OB GYN News articles from July 2003

OB GYN News archives from July 2003

Breast MRI may find missed cancer. (Specificity, Cost at Issue).
July 1, 2003... CHICAGO -- Magnetic resonance imaging detected breast tissue abnormalities that weren't seen on mammography in three recent studies, but the investigators are at odds on whether the technology should be used as a routine screening tool in women...

Combination HRT linked to dementia in older women: findings reinforce need to limit its use to short-term tx in younger women. (Women's Health Initiative).
July 1, 2003... The new finding that estrogen plus progestin therapy is associated with an increased risk for probable dementia in older postmenopausal women reenforces the need to limit hormone replacement therapy use to shortterm relief of menopausal...

FDA panel backs valtrex to cut HSV-2 transmission: transmission down 75% in partners. (Monogamous, Heterosexual Couples).
July 1, 2003... GAITHERSBURG, MD. -- A federal advisory panel has recommended that suppressive therapy with valacyclovir be approved for reducing the risk of genital herpes transmission from infected to uninfected sexual partners. The Food and Drug...

Vital signs: medicare among Americans' top health priorities for the president and congress.
July 1, 2003... VITAL SIGNS Medicare Among Americans' Top Health Priorities for the President and Congress Percent Saying Percent Saying "Very Important" "Most Important" * Helping...

No rise in major birth defects with lamotrigine. (10-Year Registry Data).
July 1, 2003... HONOLULU -- A prospective analysis of 10 years of pregnancy registry data has found no evidence that use of the anticonvulsant lamotrigine in the first trimester is associated with an increase in major birth defects, Dr. Mark S. Yerby reported....

Most women who stop HRT remain off therapy. (Satisfied with Decision).
July 1, 2003... NEW ORLEANS -- Most of the women in a study on discontinuation of hormone replacement therapy were satisfied with their decision to stop therapy and were still off it at a 3-4 month follow-up, Dr. Steve Hasley reported at the annual meeting of...

Low BMD tied to future dementia. (Framingham Study Data).
July 1, 2003... BALTIMORE -- Low bone mineral density in older women is associated with a more than twofold increase in the risk of developing Alzheimer's disease and other forms of dementia, according to a new analysis of data from the Framingham Study...

Saving the safety net. (Guest Editorial).
July 1, 2003... Politicians have long debated the need to fix our health insurance system. But if we are to meaningfully address the present crisis in health care costs, access, and quality, we must be willing to directly challenge the very underpinnings of...

Letters.
July 1, 2003... We Are So Bad Article after article, study after study, the data flow in: We physicians are a bad lot. We interrupt, we rush, and our utilization of high-tech procedures shows us to be racists. We are poor communicators. We aren't...

Talk back online.
July 1, 2003... TALK BACK ONLINE Should the U.S. Senate pass tort reform legislation capping noneconomic damage awards at $250,000 in medical malpractice cases? (June 1, 2003, p. 5) YES 90% NO 10% To Talk Back, visit...

Estimates of cesarean-related blood loss shown to be too low. (Retrospective Analysis).
July 1, 2003... PHOENIX, ARIZ, -- Estimates of maternal blood loss during cesarean section are consistently too low, and the greater the blood loss, the greater the inaccuracy according to Dr. Paul R. Shook. In a retrospective analysis of 440 women who...

Spinal anesthesia best for very premature infants. (Reduced Mortality).
July 1, 2003... PHOENIX, ARIZ, -- Spinal anesthesia was associated with a significantly lower risk of mortality among very premature infants than general or epidural anesthesia in a retrospective review of almost 900 women who were delivered by cesarean...

Ondansetron relieves pruritus linked to spinal opioids. (Cost a Major Drawback).
July 1, 2003... PHOENIX,. ARIZ. -- Ondansetron has a dose-related prophylactic effect in relieving pruritus associated with spinal opioids administered for labor analgesia, Dr. Scott Segal said. Patients who received 8 mg of ondansetron intravenously along...

Top causes of pregnancy-related deaths. (Data Watch).
July 1, 2003... DATA WATCH Top Causes of Pregnancy-Related Deaths in 1991 - 1999 % of All Cause of Pregnancy-Related Mortality Death Deaths Ratio *...

