OB GYN News articles from July 2001

OB GYN News archives from July 2001

Pituitary Tumors In 20% of Adults.
July 1, 2001... SAN ANTONIO -- One in five adults has a pituitary tumor, according to a metaanalysis of nine carefully designed autopsy and radiographic studies. "About one-third of these [tumors] may result in pituitary excess syndromes," with symptoms...

Low-Dose HRT Cuts Hot Flashes, Protects Bones.
July 1, 2001... Fewer adverse effects seen with low-dose regimen, which may improve compliance. WASHINGTON -- Low-dose HRT is as effective as conventional higher-dose therapy in decreasing both the number and severity of hot flashes and in raising bone...

Peripheral Densitometry Predicts Fracture Risk.
July 1, 2001... Heel, forearm, finger sites equally predictive. CHICAGO -- Bone densitometry readings at the heel, forearm, and finger are all about equal in their ability to help physicians identify white women at risk of fracturing any of their hones...

VITAL SIGNS.
July 1, 2001... VITAL SIGNS Top 10 Drugs in Year 2000 Retail Sales * 2000 Avg. Annual % 2000 Sales Price per % Change Change in (In Billions) Prescription In Price Utilization...

Less Blood Loss With Harmonic Scalpel Than Unipolar Cautery.
July 1, 2001... RANCHO MIRAGE, CALIF. -- The harmonic scalpel is associated with less blood loss than unipolar cautery for uterine incisions performed during laparoscopic myomectomy, Dr. Andrew Harper reported. In a retrospective cohort study of 166...

FROM THE FRONT LINE Losing the Future.
July 1, 2001... As ob.gyns. we tend to deal with death more frequently than most other physicians. Since most of these deaths we encounter occur in the first trimester of pregnancy, however, we may not give them the importance they deserve. Psychologists...

Back and Forth.
July 1, 2001... Dear Dr. Weinberg: I read with interest your column "A Look Forward to the Past" (From the Front Line, April 1, 2001, p. 5). I have been doing supracervical hysterectomies on appropriate cases for the past 5-6 years. In addition to...

PRO & CON.
July 1, 2001... Is Accutane overprescribed? YES Acne may be discomforting, even debilitating, but severe birth defects are truly tragic. There is no question that Accutane is overprescribed. The number of prescriptions written annually rose from...

LETTERS.
July 1, 2001... Centralize Credentialing In 4 years as a locum tenens physician, I've filled out at least 15 credentialing applications asking for the same information. Much of it, such as my high school transcripts from 30 years ago, is irrelevant. All...

Study Finds Misoprostol Safe for Some VBAC Cases.
July 1, 2001... CHICAGO -- Despite published reports and committee opinions to the contrary, careful misoprostol use in select [patients undergoing vaginal birth after cesarean section is safe, according to the author of one of the largest studies to date to...

Color Flow Doppler Guides Ectopic Management.
July 1, 2001... MAUI, HAWAII -- Transvaginal ultrasound can be helpful not only in diagnosing ectopic pregnancy but in guiding management of the disorder, Dr. Bill Yee said at a conference on ob.gyn. ultrasound sponsored by the University of California,...

Fetal Heart Rate Abnormalities Higher With Cytotec Inductions.
July 1, 2001... SAN DIEGO -- Cytotec was more effective for cervical ripening and labor induction with an unfavorable cervix than were two forms of dinoprostone, but it was associated with a higher incidence of fetal heart tracing abnormalities. In a...

Ropivacaine Linked to Fewer First-Stage Cesareans.
July 1, 2001... SAN DIEGO -- Women who received ropivacaine as the analgesic agent in a walking epidural had fewer first-stage cesarean deliveries than those who received bupivacaine, Dr. David Campbell said at the annual meeting of the Society for Obstetric...

Bacteria Can Flourish in Hospital Whirlpools.
July 1, 2001... SAN DIEGO -- Women in labor who sit in whirlpools are not alone in the tub. Whirlpools available to women for relaxation during labor may contain bacteria that are not eliminated by hospital cleaning protocols, Dr. Ingrid M. Browne said in...

