OB GYN News articles from March 2005

OB GYN News archives from March 2005

First vulvodynia guideline published.(News)
March 1, 2005... HOUSTON -- A new guideline for the diagnosis and treatment of vulvodynia offers multiple treatment options, including experimental and complementary therapies, for the controversial disorder. "We have oceans of lotions, potions, and notions...

Public support for various health reforms.(VITAL SIGNS)
March 1, 2005... Public Support for Various Health Reforms Require publication of negative drug trial results 72% Change patent laws to favor generics 59% Expand tax-free health savings accounts 57% Legalize importation of...

Prior C-section associated with worse outcomes: ICU admission, postpartum infection cited.(News)
March 1, 2005... RENO, NEV. -- A prior cesarean delivery can have an adverse effect on maternal and neonatal postpartum outcomes in subsequent births, according to a retrospective study of 10,600 live births. Women who had received a prior cesarean and then...

SSRIs tied to neonatal withdrawal symptoms.(News)
March 1, 2005... International reports of withdrawal symptoms in 93 newborns whose mothers had taken selective serotonin reuptake inhibitors during pregnancy raise concerns about a possible causal relationship between such symptoms and drugs in this class,...

Dietary fat, sodium tied to stroke risk.(News)
March 1, 2005... NEW ORLEANS -- For the first time, physicians have evidence independently linking high dietary levels of fat and sodium to an increased risk of ischemic stroke, based on findings from an epidemiologic study in New York. Experts who heard...

Study links BMD screening to fewer hip fractures.(News)
March 1, 2005... Bone density screening was associated with fewer hip fractures compared with usual medical care in a study of more than 3,000 adults aged 65 and older. "Although some groups recommend screening, no study had proved that screening prevents...

Tamoxifen for breast Ca associated with lower heart disease risk.(News)
March 1, 2005... Women who took tamoxifen for breast cancer had a 60% decreased risk of developing ischemic heart disease during the recommended 5 years of treatment, compared with women who had other cancers not treated with tamoxifen, Brian D. Bradbury,...

AEH biopsies led to diagnosis of invasive adenocarcinoma in 40%.(News)
March 1, 2005... UNIVERSAL CITY, CALIF. -- Invasive adenocarcinoma was found at hysterectomy in more than 40% of patients who had been diagnosed with atypical endometrial hyperplasia (AEH) at specialized centers of the Gynecology Oncology Group, shocking study...

Federal adoption initiatives.(LETTERS)(Letter to the Editor)
March 1, 2005... I thought your readers might be interested in learning of federal initiatives to increase the number of children being adopted into loving homes ("How to Prepare for Adoption," The Rest of Your Life, Dec. 15, 2004, p. 18). In July 2002,...

Helping uninsured women.(LETTERS)(Letter to the Editor)
March 1, 2005... I do not believe we can afford universal health care, nor do I believe that all Americans would receive quality care in a timely fashion if our politicians agreed to enact such a plan ("Covering the Uninsured," Policy & Practice, Jan. 1, 2005,...

Timing of antibiotics for cesarean.(LETTERS)(Letter to the Editor)
March 1, 2005... Of course nothing was gained by giving prophylactic antibiotics earlier for cesarean deliveries ("Usual Timing of Antibiotics in Cesarean Delivery is Adequate," Jan. 1, 2005, p. 7). The quoted study compared administration at skin incision with...

Correction.(Correction Notice)
March 1, 2005... An article in the Jan. 15 issue ("Investigational DMPA-SC Treats Endometriosis Pain, Curbs BMD Loss," p. 10) should have stated that depot medroxyprogesterone acetate-subcutaneous was approved by the Food and Drug Administration in December...

Pain relievers.
March 1, 2005... "Are you sure it's the sniffles? According to my internet research, I'm suffering from acute Himalayan spotted fever!"

Electronic medical records--a primer.(GUEST EDITORIAL)
March 1, 2005... The day will come, probably in the not-too-distant future, when you will have to seriously consider switching to electronic medical records. Most physicians dread that day, and with good reason: Choosing the right EMR system for your...

Should red and processed meats be removed from U.S. dietary guidelines?(PRO & CON)
March 1, 2005... YES The study by Ann Chao, Ph.D., et al. that recently appeared in the Journal of the American Medical Association showing that red and processed meat consumption greatly increases one's risk of colon cancer is but one example of the...

