OB GYN News articles from January 2003

OB GYN News archives from January 2003

OC-Clomiphene Tx aids Ovulation. (Randomized, Controlled Trial).
January 1, 2003... RANCHO MIRAGE, CALIF.--Ovulation and pregnancy rates soared in women who had previously failed clomiphene citrate--based infertility therapy when they received 2 months of monophasic oral contraception before trying clomiphene again, Dr. Emmett...

Raloxifene linked to decreased risk of stroke, TIA: findings based on a subgroup of women at high risk for cardiovascular disease. (Postmenopausal Women).
January 1, 2003... CHICAGO--Treatment with raloxifene continues to show an ability to protect against cardiovascular events in postmenopausal women, based on additional post hoc analyses of data collected in a large osteoporosis trial. The cardiovascular...

New rapid group B strep test has 94% sensitivity: laboratory staffing an issue for hospitals. (Results in 1 Hour).
January 1, 2003... A newly approved rapid lab test for group B streptococcus could help address the problem of determining colonization status at the time of delivery in women who have not been tested and are in preterm labor or have not had prenatal care. ...

FDA approves novel osteoporosis treatment. (First Agent to Stimulate Bone Formation).
January 1, 2003... The Food and Drug Administration has approved the first osteoporosis treatment that stimulates new bone formation. Teriparatide, manufactured by Eli Lilly & Co. and marketed as Forteo, is a portion of human parathyroid hormone, which is the...

Clinical factors flag women with high fracture risk. (Osteopenic, Postmenopausal Women).
January 1, 2003... SAN ANTONIO -- A series of four simple, clinical factors can identify postmenopausal women with osteopenia who face the highest risk of a bone fracture. The most powerful of these predictors is a prior history of fracture, Dr. Paul D....

The death of common sense. (Guest Editorial).
January 1, 2003... The legal tort system of America is corroding the fabric of our society, and we need a radical overhaul of the underlying philosophy. The harm to society of our tort system is not the occasional crazy verdict, but the fear and distrust of...

Correction.
January 1, 2003... In a study, a total of 13% of surveyed pharmacists called emergency contraception a form of abortion ("Many Pharmacists Lack Knowledge About ECs," Nov. 1, 2002, p. 13).

Should the federal government become more involved in vaccine manufacture and distribution? (Pro & Con).
January 1, 2003... YES I do not believe that market forces alone will satisfy this country's need for routine childhood and adult vaccines, or vaccines related to bioterrorism. Government participation is necessary to ensure that public health remains the...

Drug update: hormone replacement therapy.
January 1, 2003... Management of the menopausal woman is more of an art than a science. For patients plagued by urogenital atrophy or vasomotor symptoms, such as hot flashes, night sweats, and insomnia, female hormones are among the most effective treatments. ...

Temporary amenorrhea found attractive in survey. (Convenience an Issue).
January 1, 2003... SAN DIEGO--Temporary amenorrhea was an attractive option to most of the military women who participated in a recent survey at the Walter Reed Army Medical Center in Washington, D.C., Capt. Nicole Powell-Dunford, MC, USA, reported. ...

Recurrent vaginitis: beat it back, then suppress it. (Intermittent Antimicrobial Therapy).
January 1, 2003... INDIANAPOLIS -- A key concept in dealing with women with recurrent vaginitis is to treat until they are asymptomatic and then suppress with intermittent antimicrobial therapy, according to Dr. David Soper, a vaginitis expert. "They need to...

Allograft may augment prolapse repair. (2-Year Follow-up of Seven Patients).
January 1, 2003... SAN FRANCISCO--A 2-year follow-up study of seven patients found that dermal allografts used to augment prolapse repairs integrated well with the patients' tissue and showed no signs of rejection. Many gynecologic surgeons have begun using...

Two-trocar technique for large uteri. (LAVH).
January 1, 2003... NEW ORLEANS--A two-trocar technique can be safe and effective for laparoscopically assisted vaginal hysterectomy in women with uteri over 200 g, Dr. Marlan Schwartz said at an international congress sponsored by the Society of Laparoendoscopic...

Metastases risk highest in those with ascites. (Laparoscopy).
January 1, 2003... NEW ORLEANS--The risk of port-site metastases in those undergoing laparoscopy for gynecologic malignancy was highest in those with ascites in a study of 82 patients. The study participants underwent 87 procedures that involved 330 trocar...

