OB GYN News articles from January 2002

OB GYN News archives from January 2002

AMA Leaders call for Unified Front. (Medicare, Tort Reform).
January 1, 2002... SAN FRANCISCO -- Leaders of the American Medical Association urged the House of Delegates at its interim meeting to set aside differences and unite on Medicare reform and other legislative issues important to physicians. "When medicine is...

Nurses' health study: HRT may worsen asthma; Stopping HRT in those with severe or uncontrolled asthma may be warranted. (Preliminary Data).
January 1, 2002... PHILADELPHIA -- Hormone replacement therapy appears to worsen asthma, especially in women who had asthma before menopause. The causal link between estrogen use and exacerbation of asthma is preliminary, but it is suggestive enough to...

Letrozole effective for ovulation induction: Higher pregnancy rates than clomiphene. (Decreased Multiples Risk?).
January 1, 2002... ORLANDO, FLA. -- Letrozole, an aromatase inhibitor approved for treating advanced breast cancer, may soon replace clomiphene citrate as first-line therapy for ovulation induction, Canadian experts predicted. Compared with clomiphene...

Rosiglitazone may induce ovulation in metformin-resistant PCOS. (Small Study).
January 1, 2002... ORLANDO, FLA. -- Rosiglitazone, an insulin-sensitizing agent, holds promise for ovulation induction in metformin-resistant polycystic ovary syndrome, results of a small study suggest. "Probably half of PCOS [polycystic ovary syndrome]...

HIV Testing. (AMA Briefs).
January 1, 2002... Mandatory testing of pregnant women for HIV would not be good policy, but physicians must continue to offer HIV testing to all pregnant women, allowing them the right to refuse, a report adopted by the House said. Mandatory testing might...

SCHIP. (AMA Briefs).
January 1, 2002... Efforts should be made to see that more children and pregnant women get enrolled in State Children's Health Initiative Programs (SCHIP) before they are expanded to include adults, the delegates said. Many states currently have SCHIP funds that...

Smallpox Bioterrorism. (AMA Briefs).
January 1, 2002... The House declined to urge for a call to vaccinate the U.S. population against smallpox as a protection against a terrorist attack with the disease, which was eradicated in 1979, and instead pledged to follow the lead of government agencies...

Health Insurance. (AMA Briefs).
January 1, 2002... The United States has a serious lack of competition in the health insurance market, according to a study, which is said to be the most extensive ever performed on this topic. It was found that there are a number of markets where a single...

HIPAA Privacy. (AMA Briefs).
January 1, 2002... The AMA will study the privacy regulations spelled out under the Health Insurance Portability and Accountability Act (HIPAA) rules and propose that the government delay enacting them if they are found to be too burdensome. The privacy...

Safety-Net Hospitals. (AMA Briefs).
January 1, 2002... The AMA must act to save safety-net hospitals, which are in serious jeopardy, the delegates said. In the last few years, the hospitals that provide the most indigent care have been hard hit by Medicaid cuts and by the fact that Medicaid HMO...

Physician Prescribing Data. (AMA Briefs).
January 1, 2002... Debate continued to rage in the House over the AMA's sale of its master file on physicians, which includes the physician's Drug Enforcement Administration number, which pharmaceutical sales people can then match with prescription data purchased...

Organ Donation. (AMA Briefs).
January 1, 2002... The House of Delegates voted to delay a decision on supporting studies of whether payment would increase organ donations. The ethics panel of the AMA issued a report saying that concerns about the pernicious and beneficial effects of payment...

Stage I Uterine Papillary Ca often recurs. (Largest Case Series).
January 1, 2002... ASHLAND, ORE. -- Even early-stage uterine papillary serous carcinoma patients had a high rate of recurrence in a study of 100 cases of this aggressive form of endometrial cancer. Among 35 patients with stage I or stage II disease, half were...

Letters.
January 1, 2002... Clean Doctor, Clean OR I was surprised to learn that Dr. Harry Reich does not realize that one wears an operating mask to protect the operating room, as well as an open wound, from contamination ("Editor's Note," Oct. 15, 2001, p. 6). ...