Early delivery improves mortality among twins.(Obstetrics)
March 1, 2005... RENO, NEV. -- Obstetricians are delivering more sets of twins early--a trend that is improving neonatal mortality, Cande V. Ananth, Ph.D., said at the annual meeting of the Society for Maternal-Fetal Medicine. Black twins, however, are not...

Twin VBAC not associated with increased risk of rupture.(Obstetrics)
March 1, 2005... RENO, NEVADA -- Attempting vaginal birth after cesarean section in twin deliveries may be no more risky than attempting VBAC in singleton pregnancies, according to a review of almost 25,000 deliveries. The review found that women with twins...

Vacuum associated with more dystocia than forceps.(Obstetrics)
March 1, 2005... RENO, NEVADA -- Forceps delivery is associated with more perineal tears than is vacuum delivery, but the vacuum is associated with more complications for the infant, including shoulder dystocia, Aaron B. Caughey, M.D., said at the annual...

Intracranial infection can mimic hypoxic injury.(Obstetrics)
March 1, 2005... CABO SAN LUCAS, MEXICO -- What looks like damage from hypoxic ischemic encephalopathy on neonatal brain imaging actually can be caused by intracranial infection, Robert A. Zimmerman, M.D., said during a conference on obstetrics, gynecology,...

Breast-feeding may help ease AED withdrawal.(Obstetrics)
March 1, 2005... BRECKENRIDGE, COLO. -- A strong case can be made for encouraging a few weeks or months of breast-feeding by epileptic women who continued their seizure medication throughout pregnancy, Jose E. Cavazos, M.D., said at a conference on epilepsy...

A quarter of pregnant women say 'no' to abortion for Down syndrome.(Obstetrics)
March 1, 2005... PHOENIX, ARIZ. -- About one-quarter of a diverse group of pregnant women would not consider a pregnancy termination for a fetus with Down syndrome, according to a study presented at the annual meeting of the Pacific Coast Obstetrical and...

Donor-egg pregnancies, hypertension linked.(Obstetrics)
March 1, 2005... PHOENIX, ARIZ. -- Pregnancies achieved using donor-egg in vitro fertilization can present a higher risk of pregnancy-induced hypertension than those achieved through standard IVF, according to the results of a retrospective study. ...

Infant mortality inversely related to mothers' education level.(DATA WATCH)
March 1, 2005... Infant Mortality Inversely Related to Mothers' Education Level Note: Most of the women with 0-8 years of education were born outside the 50 states and D.C., and they tend to have lower infant mortality than do native-born mothers. ...

MRI can diagnose acute abdominal pain in pregnancy.(Obstetrics)
March 1, 2005... Magnetic resonance imaging is an effective means of diagnosing acute abdominal and pelvic pain in pregnant patients, and it avoids fetal exposure to the radiation of a computerized axial tomography exam, Katherine Birchard, M.D., and her...

Researchers tie subfertility to higher risk of neonatal death.(Obstetrics)
March 1, 2005... Women who do not conceive within 1 year of trying may face an increased risk of their babies dying by the first month post partum, according to Danish researchers. "Subfecundity may be associated with an increased risk of neonatal death...

Proteomic analysis may predict preterm labor.(Obstetrics)
March 1, 2005... Biomarkers of intra-amniotic infection and inflammation can be rapidly detected in amniotic fluid using proteomic analysis. And the identification of a distinctive biomarker profile can predict imminent preterm delivery with 100% accuracy,...

Neuraxial analgesia early in labor is good option.(Obstetrics)
March 1, 2005... Nulliparous women who request pain relief early in labor may be better off receiving neuraxial analgesia than systemic opioid analgesia, according to investigators of a recently published, randomized trial. Of 728 women who had spontaneous...

Study finds rate of cesarean sections was not affected by elective induction.(Obstetrics)
March 1, 2005... WASHINGTON -- Elective induction did not adversely affect the cesarean-section rate or maternal fetal morbidity in a retrospective cohort study of 361 nulliparous patients. The women, who were at 37-41 weeks' gestation, were delivered from...