Forceps linked to levator ani problems. (Vacuum Also Implicated).
January 1, 2003... SAN FRANCISCO--Having an operative vaginal delivery nearly quadrupled a woman's risk of developing an abnormality of the levator ani muscle--an important muscle for pelvic organ support--in a study of 280 women. An operative vaginal...

Family history of breast cancer makes women reluctant to use genetic tests. (Less Than 50% of Americans Know of Tests).
January 1, 2003... BALTIMORE -- About 44% of U.S. adults are aware that genetic rests exist that can identify people with inherited cancer susceptibility, based on a survey of more than 27,000 people. But many women with a personal or family history of breast...

Vulvar melanoma can strike younger women. (Case Report).
January 1, 2003... PORTO, PORTUGAL -- Despite its reputation as a malignancy of elderly females, vulvar melanoma also can occur in younger women, Dr. Patricia Santos reported. at the 23rd Congress of the International Society for Dermatologic Surgery. A...

BRCA1 mutations tied to raised risk of other cancers. (Beyond Breast Cancer).
January 1, 2003... Women carrying BRCA1 mutations had approximately twice the overall risk of developing cancer at sites other than the breast or ovary in a cohort study of almost 12,000 people. Compared with the general population, women with RRCA1 mutations...

Investigational genetic screen may predict chemotherapy responders. (Ovarian Cancer).
January 1, 2003... BALTIMORE -- A genetic screen for two metabolic enzymes identified women with ovarian cancer who did not respond to treatment with paclitaxel in a preliminary study with 41 patients. This is the first time that a genetic screen for...

Ultrasound 3-D imaging correlates with hysteroscopy. ('Feasible and Fast').
January 1, 2003... NEW YORK--Three-dimensional ultrasound results correlated well with hysteroscopy findings and provided more diagnostic information than was obtained through two-dimensional ultrasound in a prospective study of 28 gynecologic patients. ...

Endometriosis accounts for most cases of pelvic pain. (Empiric Therapy an Option).
January 1, 2003... NEW ORLEANS--Gynecologic sources--most often endometriosis--accounted for the vast majority of chronic pelvic pain cases in a recent case series. The findings suggest that empiric therapy for chronic pelvic pain, rather than diagnostic...

Speculum lubricant appears not to affect pap smear. (Reconsider Dogma?).
January 1, 2003... SAN DIEGO--When it comes to reading Pap smears, it doesn't matter if you lubricate the speculum, Dr. J. Scott Pies said at the annual meeting of the American Academy of Family Physicians. In a pilot study conducted at Indiana University,...

Physical therapy may bring relief to patients with chronic pelvic pain. (Urinary, Sexual Function Improved).
January 1, 2003... SAN DIEGO--When managing a patient with chronic pelvic pain, consider a referral to a physical therapist, Dr. James C. Lukban recommended at a meeting sponsored by the International Pelvic Pain Society. A regimen of physical therapy...

Focused US treats fibroids in phase II study. (Successful in 43 of 55 Women).
January 1, 2003... NEW YORK--Focused ultrasound guided by MRI accurately treated 43 of 55 women with uterine fibroids in a multi-center phase II study prompting initiation of a phase III clinical trial. This procedure may provide a less painful and less...

Cytokines may predict funisitis in PPROM. (Maternal Serum Examined).
January 1, 2003... BANFF, ALTA.--Levels of certain cytokines in maternal serum may help predict which patients with preterm premature rupture of the membranes are likely to develop funisitis. In the setting of preterm premature rupture of the membranes...

Metformin may block gestational diabetes. (Polycystic Ovary Syndrome).
January 1, 2003... CHICAGO -- Treatment with metformin appeared to cut the risk of gestational diabetes in a study of 72 women with polycystic ovary syndrome. The women together had a total of 76 pregnancies during which they were treated with metformin; the...

Your arrested labor prediction may be wrong. (Presumed Risk Factors).
January 1, 2003... RANCHO MIRAGE, CALIF. -- Two unnecessary cesarean sections would be performed for every woman spared a long and unproductive labor if maternal age, height, and estimated neonatal birth-weight were used to predict which patients would have an...