Breast-Feeding Not Affected by Walking Epidural.
July 1, 2001... SAN DIEGO -- Babies of mothers who received an ultralow-dose "walking" epidural showed no negative effects in their ability or willingness to breast-feed, Dr. Sue Reid said at the annual meeting of the Society for Obstetric Anesthesia and...

Pyogenic Sacroiliitis Dx Delayed in Pregnancy.
July 1, 2001... ARLINGTON, VA. -- The diagnosis of pyogenic sacroiliitis is "always" delayed when the condition arises in pregnancy or peripartum because the hallmark symptoms--hip or buttock pain and tenderness over the sacroiliac joint--are initially...

Erythromycin Can Prolong Pregnancy, Improve Neonatal Outcomes in pPROM.
July 1, 2001... Erythromycin has beneficial effects on the neonate when administered to a woman with pDreterm, premature rupture of the membranes, according to findings from two large trials. But antibiotics are unwarranted in patients in preterm labor...

Antidepressants and Neurodevelopment.
July 1, 2001... There is no evidence that selective serotonin reuptake inhibitors increase the risk of malformations in babies exposed to these drugs in utero. In 1993 we published a study that did not find an excess of birth defects in the babies of women who...

Procedure May Make Office Sterilization Possible.
July 1, 2001... CHICAGO -- A novel method of occluding fallopian tubes may someday make sterilization an office-based procedure, Dennis R. Stewart, Ph.D., said during the annual meeting of the American College of Obstetricians and Gynecologists. The...

Two Serotonergic Antidepressants, Novel OC Promising for PMS, PMDD.
July 1, 2001... CHICAGO -- Research on agents to ease menses-triggered, psychological and physiologic symptoms received considerable attention at the annual meeting of the American College of Obstetricians and Gynecologists. "Premenstrual symptoms occur...

Try Biopsy, Imaging Before More Invasive Tests.
July 1, 2001... CHICAGO -- Office-based sonohysterography and endometrial biopsy may help some patients avoid more invasive surgical procedures such as D & C and hysteroscopy in the evaluation of abnormal uterine bleeding. In a recent study 113 patients...

Ovarian Ablation, Suppression May Aid Ca Therapy.
July 1, 2001... SAN FRANCISCO -- Ovarian ablation or suppression shows promise as an adjuvant therapy in breast cancer, particularly in premenopausal women with receptor- positive lesions. In fact, the positive effect of adjuvant chemotherapy may be due in...

Age Not Always Predictive of Chemo Tolerance.
July 1, 2001... SAN FRANCISCO -- Some older women maintain their physical function during adjuvant therapy for breast cancer as well as--and perhaps better than--younger women, Dr. James M. Watters reported at the annual meeting of the American Society of...

Tamoxifen Effective Only With BRCA2 Mutations.
July 1, 2001... SAN FRANCISCO -- Tamoxifen is successful in preventing breast cancer in women with familial BRCA2 mutations but not BRCA1 mutations, Mary-Claire King, Ph.D., said during the annual meeting of the American Society of Clinical Oncology. In a...

Genetic Testing Often Alters Treatment Decisions.
July 1, 2001... DANA POINT, CALIF. -- A positive test for BRCA1 or BRCA2. mutations frequently alters the initial treatment decisions of breast cancer patients, many of whom subsequently elect to undergo bilateral mastectomy Dr. Claudine Isaacs reported at the...

Gynecologic Oncologists See Less Than Half of All Patients With Ovarian Cancer.
July 1, 2001... NASHVILLE, TENN. -- Less than half of all ovarian cancer patients in Utah are seen by a gynecologic oncologist. And access to specialist care is particularly poor for women under 40 and over 70 years of age, Dr. Michael Carney said during...

Genital Surgery in Intersex Infants Often Found Inadequate.
July 1, 2001... TORONTO -- The use of genital surgery in infants born with intersex genitalia urgently needs to be reevaluated because the surgeries are often inadequate, according to a team of British experts from University College London Hospitals. ...

