OB GYN News articles from May 2000

OB GYN News archives from May 2000

Menopause-Focused Practice Flourishes.
May 1, 2000... When Dr. Margaret Mahony decided to leave a managed care--laden physician group two years ago to go solo in San Jose, Calif., she made two major decisions about her new gynecology practice: It would be a cash-up-front business, and it would...

Study Weakens Case for HRT in Cardioprevention.
May 1, 2000... Hormone use tied to slightly more heart attacks, strokes, and thromboembolysis. Hormone replacement therapy should not be prescribed as first-line medication in the prevention of heart disease, according to preliminary findings of the...

Spinal Curvature Loss Tied To Pelvic Organ Prolapse.
May 1, 2000... Losing normal lumbar lordosis raises risk. NEW ORLEANS -- Loss of normal lumbar spinal curvature may predispose women to pelvic organ prolapse, Dr. T. Fleming Mattox reported at the annual meeting of the Society of Gynecologic Surgery. ...

The Search for Pearls Continues.
May 1, 2000... Since September, I've been writing the monthly CLINICAL PEARLS column for OB.GYN. NEWS, and I would like to thank those of you who have contributed useful suggestions for managing challenging situations. In November, for example, Dr. Pearl...

Nitrates in Water Linked to Bladder Ca.
May 1, 2000... BETHESDA, Mo. -- Nitrate levels in drinking water correlated with bladder cancer incidence in a study of 16,536 Iowa women, Dr. J. Cerhan said at the annual meeting of the American Society of Preventive Oncology. Nitrate is endogenously...

Paroxetine Relieves Hot Flashes in Breast Ca Survivors.
May 1, 2000... TAMPA, FLA. -- Hot flashes appear to be reduced by the selective serotonin reuptake inhibitor paroxetine. In a 30-patient pilot study, paroxetine (Paxil) significantly relieved the hot flashes of breast cancer survivors experiencing...

HPV Screening Bests Pap for Triaging ASCUS.
May 1, 2000... Human papilomavirus testing appears to be slightly better than standard repeat Pap smears in triaging women with equivocal cytology results, according to preliminary results from a large National Cancer Institute trial. But the jury is...

Breast-Feeding Ups HIV Transmission Risk by 16%.
May 1, 2000... Breast-feeding increases by at least 16% the risk that infants will acquire HIV from their mothers, according to the results of a randomized, prospective trial. In a study of 401 HIV-positive women in. Nairobi, Kenya, breast-fed infants...

Asymptomatic Herpes Still Contagious.
May 1, 2000... Patients who are seropositive for herpes but asymptomatic shed the virus from their genital tracts at the same rate as those with symptoms, reported Dr. Anna Wald of the University of Washington, Seattle, and her associates. In a study...

Multipurpose OCs.
May 1, 2000... What do duct tape, WD-40, and oral contraceptives have in common? They are all handy for multiple odd jobs. Originally prescribed 40 years ago for contraception in daily doses of 100 [mu]g of ethinyl estradiol or mestranol, most birth...

LETTERS.
May 1, 2000... Small Change, Big Effect Last July the American College of Obstetricians and Gynecologists issued a Practice Bulletin on vaginal birth after previous cesarean delivery, updating a Practice Bulletin on the topic that had been issued in...

Is allowing physicians to bargain collectively a good idea?
May 1, 2000... Yes Right now, only two groups of physicians can organize: medical residents and employed physicians (meaning those who are not in a supervisory role). Employed physicians represent only about one in seven doctors currently practicing. ...

What's a Woman to Do?
May 1, 2000... For decades, postmenopausal women have been cajoled to take estrogens for their potential to decrease the risk of coronary heart disease. Now the preliminary results of the Women's Health Initiative indicate that this is an erroneous and...

BMD Loss in First Year of Tx? Don't Switch Agents.
May 1, 2000... BETHESDA, MD. -- Patients who lose bone mineral density during the first year of treatment with agents that generally are effective for osteoporosis should not be automatically switched to another therapy. They most likely will gain bone...

