OB GYN News articles from June 2003

OB GYN News archives from June 2003

Medical liability reform urged. (Strategies Offered).
June 1, 2003... NEW ORLEANS -- A complete overhaul of the medical justice system and a no-fault insurance plan were among the possible solutions to the medical liability insurance crisis suggested by speakers at the annual meeting of the American College of...

Cardiac event risk low in young, healthy HRT users: WHI findings may not apply to healthy women treating menopausal symptoms. (Four Large, Randomized Trials).
June 1, 2003... NEW ORLEANS -- The overall risk of cardiovascular events is extremely low in healthy women in early menopause who rely on hormone therapy to treat their menopausal symptoms, according to pooled data from four large randomized clinical trials....

Drop in breast ca mortality linked to mammography: study criticized as 'seriously flawed'. (40-Year Retrospective Study).
June 1, 2003... A new Swedish study linking routine screening mammography with a 44% decrease in breast cancer mortality hasn't convinced some experts, who claim it suffers from the same flaws that plagued a 2002 study by the same authors. The new...

Vital signs: Top 10 diagnoses in ob.gyn. office visits in 2002.
June 1, 2003... VITAL SIGNS Top 10 Diagnoses in Ob.Gyn. Office Visits in 2002 % of Office Visits Supervision of Normal Pregnancy 15.3 Gynecologic Exam 10.9...

More than 100 pregnant women exposed to smallpox vaccine. (December 2002-April 2003).
June 1, 2003... In recent months, 103 women in the United States either received the smallpox vaccine before they knew they were pregnant or conceived within 4 weeks after being vaccinated, according to a Centers for Disease Control and Prevention report. ...

Doctor groups call on Senate to pass medical liability reform. (Cap On Noneconomic Damages).
June 1, 2003... NEW ORLEANS -- Calling the medical liability system an abomination, representatives from three major medical organizations joined forces at the annual meeting of the American College of Obstetricians and Gynecologists and called upon the U.S....

Building medical coalitions. (Guest Editorial).
June 1, 2003... Medical organizations that represent the primary care specialties are forming dynamic new partnerships with each other at an unprecedented level. Over the past 2 years, the leaders of the American College of Obstetricians and Gynecologists,...

Menopause changes infection, disease landscape. (STDs are Less Likely).
June 1, 2003... WASHINGTON -- The spectrum of gynecologic infection and disease in peri- and postmenopausal women differs dramatically from that of younger women, according to Dr. David A. Eschenbach. Sexually transmitted infections become less common as...

Investigational drug shrinks fibroids in early trials. (Also Reduces Bleeding).
June 1, 2003... WASHINGTON -- An investigational drug shows great promise not only in decreasing the symptoms associated with leiomyomas, but in shrinking them as well. Unlike other drugs used to treat fibroids, asoprisnil does not induce a hypoestrogenic...

Wider use of office flexible hysteroscopy urged. (Only 3% of U.S. Gyns. Use It).
June 1, 2003... SCOTTSDALE, ARIZ. -- To hear Dr. Keith Isaacson talk about it, you'd think that office-based flexible hysteroscopy is far and away the best means of getting a good look at a submucous myoma. So why are only 3% of U.S. gynecologists doing...

Suggested criteria for UAE weed out undesirable candidates. (Expert Opinion).
June 1, 2003... SCOTTSDALE, ARIZ. -- Physicians should become more selective in identifying patients who are appropriate candidates for uterine artery embolization for the treatment of fibroids, Dr. Francis L. Hutchins Jr. advised. Since uterine artery...

Fluconazole keeps recurrent candidiasis at Bay. (Maintenance Prophylaxis).
June 1, 2003... WASHINGTON -- New data from two studies suggest that there is hope for women with complicated vulvovaginal candidiasis, Dr. Jack D. Sobel said at an update on sexually transmitted diseases sponsored by OB.GYN. NEWS and Boston University. ...

Primary care doctors embrace genetic testing. (Susceptibility Testing for Cancer).
June 1, 2003... PHILADELPHIA -- More than a third of primary care physicians surveyed referred at least one patient for a genetic test of susceptibility to cancer in 1999 or 2000 in a sample of 433 local doctors. In addition, 89% of the responding...