Counseling Key to Helping Teens Stay on Depo-Provera.
July 1, 2001... TORONTO -- Teenagers can achieve high continuation rates and low levels of side effects with Depo-Provera if they are given a good deal of support and counseling, the results of two studies suggest. "There are things that the physician can...

Symptom Scoring Helps Flag Interstitial Cystitis.
July 1, 2001... CHICAGO -- As many as one in three women with chronic pelvic pain may have interstitial cystitis, and a simple symptom scoring system may help identify them. "Among women with chronic pelvic pain, 30%-60% may have normal findings on...

Secondary Headache Diagnosis.
July 1, 2001... The most time-efficient work-up of headache consists of four key questions and a brief search for "red flags," two speakers said at the annual meeting of the American Headache Society. Organic causes account for 1%-2% of headaches seen in...

Hysterectomy Can Worsen Migraines.
July 1, 2001... Have you ever had a patient ask if surgically removing her uterus might help her migraines? Headache specialists hear this question from "an amazing number" of women, Dr. Jan L. Brandes said at a meeting sponsored by the Diamond Headache...

The Obesity Paradox.
July 1, 2001... Cardiovascular morbidity and mortality are increased in a variety of lean or normal-weight individuals, compared with obese people with preexisting cardiovascular disease. That finding emerged from two studies presented at the annual...

Cardiovascular Effects of Alcohol.
July 1, 2001... Alcohol's cardiovascular benefits are most likely a class effect, so red wine isn't uniquely cardioprotective, Dr. Robert A. Vogel said at a conference sponsored by the American College of Cardiology. In a Kaiser Permanente study of...

Teens Like Herbal Remedies.
July 1, 2001... Adolescents with eating disorders use herbal remedies for weight control and other purposes, Dr. Debra Katzman reported at the annual meeting of the Society for Adolescent Psychiatry. "Heath care providers must be prepared to ask about the...

Gingko Biloba and Cognition.
July 1, 2001... The evidence that gingko bioba enhances cognition in healthy adults is not strong, consistent, or reliable, Dr. Gary Wenk said during a psychopharmacology update sponsored by the University of Arizona. Gingko biloba is the most thoroughly...

Green Tea Doesn't Prevent Gastric Ca.
July 1, 2001... Consumption of green tea does not protect against gastric cancer, reported Dr. Yoshitaka Tsubono of Tohoku University, Sendai, Japan, and associates. In a prospective cohort study done in an area in northern Japan with a high incidence of...

Treatment of Nightly GERD.
July 1, 2001... [Histamine.sub.2] blockers are ineffective when used regularly with a proton pump inhibitor to control nocturnal acid breakthroughs in patients with gastroesophageal reflux disease, Dr. Joel E. Richter said at a gastroenterology update...

Cox-2 Drugs Differ in Effect on Blood Pressure.
July 1, 2001... ORLANDO, FLA. -- Rofecoxib was associated with an increase in mean systolic blood pressure, but celecoxib was not, in a randomized trial of the cyclooxygenase-2 inhibitors in arthritic patients with treated hypertension. Celecoxib-treated...

Drug Update: Hypothyroidism.
July 1, 2001... Ask 100 endocrinologists what they prescribe for hypothyroidism and you'll generally get the same answer: levothyroxine--synthetic thyroxine, or [T.sub.4]. Experts say synthetic [T.sub.4] therapy most closely mimics the effects of a...

Primary Care Doesn't Detract From Training.
July 1, 2001... LAKE BUENA VISTA, FLA. -- The establishment of primary care training requirements for ob.gyn. residency programs hasn't interfered with the training residents have received in several obstetric and gynecologic procedures, Dr. Hal C. Lawrence...

Online Resources for Native American Data.
July 1, 2001... The Native Health Research Database (NHRD) and the Native Health History Database (NHHD) contain more than 6,690 health-related documents spanning almost 300 years of American Indian and Alaska Native health history. The NHRD, which can be...