Osteoporosis: Not Just a Disorder Of Older White Women.
May 1, 2000... BETHESDA, MD. -- The clinical view of osteoporosis needs to be expanded to address patients' bone health throughout the life span. Osteoporosis is not an age- or gender-dependent disease, panelists agreed at a conference on osteoporosis...

Education Raises Low-Income Mammography Rate.
May 1, 2000... BETHESDA, MD. -- Good advice from a trusted friend. That is what health care educators at the Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, successfully used to encourage mammography screening in...

Correction.
May 1, 2000... The correct telephone number for ordering the National Cancer Institute's software for estimating a patient's risk of developing breast cancer is 800-4-CANCER ("NCI's 'Risk Disk' Estimates Breast Cancer Risk," Feb. 1, 2000, p. 17).

Routine Urodynamic Testing for Incontinence.
May 1, 2000... NEW ORLEANS -- Routine urodynamic testing adds expense but little else to the evaluation of patients with stress incontinence, Dr. Anne Weber said at the annual meeting of the Society of Gynecologic Surgeons. The main value of urodynamic...

Pelvic Organ Prolapse More Common Than Once Thought.
May 1, 2000... ST. PETERSBURG, FLA. -- "Is this normal?" That's what one of Dr. Steven Swift's patients asked him when he examined her cystocele. She was referred to him for correction of this common condition, but it didn't bother her at all. He wasn't...

Adult Fertility Unaffected by Childhood Eating Disorders.
May 1, 2000... CARMEL, CALIF. -- The prognosis for later fertility for adolescents who have an eating disorder looks good, judging from the findings of a small study Fourth-year medical student Alison Volpe and her associates contacted 38 patients who...

Chemo+Stem Cell Transplant for Breast Cancer.
May 1, 2000... High-dose chemotherapy plus stem-cell transplantation offers no survival advantage over conventional chemotherapy for women with metastatic breast cancer, reported Dr. Edward A. Stadtmauer and his associates at the University of Pennsylvania...

Chemo Ups Secondary Risks in Breast Ca Patients.
May 1, 2000... SAN ANTONIO -- Breast cancer patients who receive chemotherapy face elevated long-term risks of secondary acute leukemias, myelodysplastic syndrome, and osteoporosis, according to studies presented at a breast cancer symposium sponsored by the...

Weight Gain After Chemo Tied to Inactivity.
May 1, 2000... BETHESDA, MD. -- The weight gain that is a significant and common side effect of adjuvant chemotherapy for breast cancer may be related to decreased physical activity, Dr. Wendy Demark-Wahnefried said at the annual meeting of the American...

Effects of Breast Ca Tx on Sex Lives Ignored.
May 1, 2000... BETHESDA, MD. -- Physicians usually fail to discuss the possible effects of breast cancer surgery on older women's sex lives, Dr. Lori A. Crane said at the annual meeting of the American Society of Preventive Oncology. Research concerning...

HRT Linked to False-Positive ECG Stress Tests.
May 1, 2000... ANAHEIM, CALIF. -- One in five women taking oral estrogen replacement therapy had a false-positive treadmill exercise stress test in a prospective study Dr. Amy J. Arouni said at the annual meeting of the American College of Cardiology. ...

Electronic Breast Palpation Device Tested.
May 1, 2000... SAN ANTONIO -- Clinical breast examination sorely needs a dose of objectivity, according to Dr. Kevin Hughes. An investigational electronic breast palpation device--Assurance Medical's BreastView Visual Mapping System-- may be the answer....

Stage Uterine Papillary Serous Carcinomas.
May 1, 2000... SAN DIEGO -- Surgical staging found metastases in 8 of 12 uterine papillary serous carcinoma cases that were presumed to be noninvasive, Dr. Paola A. Gehrig said at the annual meeting of the Society of Gynecologic Oncologists. A...

