OB GYN News articles from March 2003

OB GYN News archives from March 2003

Report outlines causes of NE, CP. (Most Occur Before Labor).
March 1, 2003... The majority of newborn brain injuries are not the result of birth asphyxia but occur before the onset of labor, according to a comprehensive report released last month by the American College of Obstetricians and Gynecologists and the American...

Guidelines largely agree on cervical cancer screening: U.S. Preventive Services Task Force issues evidence-based guidelines. (Similar to those of ACS).
March 1, 2003... Now that the U.S. Preventive Services Task Force has issued cervical cancer screening guidelines similar to those issued recently by the American Cancer Society, experts say that having the two sets of recommendations may lend more weight to...

Unilocular ovarian cysts common, rarely malignant: follow patients with serial ultrasound. (Postmenopausal Women).
March 1, 2003... NEW ORLEANS -- Unilocular ovarian cysts are fairly common but rarely malignant in postmenopausal women, and most can safely be followed conservatively with serial ultrasounds. That finding emerged from a study of more than 15,000 women that...

Community-acquired methicillin-resistant Staphylococcus aureus infections hit Los Angeles. (Young, Otherwise Healthy Women Affected).
March 1, 2003... LOS ANGELES -- Public health officials are investigating an outbreak of an aggressive, community-acquired, methicillin-resistant Staphylococcus aureus skin infection that has struck more than 1,000 people, including newborns, young athletes,...

Medicine in space. (Guest Editorial).
March 1, 2003... The tragic loss of the Space Shuttle Columbia and its crew reminded the nation of the importance of the space program and the courage of those who choose to risk their lives in the name of scientific discovery. If the seven men and women...

Letters.
March 1, 2003... Good Advice for Doctors The threat of litigation has destroyed the patient-doctor relationship and severely tarnished the medical profession. Philip K. Howard's guest editorial "The Death of Common Sense" speaks to every doctor who has...

Correction/clarification.
March 1, 2003... The following category should have been included in "Drug Update: Hormone Replacement Therapy" (Jan. 1, 2003, p. 8). Drug: synthetic conjugated estrogens (Cenestin) Dosage: 0.625-1.25 mg/day Cost/Day: $0.67 (0.625 mg/day) based on...

Pro & con: is the insurance cycle responsible for rising malpractice premiums?
March 1, 2003... YES Medical malpractice claims have held steady yet insurance premiums have skyrocketed. This pattern can be attributed to the cyclical nature of the commercial insurance business. We are in the midst of a classic "hard" insurance...

Take family ca history in pregnancy or risk lawsuit. (New Frontier of Medical Litigation).
March 1, 2003... CANCUN, MEXICO -- Cancers of genetic origin are the next frontier of medical litigation, Dr. Aubrey Milunsky said at a conference on obstetrics. gynecology perinatal medicine, neonatology, and the law. "Juries increasingly believe that...

Acne Therapies. (Drugs, Pregnancy, and Lactation).
March 1, 2003... Topical and systemic agents are used in the treatment and prevention of acne, ranging from those that have negligible risks during pregnancy to a drug that is a major teratogen. Azelaic acid (Azelex, Finevin), a topical antimicrobial,...

Undertreatment a problem in pregnant asthmatics. (Management Tips).
March 1, 2003... SARASOTA, FLA. -- The biggest problem with asthma in pregnancy is undertreatment, Dr. Felice Baron said at a pennatal symposium sponsored by Symposia Medicus. Patients, and often their physicians, tend to fear that asthma medications could...

Trisomy 13 survival can exceed 1 year. (Seen in 8% of Affected Infants).
March 1, 2003... BALTIMORE -- About 8% of infants born with either trisomy 13 or trisomy 18 survive longer than 1 year, Dr. Sonja A. Rasmussen said at the annual meeting of the American Society of Human Genetics. "The perception among most physicians is...

Prenatal care gap shrinks between whites and African Americans. (Improved Care for Both).
March 1, 2003... The difference in prenatal care use between African American and white women is shrinking. The proportion of women receiving adequate prenatal care rose for both groups from the early 19805 to the late 1990s: from 27% to 44% for African...

New theories emerge on nonvertex twin delivery. (Breech Extraction may not be so Risky).
March 1, 2003... SARASOTA, FLA. -- Dogm a regarding the approach to take with a nonvertex second twin is increasingly being challenged by the evidence, Dr. Roger B. Newman said at a perinatal symposium sponsored by Symposia Medicus. A barrage of papers...

