OB GYN News articles from March 2000

OB GYN News archives from March 2000

Breast Imaging Goes Digital.
March 1, 2000... The Food and Drug Administration's approval of a digital mammography device in January is considered by experts to be the first step in harnessing digital technology to help find breast cancers at an earlier stage. But for now, digital...

Breast Cancer Risk Rises Slightly Among HRT Users.
March 1, 2000... Relative risk rises by 0.08 per year with combined HRT and 0.01 with estrogen alone. Publication of a study indicating that long-term estrogen-progestin replacement therapy increases the risk of breast cancer in postmenopausal women has...

FDA Panel Conditionally Backs Fetal Pulse Oximeter.
March 1, 2000... Impact on cesarean rate must be watched. GAITHERSBURG, MD. -- A fetal pulse oximeter that measures fetal oxygen saturation during labor was recommended for approval "with conditions" by a Food and Drug Administration advisory panel. In...

HRT Interferes With Screening.
March 1, 2000... Screening mammography is less sensitive among women who use hormone replacement therapy than among those who don't. In fact, 20% more cancers would be detected among HRT users if the sensitivity were equal to that in nonusers, according to...

Computers Beat Clinicians at Fetal Heart Monitoring.
March 1, 2000... ST. PETERSBURG, FLA. -- Practice will never make perfect when it comes to clinicians reading fetal heart rate tracings, according to Dr. Lawrence Devoe. Even when following the latest guidelines on fetal heart monitoring, physicians and...

HRT Offers Advantages for Breast Ca Survivors.
March 1, 2000... SAN ANTONIO -- Hormone replacement therapy in long-term breast cancer survivors is likely to have a net mortality benefit in addition-to substantially improving the quality of life, Dr. Joseph Ragaz said at a breast cancer symposium sponsored...

Scoring System Aids Endometrial Cancer Tx.
March 1, 2000... SAN FRANCISCO -- A scoring system based on age and risk factors helps identify patients with stage Ib-IIb endometrial cancer who might benefit from further treatment with radiation or chemotherapy Dr. James Roberts said. The basic...

Hospitals Brace for Year-Long Penicillin G Shortage.
March 1, 2000... Intravenous penicillin G remains in short supply nationwide and may not be widely available again until late 2000. A nationwide survey of 481 infectious disease specialists showed that 76% had experienced shortages of intravenous penicillin...

Surgeon General Launches National Health Agenda.
March 1, 2000... Federal officials have picked the priorities and set the benchmarks that will guide efforts to monitor and improve the nation's health over the next 10 years. Goals related to sexual behavior, obesity, substance abuse, mental health,...

The Ultimate Teacher.
March 1, 2000... Nancy Maples has done everything but award two of my colleagues and me continuing medical education credits in recognition of what she taught us. Nancy is a psychiatric nurse whom I first saw a decade ago for a routine gynecologic...

Do abstinence-only sex education programs work?
March 1, 2000... Dr. Tom Coburn YES There is some new research showing that some private-sector abstinence-only programs are successful in reducing teen pregnancy and STD rates. And the National Institutes of Health attributes the dropping teen...

Neurologic Disorder: Look for Congenital Syndrome.
March 1, 2000... WAIKOLOA VILLAGE, HAWAII -- Minor congenital anomalies can be an important tip-off that mental retardation or another neurologic disorder in childhood is caused by a congenital syndrome rather than a problem that occurred during labor and...

Meconium Aspiration Syndrome on the Wane.
March 1, 2000... WAIKOLOA VILLAGE, HAWAII -- Meconium aspiration syndrome appears to have occurred less and less often during the last several years, two speakers observed during a discussion at a conference on obstetrics, gynecology perinatal medicine,...

Hypertension Medication May Decrease Birth Weight.
March 1, 2000... Taking high blood pressure medication during pregnancy may lead to lower birth weights, according to Dr. P. von Dadelszen and colleagues at the University of Toronto. In a metaanalysis of 45 randomized, controlled studies following 3,773...