MS drug did not raise risk in pregnancy study. (Glatiramer Acetate).
July 1, 2003... HONOLULU -- A study of 345 pregnancies occurring in women taking glatiramer acetate for multiple sclerosis suggested that use of the drug results in no increased risk of adverse fetal or pregnancy outcomes. Spontaneous abortion in users of...

Deet. (Drugs, Pregnancy and Lactation).
July 1, 2003... DEET, or N,N-diethyl-m-toluamide, is the most widely used insect repellent in the world and is found in various products in concentrations ranging from 10% to 100%. Over many years of use, DEBT generally has been shown to be safe when used...

Conservative treatment of cervical dysplasia linked to rise in PPROM risk. (Seen in Subsequent Pregnancy).
July 1, 2003... WASHINGTON Conservative treatment of cervical dysplasia in women of reproductive age is associated with a 2.7fold increase in the risk of preterm premature rupture of the membranes in a later pregnancy, Lynn Sadler, Ph.D., said at the annual...

Prescribe diet, exercise after gestational diabetes. (Many Will Develop Type 2 Diabetes).
July 1, 2003... LITTLE ROCK, ARK. -- Diabetes prevention strategies should be initiated in all women who had gestational diabetes during pregnancy Dr. Sin Kjos said at the annual meeting of the North American Diabetes in Pregnancy Study Group. About 70%...

Continuous monitoring helps manage gestational diabetes. (Glucose Control).
July 1, 2003... LITTLE ROCK, ARK. - Continuous glucose monitoring is a promising tool for the management of women with gestational diabetes, Dr. Lois Jovanovic said at the annual meeting of the North American Diabetes in Pregnancy Study Group. Continuous...

Short-acting insulin analogues deemed safe, effective in pregnancy. (Data Lacking on Long-Acting Analogues).
July 1, 2003... LITTLE ROCK, ARK. -- Short-acting insulin analogues are safe and optimal for use in insulin-requiring diabetic pregnancies, but there are not enough data yet to recommend the new long-acting analogues for pregnant women, Dr. Lois Jovanovic...

Drug update: treating menopausal vasomotor symptoms without hormones.
July 1, 2003... Many menopausal symptoms don't need treatment. Up to 85% of perimenopausal women develop vasomotor symptoms such as hot flashes or sweating; perhaps half of these women find their symptoms disturbing. Systemic hormone replacement therapy...

Vulvar folliculitis in adolescents often caused by waxing, shaving. (Complete Removal of Pubic Hair).
July 1, 2003... PHILADELPHIA -- The female fight against unwanted hair has descended to the pubic region: Many teens are now removing all of their pubic hair, increasing their risk of developing vulvar folliculitis. "Grooming of the pubic hair can now be...

Underlying bleeding disorders implicated in half of all menorrhagia cases in adolescents. (Platelet Function Test).
July 1, 2003... PHILADELPHIA -- About half of adolescents with menorrhagia have an underlying bleeding disorder, according to a study with 30 patients at one institution. A good way to assess bleeding disorders in these young patients is with a platelet...

Outpatient care called safe for teens with PID. (Review of 145 Patients).
July 1, 2003... PHILADELPHIA -- Outpatient treatment of pelvic inflammatory disease is safe for adolescent girls, even though almost a quarter of patients fail outpatient treatment and require hospitalization, based on a review of 145 patients at one hospital....

New cervical cancer tx may preserve fertility. (Abdominal Radical Trachelectomy).
July 1, 2003... NEW ORLEANS -- A new approach to the treatment of cervical cancer could save the fertility of many women, according to one of the pioneers of the technique. "Unfortunately, the majority of cervical cancer patients are still treated with...

Abdominal sacrocolpopexy suitable for young, sexually active patients. (Vaginal Vault Prolapse).
July 1, 2003... FORT LAUDERDALE, FLA. -- Patients with vaginal prolapse who wish to remain sexually active are good candidates for abdominal sacrocolpopexy Dr. G. Willy Davila said at a symposium on pelvic floor disorders sponsored by the Cleveland Clinic...