Spot heart defects early to increase survival. (Routine Surveillance Inadequate).
March 1, 2003... CANCUN, MEXICO -- Prenatal detection of congenital heart defects can improve an infant's chance of survival if delivery is then done at a tertiary cardiac center. But most congenital heart defects won't be seen with a prenatal ultrasound...

Concerns crop up about aromatase inhibitors. (Musculoskeletal Problems, Fractures).
March 1, 2003... SAN ANTONIO -- Updated results of the world's largest breast cancer treatment trial have injected a cautionary note into efforts to develop the aromatase inhibitors as breast cancer chemoprevention agents. Extended follow-up data from the...

Radiation beneficial in elderly patients after breast-conserving Tx. (Large Retrospective Review).
March 1, 2003... SAN ANTONIO -- Omitting radiation therapy following breast-conserving surgery in elderly patients adversely affects survival, Dr. Pauline T. Truong said at a breast cancer symposium sponsored by the San Antonio Cancer Institute. Dr. Truong...

Nipple-sparing mastectomy a new option for early breast ca. (Performed in 34 Patients).
March 1, 2003... SAN ANTONIO -- Nipple-sparing mastectomy with immediate reconstruction is an important new option in women with early-stage breast cancer and in high-risk patients who want prophylactic mastectomy, Dr. Joseph P. Crowe said. Cosmetic...

Regret after total colpocleisis in 8 of 92 women. (Largest Series to Date).
March 1, 2003... SAN FRANCISCO -- Eight of 92 women who were contacted 2 years after undergoing total colpocleisis for advanced pelvic organ prolapse said they regretted having the operation, but only 1 of the 8 said she would not undergo the surgery if she...

Tell laparoscopy patients about laparotomy. (Conversion Risk).
March 1, 2003... MIAMI BEACH -- Counsel all laparoscopy patients that their procedure could be converted to a laparotomy, Dr. Andrew Sokol said in a poster presented at the annual meeting of the American Association of Gynecologic Laparoscopists. The...

Identify Pelvic floor defects during hysterectomy. (Repair or Reattach Uterosacral Ligaments).
March 1, 2003... ST. LOUIS -- Hysterectomy, be it abdominal or vaginal, presents a fine opportunity for prophylaxis against vaginal eversion, Dr. G. Rodney Meeks said at the 12th International Pelvic Reconstructive and Vaginal Surgery Conference. "I think...

Mesh holds up well in posterior prolapse repairs. (Cell and Porcine Mesh).
March 1, 2003... MIAMI BEACH -- Both small intestine cell mucosa mesh and porcine dermis mesh yield excellent results when used for posterior vaginal wall prolapse, Dr. Jim Ross said at the annual meeting of the American Association of Gynecologic...

BMD loss may not signal treatment failure. (Early in Therapy).
March 1, 2003... NEW YORK -- A loss of bone mineral density during the first year of osteoporosis treatment with an antiresorptive agent may not indicate treatment failure and may be compensated for by bone mineral density gains in the second year of treatment,...

Teriparatide works regardless of age, fracture Hx. (Linked to Fewer Vertebral Fractures).
March 1, 2003... Teriparatide increases vertebral density and decreases the risk of spinal fractures in postmenopausal women regardless of their age, fracture history, or bone mineral density at baseline, reported Dr. Robert Marcus and his associates at Eli...

Fractures often overlooked in Crohn's patients. (Vertebral Fractures).
March 1, 2003... Vertebral fractures often go clinically undetected in patients with Crohn's disease who have osteoporosis or osteopenia, said J. Klaus of the University of Ulm (Germany) and associates. Of 293 consecutive patients with Crohn's disease, 111...

Modest weight loss goes far in PCOS patients. (Better Endocrine, Reproductive Function).
March 1, 2003... NEW YORK -- Modest calorie restriction can have a profound effect on reproductive and endocrine function in some overweight women with polycystic ovary syndrome, Dr. Sarah L. Berga said at a media briefing on pituitary/hormonal disorders...

Endometriosis pain relief can last up to 5 years. (Post Laparoscopy).
March 1, 2003... MIAMI BEACH -- Laparoscopic treatment of endometriosis relieves chronic pelvic pain for up to 5 years, Dr. Amy Weaver said in a poster presentation at the annual meeting of the American Academy of Gynecologic Laparoscopists. In a...