Accutane pregnancy prevention rules revised. (Negative Pregnancy Test Mandatory).
January 1, 2002... The risk management program to prevent Accutane-exposed pregnancies has been revised. Announced in October and effective this month, SMART (System to Manage Accutane-Related Teratogenicity) is designed to enhance the safe and appropriate...

Accutane. (Drugs, Pregnancy, and Lactation).
January 1, 2002... Accutane (isotretinoin), a vitamin A derivative, is probably the most teratogenic drug on the market today. The Organization of Teratology Information Services has reported a marked increase in the number of Accutane-exposed pregnancies in the...

Postpartum DMPA doesn't prevent lactation. (Pregnancy Prevention).
January 1, 2002... ASHLAND, ORE. -- Immediate post-partum initiation of progestin-only contraceptives does not appear to interfere with the production of breast milk and protects women against unintended pregnancy in the first months following delivery, Dr. Anita...

Reserve long-term heparin for high-risk patients. (Current Embolism, Deep Vein Thrombosis).
January 1, 2002... PALM BEACH, FLA. -- Obstetrical patients with thrombophilias are commonly given long-term heparin prophylaxis despite a lack of evidence that their abnormalities cause adverse outcomes, Dr. Baha Sibai said at the annual meeting of District V...

Drug update: Outpatient treatment of deep vein thrombosis.
January 1, 2002... Outpatient management with a low-molecular-weight heparin is the wave of the future for treating deep vein thrombosis. Already prevalent in Europe and Canada, a surge of outpatient programs in the United States is expected in the next 5 years....

Hemorrhoid stapler: Less pain but less effective. (Alternative to Standard Excision).
January 1, 2002... SAN DIEGO -- Surgeons have embraced a vast array of alternatives to excisional hemorrhoidectomy. The explanation is simple: The operation hurts like the dickens. Hemorrhoids have been frozen, heated, strangled with rubber bands, cut with a...

Office hysteroscopy boosts cost efficiency, patient satisfaction. (Routine Use Advocated).
January 1, 2002... BALTIMORE -- Office hysteroscopy should become an integral skill and a routine method of evaluating the uterus, Dr. Linda Bradley said at a symposium on women's health sponsored by Mercy Medical Center. Performing hysteroscopy in the office...

Tension-Free vaginal tape: Follow the rules. (Technical Errors Cause Complications).
January 1, 2002... CHICAGO -- Precise adherence to the tension-free vaginal tape procedure outlined in 1996 should minimize the chance of complications, Dr. Carl G. Klutke said at a Gynecare-sponsored satellite symposium held during the annual meeting of the...

Correct needle insertion sidesteps vascular injury. (Avoid Lateral Rotation).
January 1, 2002... CHICAGO -- Aim for the patient's shoulder, and don't rotate the needle laterally. Those two pieces of advice for performing the tension-free vaginal tape (TVT) insertion procedure were offered by Dr. Tristi W.Muir at the annual meeting of...

TVT may be as effective as burch colposuspension for stress incontinence. (Quicker Recovery).
January 1, 2002... CHICAGO -- Preliminary data suggest that the tension-free vaginal tape procedure is as effective as the Burch colposuspension in the treatment of primary genuine stress incontinence, with a more rapid recovery time. That finding emerged...

Inflammation of the vulva a diagnostic challenge. (Eczema, Contact Dermatitis).
January 1, 2002... PALM BEACH, FLA. -- Chronic inflammation of the vulva may be partly self-induced, but the relentless scratching or rubbing that typically causes it is a normal response to the itching associated with a milder but persistent case of eczema or...

Foam cushions lessen mammography pain. (Image Quality Maintained).
January 1, 2002... CHICAGO -- If you've ever had a patient say that she's never going back for a mammogram because it's just too painful, tune in: Single-use foam cushions significantly reduced the pain from mammograms without compromising image quality,...

Mammography accurate in women with end-Stage renal disease. (Calcifications Don't Impact Results).
January 1, 2002... SAN FRANCISCO -- Women with end-stage renal disease have an increased rate of benign breast calcifications, but these do not interfere with the accurate interpretation of mammograms, Dr. Mario Castellanos said at the annual World Congress of...