Use of Encryption Service for Patient E-Mails Urged.
July 1, 2001... DENVER -- George Orwell had it right: Big Brother really is watching. All of your movements on the Internet are tracked by outside parties--and this has major implications for protecting patient privacy in an era when a growing number of...

Manufacturers May Replace Samples With Vouchers.
July 1, 2001... WASHINGTON -- In the wake of recent abuses of the "free sample" system in physician's offices, some pharmaceutical companies are opting for vouchers to better track drug samples. Dr. Paul Kalb, an attorney in Washington, D.C., suggested...

N.C. Medicaid Drug Costs Reflect National Trend.
July 1, 2001... DENVER -- Whopping increases in Medicaid prescription drug expenditures in North Carolina provide insight into physician prescribing trends that may be broadly applicable elsewhere, Dr. Kenneth Fink said at the annual meeting of the Society of...

ROE V. WADE CHALLENGED.
July 1, 2001... Two women who were the plaintiffs in the landmark Supreme Court decision establishing the right to legal abortion recently filed friend-of-the-court briefs in a federal class action lawsuit that would allow women to file wrongful death suits...

BILL FOR INFERTILITY COVERAGE.
July 1, 2001... A bill that would require federal employee health plans to pay for infertility coverage is pending before the House Committee on Government Reform. Any health plan that provides obstetrical benefits would also be required to provide coverage...

INSIGHT ON TEEN PREGNANCY.
July 1, 2001... Effective school and community programs to prevent teen pregnancy provide basic information in a consistent fashion, consider the social pressures placed on teens, and last more than a few hours, according to a report funded by the National...

PHARMACISTS AND MEDICARE.
July 1, 2001... A new bill would give pharmacists "health care provider" status under the Social Security Act, making them eligible to receive Medicare reimbursement, along with other non-physician providers such as nurse practitioners, physician assistants,...

CENTER TRACKS BIRTH DEFECTS.
July 1, 2001... A new center that will track and study birth defects in the United States has been created within the Centers for Disease Control and Prevention in Atlanta. The National Center on Birth Defects and Developmental Disabilities was created by the...

Compact Ultrasound Scanners.
July 1, 2001... The SDU-2200 and the SDU-1200 are digital color ultrasound scanners that provide abdominal, pelvic, fetal, and vascular imaging through the use of linear and convex high-density probes. The SDU-2200 can also perform cardiac imaging, while the...

Portable Ultrasound.
July 1, 2001... SonoSite 180Plus and SonoHeart Plus hand-carried ultrasound systems feature pulsed-wave Doppler, tissue harmonic imaging, and ECG capability. The devices, which weigh 5.4 pounds, also offer M-mode for high-resolution assessment of size and...

Medical Headlight.
July 1, 2001... The EZ Headlight features a bright, 8,000-candlepower Xenon lamp that provides coaxial lighting without a halo effect. Housed in an adjustable swivel, it comes with either a cotton or leather headband and a Velcro fastener. Powered by AA...

Managing Residency.
July 1, 2001... InResidence.com is a comprehensive Web-based data management system for ob.gyn. residency programs that allows their residents to collect clinical encounter data using the Internet or Palm operating system software. The system also allows...

New Proton Pump Inhibitor.
July 1, 2001... Nexium (esomeprazole magnesium) has been approved for the treatment of heartburn and other symptoms associated with gastroesophageal reflux disease as well as for healing and maintenance treatment of erosive esophagitis. It also has been...

Membrane Perforator.
July 1, 2001... Securline amniotic membrane perforator is designed to rupture the amniotic membrane without injury to mother or fetus. It has a rounded tip with a protected point, measures 10.5 inches in length, is made of molded plastic, and has molded sides...

New Migraine Tablet.
July 1, 2001... Zomig (zolmitriptan) has been approved as an orally disintegrating tablet for the treatment of acute migraine in adults.