Visual, hidden clues to PCOS aid diagnosis. (Hair Removal).
March 1, 2003... NEW YORK -- Polycystic ovarian syndrome is underrecognized but could be more widely diagnosed if clinicians were better attuned to its visual clues, including hirsutism, which many patients are effective in partially hiding, Dr. Geoffrey...

How to approach the pediatric pelvic exam. (Diagnosing Vulvovaginopathies).
March 1, 2003... HOUSTON -- Familiarity with prepubertal anatomy and an appropriate examination are your best tools for diagnosing pediatric vulvovaginopathies, according to Dr. Susan Pokorny. Signs and symptoms are less useful diagnostic aids but can help...

Free mammograms don't boost compliance rates. (Urban, Low-Income Patients).
March 1, 2003... CHICAGO -- Offering free mammograms to low-income women was not enough to encourage them to receive the tests in a study of 371 urban, low-income patients. Although more than 90% of the women who were offered free mammograms agreed to...

Laparoscopy for endometriosis improves quality of life. (Ongoing 11-Year Study).
March 1, 2003... MIAMI BEACH - Laparoscopic excision of endometriosis results in a low rate of recurrence and persistence, preserves fertility, and significantly improves quality of life, Dr. Ken Sinervo reported at the annual meeting of the American...

Gender bias alleged in CPT reimbursement codes. (Study of CPT-4 Codes for 2001).
March 1, 2003... SAN FRANCISCO -- An analysis of codes in the federal system used to calculate physician reimbursements revealed a persistent bias favoring higher payments for physicians who treat men, Dr. Geoffrey W. Cundiff said. Like results from...

Rape victims generally prevail in court cases. (Case-Control Study).
March 1, 2003... RANCHO MIRAGE, CALIF. -- When sexual assault victims pursue legal action against their assailants, they prevail in the vast majority of cases, regardless of whether they sustained traumatic injuries, a case-control study determined. In an...

Health care organizations face six new Patient Safety Goals. (Set by JCAHO).
March 1, 2003... Thousands of health care organizations nationwide are now required to implement a number of patient safety measures or risk citations from the nation's largest accrediting body. The National Patient Safety Goals, developed by the joint...

Suicide is top cause of early death in physicians. (Far Higher than in General Population).
March 1, 2003... HENDERSON, NEV. -- Suicide ranks as the leading cause of premature death among physicians, Dr. Peter Mansky said at the annual meeting of the American Academy of Addiction Psychiatry. "Physicians probably start out with better health than...

State of the Union Address. (Policy & Practice).
March 1, 2003... In his State of the Union Address President Bush spoke in favor of some policies that drew fire from women's rights organizations. "I ask you to protect infants at the very hour of their birth and end the practice of partial-birth abortion. And...

NARAL's name change. (Policy & Practice).
March 1, 2003... The National Abortion Rights and Reproductive Action League has changed its moniker and updated its mission. The group's new name, NARAL Pro-Choice America, retains the well-known NARAL acronym. Along with the name change, NARAL says it plans...

Roe v. Wade turns 30. (Policy & Practice).
March 1, 2003... The 30th anniversary of Roe v. Wade was commemorated in a clash between abortion rights advocates and abortion foes. Thousands of antiabortion activists marched on the U.S. Supreme Court in Washington, D.C., where President Bush called on...

Health policy predictions. (Policy & Practice).
March 1, 2003... Health policy is still very much on the minds of constituents, two policy analysts said at a meeting. Speaking at the 2003 National Health Policy Conference in Washington, D.C., Dr. Thomas E. Mann of the Brookings Institution, delivered a...

Sen. Breaux's health plan. (Policy & Practice).
March 1, 2003... Sen. John Breaux (D-La.) has announced a plan for universal health coverage for all Americans. No timetable exists for the introduction of such legislation, but Sen. Breaux is proposing the plan to spark debate and get universal health coverage...

Think like an MBA to make practice profitable. (Business School Tips).
March 1, 2003... SAN FRANCISCO -- Medicine is not a business. It follows a higher standard, and physicians must choose between high-quality medicine and profits. Right? Wrong. Physicians can offer high-quality medicine and still make a profit, but they...