Study: total laparoscopic hysterectomy safe alternative to abdominal approach. (Benign Uterine Disease).
July 1, 2003... SCOTTSDALE, ARIZ. -- Total laparoscopic hysterectomy can be a safe and effective alternative to abdominal hysterectomy in patients with benign uterine disease who are not candidates for vaginal hysterectomy Dr. David J. Levine said. On the...

One-fourth of teens may have bacterial vaginosis. (Sexual Activity not a Prerequisite).
July 1, 2003... SEATTLE -- The prevalence of bacterial vaginosis among young women appears to be about 27%, according to a survey of 1,938 young women who were entering the military. The prevalence among those who were sexually experienced was 28%, but...

EC pills likelier to be used when supplied in advance. (Prescription Isn't Enough).
July 1, 2003... NEW ORLEANS -- Women with an advance supply of emergency contraceptive pills are significantly more likely to use them than women who receive just an advance prescription, preliminary results of a randomized study suggest. Providing a...

Markers for sterilization regret include prodding partner, young age. (Counseling Opportunity).
July 1, 2003... NEW ORLEANS -- Young age, nonwhite race, a prodding partner, and current relationship problems are key signs that a woman undergoing sterilization will later regret her decision, Dr. Cher P. Moseman reported at the annual meeting of the...

Douching after sex linked to bacterial vaginosis. (BV Risk Doubled).
July 1, 2003... SEATTLE -- Young women and teens who douche after sex are twice as likely to have bacterial vaginosis as those who douche at other times, Dr. Tina Simpson said at the annual meeting of the Society for Adolescent Medicine. Of 213 females...

Weekly, daily risedronate equally effective. ('A Reasonable Alternative').
July 1, 2003... SAN DIEGO -- A 35-mg weekly dose of risedronate is just as effective as a 5-mg daily dose, according to results of a detailed bone study. The findings suggest that weekly dosing of the agent for postmenopausal women "is a reasonable...

Bisphosphonate approved, but not being launched. (Convenient Dosing Sought).
July 1, 2003... The Food and Drug Administration has approved a daily formulation of ibandronate sodium for the treatment and prevention of postmenopausal osteoporosis, but the manufacturer has no immediate plans to launch the bisphosphonate until more...

Chronic low-dose aspirin therapy tied to GI bleeding. (No Safe Dose?).
July 1, 2003... ORLANDO, FLA.--Long-term low-dose aspirin therapy is a risk factor for gastrointestinal bleeding, data from the Physicians' Health Study suggest. The finding comes from a case-control study of 451 case patients and 1,804 control patients...

Proton-pump inhibitors also effective in nonerosive reflux disease. (Accounts for 50%-70% of Gerd Cases).
July 1, 2003... SEATTLE--Proton-pump inhibitors, the therapeutic mainstay for gastroesophageal reflux disease, are also highly effective in the treatment of nonerosive reflux disease, according to a new metaanalysis. That's good news, since nonerosive...

Gastroesophageal reflux disease. (Women's Health Adviser).
July 1, 2003... Gastroesophageal reflux disease is more than the occasional heartburn that causes discomfort after a rich meal. The condition causes frequent, severe heartburn and acid regurgitation. It often interferes with sleep, destroys the pleasure of...

Monkeypox exposure? Offer smallpox vaccine. (Pregnancy not a Contraindication).
July 1, 2003... Persons who've had close or intimate contact with symptomatic individuals or animals confirmed to have monkeypox should receive the smallpox vaccine, ideally within 4 days of exposure. That recommendation, issued by the Centers for Disease...

Teaching hospitals hit over pelvic exam consent. (Anesthetized Patients).
July 1, 2003... Teaching hospitals are being called into question over their consent procedures to conduct pelvic exams on anesthetized patients. But a new grassroots advocacy organization is contending that the preoperational consent forms given to...

Agencies disagree on uniform medicare coverage policy. (Local or National?).
July 1, 2003... BALTIMORE -- Federal agencies disagree about whether Medicare should continue to have two types of coverage policies: local coverage decisions that affect only a certain geographic area, and national coverage decisions that affect beneficiaries...

Nevada restricts delivery discounts. (Policy & Practice).
July 1, 2003... NEVADA RESTRICTS DELIVERY DISCOUNTS Ob.gyns. in Nevada can no longer count on paying malpractice insurance premiums on the basis of the number of deliveries they perform per year, thanks to a law signed by Republican Coy. Kenny Guinn in May...