Researchers urge prenatal screening for toxoplasmosis.(Obstetrics)
March 1, 2005... All pregnant women should undergo screening for Toxoplasma gondii infection once each trimester, and all newborns should be screened for congenital toxoplasmosis, Kenneth M. Boyer, M.D., and colleagues have recommended. Even a thorough...

GnRH agonist may curb ovarian failure in lupus.(Obstetrics)
March 1, 2005... SNOWMASS, COLO. -- A gonadotropin-releasing hormone agonist can prevent ovarian failure in lupus patients on cyclophosphamide, according to a small, case-control study conducted at the University of Michigan. Evidence suggests that by the...

Efficacy most important to parents for STI vaccines.(Obstetrics)
March 1, 2005... Parents of adolescents appear to accept the idea of vaccinating their teens against sexually transmitted infections, expressing the most concern about the efficacy of the vaccine and the severity of the infection it could prevent, rather than...

Urinary cytology not useful as screen for bladder invasion.(Obstetrics)
March 1, 2005... WASHINGTON -- Urinary cytology was found to be "of limited use" in detecting whether pelvic cancer has invaded the bladder, Kelly L. Molpus, M.D., reported at the annual meeting of the Central Association of Obstetricians and Gynecologists. ...

Genital atrophy rapid after discontinuing hormone therapy.(Gynecology)
March 1, 2005... WHITE SULPHUR SPRINGS, W.VA. -- Within just 6-12 months of discontinuing hormone therapy, more than 96% of postmenopausal women will show altered vaginal pH, a marker for tissue change and its associated genital atrophy, Murray Freedman, M.D.,...

Confidentiality is critical for teen gyn. care.(Gynecology)
March 1, 2005... BOSTON -- A few adjustments might be needed to make your practice approachable and comfortable for adolescent patients, but the long-term payoffs can be worth it. "Why is it some people aren't so comfortable taking care of adolescents?...

FDA warns about imported test kits.(Gynecology)
March 1, 2005... The Food and Drug Administration is warning consumers about possible false results from several unapproved home-use diagnostic test kits marketed in the United States via the Internet by Globus Media of Montreal. The test kits are not...

Ear acupuncture may ease tamoxifen hot flashes.(Gynecology)
March 1, 2005... EXETER, ENGLAND -- A standardized ear acupuncture protocol effectively reduced hot flashes in women receiving tamoxifen as adjuvant treatment for breast cancer, according to an interim analysis presented at a symposium on alternative and...

Think interstitial cystitis in cases of chronic pelvic pain.(Gynecology)
March 1, 2005... SAN FRANCISCO -- In an overwhelming majority of women presenting with chronic pelvic pain, the bladder is the pain-generating organ, Edward J. Stanford, M.D., said at the annual meeting of the American Association of Gynecologic Laparoscopists....

Survey: doctors overestimate HT's risks, benefits.(Gynecology)
March 1, 2005... WHITE SULPHUR SPRINGS, W.VA. -- Most physicians who prescribe hormone therapy still overestimate both its long-term risks and benefits, R. Stan Williams, M.D., said at the annual meeting of the South Atlantic Association of Obstetricians and...

Combined approach helps ease pelvic floor dysfunction.(Gynecology)
March 1, 2005... WASHINGTON -- Brooke Gurland, M.D., realized that, despite her training as a colorectal surgeon, she didn't have a complete perspective on pelvic floor dysfunction. Fellows in colorectal surgery "weren't even trained to know the anatomy of...

HPV DNA screening could help limit surgery.(Gynecology)
March 1, 2005... WHITE SULPHUR SPRINGS, W.VA. -- A treatment algorithm based on DNA identification of high-risk human papilloma virus subtypes could eliminate much unnecessary surgical intervention for women eventually found to have no cervical abnormality,...

Study suggests hormonal contraceptives do not cause women to gain weight.(Gynecology)
March 1, 2005... WASHINGTON -- Women's perceptions that they gain weight when taking hormonal contraceptives are not realities, according to a randomized study. Data from a poster presented at the annual meeting of the Association of Reproductive Health...

Secondary causes of bone loss often missed: ob.gyns., other primary care doctors less likely to follow up on problematic scans.(Gynecology)
March 1, 2005... WASHINGTON -- Primary care physicians are less likely than specialists to initiate a work-up for secondary causes of bone loss in patients with scans indicating low bone density, despite a recommendation to do so. That finding emerged from...