Miscarriage Increases Risk For Depressive Disorders.
March 1, 2000... TORONTO - Women who have had a miscarriage are eight times more likely to develop an episode of obsessive-compulsive disorder in the following 6 months than women in the general population, Pamela A. Geller, Ph.D., reported at the annual...

Conservative Therapy for Severe Preeclampsia.
March 1, 2000... WAIKOLOA VILLAGE, HAWAII -- Conservative management is appropriate for select cases of severe preeclampsia, said Dr. Maurice L. Druzin, chief of maternal fetal medicine at Stanford (Calif) University. In select women who are at 26-28 weeks'...

Tocolytics Not Meant for Maintenance Therapy.
March 1, 2000... SARASOTA, FLA. -- Tocolytic therapy may delay delivery for up to 48 hours in patients with preterm labor, but it may be of little value for prophylaxis or maintenance therapy, Dr. Washington Hill said at a perinatal symposium sponsored by...

Misoprostol Linked to Uterine Rupture in VBAC.
March 1, 2000... WAIKOLOA VILLAGE, HAWAII -- Misoprostol is not a safe choice for labor induction in women who've had a previous cesarean section, maintained Dr. Thomas Benedetti, director of the department of perinatal medicine at the University of Washington...

Standard Antepartum Testing of Preterm Fetuses.
March 1, 2000... WAIKOLOA VILLAGE, HAWAII -- The traditional antepartum tests used to assess the term fetus can also be used effectively to evaluate the preterm fetus, Dr. Maurice L. Druzin said. But if the fetus is preterm, "the possibility of...

Physicians Too Aggressive on ASCUS Follow-Up.(interpreting Pap test results)
March 1, 2000... SAN FRANCISCO -- Physicians are too quick to order repeat Pap smears when an initial Pap test comes back with a reading of atypical squamous cells of undetermined significance, results of two studies suggest. Guidelines issued by the...

Recurrent Vaginitis May Be Due to New Strains of Yeast.
March 1, 2000... NEW YORK -- Patients with recurrent or persistent vaginitis may be infected with less common strains of yeast that require more aggressive treatment, according to Dr. Philip Brooks of the University of California, Los Angeles. "I treat a...

Finding Pathology in 'Normal' Infertility Patients.
March 1, 2000... NEW YORK -- Infertility patients who are classified as "normal" according to all other criteria often have pathology on laparoscopy, Dr. Stephen Corson said at a gynecology meeting sponsored by Symposia Medicus. In a study of 100...

Molecular Tests Flag Chlamydia.
March 1, 2000... New molecular-based tests have transformed the diagnosis of genitourinary infections caused by Chlamydia trachomatis more than for any other infectious disease. That's because the new tests are relatively quick and easy and are more than...

Copper IUDs Can Restore Regular Menstrual Cycles.
March 1, 2000... Insertion of copper IUDs can restore regular menses in women with secondary amenorrhea, reported Dr. Fortunato Vesce and associates at the University of Ferrara (Italy). In an observational study, regular menses resumed in 40 out of 48...

Molecular STD Tests Are Popular.
March 1, 2000... Molecular-based diagnostic tests have become the standard of care for a handful of infectious diseases in addition to Chlamydia trachomatis. Despite this modest penetration, molecular tests for infectious diseases now make up most of the...

Newer Antibiotics Aren't Necessarily Better.
March 1, 2000... SARASOTA, FLA. -- Newerantibiotics are not necessarily better than older ones for treating ob.gyn.-related infections, Dr. Patrick Duff said at a perinatal symposium sponsored by Symposia Medicus. Dr. Duff, professor of ob.gyn. at the...

Master DEXA Reports, Don't Rely on Radiology.(dual-energy x-ray absorptiometry to measure bone density)
March 1, 2000... NEW YORK -- Gynecologists should not assume that radiologists' reports provide an accurate assessment of their patients' bone mineral density following a dual-energy x-ray absorptiometry scan, Dr. Philip Brooks cautioned at a gynecology meeting...