Florida notification law repealed. (Policy & Practice).
July 1, 2003... FLORIDA NOTIFICATION LAW REPEALED A woman puffing her child up for adoption in Florida will not have to disclose information about sexual history now that the state legislature has repealed the 2001 law that set up the notification requirement....

Eric Robert Rudolph arrested. (Policy & Practice).
July 1, 2003... ERIC ROBERT RUDOLPH ARRESTED Alleged abortion clinic bomber Eric Robert Rudolph was arrested May31 in North Carolina. Rudolph, who was one of the FBI's 10 most wanted fugitives, is charged with bombing attacks on a health clinic in Birmingham,...

Overseas military abortion ban upheld. (Policy & Practice).
July 1, 2003... OVERSEAS MILITARY ABORTION BAN UPHELD Congress rejected efforts to overturn a ban on abortions at US. military hospitals overseas. The ban affects military women deployed overseas as well as female dependents who have accompanied a...

GLMA protests 'Gensorship'. (Policy & Practice).
July 1, 2003... GLMA PROTESTS 'CENSORSHIP' The Gay and Lesbian Medical Association (GLMA) is protesting what it calls "censorship and monitoring" from health officials in the Bush administration. In a letter to President Bush, the group cites media reports...

Condoms don't increase teen sex. (Policy & Practice).
July 1, 2003... CONDOMS DON'T INCREASE TEEN SEX The availability of condoms does not increase sexual activity and could help prevent HIV, according to a study in the June issue of the American Journal of Public Health by Susan M. Blake, Ph.D., of George...

Retired volunteers may need malpractice insurance. (Working at Free Clinics).
July 1, 2003... Retired physicians across the country are discovering that it can get expensive to volunteer their services at a free clinic. Dr. Martin Gonzalez, a retired physician in Oak Park, Ill., was turned away from a homeless shelter after he...

Study: students enter medical school with 'empathy deficit'. (Training Increases Deficit).
July 1, 2003... SALT LAKE CITY -- Undergraduate students planning medical careers show significantly less empathy than those planning to enter other professions, J. Kenneth Arnette, Ph.D., reported at the annual meeting of the Society of Behavioral Medicine....

E-consults with specialists led to tx change in 90% of cases. (Diagnosis Changed in 5%).
July 1, 2003... Online consultations between specialists and referring physicians led to a change in treatment in 90% of cases, according to the findings of a retrospective study. In 5% of cases, the online consultation led to a change in the patient's...

New antivomiting medicine. (Products).
July 1, 2003... Emend (aprepitant) is approved for use in combination with other antivomiting medicines to help prevent the acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy. The drug,...

Free breast-feeding guide. (Products).
July 1, 2003... Avent is offering a free breast-feeding guide. The 24-page brochure features information about the health and nutritional benefits of breast-feeding, breast pumps, nutrition for mothers, positions, and returning to work. For more information or...

Cordless fetal monitor. (Products).
July 1, 2003... The Avalon CTS cordless fetal transducer is designed for pregnant women from about 22 weeks through delivery. It enables monitoring while women rest, bathe, or move around. The built-in lithium batteries operate for up to 16 hours and can be...

Progesterone gel for amenorrhea. (Products).
July 1, 2003... Prochieve progesterone gel is available in a 4% strength. The bioadhesive vaginal gel is used to treat secondary amenorrhea. For more information on this product, contact Columbia Laboratories Inc. at 973-994-3999 or on the Web at...

Upgraded ultrasound systems. (Products).
July 1, 2003... The HDI 4000 system combines high-definition imaging broadband technology with live 3-D imaging. The Ultramark 400C system includes a new, high-resolution monitor with an auxiliary monitor for patient viewing. A new transducer improves 2-D...

Bioterrorism resource. (Products).
July 1, 2003... A bioterrorism reference center is available for subscribers to PDxMD, Elsevier's evidence-based electronic primary care information service. The bioterrorism reference center includes diagnosis and treatment information related to the Centers...

Panic disorder wafers available. (Products).
July 1, 2003... Klonopin wafers (clonazepam orally disintegrating tablets) are now available in the United States. The wafers--for treatment of panic disorder with and without agoraphobia in adults--dissolve on the tongue without the patient needing to have...