Routine questions about sex important to elderly. (Initiate the Conversation).
June 1, 2003... HONOLULU -- "How's your sex life?" Many doctors never think to ask their older patients this question, despite the evidence suggesting sex is an area of interest for many older adults who are living longer and healthier lives, Dr. Tomas L....

Two-rod contraceptive implant offers quick removal. (Not Marketed in North America).
June 1, 2003... NEW ORLEANS -- The two-rod levonorgestrel contraceptive implant Jadelle is almost identical to Norplant in terms of efficacy and side effects, but it's easier to remove than the six-rod device, Dr. Livia Wan said. In fact, removal of the...

OTC status sought for emergency contraceptive. (Plan B).
June 1, 2003... NEW ORLEANS -- Makers of the prescription emergency contraceptive Plan B have applied to the Food and Drug Administration to obtain over-the-counter status for their product. If the agency approves the application, U.S. women should be able...

Patient education key in treating SSRI-induced sex problems. (Limited Clinical Trial Data).
June 1, 2003... SAN DIEGO -- "Sexual functioning is complex-and so is talking about it with your patients," Dr. Robert K. Schneider observed at the annual meeting of the American College of Physicians. The first step in treating sexual dysfunction caused...

Fetal cardiac arrhythmia: new diagnostic options. (Magnetocardiography, Pulsed Doppler).
June 1, 2003... NEW YORK -- M-mode echocardiography, pulsed Doppler, and fetal magnetocardiography have the potential to revolutionize diagnosis of fetal cardiac arrhythmias, but like many advances in diagnostic technology they will likely leave clinicians...

The quest for earlier aneuploidy diagnosis. (Nuchal Translucency, Skinfold Depth).
June 1, 2003... NEW ORLEANS -- Some of the hurdles on the path toward accurate first-trimester aneuploidy screening may be less difficult to clear than previously thought, according to the results of two related studies presented at the annual meeting of the...

Stimulants, narcotics, hallucinogens. (Drugs, Pregnancy, and Lactation).
June 1, 2003... In the late 1990s, an estimated 3% of pregnant women used illicit drugs in early gestation, according to the Centers for Disease Control and Prevention. Pregnancy complications and poor fetal outcomes are common in these women. However, drug...

Tech advances bode well for prenatal genetic Dx. (Limits to Applicability).
June 1, 2003... NEW YORK -- Over the next 10 years, expect to see major technologic advances in both intrauterine diagnostic imaging and prenatal genetic testing. But exciting as they are, none of these advances will likely deliver your patients' greatest...

Counseling key with diabetic nephropathy. (Before Pregnancy).
June 1, 2003... DALLAS -- Diabetic nephropathy does not appear to be adversely affected by pregnancy but pregnancy can most definitely be adversely affected by diabetic nephropathy Pregnant patients with diabetic nephropathy have a greater risk of delivering a...

Simple screen accurately identifies migraine. (For Use in Primary Care Setting).
June 1, 2003... HONOLULU -- A positive response on two out of three questions provides a simple yet powerful way to identify migraine headaches in the primary care setting, Dr. David W. Dodick reported at the annual meeting of the American Academy of...

'Sinus' headache may really be a migraine. (Sumatriptan Effective TX).
June 1, 2003... HONOLULU -- The overwhelming majority of "sinus" headaches are actually migraine headaches, according to a large clinical trial reported by Dr. Curtis P. Schreiber at the annual meeting of the American Academy of Neurology. The 3,038...

Topical glucosamine/chondroitin cream relieves arthritic knee pain. (Small Study).
June 1, 2003... A topical cream containing glucosamine and chondroitin relieved pain in patients with osteoarthritis of the knee, said Marc M. Cohen and his colleagues at Monash University, Clayton, Australia. Since oral glucosamine is subject to...

Irritable bowel syndrome. (Women's Health Adviser).
June 1, 2003... Irritable bowel syndrome affects an estimated 10%-15% of Americans. Although IBS can't be traced to a single, organic cause and isn't associated with life-threatening conditions or complications, the syndrome can wreak havoc in the lives of...

