OB GYN News articles from May 2001

OB GYN News archives from May 2001

Malpractice Risk On Reservations.
May 1, 2001... Physicians who are not employed by the Indian Health Service but provide care to Native Americans may be putting themselves at risk for malpractice suits, according to an Albuquerque ob.gyn. Dr. Michael G. Flax, New Mexico section chair for...

No Excess CV Events Seen With Raloxifene Use.
May 1, 2001... In contrast, estrogen has been shown to raise CV risk in some women. ORLANDO, FLA. - Raloxifene may be safer for hormone replacement in postmenopausal women than estrogen. In a secondary analysis of data on 7,705 postmenopausal women...

Prophylactic Surgery May Be Too Late for Ovarian Ca.
May 1, 2001... Five of 60 women had disease at surgery. NASHVILLE, TENN. -- For women at high risk of developing ovarian cancer, prophylactic oophorectomy may sometimes come too late. And a full hysterectomy, in addition to a bilateral...

ERT Use Linked to Increased Risk of Ovarian Ca Mortality.
May 1, 2001... Women who use estrogen replacement therapy after menopause have up to 2.2 times the risk of dying from ovarian cancer, compared with women who never used the therapy. Both length of estrogen use and, among former users, how recently they...

New Data Support Bone Marrow Transplant in Some Breast Ca Patients.
May 1, 2001... FORT LAUDERDALE, FLA. -- High-dose chemotherapy with bone marrow transplant appears to be more effective than multiple cycles of chemotherapy in selected women with advanced breast cancer, based on a preliminary analysis of the interim results...

A Decision About an Incision.
May 1, 2001... It's one of the most difficult clinical decisions we have to make: A patient in the emergency room may have pelvic inflammatory disease. Should you perform diagnostic laparoscopy? On the one hand, we don't like to operate on unprepared...

PRO & CON.
May 1, 2001... Should the FDA continue current dose restrictions for ephedrine alkaloids? Dr. Donald D. Hensrud is director of the Executive Health Program at the Mayo Clinic, Rochester, Minn. YES The Food and Drug Administration received 140...

Nevirapine Doesn't Improve Standard HIV Therapy.
May 1, 2001... CHICAGO -- The antiretroviral agent nevirapine doesn't provide any further reduction in the risk of perinatal HIV transmission beyond the protective effects of standard antiretroviral therapy, Dr. Alejandro Dorenbaum said at a conference on...

Breast Milk Tied To Lower BP in Adolescence.
May 1, 2001... Children who consumed breast milk during infancy had lower blood pressure in adolescence than those who were fed formula, reported Dr. Atul Singhal of the Medical Research Council Childhood Nutrition Research Centre, London, and colleagues. ...

Conflicting Ultrasound Standards Raise Legal Issues.
May 1, 2001... VAIL, COLO. -- The "limited" ultrasound examination as defined by the American College of Obstetricians and Gynecologists presents a legal minefield for obstetricians at a time when litigation involving ultrasound is increasingly common, Dr....

Age-Based Protocol Best for Early Detection of Trisomy 18.
May 1, 2001... HOT SPRINGS, VA. - An age-based protocol for assessing maternal serum markers for trisomy 18 is much more accurate than using fixed cutoff values and would be an easy adjunct to current Down syndrome screening efforts, Dr. W. Allen Hogge said....

Antibiotics Ineffective for Preterm Birth Prevention.
May 1, 2001... TORONTO -- Women at high risk of preterm delivery do not fare any better when they are given broad-spectrum antibiotics, according to results of a randomized, prospective study of more than 700 women. In fact, women with a history of...

Preterm Birth Rate Not Likely to Fall Anytime Soon.
May 1, 2001... VAIL, COLO. -- The glaring lack of success in preventing preterm birth over the past 20 years really should come as no surprise, Dr. Ronald S. Gibbs said at a conference on obstetrics and gynecology sponsored by the University of Colorado. ...

Cervical Alpha-Fetoprotein Flags Increased Risk of Preterm Birth.
May 1, 2001... RENO, NEV. -- Abnormally high maternal cervical levels of alpha-fetoprotein at 22-24 weeks' gestation were associated with an increased risk of preterm birth in a nested, case-control study presented at the annual meeting of the Society for...