Surveillance Cancer Screenings Skipped by High Risk Patients.
May 1, 2000... SAN DIEGO -- Women who leave ovarian cancer risk assessments believing they are at high risk for the disease are more likely than others to miss follow-up screening appointments, a study of 83 women suggested. Two other factors that may...

Aggressive Chemo, Radiation an Option for Advanced Vulvar Ca.
May 1, 2000... CHICAGO -- An aggressive regimen of combined chemotherapy and radiation produced long-term, disease-free survival in a fourth of patients with advanced carcinoma of the vulva, Dr. Gustavo Montana reported at the annual meeting of the...

ANTIDEPRESSANTS.
May 1, 2000... Even today, many clinicians mistakenly believe that pregnancy is protective against the development or relapse of depression. That misperception persists despite several studies over the past 6 years demonstrating that women experience episodes...

One-Fourth of Some Cesareans May Be Premature.
May 1, 2000... Nearly one in four women with non-breech, term gestations may be undergoing cesarean sections earlier in the course of their labor than recommended, according to a study sponsored by the Agency for Healthcare Research and Quality. But not...

Vitamin C Levels Tied to Preterm Labor, PPROM.
May 1, 2000... CHICAGO -- Vitamin C levels are much lower in the amniotic fluid of women with preterm premature rupture of the membranes and premature labor with intact membranes, compared with those of women in normal pregnancies, Dr. Yoon Ha Kim said at the...

Tailor Maternal Weight Gain to Prepregnancy BMI.
May 1, 2000... MIAMI BEACH - The optimal amount and rate of weight gain in women with twin gestations should be determined based on their prepregnancy body mass index, results of a recent study suggested. The study which included 2,324 twin pregnancies,...

Genetic Screening Up Twofold at Cedars-Sinai.
May 1, 2000... PALM SPRINGS, CALIF. -- The number of referrals for genetics consultation appears to be skyrocketing, at least according to the experience of one genetics screening program, Dr. Ora Gordon said at a meeting sponsored by the American College of...

Optimal Dose for Second-Trimester Termination.
May 1, 2000... MIAMI BEACH -- Intravaginal misoprostol 400 mcg every six hours is the most effective dosage for terminating a second-trimester pregnancy, while keeping maternal side effects to a minimum, Dr. Jan Dickinson recommended at the annual meeting of...

Is Intubation Training Going Down the Tubes?
May 1, 2000... NEW ORLEANS -- With wider access to neonatal intensive care units and pressure on residency directors to cram in primary care training, intubation as a core skill in ob.gyn. training faces an uncertain future. The Ob.Gyn. Residency Review...

Kaiser, Others Offering Cystic Fibrosis Carrier Screening.
May 1, 2000... PALM SPRINGS, CALIF. -- Kaiser Permanente Northern California has begun offering routine cystic fibrosis pregnancy screening, joining the growing number of providers and patients who have decided that testing issues can be resolved and that...

Try Placing Horizontal Imbricating Sutures.
May 1, 2000... VAIL, COLO. -- Before performing a hysterectomy as a last resort to stop a postpartum hemorrhage, try a surgical technique that involves horizontal imbricating sutures, Dr. Larry Gilstrap III advised. "I've performed it on 20 women, with...

Do Episiotomies Sooner, Repair Differently.
May 1, 2000... VAIL, COLO. -- If a mediolateral episiotomy is required, do it sooner rather than later and repair it differently, Dr. Karlotta Davis advised at a conference on obstetrics and gynecology sponsored by the University of Colorado. "I see such...

Weight Loss Won't Affect Nursing Infants.
May 1, 2000... In overweight women who breast-feed exclusively, moderate weight loss in the early postpartum period does not affect the baby's weight gain or length, according to Cheryl A. Lovelady, Ph.D., and her associates at the University of North...

H. pylori Eradication.
May 1, 2000... "Test and treat" for Helicobacter pylori infection was an effective strategy for managing uninvestigated dyspepsia in a trial with nearly 300 patients. One hundred and forty-five patients with H. pylori infection received 20 mg omeprazole,...