Drug update: oral agents for type 2 diabetes. (Clinical Rounds).
June 1, 2003... Treatment of type 2 diabetes has come a long way in a few years. Until 1994, the only drug options in the United States were sulfonylureas and insulin. Today, there are four additional classes of glucose-lowering drugs. Diet and exercise...

New approach to physician incentives advocated. (Medicare Providers).
June 1, 2003... WASHINGTON -- There has got to be a better way for Medicare to reward physicians who provide quality care. The Medicare Payment Advisory Commission (MedPAC) is advising the Department of Health and Human Services to test provider payment...

IOM report urges improvements in training programs. (Five Core Competencies).
June 1, 2003... Physicians and other health care professionals are not being trained adequately to provide the highest quality and safest medical care possible, according to a new Institute of Medicine report. The report suggests that training programs in...

Council targets language barriers to health care. (California ACOG Chapter Involved).
June 1, 2003... Results from a survey of leading physician organizations, medical groups, and other health care associations in California suggest that nearly half (48%) of the 293 respondents knew of an instance in which a patient's limited English...

Abortion privacy. (Policy & Practice).
June 1, 2003... Abortion rights activists are bemoaning and abortion opponents are praising the U.S. Supreme Court's refusal to consider whether South Carolina abortion providers may allow patient files to be copied and removed from clinics. A 1995 law in...

Forced sterilization. (Policy & Practice).
June 1, 2003... North Carolina Gov. Mike Easley signed a new law repealing the state's policy that allowed forced sterilization of the mentally ill for the "public good." North Carolina sterilized more than 7,600 people under the state's eugenics program from...

HIV tests for pregnant women. (Policy & Practice).
June 1, 2003... Just as a survey of Ohio doctors found that fewer than half routinely offered HIV screening to their pregnant patients, Illinois lawmakers passed compromise legislation mandating routine HIV screening for infants whose mothers were not tested...

Temporary docs. (Policy & Practice).
June 1, 2003... Spending on temporary doctors in the United States more than quadrupled from 1997 to 2002, to $2.08 billion, according to Staff Care Inc., the temporary placement division of the physician recruitment firm Merritt Hawkins & Associates. That is...

Liability reform kit. (Policy & Practice).
June 1, 2003... Physicians fighting the medical liability crisis can request a special kit from the American Medical Association and redecorate their waiting rooms with posters and patient brochures. This "physician action kit" is part of the AMA's grassroots...

Physician services growth chart. (Policy & Practice).
June 1, 2003... Imaging appears to be the fastest-growing service physicians are billing for under the Medicare program, researchers told the Medicare Payment Advisory Commission. Analysis of physician services is an ongoing project at MedPAC. In the latest...

Women's health campaign. (Products).
June 1, 2003... "Putting Women's Health First" is a campaign supported by Digene Corp., which markets tests for detecting human papillomavirus (HPV), and partners that include the National Cervical Cancer Coalition. The campaign educates women about cervical...

Germicidal hand wipes. (Products).
June 1, 2003... Hibistat germicidal hand rinse now comes in a towelette application. Users should rub hands vigorously with the towelette for 15 seconds to cleanse hands. For more information, contact Regent Medical, 800-843-8497, www.regentmedical.com.

Brush-free surgical scrub. (Products).
June 1, 2003... A new surgical scrub line that features Triseptin Waterless, a scrub that can be used without water and a scrub brush. The alcohol-based scrub contains preservative and surfactant components. Two 90-second applications are required. For more...

Acute migraine Rx available. (Products).
June 1, 2003... Relpax (eletriptan HBr) is available for the acute treatment of migraine. The drug is available in 20- and 40-mg tablets. The maximal recommended single dose is 40 mg, and the daily dosage should not exceed 80 mg. It should not be given to...

HIV patients with herpes. (Products).
June 1, 2003... Valtrex (valacyclovir HCl) caplets are indicated for the suppression of recurrent genital herpes in patients who are infected with HIV For more information, contact GlaxoSmithKline, 888-825-5249, www.Valtrex.com.

New ultrasound feature. (Products).
June 1, 2003... The Sonoline G60 S and G50 ultrasound systems now offer fully integrated real-time three-dimensional imaging. The new feature includes automated 3-D volume acquisition, which reduces operator dependency and provides geometrically accurate...