Persistent C. trachomatis may foster malignancies. (Lingering Genital Infection).
January 1, 2002... SAN FRANCISCO -- Persistent Chlamydia trachomatis infection in the genital tract may induce susceptibility to gynecologic malignancies, Dr. Steven S. Witkin said at the annual meeting of the Infectious Diseases Society of America. There is...

High-Normal BP raises CV risk. (Primary Care - Stroke).
January 1, 2002... High-normal blood pressure raises the risk of stroke, MI, and heart failure. The increased risk affects both women and men and occurs in all age groups, but is particularly high for the elderly reported Dr. Ramachandran S. Vasan of Boston...

Leading Cancers for Ages 15-30. (Data Watch).
January 1, 2002... DATA WATCH Leading Cancers for Ages 15-30 Percentage of Malignancy All Malignancy Diagnoses Lymphoma 20% Invasive skin cancer...

Human Embryo Cloning. (Practice Trends - Policy Practice).
January 1, 2002... Antiabortion advocates are encouraging lawmakers to pass legislation outlawing the cloning of human beings. This follows an announcement from Advanced Cell Technology (ACT), of Worcester, Mass., that it had cloned a human embryo to derive stem...

Nurse Anesthetist Rule. (Practice Trends - Policy Practice).
January 1, 2002... A new Medicare rule allows states to set the guidelines for physician supervision of certified registered nurse anesthetists (CRNAs). Federal guidelines call for physician supervision of CRNAs, but under the new rule, state governors (in...

Chiropractors as PCPs? (Practice Trends - Policy Practice).
January 1, 2002... Medical groups are speaking out against legislation that would allow patients to choose a chiropractor as their primary care provider in veterans' hospitals. More than one dozen medical groups recently sent a letter opposing such a provision in...

Medicare Fee Schedule Update. (Practice Trends - Policy Practice).
January 1, 2002... A bill being considered by the Senate Finance Committee would decrease the physician pay cut currently included in the 2002 Medicare fee schedule. S. 1660, the Medicare Physician Payment Fairness Act of 2001, would set the 2002 conversion...

Premenopausal Education Study. (Practice Trends - Policy Practice).
January 1, 2002... Nutrition education can successfully change dietary behavior among pre-menopausal woman at risk for cardiovascular disease, according to Karen Chapman-Novakofski, Ph.D., and colleagues at the University of Illinois, Urbana-Champaign. In a...

Patients want the Facts, not a Shoulder to Cry On. (Delivering Bad News).
January 1, 2002... SAN FRANCISCO - When giving bad news, it is more important to appear competent and knowledgeable than empathic, Patricia A. Parker, Ph.D., said at the annual meeting of the American Society of Clinical Oncology. In a survey of 351 patients...

Work-Family Conflict Fuels Physician Burnout. (Major Stressors).
January 1, 2002... MORAN, Wyo. - New insights into the toll on psychological health exacted by work-family conflict hold vital lessons for workaholism-prone physicians, Wayne M. Sotile, Ph.D., said at a conference sponsored by the American College of Cardiology....

Scheduling System. (Products).
January 1, 2002... Compass software is a Web-based scheduling system that can be used on a desktop computer or a personal digital assistant. The system handles tasks involving multiple locations, physicians, or laboratories. Physicians can view their schedules...

Electronic Stethoscope. (Products).
January 1, 2002... The 3M Littmann Electronic Stethoscope Model 4000 provides 18 times the amplification of conventional stethoscopes and can digitally record, store, and transmit sound via infrared to another Model 4000 or to a PC. It has an LCD display in the...

Individualized Weight Loss. (Products).
January 1, 2002... XENICare is a weight loss support program designed to assist patients taking Xenical (orlistat). Initially, patients have a free telephone consultation with a registered nurse or dietitian, then receive ongoing health care counseling by...

Reformulated Pain Treatment. (Products).
January 1, 2002... Percocet 7.5/325 and 10/325 (oxy-codone/acetaminophen tablets) have been approved for the treatment of moderate to severe pain. This reformulated version offers pain relief with a reduced acetaminophen content, compared with previously...

Protective Surgical Gear. (Products).
January 1, 2002... Eye Shieldz, part of a line of six new surgical protective products, come with replacement antifog lenses. The other products include the face shield and the solid side shield, which can clip onto prescription eye glass frames. Reusable...