Walking program can help fight depression in stay-at-home women. (Also Relieves Fatigue, Anger).
March 1, 2003... NEW ORLEANS -- Depression among women who stay at home can be alleviated through participation in a structured walking program, a study has shown. The findings are in agreement with other studies showing a positive association between...

Depression more prevalent among asthma patients. (Seen in 29% of 439 Asthmatics).
March 1, 2003... ATLANTA -- Depression was more common in patients with asthma than in the general population, based on the results of a study of 439 adults with asthma. Depression was most common among asthma patients who smoked, had two or more comorbid...

Soy nuts may cut BP in postmenopausal women. (Pilot Study).
March 1, 2003... CHICAGO -- Postmenopausal women who ate a 2-ounce bag of soy nuts a day had a significant reduction in their blood pressure in a controlled pilot study. "The effect on blood pressure was somewhat unexpected. The reduction was comparable to...

Salmeterol safety alert: use with an inhaled steroid. (Consistent with Guidelines).
March 1, 2003... Add an asthma controller--preferably an inhaled corticosteroid--to the treatment regimen of patients using salmeterol as monotherapy, salmeterol manufacturer GlaxoSmithKline said in a recent letter to prescribers. This recommendation was...

Data watch.
March 1, 2003... DATA WATCH Percent of Adult Patients With High Blood Pressure By Age Ages 18-64 17% Age 65 and Older 54% By Race White 23% Black 28% Hispanic 15% By Sex ...

Osteoarthritis. (Women's Health Adviser).
March 1, 2003... The fact that the American College of Rheumatology has revised its guidelines for the treatment of osteoarthritis twice in recent years is a testament to how many advances have occurred. New drugs and treatment options abound, and researchers...

Don't overlook obvious in fibromyalgia Tx. (Exercise, Analgesics).
March 1, 2003... LOS ANGELES -- Don't overlook the simple and obvious in treating fibromyalgia, Dr. Andrew F. Leuchter said at a psychopharmacology update sponsored by the University of California, Los Angeles. No cure for this disorder has been found, but...

Topical cream for intimacy. (Products).
March 1, 2003... Sensual is a topical cream designed for women to improve sensitivity during intimacy. The cream acts as a moisturizer for vaginal dryness and personal lubrication to enhance condom use and vaginal comfort during intimate sexual activity. For...

Male fertility test. (Products).
March 1, 2003... FertilMarq, a male fertility diagnostic test for use at home, is now available in the United States. The test assesses sperm concentration, providing important information for couples trying to conceive a child. Couples evaluate two separate...

Cipro XR approval. (Products).
March 1, 2003... Cipro XR (ciprofloxacin) has been approved for treating uncomplicated urinary tract infections caused by Escherichia coli, Proteus mirabilis, Enterococcus faecalis, or Staphylococcus saprophyticus. The extended-release tablets come in a 500-mg...

Laparoscopic morcellator. (Products).
March 1, 2003... The Sawalhe electromechanical morcellator is now available in 12-, 15-, and 20-mm cutting blades. It was designed to minimize procedure times in laparoscopic gynecology and urology procedures. Grasping instrument shafts allow the forceps to...

Needle safety device. (Products).
March 1, 2003... The LuproLoc needle safety device is now available for use with Lupron Depot (leuprolide acetate for depot suspension) prefilled syringes. The device, approved by the U.S. Food and Drug Administration, is designed to protect against accidental...

Resistance exerciser. (Products).
March 1, 2003... GyneFlex pelvic floor muscle exerciser is approved for the treatment of urinary incontinence in women. The device, which can be inserted into the vagina, is available in three resistance strengths: light, for women with severe incontinence or...

Blood Glucose Monitors. (Products).
March 1, 2003... The BD Logic Blood Glucose Monitor and the BD Latitude Diabetes Management system are now available. Both use BD Ultra-Fine 33 lancets, require 0.3 [micro]L of blood, and record up to 250 blood glucose results and insulin doses. The diabetes...

Cystic fibrosis screening soars. (Still Below Target Levels).
March 15, 2003... Screening of pregnant women and their partners for cystic fibrosis mutations has skyrocketed since September 2001, when the American College of Obstetricians and Gynecologists and the American College of Medical Genetics recommended that...