External Version With Anesthesia Improves Odds.
July 1, 2001... SAN DIEGO -- Both spinal and epidural anesthesia appear to increase the chance of success with external version in patients after a previous attempt has failed. Only 50% of 77 external versions were successful when performed without the...

Pesticide Exposure May Affect Fetuses.
July 15, 2001... WASHINGTON -- Children of migrant farmworkers who were exposed to pesticides in utero or through breast-feeding are at high. risk of developing associated health problems, according: to preliminary data presented by Maria A. Hernandez-Valero,...

Fetal Weight Does Not Help Predict VBAC Success.
July 15, 2001... Using weight estimates to determine who gets a trial of labor 'is not justified.' ST. JOHN'S, NFLD. -- Fetal weight estimates based on ultrasound are not useful in determining which women with a history of C-section due to cephalopelvic...

OCs May Not Stem Bone Loss in Anorexic Teens.
July 15, 2001... BMD levels will rise with weight gain. TORONTO -- Oral contraceptives do little to prevent bone loss in adolescent girls with anorexia nervosa, results of a recent study indicate. In a study of 50 adolescent girls with low bone mineral...

UAE Patients Experience Less Bleeding, Shorter Hospital Stays.
July 15, 2001... CHICAGO -- Uterine artery embolization of symptomatic fibroids was associated with fewer hospitalizations, less blood loss, and a speedier return to work than abdominal myomectomy in a single-center study. But uterine artery embolization is...

Don't Forget the Pelvic Floor.
July 15, 2001... The pelvic floor is an important aspect of maternal morbidity that is too often neglected in the debate over vaginal versus cesarean deliveries. We have all seen the tremendous stretching and distension of a spontaneous vaginal delivery, but...

LETTERS.
July 15, 2001... Physician, Train Thyself The article "Better Training: in Misoprostol Use for Labor Induction Advocated" seemed heavily slanted against the use of misoprostol and failed to address the true issues (May 15, 2001, p. 13). The...

Clarification.
July 15, 2001... The Accreditation Council for Graduate Medical Education has required that residents be evaluated in six competency areas: patient care, medical knowledge, practice-based learning and improvement, systemsbased practice, interpersonal and...

Good Birth Outcomes Possible in Women Over 50.
July 15, 2001... RANCHO MIRAGE, CALIF. -- Carefully screened women aged 50 and older who become pregnant through in vitro fertilization stand a good chance of having a term delivery with favorable maternal and neonatal outcomes, Dr. Robert Boostanfar reported...

Early Data Suggest Infliximab is Safe in Pregnancy.
July 15, 2001... ATLANTA -- Information is emerging about the effect of infliximab in pregnancy, and the initial results indicate no higher risk of miscarriage or birth defects, Dr. Jeffry A. Katz said at the annual Digestive Disease Week. This is the...

Several Risk Factors for Postpartum Urinary Retention Identified.
July 15, 2001... SAN DIEGO -- Regional anesthesia, instrumental delivery, mediolateral episiotomy, and primiparity were each associated with an increased risk of postpartum urinary retention after vaginal delivery in a retrospective study. Careful...

Take Care to Avoid Misconceptions and Myths About Multifetal Pregnancies.
July 15, 2001... MAUI, HAWAII -- The growing incidence of multifetal gestation has given rise to several myths and misconceptions, Dr. Manuel Porto said at a conference on ob.gyn. ultrasound sponsored by the University of California, Irvine. Don't be...

DATA WATCH.
July 15, 2001... DATA WATCH Twins Still on the Rise, Triplets Decline in 1999 Triplets and Other Twins Higher-Order Multiples 1995 96,736 4,973 1996 100,750 5,939 1997 104,137 6,737 1998...

Lab Thresholds Vary for Judging Aneuploidy Risk.
July 15, 2001... MAUI, HAWAII -- Laboratories nationwide may use different cutoffs for determining the results of triple-marker screening for aneuploidy--differences that can affect patient counseling. Physicians therefore must know how each lab determines...