Inhaled steroids for Asthma appear safe in pregnancy. (Concerns Raised With Oral Steroids).
January 1, 2003... SAN ANTONIO -- Accumulating data suggest that the use of inhaled corticosteroids to treat asthma does not pose an increased risk to the fetus, Dr. Michael Schatz said at an AstraZeneca-sponsored symposium held at the annual meeting of the...

Eating disorders. (Drugs, Pregnancy, and Lactation).
January 1, 2003... Eating disorders are highly prevalent in the general population, certainly more so in women, appearing to peak during the childbearing years. While we tend not to see pregnant women with anorexia nervosa because they have secondary reproductive...

Postpartum hemorrhage responds to new txs. (Medical Therapy, Other Techniques).
January 1, 2003... SARASOTA, FLA.--Most cases of postpartum hemorrhage will respond to medical therapy, and several other techniques are also proving useful, Dr. Gary A. Dildy III said at a perinatal symposium sponsored by Symposia Medicus. Among the...

Mastering the many complications of pregnancy in the obese patient. (VBAC Especially Risky in this Population).
January 1, 2003... SARASOTA, FLA. -- Obesity is the most common chronic condition complicating pregnancies in developed countries. Up to 10% of pregnant women are obese, weighing at least 200 pounds, and up to 3% are massively obese, weighing at least 300...

Induction linked to doubling of cesarean rate in nulliparas. (Data from one Hospital System).
January 1, 2003... RANCHO MIRAGE, CALIF. -- The cesarean delivery rate doubled when nulliparous women were induced in a large community hospital system, Dr. David P. Johnson reported at the annual meeting of the Pacific Coast Obstetrical and Gynecological...

Subcutaneous drain used in obese gravidas. (Cesarean Delivery).
January 1, 2003... SARASOTA, FLA. -- Use of a subcutaneous drain appears to result in improved outcomes in obese gravidas undergoing cesarean delivery, Dr. Haywood L. Brown said at a perinatal symposium sponsored by Symposia Medicus. At least one...

PA study of liability crisis. (Policy & Practice).
January 1, 2003... One-sixth of Pennsylvania's ob.gyns. have either retired early left the state, given up high-risk procedures, or gone to part-time practice to avoid skyrocketing liability insurance premiums, a survey from the Pennsylvania Medical Society says....

Panel reviews embryo donation ethics. (Policy & Practice).
January 1, 2003... Use of spare embryos for research is ethical if the research will benefit human health, an ethics panel of the American Society for Reproductive Medicine says. Ethical research requires that couples give informed consent to donate spare...

Kopp confession. (Policy & Practice).
January 1, 2003... James C. Kopp's assertion that he did not intend to kill Dr. Barnett Slepian, only wound him; is an attempt to garner sympathy for his, antiabortion views, Gloria Feldt, Planned Parenthood president, says in a statement. "Kopp's confession is a...

Phthalates and birth defects. (Policy & Practice).
January 1, 2003... A cosmetics review panel has found no link between phthalates in cosmetics and birth defects in males. The Cosmetic Ingredient Review, a Washington, D.C.-based organization, launched a yearlong review of the safety of phthalates in cosmetics,...

Physicians in FTC's scope. (Policy & Practice).
January 1, 2003... The Federal Trade Commission's health care antitrust efforts in the coming year will be focused in three areas: pharmaceuticals, physicians, and hospitals, an antitrust attorney said at a meeting of the Washington Legal Foundation. The United...

Hope endures for Medicare relief early this year. (Delay in Fee Schedule Until February).
January 1, 2003... WASHINGTON -- Medical organizations are hoping that an unprecedented delay in the 2003 Medicare physician fee schedule will buy them some time to lobby for legislation to fix the flawed payment formula. Citing various problems--including...

New medical school will train physician-investigators. (Developed to Mitigate Shortage).
January 1, 2003... Are you an accomplished, enthusiastic physician-investigator who can inspire medical students to chase their dream of advancing biomedical research and clinical practice? If so, you might fit the bill to be a guest lecturer for students on...

FDA approves over-the-counter status for the antihistamine claritin. (Allergic Rhinitis).
January 1, 2003... The Food and Drug Administration has approved a change to over-the-counter status for the antihistamine Claritin (loratadine) for treatment of the symptoms of allergic rhinitis. Manufactured by Schering-Plough, the antihistamine was slated...