Going Slow on Tension-Free Vaginal Tape Procedure.
March 1, 2000... SAN FRANCISCO - A new procedure being promoted to treat stress urinary incontinence--the tension-free vaginal tape procedure--should not be widely adopted until better data supporting its efficacy are available, two physicians cautioned at an...

Lack of Solid Data Plagues Incontinence Surgery Literature.
March 1, 2000... SAN FRANCISCO -- The National Institutes of Health is committing $1 million to conduct a large multicenter study comparing stress incontinence surgeries in at least 1,000-1,500 women. The data are desperately needed in a field plagued by a...

HPV Test Debated for Triaging ASCUS Results.
March 1, 2000... Can cervical cytology specimens be triaged by testing for oncogenic strains of human papilloma virus? For now, expert opinion is split. The conventional wisdom, voiced by experts at the National Cancer Institute and elsewhere, is that...

HPV Test May Not Replace Cervical Cytology.
March 1, 2000... Testing for oncogenic strains of human papilloma virus is close to being a routine adjunct to cervical cytology, but it may never replace cytology, at least in the United States. That's the prediction by several experts, despite the good...

Conventional Pap Smears Still Effective, Less Costly.
March 1, 2000... WAIKOLOA VILLAGE, HAWAII -- New Pap smear methods are unlikely to supersede the conventional Pap smear for widespread cervical cancer screening any time soon, Dr. Stephen C. Rubin said at a conference on obstetrics, gynecology, perinatal...

Drug Update: Irritable Bowel Syndrome.
March 1, 2000... Drug treatment of irritable bowel syndrome is appropriate for patients with disabling symptoms. Few drugs have been adequately studied for treating the syndrome, however. In general, drugs do not work very well for patients with IBS, but...

Salicylate Toxicity.
March 1, 2000... "Salicylate overdoses are on the rise," warned Dr. Robert Hoffman, director of the New York City Poison Control Center. "Aspirin went out of fashion for a while, but now it seems like almost everyone is on it" for its cardioprotective...

Watch Out for Hair Dye.
March 1, 2000... Hair dye is underappreciated as an allergen in contact dermatitis, said Dr. James Taylor of the Cleveland Clinic. Paraphenylendiamine (PPDA) in permanent hair-coloring products is the major culprit, causing contact dermatitis on the face...

Put the Bite on Diarrhea.
March 1, 2000... "Montezuma's revenge," "Delhi belly," and other variants of travelers' diarrhea can be prevented with chewable bismuth-containing tablets, reported Dr. Diane Birnbaumer at a meeting on primary care emergencies sponsored by Symposia Medicus. ...

The Long Arm of GERD.
March 1, 2000... Gastroesophageal reflux can affect more than just the esophagus. "We know that 70%-80% of patients with asthma also have gastroesophageal reflux disease [GERD]," Dr. Philip O. Katz said during a press briefing at the annual meeting of the...

Nitrates Damage Hip Joints.
March 1, 2000... Patients who use nitrates on a daily basis have double or triple the risk of osteoarthritis as nonusers, Dr. Nancy Lane said at the annual meeting of the American College of Rheumatology. In a longitudinal study initially aimed at assessing...

Rub Out Low Back Pain.(with massage)
March 1, 2000... Massage therapy could gain new respectability as an effective alternative to standard therapy for chronic low back pain, based on results of a randomized clinical trial. Massage therapy produced a substantial and persistent benefit in the...

Cisapride Use Requires ECG.
March 1, 2000... The labeling for cisapride has been strengthened to include a recommendation to perform a 12-lead electrocardiogram in every patient before prescribing the heartburn drug. Patients with QTc intervals longer than 450 milliseconds should not...

Top 10 Causes of Death in 45- to 64-Year-Olds.(Statistical Data Included)
March 1, 2000... Top 10 Causes of Death in 45- to 64-Year-Olds Cause Number Rate [+] * Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues 132,197 231 * Heart disease...

STATE ABORTION LAWS.(Statistical Data Included)
March 1, 2000... State legislatures passed 70 antiabortion measures in 1999, up from 62 in 1998, according to a survey by the National Abortion and Reproductive Rights Action League. Laws included those that prohibited the use of state funds for providing...

