treating posterior vaginal wall prolapse, according to results of a randomized, prospective trial. Enterocele repair was required in 9 of 33 patients who underwent...

Sacral Promontory Better Site for Prolapsed Organ Reattachment.
January 15, 2000... SAN DIEGO -- Although S2 and S3 are popular anatomical sites for reattachment of prolapsed pelvic organs that are based on the vaginal axis, they are weaker sites than the sacral promontory. That was the conclusion of a pilot study of the...

Large Uteri No Problem for Laparoscopic-Assisted Vaginal Hysterectomy.
January 15, 2000... LAS VEGAS -- Laparoscopic-assisted vaginal hysterectomy can be performed safely even in women with very large uteri, according to results of a 150-patient series. Uteri weighing 70-9 10 g were removed using a two- or three-port...

Patient Selection With Sonography Key to Favorable Endometrial Ablation Outcomes.
January 15, 2000... LAS VEGAS -- Careful selection of patients through the use of sonography is the key to successful outcomes with thermal endometrial ablation for abnormal uterine bleeding, according to Dr. Britt Friberg. In an observational study of more...

GnRH Agonists Cause Pain Flare-Ups in First Month.
January 15, 2000... MAUI, HAWAII -- Gonadotropin-releasing hormone agonists cause a flare-up of pain during the first month they are used to treat endometriosis, Dr. James D. Miller said at the annual meeting of the Central Association of Obstetricians and...

Limit Dose, Time On Boric Acid.
January 15, 2000... SANTA FE, N.M. -- Boric acid can be a useful treatment for vaginal candidiasis, but its potential toxicity needs to be kept in mind, Dr. Benson J. Horowitz said at the International Society for the Study of Vulvovaginal Disease World Congress....

Ultrasound Shows Tamoxifen-Induced Changes.
January 15, 2000... NEW YORK -- Tamoxifen can cause changes in the uterine lining that are apparent on ultrasound, but most of the time there's no serious pathology, according to Dr. Steven Goldstein. The drug of choice for prevention of breast cancer...

Molecular Markers Portend Recurrence After Endometrial Ca Surgery.
January 15, 2000... MAUI, HAWAII -- Molecular markers can be added to the traditional factors of histologic grade and depth of invasion to predict the prognosis of women with endometrial cancer, according to Dr. Andrea Mariani. Patients whose tumors are made...

Test African Americans for BRCA Mutations.
January 15, 2000... SAN FRANCISCO -- Genetic counseling and testing for BRCA2 and BRCA2 mutations is appropriate for African Americans with early-onset breast cancer or strong family histories of breast or ovarian cancer, Deborah McDermott said at the annual...

BRCA1/BRCA2 Mutations Seen More in Whites.
January 15, 2000... SAN FRANCISCO -- White women are much more likely than African American women to carry BRCA1 or BRCA2 genetic mutations, according to a study of unselected breast cancer patients in eastern North Carolina. At the annual meeting of the...

Deficits in Preemies Less Than 1,000 g.
January 15, 2000... ALBUQUERQUE -- The incidence of cognitive impairment and cerebral palsy seems to be rising in children born weighing less than 1,000 g, Dr. Lu-Ann Papile reported at a meeting on perinatal care sponsored by the University of New Mexico. ...