Hepatitis C.
May 1, 2000... Treating patients with hepatitis C is well within the scope of interested primary care physicians, Dr. Ted F. Bader asserted at a meeting of the Colorado chapter of the American College of Physicians--American Society of Internal Medicine. ...

Pillow Covers Matter.
May 1, 2000... Advising asthmatic patients to switch tram feather pillows to synthetic ones may be doing mote harm than good. Instead, focus on their pillow covers. Covers should be made of tightly woven fabric that is designed to exclude dust mites,...

Drop in Latex Allergies.
May 1, 2000... The prevalence and seventy at latex allergy will likely wane over the next 5-10 years, Dr. Dennis R. Ownby predicted at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "The number of new cases appears to be...

Allergy TX Guide.
May 1, 2000... A national task force has designed a single resource for primary care physicians seeking evidence-based diagnostic and treatment information on the 13 most common allergic disorders. "A physician looking through this could very quickly...

CHF Epidemic in Women.
May 1, 2000... There is an epidemic or congestive heart failure among women. Dr. JoAnn Lindenfeld studied a national sample of more than 2,400 Medicare patients hospitalized for CHF. Discharge rates were higher for women than men across all 5-year age...

Thrombolysis Road Test.
May 1, 2000... The best place to initiate thrombolytic therapy for acute myocardial infarction may be in the ambulance. That proposition is now undergoing definitive testing in the Early Reteplase Thrombolysis in Myocardial Infarction-19 (ER TIMI-19)...

Health Workers Spread 'Clouds' of S. aureus.
May 1, 2000... ATLANTA - A simple head cold may be deadlier than health care workers realize. It is well documented that some health care workers harbor and spread nosocomial organisms. The most well-known example is nasal colonization of Staphylococcus...

Physicians Are Saying 'Yes' to Industry Freebies.
May 1, 2000... SAN DIEGO -- A physician gets an all-expenses-paid trip to Las Vegas for himself and his wife. A pharmaceutical representative buys a physician a new computer. A physician gets free tickets to a local theater production or a sporting...

Personnel Management Key Challenge to Going Solo.
May 1, 2000... INDIAN WELLS, CALIF. -- Experienced physicians may find that the hardest part of running a solo practice is just that: running the practice. Personnel management--keeping good employees happy and getting rid of bad ones--certainly is not a...

Few States Offer Elderly Drug Assistance Programs.
May 1, 2000... WASHINGTON -- Almost one-third of the states have programs to help low-income senior citizens pay for their prescription drugs, but more states probably won't be following suit any time soon, Bruce Stuart, Ph.D., said at a briefing on state...

Birth Rate Rises.
May 1, 2000... The number of births in the United States rose 2% in 1998, compared with the previous year, the first such increase since 1990, according to the Centers for Disease Control and Prevention's National Center for Health Statistics. The total...

Microbicide Funding Sought.
May 1, 2000... A bill calling for more research into new microbicides to prevent sexually transmitted diseases has been introduced by Rep. Connie Morella (R-Md.). Although microbicide legislation has been introduced before, this is the first time it has...

State Embryo Decision.
May 1, 2000... The Massachusetts Supreme Court has ruled that a 44-year-old woman cannot force her ex-husband to let her use their previously-frozen embryos to have a child, even though he had earlier signed seven separate agreements saying that if the couple...

Hip Fractures Up.
May 1, 2000... The number of women over 65 who sustained hip fractures increased 23% between 1988 and 1996, according to the Centers for Disease Control and Prevention, Atlanta. Fracture risk appears to increase with age; women age 85 and older are nearly...

Herbal Medicine Experts Cite Gaps in Knowledge.
May 1, 2000... CHAPEL HILL, N.C. -- More research and tighter regulations are essential to ensure that medicinal herbs are used safely and responsibly, according to an international panel of experts in herbal medicine. At one of the first conferences to...