'Tried-and-True' Therapies for Preterm Labor Don't Measure Up.
May 1, 2001... Traditional "tried-and-true" ancillary therapies for preterm labor--hydration and bedrest--actually turn out to be tried-and-false, speakers said at the conference. Take intravenous hydration, for example. It's expensive. The true cost--...

Vitamins Under Study for Preeclampsia Prevention.
May 1, 2001... TORONTO -- New findings provide further evidence that high doses of vitamins C and E may help prevent preeclampsia in women at high risk for the disorder, but it's still too early to recommend this antioxidant regimen to patients, Lucilla...

Antiplatelet Drugs Help to Lower Preeclampsia Risk.
May 1, 2001... Antiplatelet drugs, largely low-dose aspirin, have small to moderate benefits when used for the prevention of preeclampsia, reported Dr. Lelia Duley of the Institute of Health Sciences, Oxford, England, and her associates. The researchers...

Management Program Key to Asthma Control During Pregnancy.
May 1, 2001... RENO, NEV. - Instituting a comprehensive asthma management program may be more important than the choice of which drug to use during pregnancy, Dr. Mitchell Dombrowski said at the annual meeting of the Society for Maternal-Fetal Medicine. ...

Safety of Antipsychotics.
May 1, 2001... Women typically have been counseled to avoid using psychiatric medications during pregnancy because of known or unknown risks of prenatal exposure to these medications. But data suggest that pregnancy does not protect women from new onset or...

New Approach to Risk Assessment in Twins.
May 1, 2001... VAIL, COLO. -- A major emerging theme in the management of twin pregnancies is early identification of those likely to get into trouble while sparing others the aggravation and expense of intensive management, according to Dr. John C. Hobbins....

Management, Delivery Costs Pegged at $30,000 per Twin.
May 1, 2001... VAIL, COLO. -- Current approaches to managing twin pregnancies are both extremely expensive and not very successful at avoiding problem births, according to Dr. John C. Hobbins. Moreover, the incidence of twin pregnancies has doubled in...

Selective Termination of One Twin 'Reasonable'.
May 1, 2001... VAIL, COLO. -- Even monozygotic, monochorionic twin fetuses can be discordant for a major anomaly. And when one fetus in a multiple gestation has an anomaly, it's important that the woman be made aware that selective termination of the...

Demand Still High for Fetal Reduction Procedure.
May 1, 2001... VAIL, COLO. -- High-order multifetal pregnancies continue to be a common side effect of assisted reproductive technologies--and demand remains high for multifetal pregnancy reduction. "There are a lot of women out there who are conceiving...

Do the Texas Two-Step to Harvest Fascia Lata.
May 1, 2001... BALTIMORE -- Porphysicians who appreciate clinical pearls for urogynecologic surgery, a recent urogynecology meeting sponsored by Johns Hopkins University was a Mikimoto boutique. Here are a few gems: * Texas two-step. Fascia lata is far...

Tell Patients About Donor-Site Morbidity.
May 1, 2001... LAKE BUENA VISTA, FLA. -- Tell patients that they may experience long-term donor-site morbidity when fascia lata is harvested for use in pelvic reconstructive surgery, Maj. Andrew J. Walter, MC, USAF, recommended. That advice is based on...

Levator Ani Defects May Cause Pelvic Pain.
May 1, 2001... LAKE BUENA VISTA FLA. -- Suspect levator ani defects in parous patients with unexplained pelvic pain, Dr. Martin J. Quinn advised. Of 26 parous women with unexplained pelvic pain, 20 (77%) demonstrated levator ani defects when subjected to...

Surgery Slows, Reverses Pelvic Floor Dysfunction.
May 1, 2001... BALTIMORE -- Add suture rectopexy to abdominal sacral colpoperineopexy for even greater support of the posterior attachments to the investing fascia of the rectum, Dr. Howard S. Kaufman advised. Combining these procedures, particularly in...

Pelvic Organ Prolapse Symptoms May Not Correlate With Defect Location.
May 1, 2001... LAKE BUENA VISTA, FLA. -- Symptoms of pelvic organ prolapse don't always correlate with the severity or the location of the defect. That finding emerged from a 24-month study of 237 consecutive patients presenting with symptomatic pelvic...