Outlook Bleak for Future Pregnancy.
July 15, 2001... Women who develop peripartum cardiomyopathy are likely to have poor outcomes in subsequent pregnancies, even if left ventricular function returned to normal after the disorder resolved, a recent study suggests. Most women recover from...

Breast Ca Recurrence, Mortality Not Tied to HRT.
July 15, 2001... Hormone replacement therapy does not appear to increase the risk of breast cancer recurrence or mortality from the disease among breast cancer survivors, Dr. Ellen S. O'Meara of the University of Washington, Seattle, and associates said. ...

Five-Year Ovarian Cancer Survival Rate Pegged at 44%.
July 15, 2001... SAN FRANCISCO -- The survival rate for epithelial ovarian cancer has risen dramatically over the past decade, and 5-year survival may now be about 44%, according to a Swedish population study. The study found that 2-year survival for...

Offer Counseling Early to Teens Who Have CAIS.
July 15, 2001... TORONTO-- Teenagers with complete androgen insensitivity syndrome need to be told that they are at high risk for sexual dysfunction, Dr. Cathy Minto advised. "It's important that these patients have access to gynecologic and psychological...

Don't Be Too Quick to Diagnose Teens With PCOS.
July 15, 2001... TORONTO -- Physicians who are hasty to do a lab work-up on teenage girls with irregular periods may find themselves chasing a false diagnosis of polycystic ovary syndrome. "The biggest thing we're asked to face as pediatric gynecologists...

Short-Term Data Show Benefits, Drawbacks of TVT.
July 15, 2001... SCOTTSDALE, ARIZ. -- The latest study of tension-free vaginal tape to treat urinary incontinence found that 29 of 34 patients were cured at the end of an 11-month follow-up. Nevertheless, there have been no published randomized studies of...

Nomogram Aids Bladder Outlet Obstruction Diagnosis.
July 15, 2001... SCOTTSDALE, ARIZ. - A new nomogram for catheter-free maximal urinary flow rates appears to be extremely valuable in detecting female bladder outlet obstruction after surgery for incontinence, Dr. Steven P. Petrou said at a urogynecology...

Doing Hundreds of Kegels to Treat Urinary Incontinence May Be Overkill.
July 15, 2001... SCOTTSDALE, ARIZ. - Pelvic floor muscle exercises just got simpler. New research shows that women don't need to do the hundreds of daily Kegel contractions recommended in many programs to treat urinary incontinence. A few dozen Kegels per...

Skip Urodynamics Before Incontinence Surgery.
July 15, 2001... SCOTTSDALE, ARIz. -- Routine preoperative urodynamic testing does not improve cure rates for stress urinary incontinence and is not cost effective, in women scheduled for pelvic organ prolapse repair, a computer-modeling study suggests. ...

Migraine Prophylaxis.
July 15, 2001... There is little evidence-based information about selecting prophylactic drug strategies for migraine headache, Dr. Neil H. Raskin said at the annual meeting of the American Headache Society. Evidence is weak at best for the efficacy of the...

Headache Work-Up.
July 15, 2001... Patients complaining of a previous severe headache or a headache that has continued for weeks should undergo magnetic resonance imaging, not computed tomography, Dr. Robert B. Daroff said at the annual meeting of the American Headache Society....

Type 1 Diabetics Living Longer.
July 15, 2001... People with type 1 diabetes are living longer, reported Dr. Rimei Nishimura of the University of Pittsburgh and associates. The finding, from the Allegheny County, Pa., type 1 diabetes registry probably reflects better glycemic control and...

Insulin May Boost CV Risk.
July 15, 2001... Insulin may be hazardous to the health of patients with type 2 diabetes. Two independent, observational studies found that insulin-providing treatments increased the risk of death or cardiovascular disease in patients with diabetes by more...

CFS Symptom by Symptom.
July 15, 2001... Physicians should treat chronic fatigue syndrome symptom by symptom, according to Dr. Dimitris A. Papanicolaou, chair of a consensus panel convened by the Centers for Disease Control and Prevention and the Chronic Fatigue and Immune Dysfunction...