Internet Medical Supplier.
May 1, 2000... The new Web site www.esurg.com offers medical and surgical supplies to out-of-hospital physicians and practice administrators. Prices, photographs, product descriptions, and customized templates for frequently ordered supplies are available....

Excessive Menstrual Bleeding.
May 1, 2000... The Thermachoice II Uterine Balloon Therapy system is a thermal ablation device intended to ablate the endometrial lining of the uterus in premenopausal women with menorrhagia who have completed childbearing. It's made of silicon, eliminating...

Latex-Free Surgical Gloves.
May 1, 2000... SensiCare synthetic powder-free surgical gloves are made using a polymer that is similar to natural latex rubber but free of latex proteins. Its elasticity minimizes hand fatigue and is low in residual accelerators to further minimize the...

Culturing System.
May 1, 2000... The InTray DM, a dermatophyte-culturing system that combines inoculation, growth, and observation in a single tray increases specificity by inhibiting both gram-positive and gram-negative bacteria. The tray can be used to assay hair, nail, or...

Physician Compensation.
May 1, 2000... The Physician Compensation Report is a biweekly newsletter containing data, benchmarks, and instructions on designing productivity-based compensation plans. A subscription to the newsletter, which is targeted at medical practice managers and...

HCG Monitor.
May 1, 2000... The DRx Quantitative HCG patient monitor is a single-use test to measure levels of human chorionic gonadotropic hormone in whole blood to determine pregnancy status. Digitally displayed results are available within 10 minutes.

Chlamydia, Gonorrhea Test.
May 1, 2000... The Amplicor CT/NG test uses polymerase chain reaction technology and a microwell plate format to test for both chlamydia and gonorrhea from a urine sample. The test is far more sensitive than traditional culture tests.

HRT Appears Safe for Women With Endometrial Ca.
May 1, 2000... SAN DIEGO -- Hormone replacement therapy did not increase the rates of endometrial cancer recurrence or death in the largest study ever of HRT use in women with a history of the disease. The study was too small to draw definitive...

Surgical Repair of Tubes Sometimes Beats IVF.
May 1, 2000... VAIL, COLO. -- Some infertility patients with tubal problems could achieve higher pregnancy rates with surgical repair of their tubes than in vitro fertilization, Dr. Ana Alvarez Murphy said at a conference on obstetrics and gynecology...

Estrogen Ineffective in Treating Alzheimer's.
May 1, 2000... Estrogen replacement therapy does not appear to slow the course of Alzheimer's disease in older women who already have the condition, according to the largest and longest prospective study to look at the hormone's role in treating the brain...

Unchecked Bacteriuria Can Cause Preterm Labor, Organ Failure.
May 1, 2000... VAIL, Colo. - About one in four pregnant women with bacteriuria will develop pyelonephritis if untreated, and pyelonephritis in turn may lead to preterm labor and multiorgan system failure, Dr. Larry Gilstrap warned at a meeting on obstetrics...

Test Patients' Ability to Do a Kegel Exercise.
May 1, 2000... VAIL, COLO. -- Physicians should take a more active role in instructing pregnant patients how to do pelvic floor exercises, Dr. Karlotta Davis said at a conference on obstetrics and gynecology sponsored by the University of Colorado. About...

Flu Immunization Falls Short in Office-Based Health Workers.
May 1, 2000... ATLANTA -- Influenza vaccination at health care workers is responsible for the decline in flu outbreaks in hospitals, but immunization still falls short, especially among office-based health care workers, according to experts. Dr....

Dietary Supplement Labels Scrutinized.
May 15, 2000... GAITHERSBURG, MD. -- Representatives from medical and consumer groups are urging the Food and Drug Administration to require manufacturers of dietary supplements to dearly label their products with warnings instructing women not to use them if...

Adjunctive Fetal Pulse Oximetry Boosts VBAC Rate.
May 15, 2000... Use with electronic fetal monitoring led to fewer sections, assisted vaginal deliveries. CHICAGO -- Women trying for a vaginal birth after cesarean section have more success when fetal pulse oximetry is added to electronic fetal...