Managing Endometriosis. (Products).
January 1, 2002... Lupron Depot (leuprolide acetate for depot suspension), 3.75 mg and Lupron Depot-3 Month 11.25 mg are now indicated for the initial management of endometriosis, as well as recurring symptoms, in combination with norethindrone acetate (5 mg...

Injection Pain Blocker. (Products).
January 1, 2002... The ShotBlocker is small blue plastic disk with several short blunt skin contact points on its underside and a centrally located opening through which injections can be administered. Designed to block the pain of routine injections, the device...

Skin-Softening Gloves. (Products).
January 1, 2002... SoftSkin aloe vera gel-coated gloves with vitamin E have been approved by the Food and Drug Administration for use. The medical examination gloves are specially treated to remove harmful allergy-causing proteins and powder-free. The gloves are...

Ciprofloxacin Ordered Online. (Primary Care - Infectious Diseases).
January 1, 2002... The Food and Drug Administration has issued warnings to 11 foreign Internet vendors whom it accuses of attempting to capitalize on anthrax fears by offering ciprofloxacin to American consumers. According to the FDA, the letters were sent...

Early CV Abnormalities. (Primary Care - Diabetes).
January 1, 2002... Cardiac structure and function may be impaired early in the course of type 2 diabetes, and the abnormalities are nor closely related to blood sugar control, Dr. Jennifer E. Liu said at the annual scientific sessions of the American Diabetes...

Untreated Anxiety Disorder. (Primary Care - Mental Health).
January 1, 2002... About half the patients with an anxiety disorder who are seen by a primary care physician remain untreated, based on a study of 504 patients. In dealing with anxiety disorders, primary care physicians need to do a better job of diagnosis...

BP and second stroke risk. (Primary Care - Stroke).
January 1, 2002... Blood pressure reduction cut the risk of a second stroke by 28% over 4 years in a trial that enrolled more than 6,000 patients. Regardless of their starting blood pressures, the blood pressure decrease was associated with similar reductions...

New HIV guidelines released. (Primary Care - Infectious Diseases).
January 1, 2002... The recently updated HIV Counseling, Testing, and Referral Standards and Guidelines place more emphasis on early knowledge of HIV status and on making testing more accessible. The guidelines from the Centers for Disease Control and...

Inhaled insulin: 2 years of use. (Primary Care - Diabetes).
January 1, 2002... Inhaled insulin maintains control of plasma glucose as well as injected insulin, with no diminution of effectiveness after 2 years, Dr. William H. Landschulz said at a meeting sponsored by the Diabetes Research Institute. Dr. Landschulz of...

Herbs carry psychiatric risks. (Primary Care - Mental Health).
January 1, 2002... The use of certain "natural" preparations can have serious psychiatric sequelae, including mania, psychosis, and anticholinergic delirium, Dr. Matthew Faubion said at the annual meeting of the American Academy of Psychiatry and the Law. ...

Balloon Tx works over long term: Ablation results after 5 years.
January 15, 2002... SAN FRANCISCO -- Five-year follow-up data on women with menorrhagia randomized to treatment with either balloon or roller-ball ablation found that bleeding was still well controlled in nearly 70% with either treatment. Those data, obtained...

Anastrozole beats Tamoxifen for early breast cancer: Anastrozole reduced disease recurrence risk by 17%, compared with tamoxifen. (Study of 9,366 Women).
January 15, 2002... SAN ANTONIO -- The aromatase inhibitor anastrozole is markedly more effective and better tolerated than tamoxifen for adjunctive therapy in postmenopausal women with early-stage breast cancer. Those were the major findings of the largest...

Cesarean indicated after Anal sphincter tears: Persistent anal incontinence a problem. (Subsequent Deliveries).
January 15, 2002... CHICAGO -- Anal sphincter tears during vaginal delivery increase the risk for persistent anal incontinence with subsequent vaginal deliveries. Cesarean section should be considered for these women, Dr. Jan Zetterstrom said at the annual...

Risk factors for fetal loss after Amniocentesis are identified. (Large Retrospective study).
January 15, 2002... The risk of fetal loss after amniocentesis is elevated in women aged 40 and over and in those with a history of vaginal bleeding in the current pregnancy or repeated fetal loss, a large retrospective study suggests. Researchers studied...