Colorectal cancer screening. (Women's Health Adviser).
January 1, 2003... Cancer experts are calling on ob.gyns. to promote colon cancer screening, saying that they are in a unique position to help decrease deaths from this highly curable disease. About 80% of women think of their ob.gyn. as their primary care...

Mobile bone assessment. (Products).
January 1, 2003... A new portable bone assessment device for osteoporosis management is now available. The Omnisense 8000S allows for radiation-free measurements at multiple skeletal sites. The compact, self-contained device is based on a Microsoft Windows...

Nicotine lozenges. (Products).
January 1, 2003... Commit (nicotine polacrilex) lozenges (2 mg and 4 mg) are now available for over-the-counter use by adults aged 18 years and older to reduce the withdrawal symptoms, including nicotine craving, associated with smoking cessation. For more...

Synthetic hormone. (Products).
January 1, 2003... Thyro-Tabs (levothyroxine sodium) have been approved for the treatment of hypothyroidism and the suppression of thyroid-stimulating hormone. They are available in a variety of strengths ranging from 25 to 300 [micro]g. For more information,...

Adhesive tape pack. (Products).
January 1, 2003... The Assorted Size Institutional Pack for Megazinc Pink adhesive tape contains eight 1/2 inch and eight 1-inch rolls-the sizes most often used in clinical settings. Megazinc Pink is a latex-free, waterproof, zinc oxide-based adhesive tape that...

IBD newsletter. (Products).
January 1, 2003... IBD Watch is a free one-page fax newsletter covering important developments in the treatment of inflammatory bowel disease. The newsletter offers brief summaries of recently published peer-e viewed research and is distributed monthly. To...

Adjunct diabetes Rx. (Products).
January 1, 2003... Avandamet (rosiglitazone maleate/metformin) is approved as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus, who are already treated with a combination of rosiglitazone and metformin, or who...

Chronic vulvar pain CD. (Products).
January 1, 2003... A CD-based teaching tool about chronic vulvar pain is now available from the National Vulvodynia Association (NVA). The CD includes a presentation entitled "Vulvodynia: Integrating Current Knowledge Into Clinical Practice," a self-help handout...

Safety scalpels. (Products).
January 1, 2003... DeRoyal has introduced seven disposable safety scalpels and a safety blade remover for blades with reusable metal handles. The scalpels are fully retractable, as well as color coded to identify the blade type. Full retraction will help minimize...

AMA delegates want Medicare fix. (Flawed Payment Formula).
January 15, 2003... NEW ORLEANS -- Wearing white lab coats and waving colorful signs, physicians at the interim meeting of the American Medical Association's House of Delegates protested the flawed Medicare payment formula and vowed to lobby Congress to get it...

HRT fails again in two secondary prevention studies: findings show worsening of preexisting heart disease or no cardiac benefit. (Older Postmenopausal Women).
January 15, 2003... CHICAGO -- The results of two more studies of estrogen therapy in postmenopausal women with coronary artery disease continued the losing streak of this once promising approach. Both studies involved relatively small numbers of women, and...

High U.S. mastectomy rate reported in landmark trail: pegged at 51% for early-stage disease. (Contrary to NCI Recommendations).
January 15, 2003... SAN ANTONIO -- American women with early-stage breast cancer were 21% more likely to undergo mastectomy, compared with those from the United Kingdom in the largest clinical trial of breast cancer therapy ever conducted. This is a...

FDA approves uterine artery embolization beads. (Symptomatic Uterine Fibroids).
January 15, 2003... The use of miniature acrylic copolymer beads in uterine artery embolization has been approved by the Food and Drug Administration for treating symptomatic uterine fibroids. The material, Embosphere Microspheres, manufactured by Biosphere...

Federal smallpox initiative puts focus on physician education. (Voluntary for Medical Personnel).
January 15, 2003... Physician education about smallpox vaccination has become a priority for both the public and private health sectors now that President Bush has announced his plan to reintroduce the vaccine into the U.S. population. In mid-December, the...

Office-based surgery regulation. (AMA Briefs).
January 15, 2003... By Feb. 1, the AMA should convene a work group of specialty societies and state medical associations interested in developing guidelines and model state legislation for assuring the quality of office-based surgical procedures that require...