Synthetic Mesh Beats Cadaveric Fascia Lata in Sacrocolpopexy.
May 1, 2001... LAKE BUENA VISTA, FLA. -- Synthetic mesh may provide more support and lead to better surgical outcomes than cadaveric fascia lata in abdominal sacrocolpopexy, a small retrospective cohort study suggests. After a mean follow-up of 21 months,...

TVT, Burch Have Similar Complication Rates.
May 1, 2001... LAKE BUENA VISTA, FLA. -- The tension-free vaginal tape and laparoscopic Burch procedures to correct urinary incontinence have comparable 1-year success and complication rates, according to results of a small retrospective study. The...

Surgical Blood Loss Reduced With Vasopressin.
May 1, 2001... LAKE BUENA VISTA, FLA. -- Vasopressin appears to significantly reduce blood loss during vaginal hysterectomy, according to the results of two randomized, prospective studies presented at the annual meeting of the Society of Gynecologic...

ThinPrep Far Surpasses Pap Test in SIL Diagnosis.
May 1, 2001... HOT SPRINGS, VA. -- ThinPrep offers a twofold improvement in the diagnosis of squamous intraepithelial lesions, compared with conventional Pap smears, a recent metaanalysis suggests. But despite those findings, some obgyns maintain that...

Advise Annual Pap Tests Despite Negative Results.
May 1, 2001... Women should be advised to continue having annual Pap smears even when they have negative results in consecutive years, according to Dr. Laura C. Collins of Beth Israel Deaconess Medical Center, Boston, and her associates. The...

Cervical Cancer Goes Untreated in 10% of Patients.
May 1, 2001... NASHVILLE, TENN. -- Approximately 10% of patients diagnosed with cervical cancer never pursue treatment, according to a study by the National Cancer Institute. "We knew there would be some women who choose not to undergo treatment, but we...

Dendritic Cells Eyed for Cervical Cancer Vaccine.
May 1, 2001... SOUTH LAKE TAHOE, NEW. -- The use of harvested dendritic cells may be the key to producing a vaccine to treat cervical cancer, according to Dr. Ricardo Estape. So far, research on the use of vaccines to treat cancer has run into serious...

HRT Use Seldom Affects Mammogram Readings.
May 1, 2001... CHICAGO -- Breast changes caused by use of hormone replacement therapy rarely complicate the interpretation of mammograms. The largest prospective study to date of the effect of hormone replacement therapy (HRT) on a woman's mammogram...

Do Bilateral Breast MRI After Cancer Surgery.
May 1, 2001... CHICAG0 -- Breast cancer patients who receive magnetic resonance imaging after breast conservation surgery should have the contralateral breast scanned at the same time, Dr. Christiane Kuhl said at the annual meeting of the Radiological Society...

Digital Mammograms Don't Spot More Cancers.
May 1, 2001... CHICAGO -- The largest study comparing digital versus film mammography, has found that despite lowering recall and biopsy rates, the digital technique does not improve breast cancer detection. Despite this, the study's lead investigator is...

Fruits, Vegetables Do Not Lower Breast Ca Risk.
May 1, 2001... Fruit and vegetable consumption had no significant impact on women's breast cancer risk in a pooled analysis of eight cohort studies. But women should still be encouraged to eat fruits and vegetables because other studies have shown that...

Use Clobetasol on Lichen Sclerosus, Then Biopsy.
May 1, 2001... SOUTH LAKE TAHOE, NEV, -- If a patient presents with what appears to be lichen sclerosus of the vulva, it is often a good idea to treat her with clobetasol propionate before attempting to biopsy any lesions unless an obvious carcinoma is...

Guidelines Seek to Mainstream Palliative Ca Care.
May 1, 2001... FORT LAUDERDALE, FLA. -- Palliative care needs to be a standard component of treatment for cancer patients, according to new practice guidelines released at the annual meeting of the National Comprehensive Cancer Network. The guidelines...

Arm Edema Common After Breast-Conserving Tx.
May 1, 2001... SAN ANTONIO -- Arm swelling accounts for roughly one-half of all moderate-to-severe long-term complications of breast-conserving therapy in breast cancer patients, Dr. Funda Meric said at a breast cancer symposium sponsored by the San Antonio...