Heavyweight charting paper. (Products).
July 1, 2003... New heavyweight charting paper comes with predriled binder holes and is designed to prevent fewer jams and mis-feeds in copiers and printers. The 8.5-by-11-inch sheets have a reinforced edge and are available in 24 or 28 pounds. For more...

AMA reassesses its priorities.(Attempt to Boost Membership)
July 15, 2003... CHICAGO -- With a reorganization plan on the cutting room floor, the American Medical Association may need to refocus its priorities in order to boost ailing membership rolls. A special committee charged with reviewing the AMA's structure...

Combo HRT tied to delayed detection of breast cancers: expert urges caution in applying these findings to younger women.(Elevated Breast CA Risk)
July 15, 2003... Invasive breast cancer is detected at a more advanced stage in women who are on estrogen-progestin therapy, compared with those who develop the disease while taking a placebo, according to a new analysis of data from the Women's Health...

Microwave ablation device clears FDA advisory panel: some user-related complications reported.(Menorrhagia Treatment)
July 15, 2003... GAITHERSBURG, MD. -- The first microwave endometrial ablation device for treating menorrhagia in premenopausal women was recommended for approval with conditions by a federal advisory panel. The unanimous decision by the nine voting members...

Smallpox vaccination expansion 'unwise'.(CDC Advisory Committee)
July 15, 2003... ATLANTA -- The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention has advised the federal government not to expand the current pre-event smallpox vaccination recommendations. The decision, made...

Canada considering ban on some forms of preimplantation sex selection.(Excludes DX of Sex-Linked Disorders)
July 15, 2003... WILMINGTON, DEL. -- The Canadian Parliament is considering a ban on nearly all forms of preimplantation sex selection, a move that alarms some reproductive health experts in both Canada and the United States. The bill in question, currently...

Clinicians first defense in controlling outbreaks.(CDC Director Addresses AMA Delegates)
July 15, 2003... CHICAGO -- The American health care system is learning how to prepare for disasters the hard way, and the first lesson has been that front-line clinicians play an important role in identifying and working to control epidemics, Dr. Julie L....

Sexual activity and access to condoms.(School Study)
July 15, 2003... Adolescents in Massachusetts high schools where condoms were available were no more likely to be sexually active than those in schools that did not offer condoms, and students with access to condoms were twice as likely to use them during their...

Postmastectomy options.
July 15, 2003... The House of Delegates voted to recommend that third-party payers provide coverage and reimbursement for breast cancer treatments such as prophylactic contralateral mastectomy, which only some insurers cover at present. Testimony centered on...

Physician reimbursement.
July 15, 2003... Despite increased focus at this meeting on the AMA as an advocate of public health, the issue of physician reimbursement took center stage, at least for a while. The delegates voted for a resolution calling for the AMA to "aggressively pursue...

Programs for girls in juvenile detention.
July 15, 2003... The House of Delegates declared its intention to work with appropriate groups to strengthen gender-specific rehabilitation programs, mental health services, and educational services for girls in juvenile detention centers. The resolution,...

Abstinence-only education.
July 15, 2003... The House of Delegates came down against abstinence-only education programs in schools, although it watered down original language that it "actively oppose" federal funding for such school programs. Instead, the new AMA policy is to endorse...

Medicare deductibles and copayments.
July 15, 2003... The AMA will seek federal legislation to require secondary insurers to pay Medicare deductibles and copayments, regardless of how much Medicare pays for the service. Short of that, the delegates voted to urge health insurance companies to make...

Clinical skills exam.
July 15, 2003... In one of the most emotional issues of the meeting, the House emphasized its opposition to the Clinical Skills Assessment Exam. More than 4 dozen delegates spoke against the exam's cost to medical students and the lack of evidence of the exam's...

Cloning.
July 15, 2003... The AMA came out in favor of using somatic cell nuclear transfer to develop stem cells for research purposes--after some concern about how the media reported its decision. The vote was widely reported in the mainstream media as support for...