HRT Users More Prone to Mammography Failures.
May 15, 2000... Cancers are less invasive, well defined. BETHESDA, MD. -- Mammography screening misses more breast cancers in women who are taking hormone replacement therapy than in those who are not, Dr. Gad Rennert reported at the 24th annual meeting of...

The Search for Pearls Continues.
May 15, 2000... Since September, I've been writing the monthly CLINICAL PEARLS column for OB. GYN. News, and I would like to thank those of you who have contributed useful suggestions for managing challenging situations. In November, for example, Dr. Pearl...

High Sugar, Fat Intake During Early Pregnancy Increases Preeclampsia Risk.
May 15, 2000... CHICAGO -- A diet high in sugar and fat during the first 20 weeks of pregnancy increases the risk of preeclampsia, regardless of age or prepregnancy body mass index, according to a Norwegian study. "Physical activity is too low and the...

OCs Inadequate for Managing Most PMS.
May 15, 2000... New recommendations on the diagnosis and treatment of premenstrual syndrome cast doubt on the everyday practice of gynecologists who have made oral contraceptives the mainstay of PMS therapy despite limited data on the effectiveness of such...

Prepare for Turbulence.
May 15, 2000... Hospital errors and the fragmented United States health care system will not be corrected by adopting the airline industry's approach to pilot instruction and accident prevention, as some experts in the managed care industry have suggested. ...

LETTERS.
May 15, 2000... Replacing an STD Relic In an article about STD screening, Dr. Gale R. Burstein stated that urethral swabs were largely a relic of the past ("Primary Care Docs Fall Short on STD Screening," Oct. 1, 1999, p. 29). Until a few years ago,...

CP, Intrauterine Infection Linked in White Preemies.
May 15, 2000... MIAMI BEACH -- Cerebral palsy appears to be associated with intrauterine infection in premature white babies but not in nonwhite infants, Dr. Judith Grether reported at the annual meeting of the Society for Maternal-Fetal Medicine. "Many...

Sphincter Damage May Persist After Surgical Repair.
May 15, 2000... MIAMI BEACH -- Even after undergoing procedures to repair third-degree pernieal tears, nearly two-thirds of women still have residual anal sphincter damage, Dr. Myra Fitzpatrick reported at the annual meeting of the Society for Maternal-Fetal...

Tough Choices on Fetal Reduction, Genetic Testing.
May 15, 2000... CHICAGO -- Difficult decisions about selective fetal reduction and invasive genetic testing often go hand in hand during the early weeks of a higher-order multiples gestation, Dr. Mark Evans said at the annual meeting of the Society for...

Peak on Ultrasound Confirms Dichorionic Twins.
May 15, 2000... SAN FRANCISCO -- If you do fetal ultrasound scans, you've probably heard of the "twin peak" sign confirming that a set of twins is dichorionic. Visually, however, all you see is one "peak." Confused? You're not alone. "I can't tell...

Three Ultrasound Findings Flag Twin-Twin Transfusion.
May 15, 2000... SAN FRANCISCO -- One fetus appears fat and happy on ultrasound but its poor little twin can't seem to grow. They're both in trouble. Chances are they're suffering from the most common complication among twins that share a placenta:...

Uterine Ruptures Not Always Associated With Scars.
May 15, 2000... CHICAGO -- Uterine rupture which is unrelated to a known scar site is not uncommon and should be suspected in cases of unexplained postpartum hemorrhage, pain, or infection, Dr. Bardett Fausett warned at the annual meeting of the Society for...

Breast Density Predicts Mammography Failure.
May 15, 2000... BETHESDA, MD. -- Breast density is one of the strongest--if not the strongest--predictors of mammography screening failure, Margaret T. Mandelson, Ph.D., said at the annual meeting of the American Society of Preventive Oncology. In what...