Teens lose bone on DMPA, recover it after stopping use.(Gynecology)
March 1, 2005... Adolescent women who use the injectable contraceptive depot medroxyprogesterone acetate lose bone mineral density each year they are on the drug but appear to rapidly recover that loss when the drug is withdrawn, results of a prospective study...

Orlistat may help in treatment of PCOS, small study shows.(Gynecology)
March 1, 2005... The weight loss drug orlistat may prove to be a useful adjunct in the treatment of polycystic ovarian syndrome, according to findings from a small randomized study that compared the drug with metformin. "[We've] demonstrated the therapeutic...

Study confirms at least two subtypes of FSAD.(Gynecology)
March 1, 2005... SANTA FE, N.M. -- While the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders defines only one type of female sexual arousal disorder, there is now physiologic evidence that there are at least two subtypes of the...

Newer radiotherapy Txs linked to less CV risk.(Gynecology)
March 1, 2005... SAN ANTONIO -- The considerable excess in cardiovascular mortality caused by older radiotherapy regimens for breast cancer appears to be greatly diminished with more modern ones, Sarah C. Darby, Ph.D., reported at a breast cancer symposium...

Locally recurrent breast Ca called 'life-or-death problem'.(Gynecology)
March 1, 2005... SAN ANTONIO -- The improved local control of breast cancer achieved via radiotherapy translates into a significant reduction in mortality due to the malignancy that becomes apparent only late, at 10 and 15 years' follow-up, Sir Richard Peto,...

Menstrual timing of breast Ca surgery doesn't affect prognosis.(Gynecology)
March 1, 2005... SAN ANTONIO -- The timing of breast cancer surgery with respect to menstrual cycle phase failed to affect prognosis in two large multicenter prospective observational studies presented at the annual breast cancer symposium sponsored by the...

Phenytoin, other antiepileptic drugs accelerate bone loss.(Gynecology)
March 1, 2005... BRECKENRIDGE, COLO. -- Antiepileptic drug usage by older women sharply increases their rate of bone mineral loss, with phenytoin being a particular offender, according to recent data from a landmark American study. This is a disturbing...

Look for catamenial epilepsy pattern.(Gynecology)
March 1, 2005... BRECKENRIDGE, COLO. -- Seizures in many epileptic women exhibit a stereotypic menses-related pattern that may have important treatment implications, Jose F. Cavazos, M.D., said at a conference on epilepsy syndromes sponsored by the University...

Discontinuing valproate may reverse PCOS in some women.(Gynecology)
March 1, 2005... BRECKENRIDGE, COLO. -- Hormonal evidence of polycystic ovary syndrome in patients on valproate is often reversed by a switch to one of the newer antiepileptic drugs, Jacci Bainbridge, Pharm.D., reported at a conference on epilepsy syndromes...

Documentation dos and don'ts can derail a lawsuit.(Practice Trends)
March 1, 2005... CABO SAN LUCAS, MEXICO -- What you put in a patient's medical record could drive a potential lawsuit to court or away from litigation, Dennis J. Sinclitico, J.D., said. "You can't control the labor and delivery. The one thing you can do is...

Health care disparities called medical error.(Practice Trends)
March 1, 2005... WASHINGTON -- Health care disparities among ethnic groups should be considered a form of medical error, James Gavin, M.D., said at a consensus conference on patient safety and medical system errors in diabetes and endocrinology. "When we...

NIH unveils strong ethics policy for all employees.(Practice Trends)
March 1, 2005... Officials at the National Institutes of Health are tightening restrictions on outside consulting arrangements with industry after more than a year of investigations turned up potential conflicts of interest. "Nothing is more important to me...

Treatment program targets 'disruptive physicians': reasons for program referral include anger, performance and compliance issues, sexual misconduct, and theft.(Practice Trends)
March 1, 2005... ARLINGTON, VA. -- Can a surgeon who brings a gun to the operating room be trusted not to use it? That's an extreme example of the kinds of questions that psychiatrists must address when doctors are referred to them for evaluations. ...