PREGNANCY AND SUPPLEMENTS.
March 1, 2000... The Food and Drug Administration has revised a rule that would have allowed manufacturers to sell herbs and other supplements for morning sickness and leg swelling in pregnancy without undergoing safety and efficacy testing. The rule, which...

MEDICAL ERRORS REPORTING.(Statistical Data Included)
March 1, 2000... In the latest chapter of the medical errors saga, several senators are pushing for legislation that would require doctors and hospitals to report mistakes. The bills come in response to an Institute of Medicine report released last November...

DOCTOR UNIONIZING EFFORTS.(Statistical Data Included)
March 1, 2000... Physicians for Responsible Negotiation (PRN), the doctors' union created by the American Medical Association last year, is in negotiations with physicians who work for a Detroit Medicaid HMO that covers more than 130,000 patients. The nascent...

ALTERNATIVE THERAPIES.(insurance coverage in Washington state.)
March 1, 2000... Health insurance plans in Washington state must pay for alternative medicine treatments, such as acupuncture, massage therapy, naturopathy, and chiropractic care under a law recently upheld by the state supreme court. Regence Blue Shield had...

BLUES, PLANS ENROLLMENT UP.(Statistical Data Included)
March 1, 2000... More than one in four Americans--or 74.5 million--are enrolled in Blue Cross and Blue Shield health insurance plans nationwide, according to new figures from a trade group representing the plans. The enrollment rates are the highest they have...

More States Implementing External Appeals Laws.(Statistical Data Included)
March 1, 2000... More states are setting up external appeals processes for resolving health care disputes, but problems with the processes continue to surface, according to several experts. In the past few years, 30 states and the District of Columbia have...

Maryland's Appeals Process: 1 Year, 599 Cases.(Statistical Data Included)
March 1, 2000... With 1 year and 599 cases under their belts, Maryland health insurance officials say the state's process for appealing medical necessity disputes is running smoothly. "We've done a lot for the citizens, and the process is working very...

Tips on Nipping Malpractice Lawsuits in the Bud.(Statistical Data Included)
March 1, 2000... NEW ORLEANS -- Dr. E. Gaylon McCollough will never forget the day a uniformed deputy sheriff served him with a lawsuit, right in the middle of his waiting room. "It was a devastating event. I felt violated. I felt shocked. A sick feeling...

Practice Management Firms Focus on Local Niches.
March 1, 2000... A new breed of ob.gyn. practice management company is trying to succeed where others have failed. Unlike several large physician practice management companies (PPMCs) that made headlines in recent years for their financial failings, the...

Three-Tiered Drug Benefits Gaining in Popularity.
March 1, 2000... More health plans are attempting to control skyrocketing pharmaceutical costs by creating three-tiered prescription drug benefits--in effect, passing more of the cost of expensive drugs on to consumers while reducing some of the hassle factor...

Canada Considers A Two-Tiered Health Care System.
March 1, 2000... SACRAMENTO -- Canadian citizens are considering the creation of a blended public/private health care system that could ultimately serve as a model for the United States, Walter Glannon, Ph.D., said at a conference on health care systems...

Ultrasound Detects Early Ovarian Ca.
March 15, 2000... SAN DIEGO -- Annual transvaginal ultrasound screening detected ovarian cancer at an early stage in a study of more than 14,000 women at high risk for the disease. But it's still too soon for wide spread adoption of annual ultrasound...

Multiple Courses of Prenatal Steroids: No Added Benefits.
March 15, 2000... Other studies show higher risk of fetal death, neonatal sepsis, and endometritis. MIAMI BEACH -- Multiple courses of prenatal corticosteroids given to women at risk of preterm delivery appear to offer no additional benefit, compared with...

Zidovudine Not Linked to Mitochondrial Defects.
March 15, 2000... Over 1,000 HIV-negative children examined. SAN FRANCISCO -- Perinatal exposure to zidovudine was not associated with mitochondrial defects in early childhood in a review of more than 1,000 HIV-negative children enrolled in a U.S. study of...