Drugs with the highest direct-to-consumer advertising spending, 2000. (Vital Signs).
March 15, 2003... VITAL SIGNS Drugs With the Highest Direct-to-Consumer Advertising Spending, 2000 % of DTC Spending % of Sales Drug Condition For All Drugs * For All Drugs ** Vioxx ...

Progesterone linked to decline in preterm births. (Women with Previous Preterm Birth).
March 15, 2003... Recipient of progesterone shots also had fewer babies born weighing less than 2,500 g. SAN FRANCISCO -- Physicians finally have a proven tool that may prevent some preterm births in women with a history of preterm delivery: weekly shots of...

Obstetrics being dropped due to malpractice costs: in one survey, 56% ponder relocating. (Results of Two Surveys).
March 15, 2003... The malpractice crisis is causing many ob.gyns. to drop obstetrics from their practices, according to two recent surveys. The most recent numbers come from Merritt, Hawkins, & Associates, an Irving, Tex.-based physician-recruiting firm....

HIPAA privacy rules: it's still not too late to comply. (April 14 Deadline).
March 15, 2003... For physicians who haven't made any plans for complying with the new federal privacy regulation that goes into effect April 14, don't worry--it's not too late to start. The regulation, part of the federal Health Insurance Portability and...

Periodontitis treatment linked to reduction in preterm births. (Pilot Trial).
March 15, 2003... SAN FRANCISCO -- Pregnant women with periodontitis who underwent a deep tooth cleaning and root planing procedure had a significantly lower rate of preterm birth than those who received no treatment in a pilot study of 366 women. Previous...

Kaiser program blazes CF screening trail.
March 15, 2003... While the American College of Obstetricians and Gynecologists is scrambling to make cystic fibrosis carrier screening a routine part of obstetric care, the physicians at Kaiser Permanente of Northern California have their program firmly in...

Group neutral on gestational diabetes screening. (U.S. Preventive Services Task Force).
March 15, 2003... The U.S. Preventive Services Task Force has taken a neutral stand on routine screening of healthy pregnant women for gestational diabetes, citing insufficient evidence to recommend for or against the procedure. And in a separate...

Congress finally delivers on Medicare payment fix. (Positive Update of 1.6% in 2003).
March 15, 2003... WASHINGTON -- Congress finally answered the call from medical organizations to increase Medicare physician payment rates. House and Senate conferees for the fiscal year 2003 omnibus spending bill last month reached an agreement that would...

Screening mammography. (Guest Editorial).
March 15, 2003... Physicians need to let screening mammographic examinations screen. The most fundamental error one can make when interpreting the results of a screening mammogram is to confuse it with a diagnostic mammogram. Physicians often try to minimize the...

Build trust by opening up. (Guest Editorial).
March 15, 2003... Trust is the glue that binds physician to patient and patient to physician. Having a trusting relationship is critical in a physician's ability to dispense good medical care. It is also a way to minimize malpractice claims. At a time when...

Does the Mirena IUD eliminate the need for endometrial resection in women with menorrhagia? (Pro & Con).
March 15, 2003... YES Long-term oral drug treatment for menstrual disorders is hampered by side effects, and the failure of medical therapy is usually considered an indication for surgery--either hysterectomy or endometrial ablation. In Scandinavia, we...

Correction.
March 15, 2003... In a Data Watch graphic, the axis label should have read "Number of Vaginal Births per 100 Live Births in Women With a Previous C-Section" ("VBAC Rate Continues to Slide," Feb. 1, 2003, p. 15).

Post-radical trachelectomy pregnancy appears safe. (Study of 80 Patients).
March 15, 2003... NEW ORLEANS -- Pregnancy following radical trachelectomy for cervical cancer is generally safe, according to a study of 80 patients who underwent the procedure. The findings from this study--the largest to date to address pregnancy...

Tips on getting pregnant smokers to quit. (Nicotine Replacement, Support Groups).
March 15, 2003... SARASOTA, FLA. -- Only 20%-40% of smokers quit smoking during pregnancy, which means up to 25% of American women smoke while pregnant, Dr. Haywood L. Brown said at a perinatal symposium sponsored by Symposia Medicus. Convincing smokers to...

Maternal smoking tied to weight problems in kids. (Large German Study).
March 15, 2003... Children of mothers who smoked during pregnancy were 1.43 times more likely to be overweight and 2.06 times more likely to be obese, compared with their counterparts whose mothers didn't smoke during pregnancy investigators reported. The...