Planning ahead called best defense against workplace violence.(Practice Trends)
March 1, 2005... SAN DIEGO -- There is no one technique or strategy that will protect you from the risk of physical attacks in your workplace by patients or coworkers, Donna Pence declared at a conference sponsored by the Chadwick Center for Children and...

Fetal pain bill returns.(POLICY & PRACTICE)
March 1, 2005... Sen. Sam Brownback (R-Kan.) has reintroduced legislation that would require abortion providers to notify women seeking abortions at 20 weeks' gestation about "substantial evidence" that the fetus can feel pain during the procedure. The "Unborn...

The state of stem cell research.(POLICY & PRACTICE)
March 1, 2005... Some members of Congress are answering the call made by President Bush in his State of the Union address last month to agree on clear standards for the use of human embryos in research. Reps. Diana DeGette (D-Colo.) and Michael Castle (R-Del.)...

Prevention first act.(POLICY & PRACTICE)
March 1, 2005... Senate Minority Leader Harry Reid (D-Nev.) recently introduced legislation aimed at expanding access to preventive health services that help reduce unintended pregnancies and abortions. The "Prevention First Act" (S. 20) calls for increased...

Abstinence education funding.(POLICY & PRACTICE)
March 1, 2005... The Bush Administration is seeking $206 million in fiscal year 2006 to fund abstinence education activities. The request is a $39 million increase over current funding levels. The money would help "educate adolescents and parents about the...

New HHS chief and Medicaid.(POLICY & PRACTICE)
March 1, 2005... Medicaid reform will be high on the agenda for HHS Secretary Leavitt. "Medicaid is not meeting its potential," Mr. Leavitt, former governor of Utah and former head of the Environmental Protection Agency, said at health care congress sponsored...

Caution urged as more teens seek breast implants.(Practice Trends)
March 1, 2005... One of the nation's largest professional societies for plastic surgeons has issued a statement recommending that its members be more cautious in performing cosmetic breast augmentation in women under age 18. The statement, issued in late...

Computerized prescribing could reduce errors.(Practice Trends)
March 1, 2005... WASHINGTON -- Computerized prescribing could greatly reduce the number of medical errors, especially when it comes to adverse drug events, David Bates, M.D., said at a consensus conference sponsored by the American Association of Clinical...

Twenty percent of group practices turn to paperless health records, survey shows.(Practice Trends)
March 1, 2005... Most group practices are still using paper medical records and charts, according to preliminary results from a survey by the Medical Group Management Association. "Paper is still the dominant mode of data collection," William F. Jessee,...

Online health information eludes seniors.(Practice Trends)
March 1, 2005... Online health information has the potential to become an important resource for seniors "but it's not there yet," the Kaiser Family Foundation reported in a survey of 1,450 adults aged 50 and older. Of the 583 respondents aged 65 and...

FDA's new drug safety board under scrutiny.(Practice Trends)
March 1, 2005... Many questions surround the authority of a new drug safety board that would oversee the management of drug safety and provide emerging information to physicians and patients about the benefits and risks of medicines on the market. Such a...

Consumer-driven health care will help quality, expert says.(Practice Trends)
March 1, 2005... WASHINGTON -- The trend toward consumer-driven health care would ultimately improve overall health care quality, Regina Herzlinger, Ph.D., said at a consensus conference sponsored by the American Association of Clinical Endocrinologists. ...

Therapy for acute bacterial sinusitis.(DRUG UPDATE)
March 1, 2005... Acute bacterial sinusitis is usually preceded by a viral infection of the upper respiratory tract. Because experts agree that the indiscriminate use of antibiotics for sinusitis has contributed to the emergence of resistant organisms,...

Panel backs coverage for diet, lifestyle change: advisory committee wants Medicare to pay for programs designed to prevent and reverse heart disease.(Clinical Rounds)
March 1, 2005... BALTIMORE -- There might not have been thunderous applause at a January meeting of the Medicare Coverage Advisory Committee, but the quiet approval was quite enough for Dean Ornish, M.D. The committee, which advises Medicare on coverage...

Maintain young adult weight to help deter cardiovascular risk.(Clinical Rounds)
March 1, 2005... NEW ORLEANS -- Young adults who maintain a stable body weight into middle age--or who at least manage to gain less than the American average of about 1 pound per year--may largely prevent progression of other cardiovascular risk factors and...