CIGNA settlement. (AMA Briefs).
January 15, 2003... The AMA has taken no official position regarding the class action lawsuit Kaiser v. CIGNA et al, or the proposed settlement. In response to widespread confusion on the issue, the delegates agreed to "state [the AMA's position] unequivocally"...

E-mail with patients. (AMA Briefs).
January 15, 2003... Physicians must use the same caution for patient confidentiality when communicating via e-mail as they do when using other forms of communication, the delegates agreed. They adopted recommendations from a Council on Ethical and Judicial Affairs...

Clinical skills assessment. (AMA Briefs).
January 15, 2003... Clinical skills assessment should fall under the purview of accredited medical schools and should be conducted using a "rigorous and consistent examination," rather than as part of evaluation for licensure, delegates agreed. Plans by the...

Racial and ethnic disparities. (AMA Briefs).
January 15, 2003... Despite advances in health care, racial and ethnic disparities in the quality of care remain a significant problem that should not be tolerated, the delegates said. They concurred with the findings of a Council on Medical Service report...

HIV/STD prevention strategies. (AMA Briefs).
January 15, 2003... Don't standby while HIV and STD prevention programs are eliminated, delegates urged the AMA. The Centers for Disease Control and Prevention recently removed a condom information sheet and a sex education curriculum from its Web site, and $135...

Study supports screening mammography. (Women Aged 40 Years and Older).
January 15, 2003... CHICAGO -- Anew study provides additional evidence of the value of breast cancer screening with mammography for women 40 and older, Dr. Gary M. Freedman said during the annual meeting of the Radiological Society of North America. Among...

Letters.
January 15, 2003... 'Service to the Community' It would seem from Dr. Abraham L. Halpern's guest editorial, "Participation in Executions,"(Nov. 15, p. 8) that if a person is sentenced to death and in the process experiences any discomfort, then the...

Pro & Con: should nuchal translucency measurements be done routinely?
January 15, 2003... YES The new standard has shifted from screening for Down syndrome at 16 weeks' gestation to screening at 12 weeks' gestation using nuchal translucency measurements. Nuchal translucency thickness is the best single marker in screening for...

Early data suggest valproate-birth defect link. (Preliminary Findings from Registry).
January 15, 2003... SEATTLE -- Sodium valproate had the highest rate of birth defects of any of 12 antiepileptic drugs during the first 30 months of an Australian epilepsy/pregnancy registry. A total of 132 epileptic patients were exposed to valproate during...

Study shows dry eyes a problem in pregnancy. (Androgen Deficiency).
January 15, 2003... NEW ORLEANS -- A significant proportion of women report dry-eye symptoms during pregnancy especially when they have had at least one previous birth, Joel Schechter, Ph.D., reported. He and his associates conducted a pilot study of 33 women,...

Case reports suggest placental invasion is on the increase. (Hike in C-Sections may be Responsible).
January 15, 2003... SARASOTA, FLA. -- Placental invasion is not the most common cause of postpartum hemorrhage, but it is occurring more frequently and it has the highest association with maternal complications resulting from postpartum hemorrhage, according to...

Molecular karyotyping offers genetic blueprint of fetus. (Investigational Technique).
January 15, 2003... BALTIMORE -- Genetic technology has now provided a new way to do prenatal genetic screening: molecular karyotyping. A genomic microarray that is in development allows analysis of a fetal genetic specimen at 1,400 different spots of the...

Some fear vaginal breech deliveries may become obsolete. (Disagreement with ACOG).
January 15, 2003... SEA ISLAND, GA. -- The art of delivering breech fetuses vaginally is likely to be lost within the next decade, given the stance taken by the American College of Obstetricians and Gynecologists in a committee opinion issued in 2001. With...

Legal Abortions declined in the 1990s. (Data Watch).
January 15, 2003... DATA WATCH Legal Abortions Declined in the 1990s Number of Rate of Abortions Legal Abortions per 1,000 Women in Millions Aged 15-44 Years 1991 1.38 24 1993 1.33 ...

Forceps associated with severe perineal tears. (Risk Increased 12-Fold).
January 15, 2003... SAN FRANCISCO -- The risk for a third-or fourth-degree perineal tear increased 12-fold in women who underwent forceps-assisted deliveries in a retrospective study of 267 vaginal births. In a separate study of 148 nulliparous women who...