Service gives meaning. (Guest Editorial).
January 15, 2002... Maintaining physician commitment is one of the most urgent issues facing hospital administrators and medical educators today. Unprecedented numbers of doctors are abandoning practice for administration or taking early retirement. In a...

Do third-generation OCs carry a higher risk of venous thrombosis than second-generation OCs? (PRO & CON).
January 15, 2002... [YES] We systematically put together all the evidence that is available in our metaanalysis (BMJ 323[7305]:131-37, 2001). From that analysis you can clearly see that there is an excess risk when you use third-generation oral...

ACOG releases new guidelines on exercise: 30 minutes per day in pregnancy.
January 15, 2002... NEW YORK -- The American College of Obstetricians and Gynecologists is encouraging healthy pregnant women to kick off the new year with moderately vigorous daily exercise. The college's new guidelines on exercise and pregnancy issued...

No benefit seen with DeLee Suction. (Thick Meconium).
January 15, 2002... Newborn infants who underwent DeLee suction had no improvement in their clinical outcome, compared with those who had bulb suction, a retrospective study suggests. The study included 230 infants, 115 of whom had DeLee suction. The...

Recurrent miscarriage tied to insulin resistance: Check fasting insulin levels.
January 15, 2002... ORLANDO, FLA. -- Women who have had at least two miscarriages are more than twice as likely to have insulin resistance as those without recurrent pregnancy loss, according to results of a study of 172 women. "The women in my study had...

Infuse Terbutaline to prolong Triplet gestations. (Continuous Drug Delivery).
January 15, 2002... Triplet pregnancy can be prolonged for a longer period with continuous subcutaneous terbutaline infusion than with oral terbutaline, said Dr. John P. Elliott of the Good Samaritan Medical Center, Phoenix, Ariz., and his colleagues. In...

Alloimmune Thrombocytopenia: Tx and diagnosis. (Gamma Globulin Effective).
January 15, 2002... SARASOTA, FLA. -- Alloimmune thrombocytopenia is one of the true success stories in maternal-fetal medicine, Dr. Richard L. Berkowitz said at a symposium on high-risk pregnancy sponsored by Symposia Medicus. Recent advances in...

Preeclampsia easily confused with a wide range of syndromes: Acute Fatty Liver, Thrombophilias.
January 15, 2002... PALM BEACH, FLA. -- The clinical presentation of a range of medical syndromes can easily be confused with that of severe preeclampsia, Dr. Baha Sibai said at the annual meeting of District V of the American College of Obstetricians and...

Data watch: Leading causes of Neonatal death, 1999.
January 15, 2002... DATA WATCH Leading Causes of Neonatal Death, 1999 Percent of Deaths Total Deaths (%) Disorders Related to Short...

Transvaginal Hydrolaparoscopy advocated: Evaluates infertility, pelvic pain.
January 15, 2002... SAN FRANCISCO -- Transvaginal hydrolaparoscopy is a simpler, safer, and cheaper alternative to hysterosalpingography and transabdominal laparoscopy for the evaluation of infertility or gynecologic problems. That's the assessment of two...

Nasogastric decompression treats Small-Bowel obstruction: Expectant management usually successful.
January 15, 2002... SAN DIEGO -- Small-bowel obstruction after abdominal surgery can be expectantly managed using nasogastric decompression, Dr. Sharif H. Ellozy said at the annual meeting of the American Society of Colon and Rectal Surgeons. Within 6 days,...

Once-daily Tolterodine treats overactive bladder: More effective than twice-daily version.
January 15, 2002... CHICAGO -- Once-daily tolterodine 4 mg is an effective, well tolerated, and convenient therapy for overactive bladder in women, two investigators said in separate presentations at the annual meeting of the American Urogynecologic Society. ...

Moderate exercise rarely increases incontinence: Obesity, family history are exceptions.
January 15, 2002... CHICAGO -- Moderate exercise is not likely to increase the risk for urinary incontinence in women unless they are obese or have a family history of urinary incontinence, Dr. Dallas Johnson said at the annual meeting of the American...