Exercises for chronic conditions: lumbar stenosis.(EXERCISE RX)
March 1, 2005... Lumbar spinal stenosis occurs in the lower back, where most back movement takes place. The condition develops when osteoarthritis causes a narrowing of the opening in the vertebrae through which the spinal nerves pass. In some advanced cases,...

Emotional abuse may raise risk of mental illness.(Clinical Rounds)
March 1, 2005... SCOTTSDALE, ARIZ. -- People who are emotionally and physically abused by their intimate partners develop more mental illness and substance abuse problems than those who are only physically abused, Susan Ditter, M.D., said at the annual meeting...

Health advisory issued for nevirapine.(Clinical Rounds)
March 1, 2005... The Food and Drug Administration has issued a public health advisory to alert physicians to label changes for nevirapine (Viramune), addressing an increased risk of liver toxicity in certain women. The Indications and Usage section of the...

Statins may up risk of developing osteoarthritis.(Clinical Rounds)
March 1, 2005... A new study puts a twist in the theory that statins could conveniently serve dual purposes in patients with inflammatory diseases that affect both the joints and heart. Findings from the investigation, involving 5,678 women aged 65 and...

Directional exercise helps to relieve low back pain.(Clinical Rounds)
March 1, 2005... ORLANDO, FLA. -- A standardized mechanical assessment of patients with low back pain--whether acute or chronic--identifies a large subgroup who will obtain an excellent response when prescribed exercises matched to the directional nature of...

Attention-deficit hyperactivity disorder.(WOMEN'S HEALTH ADVISER)
March 1, 2005... Up to 70% of children who have been diagnosed with attention-deficit hyperactivity disorder continue to experience symptoms into adulthood, and as a result, as many as 8 million adults are affected. That figure may come as a surprise to...

Surgeons respond to pelvic reconstruction column.(THE MASTER CLASS)
March 1, 2005... As editor of the Master Class columns on gynecology, I was very proud to have C.Y. Liu, M.D., present an excellent two-part discourse on pelvic floor prolapse in the October 1, 2004, and November 1, 2004, issues of OB.GYN. NEWS. I...

Periodontal disease raises preterm risk.(News)
March 15, 2005... UNIVERSAL CITY, CALIF. -- Every prepregnancy consultation should include a recommendation for a full periodontal examination, and patients should be monitored throughout pregnancy for signs of periodontal disease. Todd Hartsfield, D.D.S.,...

Medical care spending outstrips inflation.(VITAL SIGNS)
March 15, 2005... Medical Care Spending Outstrips Inflation Note: Based on Consumer Price Index (CPI) data from the Bureau of Labor Statistics. Source: Centers for Disease Control and Prevention

Maternal morbidity rises sharply with repeat cesareans: largest increase seen after fourth delivery.(News)
March 15, 2005... RENO, NEV. -- Maternal morbidity increases significantly with each subsequent cesarean delivery, according to a large prospective cohort study reported by Robert M. Silver, M.D., at the annual meeting of the Society for Maternal-Fetal Medicine....

17P: best for prior preterm births before 34 weeks.(News)
March 15, 2005... RENO, NEV. -- Therapy with 17[alpha]-hydroxyprogesterone caproate to prevent recurrent preterm birth is associated with an overall prolongation of pregnancy, especially in women with a prior spontaneous birth before 34 weeks' gestation,...

Patient-delivered Tx for partners reduces gonorrhea, chlamydia rates.(News)
March 15, 2005... The provision of chlamydia or gonorrhea treatment directly to patients' sexual partners, without requiring the partners to visit a physician, significantly improved infection control in patients, researchers at the University of Washington in...

Win a portable DVD player!(News)
March 15, 2005... It's time again for our annual Clinical Pearls contest. This year we are awarding a portable DVD player with car kit to nine lucky winners. Bruce L. Flamm, M.D., will select the top nine entries, which will be featured in upcoming columns. ...

Early West Nile case may bode ill for western U.S.(News)
March 15, 2005... LOS ANGELES -- The first human case of West Nile virus infection this year was diagnosed in Los Angeles in early February, perhaps setting the stage for an early and virulent season for the far western United States. "Since West Nile virus...