VNS Therapy. (Products).
June 1, 2003... VNS Therapy, a medical device therapy that uses vagus nerve stimulation to treat epilepsy, is now indicated for women of childbearing age. Animal studies have revealed no evidence of impaired fertility or harm to the fetus as a result of VNS...

Urinary incontinence hammock. (Products).
June 1, 2003... The Monarc subfascial hammock is approved for the treatment in women of urinary incontinence that is the result of urethral hypermobility and/or intrinsic sphincter deficiency For more information, contact American Medical Systems Inc.,...

Guidelines address 'prehypertension'. (Suggest Lifestyle Interventions).
June 15, 2003... NEW YORK -- New hypertension guidelines issued by the National Heart, Lung, and Blood Institute reflect an urgent need to intervene earlier and more aggressively to prevent high blood pressure from causing serious health consequences. The...

HRT linked to increase in urinary incontinence. (Older Postmenopausal Women).
June 15, 2003... Risk of urge incontinence up more than twofold; stress incontinence rises fourfold. NEW ORLEANS -- Hormone replacement therapy was associated with a more than twofold increase in risk of urge incontinence and an almost fourfold increase in...

Multiparas: C-Section, cervical ripening link seen: women had previously delivered vaginally. (Elective Induction).
June 15, 2003... NEW ORLEANS -- The risk of cesarean section is five times higher in women with at least one previous vaginal delivery who receive cervical ripening before elective induction, compared with women who have spontaneous labor. In contrast,...

ACOG installs new president and president-elect at annual meeting.
June 15, 2003... Dr. John M. Gibbons Jr. was installed as the 54th president of the American College of Obstetricians and Gynecologists at the group's annual meeting. Dr. Gibbons is in private practice in Hartford, Conn. He also is professor of ob.gyn. at...

Indications, not device, blamed for VAD injuries. (Retrospective Study).
June 15, 2003... NEW ORLEANS -- Most injuries associated with vacuum-assisted delivery are not caused by the device but the indication for its use, results of a retrospective study of almost 400 cases showed. Most serious perinatal injuries associated with...

Critics assail JNC 7 guidelines as misguided, misleading.
June 15, 2003... The JNC 7 hypertension guidelines promote a kind of "cookbook" medicine that, at best, will unnecessarily worry millions of healthy Americans and, at worst, may lead to inappropriate pharmacotherapy for truly hypertensive patients, according to...

Unprepared for a SARS quarantine. (Guest Editorial).
June 15, 2003... The Centers for Disease Control and Prevention has performed admirably to stem a severe acute respiratory syndrome (SAPS) epidemic in the United States. Despite the strong federal response, the United States is ill prepared to cope with...

Letters.
June 15, 2003... Gray Areas Are Green in Court "Anyone can sue, but to be successful the plaintiff must prove that a doctor made a mistake or breached the standard of care, and that he or she caused an injury as a result." This statement, which appeared in...

Corrections.
June 15, 2003... In "Fondaparinux May Match Heparins for VTE Treatment" (March 15, 2003, p. 29), the outcome measure rate of recurrent venous thromboembolic events" was incorrectly cited in both studies as "death rate." In the article "What Patients Need...

Clarification.
June 15, 2003... Jadelle is marketed in Europe by Schering Oy of Finland. Wyeth holds the U.S. rights to a two-rod contraceptive implant, which has been approved by the Food and Drug Administration, but has not marketed it in the United States ("Two-Rod...

Tips on obstetric anal sphincter laceration repair. (Evidence-Based Approach).
June 15, 2003... NEW ORLEANS -- About a third of all women who experience anal sphincter injury at the time of childbirth will develop anal incontinence. Short of prevention, the best approach to this problem is proper repair of the injury, speakers said at the...

Apnea risk declines with gestational age. (Still Elevated at 35 Weeks).
June 15, 2003... GREENWICH, CONN. -- The risk for neonatal apnea decreases with increasing age at birth, but still remains elevated at 35 weeks' gestation, Dr. Prakash M. Kabbur said a meeting of the Eastern Society for Pediatric Research. A retrospective...

Delay abdominal ultrasounds on obese gravidas. (Improves Visualizatin).
June 15, 2003... WASHINGTON -- Waiting until after 18 weeks' gestation to perform abdominal ultrasound on an obese gravida greatly improves fetal craniospinal visualization, Dr. Israel Hendler reported at the annual meeting of the Society for Gynecologic...