FluMist endorsed as influenza vaccine alternative.(Healthy People Aged 5-49 Years)
July 15, 2003... ATLANTA -- The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention has endorsed the use of FluMist as "an important new option" for vaccinating healthy individuals aged 5-49 years. The new...

Second low-dose estrogen-MPA combo approved.(Two Prempro Formulations)
July 15, 2003... The Food and Drug Administration has approved a second low-dose formulation of the conjugated estrogen-medroxyprogesterone acetate combination. Last month the FDA approved a Prempro formulation (0.3 mg of conjugated estrogens and 1.5 mg of...

The HIV prevention challenge.(Guest Editorial)
July 15, 2003... The need for enhanced HIV prevention efforts by health care providers is greater than ever. An estimated 850,000950,000 people in the United States are living with HIV or AIDS--more than at any point in the epidemic. The treatment...

Correction.
July 15, 2003... In the article "Irritable Bowel Syndrome" (Women's Health Adviser, June 1, 2003, p. 21), the first sentences referencing tegaserod and alosetron were incorrect. They should have read, "Tegaserod maleate (Zelnorm), approved in 2002, is indicated...

Should rapid HIV testing be available over the counter?(Pro & Con)
July 15, 2003... YES If the goal of medicine is patient empowerment, why not allow patients to go to a pharmacy, buy a rapid HIV test, and test themselves in the privacy of their own homes? The link to medical care in our current system of HIV...

Paxil tied to drop in hot flash severity, frequency.(Decreased by at Least 62%)
July 15, 2003... NEW ORLEANS -- Paroxetine was linked to significant reductions in the frequency and severity of hot flashes in menopausal women in a randomized, double-blind, placebo-controlled trial. The findings suggest that the selective serotonin...

Chlamydia linked to ovarian cancer risk.(Case-Control Study)
July 15, 2003... Chlamydia trachomatis infection may cause more than pelvic inflammatory disease in patients, Dr. Roberta B. Ness of the University of Pittsburgh and her colleagues reported. In a population-based case-control study of 117 ovarian cancer...

Young adults often unaware of HIV risk.(High-Risk Behavior Reported in 19%)
July 15, 2003... VANCOUVER, B.C. -- Most young adult Americans who engage in HIV risk behaviors underestimate their infection risk and have not been tested for HIV recently, according to the findings from a new national study. The study was undertaken in...

Home pregnancy testing by teens flags ambivalence about childbearing.(Counseling Encouraged)
July 15, 2003... PHILADELPHIA -- When a teenage girl uses a home pregnancy test, it reveals more than whether she's conceived. It also is a red flag that she sees less of a downside to becoming pregnant, based on the results of a study of 340 adolescent...

New PID diagnostic rules boost number of cases.(CDC's 2002 Diagnostic Revision)
July 15, 2003... PHILADELPHIA -- Looser diagnostic criteria for pelvic inflammatory disease mean that more patients are getting diagnosed with the disease. It stood to reason that when the Centers for Disease Control and Prevention broadened its definition...

LSH free of complications in 54 women with large uteri.(Weighing More Than 300 G)
July 15, 2003... SCOTTSDALE, ARIZ. -- La-paroscopic supracervical hysterectomy resulted in no complications in a series of 54 patients with large uteri, each weighing more than 300 g. The cases were among 329 la-paroscopic supracervical hysterectomies...

[Beta]-blocker + statin reduces perioperative cardiac risk.(Noncardiac Surgery)
July 15, 2003... SNOWMASS, COLO. -- Prescribing a perioperative 13-blocker and a statin is one of the most important measures a physician can take to reduce perioperative cardiovascular risk in patients undergoing noncardiac surgery, Dr. Robert A. Vogel said at...

Attention to bladder neck, apex crucial to paravaginal repair.(Key to Support)
July 15, 2003... FORT LAUDERDALE, FLA. -- The bladder neck and apex are the most important components of paravaginal defect repair, no matter where the defect is located, Dr. Mark Walters said at a symposium on pelvic floor disorders sponsored by the Cleveland...

Growing evidence: cranberry juice tied to lower UTI risk.(NIH Undertakes Large Study)
July 15, 2003... The cranberry juice question may soon be answered. The National Institutes of Health has launched an initiative to provide approximately $2.6 million in grants for research into the efficacy of high-grade cranberry products for the...