Patients rarely advised on food-borne illnesses. (Discussed by 20% of Obstetricians Surveyed).
January 15, 2003... ATLANTA -- Obstetricians need to do a better job educating their pregnant patients about food-borne illnesses, Stepy Thomas said in a poster presentation at an international conference on emerging infectious diseases sponsored by the Centers...

After 21 weeks, Amniocentesis still 'fairly safe'. (Rate of Nonlethal Complications was 3%).
January 15, 2003... NEW YORK -- Amniocenteses performed after 21 weeks' gestation caused nonlethal complications in 3% of 365 procedures, but other invasive prenatal procedures done after 21 weeks were riskier, Dr. Alain Gagnon reported. The findings came...

Early-pregnancy glucose screen shows promise. (14-18 Weeks).
January 15, 2003... Glucose screening for gestational diabetes at up to 18 weeks' gestation may be an effective alternative to testing during the third trimester in certain cases, said Dr. Gerard C. Nahum of Duke University, Durham, N.C., and his associates. ...

Alternative Tx for hyperemesis gravidarum. (Review of the Data).
January 15, 2003... SARASOTA, FLA. -- Several alternative regimens appear to be beneficial for the treatment of hyperemesis gravidarum, Dr. Roger B. Newman said at a perinatal symposium sponsored by Symposia Medicus. Alternative regimens can be difficult to...

Anxiety not linked to breast cancer outcomes. (No Effect on Distant Metastasis, Death).
January 15, 2003... SAN ANTONIO -- Psychosocial factors aren't related to outcome in women with early-stage breast cancer, Dr. Pamela J. Goodwin reported at a breast cancer symposium sponsored by the San Antonio Cancer Institute. Contrary to popular belief,...

Cervical Ca rate remains higher in Hispanic women. (Data from 1992 to 1998).
January 15, 2003... The incidence of invasive cervical cancer decreased significantly among Hispanic women (by 4.4%) and among non-Hispanic women (by 2.0%) between 1992 and 1999, the Centers for Disease Control and Prevention reported. But despite those...

More data support breast-conserving surgery. (Phase I or II Cancer).
January 15, 2003... CHICAGO -- Follow-up to a National Cancer Institute trial indicates a modified radical mastectomy is no better for women with phase I or II cancer than breast-conserving surgery These results echo the recently released findings of a 20-year...

Hot flash relief associated with use of acupuncture. (Pilot Study).
January 15, 2003... EXETER, ENGLAND -- Acupuncture was associated with a reduction in the frequency and severity of hot flashes in women being treated with tamoxifen for breast cancer. In a pilot study, 47 women with a primary diagnosis of breast cancer and a...

Laser device may illuminate cervical Ca. (Under Investigation).
January 15, 2003... ATLANTA -- Clinicians may someday have a less invasive and faster way to detect cervical dysplasia than the Pap smear test, according to initial results of an ongoing study using Raman spectroscopy Physicians would shine a laser light probe...

OTC product may ease urinary urge incontinence. (Milk of Magnesia Beats Placebo in Trial).
January 15, 2003... SAN FRANCISCO -- A wee bit of milk of magnesia may be just the thing to treat urinary urge incontinence, Dr. Ralph R. Chesson Jr. suggested at the annual meeting of the American Urogynecologic Society. A randomized, double-blind,...

Weight loss linked to 53% drop in urinary incontinence episodes. (Study of Moderately Obese Women).
January 15, 2003... SAN FRANCISCO -- Overweight or moderately obese women with urinary incontinence decreased their incontinence episodes by 53% following a 3-month weight loss program in a randomized study of 47 women. Women who were randomized to...

More incontinence seen after kidney transplantation. (Prevalence Rises from 6% to 28%).
January 15, 2003... SAN FRANCISCO -- The prevalence of urinary incontinence in 100 women increased from 6% to 28% after kidney transplantation, Dr. Michael Heit reported at the annual meeting of the American Urogynecologic Society. The study fills a gap in...

Breast arterial calcification may flag heart disease. (Established Markers Pose Much Higher Risk).
January 15, 2003... CHICAGO -- Researchers have identified the threshold level of breast arterial calcification that's associated with a 20% increased risk for coronary artery disease in women. Calcium deposits in the arteries of the breast therefore may be...