VITAL SIGNS.
March 15, 2000... VITAL SIGNS Many Americans Are Willing to Pay to Insure the Uninsured [*] Willing to Pay $50 40% Not Willing to Pay More 24% Willing to Pay $5 20%...

Microlaparoscopic Sterilization Tied to Less Post-Op Pain.
March 15, 2000... LAS VEGAS -- Surgical sterilization performed with a microlaparoscope is far less painful than standard laparoscopy and just as cost effective, Dr. Ira Steinmetz said at the annual meeting of the American Association of Gynecologic...

First-Trimester AZT: No Rise In Birth Defects Observed.
March 15, 2000... SAN FRANCISCO -- Zidovudine monotherapy during the first trimester of pregnancy does not appear to increase the risk of birth defects detected at the time of delivery. The finding comes from the largest U.S. prospective registry of the...

Reasons Unclear for Widespread Antibiotic Shortage.(Statistical Data Included)
March 15, 2000... Explanations ranging from "just in time" shipping to Y2K hoarding to generic drug recalls are being floated as possible reasons for the antibiotic shortages being reported by infectious disease specialists nationwide. In a survey nearly...

High Mortality, Early Onset Mark the Flu Season.(Statistical Data Included)
March 15, 2000... BETHESDA, MD. -- Did this year's influenza vaccine fail? Even though the vaccine was well matched to the virus strains that were detected, unusually high mortality and an early onset marked the 1999-2000 flu season. Explanations abound...

Do residents work too many hours?(PRO & CON)
March 15, 2000... Do residents work too many hours? YES It is simply not human to be able to function adequately while working sometimes 40 or more continuous hours on call. The length of the American work week is generally considered to be 40 hours. It...

LETTERS.
March 15, 2000... Making the Lawyers Happy The mandatory reporting of medical errors by hospitals and doctors sounds good in theory, but due to the extreme, litigious climate that exists not only in the field of medicine but in society in general, this...

Antidepressants Appear Safe During Pregnancy.
March 15, 2000... Women who use antidepressants during pregnancy are not significantly increasing the risk of congenital malformations in their infants, according to results of a large prospective study Dr. A. Ericson of the Centre for Epidemiology in...

Postpartum Bacteremia Caused By Edwardsiella tarda Infection.
March 15, 2000... BETHESDA, MD. -- A woman with symptoms of endomyometritis was found to have the first known case of postpartum bacteremia due to Edwardsiella tarda, Dr. Gautham Nayak reported at the annual meeting of the Washington, D.C., Chapter of the...

Treat Group B Strep During The Late Third Trimester.
March 15, 2000... ST. PETERSBURG, FLA. -- Using penicillin G to treat a patient colonized with group B streptococcus during the late third trimester can eradicate her bacterial load when it comes time for her to deliver, according to results of a small...

Elective Cesarean Found to Be Cost Effective.
March 15, 2000... SAN FRANCISCO -- Elective cesarean section in HIV-positive pregnant women is a cost-effective strategy. An analysis conducted by researchers at the National Institute of Child Health and Human Development in Bethesda, Md., predicted that...

Delivering Gestational Diabetic Mothers.
March 15, 2000... SARASOTA, FLA. - Shoulder dystocia is a major concern in women with gestational diabetes--even when the baby is estimated to weigh less than 4,000 g, Dr. John F. Huddleston said at a perinatal symposium that was sponsored by Symposia Medicus....

Lateral Flaps Can Repair Severe Vaginal Prolapse.
March 15, 2000... ST. PETERSBURG, FLA. -- Vaginal prolapse repair using lateral flaps is an effective technique that can be mastered by generalist ob.gyns., according to Dr. Mitchel S. Hoffman. The goal is to make a precise creation of the new apex and...

Umbilical Insertion of Primary Laparoscopic Cannula Appears Safe.
March 15, 2000... LAS VEGAS -- Direct umbilical insertion of the primary cannula in laparoscopic surgery can be performed safely and rapidly with good cosmetic results, according to Dr. Gerard Pregenzer. In a Study of 900 women who underwent diagnostic or...