Parity linked to OAB with urge incontinence. (Neurologic Damage).
January 15, 2002... CHICAGO -- Parity maybe a risk factor for overactive bladder with urge incontinence, Dr. Julia B. VanRooyen reported at the annual meeting of the American Urogynecologic Society. This conclusion is consistent with the theory that local...

FDA approves home test kit for menopause: Experts question its value.
January 15, 2002... The Food and Drug Administration has approved the first-ever home urine test designed to help women determine if they have approached menopause. But experts interviewed for this story questioned the value of the test, which is manufactured...

Atherosclerosis protection afforded to some. (Estradiol Therapy).
January 15, 2002... ASHLAND, ORE. -- Obese postmenopausal women on lipid-lowering therapy appear to derive no additional protection against atherosclerosis when they take unopposed estradiol, but obese and nonobese women with normal cholesterol levels do seem to...

Perioral herpes healing. (Dermatology).
January 15, 2002... Docosanol 10% cream (Abreva) applied five times per day effectively reduces the symptoms of recurrent perioral herpes sores, said Dr. Stephen L. Sacks of the University of British Columbia, Vancouver, and his colleagues. Docosanol can be...

Cost-effective acne rreatment. (Dermatology).
January 15, 2002... Azelaic acid cream plus benzoyl peroxide gel is a cost-effective alternative to benzoyl peroxide / erythromycin gel for acne treatment, Dr. Barry Solomon reported in a poster session at the annual meeting of the American Academy of Dermatology....

Systolic HT in the elderly. (Hypertension).
January 15, 2002... Treating isolated systolic hypertension in the elderly may be the single greatest contribution that primary care physicians can make to the nation's health, Dr. Lee A. Green said at the annual meeting of the American Academy of Family...

Combination HT Therapy. (Hypertension).
January 15, 2002... The combination of an angiotensin receptor blocker plus hydrochiorothiazide is a more cost-effective treatment for hypertension than an angiotensin receptor blocker alone, Daniel E. Hilleman, Pharm.D., said in a poster presentation at the...

Fingernail police are coming. (Infectious Diseases).
January 15, 2002... Long fingernails spread nosocomial infections, Dr. Shelly A. McNeil reported at the annual meeting of the Infectious Diseases Society of America. Nails extending more than 3 mm beyond the fingertip are more likely to harbor pathogens and...

Gloves not a perfect barrier. (Infectious Diseases).
January 15, 2002... Gloves are an important way to reduce infection transmission, but they are not the 100%-effective barrier many assume them to be, Dr. Curtis P. Hamann said at the annual meeting of the Pacific Dermatologic Association. Latex gloves are...

Affordable software keeps info at your fingertips. (Handheld Computers).
January 15, 2002... ATLANTA -- A myriad of medical software for handheld computers can help you organize, schedule, code, calculate, dose, and track, speakers said at the annual meeting of the American Academy of Family Physicians. Many popular programs can be...

Operating System drives choice between handheld computers. (Palm VS. Windows CE).
January 15, 2002... ATLANTA -- The two main choices of handheld computer operating systems each have tradeoffs for physicians, according to experts. Computers that use the Palm operating system--which runs PalmPilot, Handspring Visor, and similar handheld...

Report card on women's health. (Policy Practice).
January 15, 2002... Most states and the United States overall are failing to meet the health needs of women, a new report says. Making the Grade on Women's Health, a National and State-by-State Report Card from the National Women's Law Center, University of...

Ob. Gyns. and managed care. (Policy Practice).
January 15, 2002... OB.GYNS. AND MANAGED CARE Ninety-five percent of ob.gyns. participate in managed care plans, according to a survey of fellows of the American College of Obstetricians and Gynecologists. The survey, conducted in 1998, was designed to assess the...

Antiabortionist is arrested. (Policy Practice).
January 15, 2002... Fugitive antiabortion extremist Clayton Lee Waagner, the primary suspect in the mailing of anthrax threats to reproductive health clinics in October and November, has been arrested, the Department of Justice says. Waagner was one of the FBI's...

Access to contraception. (Policy Practice).
January 15, 2002... While progress has been made in requiring insurance companies to cover contraception, states still aren't doing enough to ensure adequate access to it, a National Abortion and Reproductive Rights Action League report says. Only eight states...