Study shows there's no need to discourage pregnancy in Ca survivors. (Previous Radiation Tx May Raise Risks).
June 15, 2003... NEW ORLEANS -- Pregnancy should not be discouraged in women who have undergone cancer therapy because they have a low risk of cancer recurrence and pregnancy complications, Dr. Elyce Cardonick said at the annual meeting of the American College...

Evolving strategies target infection-induced preterm labor. (Could Cut Preterm Birth Rate By 30%).
June 15, 2003... NEW ORLEANS -- The prevention of infection-induced preterm birth could reduce the overall rate of preterm birth by as much as 30%, Dr. Ronald Gibbs said at the annual meeting of the American College of Obstetricians and Gynecologists. But...

Soriatane's new labeling focuses on pregnancy. (Psoriasis Drug).
June 15, 2003... MAUI, HAWAII -- Newly updated labeling for the psoriasis drug Soriatane places more emphasis than ever on pregnancy-related issues. The prominent black box warning at the front of the package insert contains a new requirement that patients...

Glyburide efficacy demonstrated in real-life clinical settings. (High Fasting Glucose BMI Predict Failure).
June 15, 2003... LITTLE ROCK, ARK. - Glyburide is an effective and convenient treatment for gestational diabetes mellitus in real-life clinical practice, Dr. Deborah L. Conway said at the annual meeting of the North American Diabetes in Pregnancy Study Group....

LGA infants have higher body fat if mother has diabetes. (Similar Birth Weights).
June 15, 2003... LITTLE ROCK, ARK. -- Large-for-gestational-age infants of women with gestational diabetes have higher proportions of body fat than do infants of the same size who are born to women without diabetes, Dr. Celeste Durnwald reported. Compared...

Acarbose, metformin studied in GDM. (Oral Agents).
June 15, 2003... LITTLE ROCK, ARK. -- A landmark study demonstrating the efficacy of glyburide use in gestational diabetes mellitus has given the green light to investigations into the use of other oral hypoglycemic agents during pregnancy Dr. Thomas R. Moore...

Obese women with GDM more likely to need insulin therapy. (Diet Alone Works In Some).
June 15, 2003... LITTLE ROCK, ARK. -- Heavier women with gestational diabetes mellitus may be more likely to require insulin therapy Denise Hopkins, Pharm.D., said at the annual meeting of the North American Diabetes in Pregnancy Study Group. But data from...

'Myths' used to justify some fibroid surgeries. (Expert Opinion).
June 15, 2003... SCOTTSDALE, ARIZ. -- Too often the reasons physicians give for surgically removing uterine fibroids aren't based on fact, Dr. William H. Parker said at an international congress on uterine fibroids sponsored by the American Association of...

Cryotherapy nearly halved size of uterine fibroids in pilot study. (Menorrhagia Relieved in 14 of 15 Women).
June 15, 2003... SCOTTSDALE, ARIZ. -- Freezing uterine fibroids nearly halved fibroid size and eliminated fibroid symptoms in nearly all of 20 patients at a 6-month follow-up in a pilot trial. Cryomyolysis was performed using the Her Option system, which is...

No retreatment in 75% after global ablation. (Thermachoice).
June 15, 2003... SCOTTSDALE, ARIZ. --In the longest follow-up study on any of the global ablation technologies, 75% of 188 women followed for 4-6 years after a Thermachoice ablation needed no further surgery to control menorrhagia. In all, 86% of patients...

Endometrial ablation for fibroids under study. (Off-Label Treatment).
June 15, 2003... SCOTTSDALE, ARIZ.--You can heat it, poach it, zap it, freeze it, or microwave it. There are more ways than ever to globally ablate the endometrium. Introduced in the 1990s as alternatives to hysterectomy for women with dysfunctional...

Preop steroids may cut asthmatics' complications. (Regimen Appears Safe).
June 15, 2003... DENVER -- Corticosteroids can safely be given to asthmatics before surgery to improve lung function and reduce pulmonary complications, Dr. Fanny W Su said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. ...