Vaccine Immunotherapy Targets Breast Cancer.
March 15, 2000... SAN ANTONIO -- Vaccine immunotherapy has emerged as a promising approach in the treatment of breast cancer, Dr. Martin A. Cheever reported at a breast cancer symposium sponsored by the San Antonio Cancer Institute. Early clinical trials...

Tailor DCIS Treatment to Cancer Recurrence Risk.(ductal carcinoma in situ)
March 15, 2000... SAN ANTONIO -- The emerging trend in management of ductal carcinoma in situ is to tailor treatment intensity to the level of an individual's recurrence risk, Dr. Monica Morrow said at a breast cancer symposium sponsored by the San Antonio...

Screening of Women With BRCA Mutations Remains Tricky.
March 15, 2000... SAN ANTONIO -- Managing women with BRCA1 or BRCA2 mutations still requires a lot of guesswork, Dr. Richard M. Elledge said at a breast cancer symposium sponsored by the San Antonio Cancer Institute. American and European experts recommend...

Cryosurgery May Freeze Out Cold Steel in Breast Ca.
March 15, 2000... SAN ANTONIO -- MRI-guided percutaneous cryosurgery of breast cancer shows early promise as a minimally invasive procedure offering improved cosmetic results, Dr. Jacques Morin said at a breast cancer symposium sponsored by the San Antonio...

Biomarkers May Spare Early Breast Cancer Patients Adjuvant Therapy.
March 15, 2000... SAN ANTONIO -- An intensive search is underway for prognostic biomarkers in early-stage breast cancer. The goal is to identify factors that will enable physicians to classify patients as high risk--and therefore in need of rigorous...

High Court Case Could Put a Chill on HMOs.
March 15, 2000... WASHINGTON -- The outcome of a managed care case heard by the U.S. Supreme Court last month could have a chilling effect on HMOs. The case, Pegram v. Herdrich, is the first managed care liability case to reach the U.S. Supreme Court. The...

WOMEN'S HEALTH MANDATES.
March 15, 2000... Coverage for prescription contraceptives was the hottest women's health topic in state legislatures last year, according to the Blue Cross and Blue Shield Association, in Washington. Nine states--California, Connecticut, Georgia, Hawaii, Maine,...

BONE MARROW TRANSPLANTS.
March 15, 2000... The nation's largest health insurer announced last month that it will no longer cover most bone marrow transplants for breast cancer patients. Aetna U.S. Healthcare's decision came shortly after researchers disclosed that a South African study...

GENETIC DISCRIMINATION.
March 15, 2000... President Bill Clinton signed an executive order last month barring federal agencies from using genetic information in any hiring or promotion decisions. The order prohibits the government from "obtaining or disclosing" genetic information...

LATE PAYMENT LAWSUIT.
March 15, 2000... The Medical Association of Georgia and the American Medical Association are suing Aetna U.S. Healthcare for not paying claims on time. The class action suit, filed last month in superior court in Atlanta, alleges that Aetna routinely delays...

NURSE PRESCRIBING.
March 15, 2000... Last month, Republican Gov. Bob Taft of Ohio signed a law making Ohio the 50th state to allow advanced-practice nurses to prescribe medication. The law allows nurses to prescribe only under physician supervision, and physicians can supervise...

AMAP IS DEAD.(American Medical Accreditation Program)
March 15, 2000... The American Medical Association has decided to pull the plug on its 3-year-old American Medical Accreditation Program (AMAP). The program lost nearly $5 million in 1999, and AMA officials had been searching for new business partners for the...

Coding Software.
March 15, 2000... PocketCode, a portable coding tool, is available as a Windows-based desktop application or as a personal digital assistant program. It streamlines claims processing, helps ensure accurate billing, and--through quarterly coding updates...

Blood Analysis System.
March 15, 2000... The desktop Careside Analyzer can carry out 37 blood tests for chemistry, electrochemistry, and coagulation, representing more than 80% of all routine blood tests ordered on an outpatient basis, with results in 15 minutes. The tests are...