Anticoagulation in pregnant heart valve patients. (Warfarin Calleed Reasonable Approach).
March 15, 2003... SNOWMASS, COLO. -- Continued use of warfarin throughout pregnancy is a reasonable management strategy in selected women with a prosthetic heart valve, Dr. Carole A. Warnes said at a conference sponsored by the American College of Cardiology....

Childbirth, pregnancy tied to PTSD, expert says. (Recognition is Low).
March 15, 2003... NEW YORK -- Pregnancy and childbirth should be added to the list of risk factors for posttraumatic stress disorder and a diagnostic code for traumatic childbirth should be created, according to Dr. Diana Dell. "Every obstetrician and...

Reconsideration of 'purple pushing' urged. (Labor and Delivery).
March 15, 2003... SARASOTA, FLA. -- Physiology suggests the standard positioning and pushing techniques used during labor and delivery require rethinking, according to Lisa Miller, certified nurse-midwife. Long Valsalva's maneuvers--or "purple pushing"--and...

Topical clobetasol urged for lichen sclerosus tx. (Patient Education, Support Key).
March 15, 2003... HOUSTON -- Ultrapotent topical clobetasol should be the mainstay of treatment for genital lichen sclerosus, despite a widely held belief that it shouldn't be used on the vulva, according to Dr. Elizabeth Edwards. Studies comparing...

At least 50% of in-situ vulvar ca seen in women 20-39 years old. (May be Related to HPV Infection).
March 15, 2003... HOUSTON -- The incidence of in-situ carcinoma of the vulva is increasing, and it's affecting women at younger ages, Dr. Raymond H. Kaufman said at a conference on vulvovaginal diseases sponsored by Baylor College of Medicine. Most current...

Small, aphthous ulcers may mean anogenital Crohn's. (Vulvar, Perinatal Involvement).
March 15, 2003... HOUSTON -- There are only about 30 published cases of anogenital Crohn's disease, but anecdotal reports of it are relatively common, according to Dr. Peter J. Lynch. Chronic Crohn's disease may damage lymphatic channels and leave patients...

Variety of contraceptives okay for disabled women. (Not Limited to Depo-Provera).
March 15, 2003... NEW YORK -- Although contraceptive injection is widely used in mentally and physically disabled women, many of these patients are candidates for a much wider variety of contraceptive methods, according to Dr. Maida Taylor. "There is a ton...

Estrogen contraception may exacerbate seizure frequency. (Survy of 93 Women With Epilepsy).
March 15, 2003... SEATTLE -- One in five women with epilepsy could experience an increase in the frequency of their seizures after initiating estrogen-containing contraception, according to a survey of 93 epilepsy patients who had used hormonal contraception....

Diabetic women at risk for atypical osteoporosis. (Higher Rate of Fractures).
March 15, 2003... NEW YORK -- Women with type 2 diabetes appear to develop an atypical form of osteoporosis, Dr. Michael Kleerekoper said at a conference sponsored by the American Diabetes Association. These women tend to have fractures at atypical sites, to...

History of HRT use tied to fewer bone metastases. (Breast Cancer Patients).
March 15, 2003... SAN ANTONIO -- Women who have been on hormone replacement therapy before being diagnosed with breast cancer have a significantly reduced incidence of bone metastases, Dr. Ingo J. Diel said at a breast cancer symposium sponsored by the San...

Survival in invasive epithelial ovarian cancer has improved. (African Americans Haven't Caught Up).
March 15, 2003... NEW ORLEANS -- The survival rate in women with primary invasive epithelial ovarian cancer has steadily improved over the past 3 decades, Dr. Adnan R. Munkarah reported at the annual meeting of the Society of Gynecologic Oncologists. The...

Cowden syndrome more common than suspected. (Linked to Increased Risk for Breast CA).
March 15, 2003... SAN ANTONIO -- Cowden syndrome is much more common than traditionally thought, Dr. Charis Eng said at a breast cancer symposium sponsored by the San Antonio Cancer Institute. Since the discovery that germline mutations of the tumor...

Drug update: prevention of osteoporosis in postmenopausal women.
March 15, 2003... Three basic options exist for preventing osteoporosis and fractures in postmenopausal women: the workhorse bisphosphonates, the intriguing option raloxifene, and estrogen replacement. The newcomer, teriparatide, is labeled for treatment only....