Break anogenital itch-scratch cycle with sedatives. (Antidepressants Sometimes Needed).
June 15, 2003... Houston--Sometimes sedatives or antidepressants are needed to break an insidious cycle of itching and scratching before the cause of a patient's anogenital pruritus can be identified. Scratching at night, even during sleep, is one of the...

HHS warns about 'contractual joint ventures'. (Penalities of up to $50,000 Possible).
June 15, 2003... WASHINGTON -- Physicians who have recently started joint ventures in their offices, beware: The Department of Health and Human Services may be taking a special interest in you. The department's Office of Inspector General (OIG) recently...

Residencies brace for disruptions with new work hours. (July 1 Implementation Date).
June 15, 2003... Most residency programs will be able to comply with the new work hours that go into effect in July, but they'll have to make some adjustments. Dr. Ingrid Philibert, director of field activities with the Accreditation Council for Graduate...

Fetal Homicide Bill. (Policy & Practice).
June 15, 2003... Seeking to make use of the publicity surrounding the murder of pregnant Laci Peterson in California, several members of Congress have introduced legislation aimed at making it a federal crime to injure or kill a fetus during the commission of a...

Medicaid Funding for Abortions. (Policy & Practice).
June 15, 2003... The New York State Senate passed a measure restricting Medicaid funding to only those abortion procedures that are necessary to save the life of the mother or in cases of rape or incest. The bill has been referred to the state's Assembly where...

Stored Embryos. (Policy & Practice).
June 15, 2003... A survey of more than 430 U.S. fertility clinics found that nearly 400,000 embryos are being stored for future use--many more than previously thought. While the findings may have generated publicity because of embryos' use as a source of stem...

25-To-Life. (Policy & Practice).
June 15, 2003... James Kopp, the militant antiabortion activist convicted of second-degree murder in the killing of New York abortion provider Dr. Barnett Slepian, was sentenced in a Buffalo courtroom to a prison term of 25 years to life. According to news...

Medicaid Funding Cutbacks. (Policy & Practice).
June 15, 2003... President Bush's current Medicaid proposal would result in nearly half a trillion dollars being cut from the program over the next decade, according to an analysis by the nonprofit Families USA. Federal support for Medicaid and the State...

Overworked Nurses. (Policy & Practice).
June 15, 2003... Three out of five hospital nurses say they care for too many patients, according to a survey from the American Federation of Teachers and its health care division, AFT Healthcare. "Nurse understaffing may seem to save money in the short...

Smallpox vaccination program questioned. (Mistrust of CDC).
June 15, 2003... WASHINGTON -- The Bush administration's effort to vaccinate health care providers for smallpox as a way of preparing for a potential outbreak was criticized recently by several local health officials, some of whom questioned the credibility of...

West Nile virus appears to be heading West. (Summer Forecast 2003).
June 15, 2003... West Nile virus may march westward during the summer of 2003, promulgating disease in record numbers in the Great Plains, the West, and Alaska, two Harvard University investigators predict. In the meantime, physicians are urged to stay...

Psychological benefits seen with statin use. (Reduced Risk of Atrial Fibrillation).
June 15, 2003... CHICAGO -- Does the list of unexpected side benefits of statin therapy have no end? The latest potential additions to the list are improvement in psychological state and reduced risk of new-onset atrial fibrillation, according to two...

Cholesterol guidelines called 'hopelessly out of date'. (Expert Opinion).
June 15, 2003... SNOWMASS, COLO. -- National Cholesterol Education Program guidelines need an urgent overhaul, Dr. Robert Vogel asserted at a conference sponsored by the American College of Cardiology "I'm basically here to trash the guidelines. I think if...

Metabolic syndrome increases stroke risk. (Especially in Women).
June 15, 2003... HONOLULU -- A large, prospective, epidemiologic study has found that metabolic syndrome is associated with a significantly increased risk of stroke, especially in women, Bernadette M. Boden-Albala, Dr. P.H., reported at the annual meeting of...

Survey: ob.gyns. seldom calculate body mass index. (Half Monitor Weight Loss).
June 15, 2003... NEW ORLEANS -- Most ob.gyns. are comfortable discussing weight and weight-loss issues with their patients, but few calculate body mass index and only about half observe patients for weight loss, a recent survey shows. The survey of more...