Mastectomy Patients Older, Had Biopsy Done.
May 1, 2001... SAN ANTONIO -- Breast cancer patients who opt for mastectomy tend to be older and are more like[y to have had prior breast biopsy than those who choose breast-conserving therapy Dr. Valerie L. Staradub said at a breast cancer symposium...

Slim-Fit Tampon Mistakenly Inserted Into Urethra.
May 1, 2001... Slim-fit tampons are so narrow that they can mistakenly be inserted into the urethra by young women who have never used tampons before, according to Dr. Joann Richichi and Dr. Marianne DiGiovanni of Turnersville, NJ. They report the case...

Comprehensive Surgical Staging Defended.
May 1, 2001... SOUTH LAKE TAHOE, NEV. -- Comprehensive surgical staging of endometrial cancer with lymph node evaluation can identify high-risk patients who could benefit from radiation therapy, Dr. Anthony H. Russell said at an obstetrics and gynecology...

Many Residents Sidestep Sexual Dysfunction Issues.
May 1, 2001... LAKE BUENA VISTA, FLA. -- There's plenty of literature documenting a reluctance among seasoned ob.gyns. to discuss sexual health issues. But now it appears that even residents who were trained during the "it's OK to be dysfunctional" age of...

Health Plans, Others Defining 'Medical Necessity'.
May 1, 2001... WASHINGTON -- Managed care plans and accrediting bodies have started to incorporate elements of a Stanford (Calif.) University definition that seeks to achieve consensus in "medical necessity" decisions. The state of Hawaii went so far as...

Hard Sell on Tap for Ob.Gyn. Residency Programs.
May 1, 2001... The 3-year dip in the number of graduating medical students going into ob.gyn. appears to be stabilizing, but education experts are still on tenterhooks about the dwindling numbers of new residents in the specialty. Throughout the early to...

Ob.Gyn. Residency Programs Could Get Fewer Volunteers.
May 1, 2001... LAKE BUENA VISTA, FLA. -- The constraints of managed care could make ob.gyn. residency programs especially vulnerable to a dwindling pool of private physicians willing to volunteer their time to education, experts said at the annual meeting of...

Ob.Gyns. Ill Prepared for Future Genetic Testing.
May 1, 2001... LAKE BUENA VISTA, FLA. -- As gynecologists increasingly take on the role of primary care providers, genetics screening and testing are going to fall into their purview, and tomorrow's graduates aren't likely to be prepared, Dr. Charles J. Macri...

New Curriculum Targets Sexual Assault Management.
May 1, 2001... LAKE BUENA VISTA, FLA. -- A new residency training program is aimed at preparing ob.gyns. to identify and manage women who've been sexually assaulted, even when the incident occurred years beforehand. The curriculum, which was developed in...

ANTIABORTION EXTREMIST ARRESTED.
May 1, 2001... James Charles Kopp, an antiabortion extremist wanted for allegedly murdering Dr. Barnett Slepian, has been arrested in France, the Federal Bureau of Investigation says. Dr. Slepian was shot to death in Qctober 1998 in his Amherst, N.Y, home....

RULING IN FAVOR OF ABORTION FOES.
May 1, 2001... The U.S. Court of Appeals for the 9th Circuit has ruled that an antiabortion group's posters and Web site are protected by the First Amendment. The court ruled that the American Coalition of Life Activists was protected by the First Amendment...

SUPREME COURT CURBS DRUG TESTING.
May 1, 2001... Drug testing of pregnant women by a Charleston, S.C., hospital is unconstitutional, the Supreme Court has ruled in a decision that stands to a affect more than 30 states that allow such tests. The suit involved 10 women whose test results...

SMOKING 'EPIDEMIC' IN WOMEN.
May 1, 2001... Cigarette smoking is having a devastating effect on women's health, a new Surgeon General's report says. Since 1980, nearly 3 million U.S. women have died prematurely from smoking-related diseases. Smoking among women carries unique risks,...

SUIT OPPOSES INTERNET BLOCKING.
May 1, 2001... Saying that it prevents teens from getting sound information on sensitive subjects, the Alan Guttmacher Institute has joined the American Civil Liberties Union and Planned Parenthood in a lawsuit to block a federal law requiring libraries to...

Better Physician Credentialing Needed.
May 1, 2001... New ORLEANS -- Recent cases in which physicians intentionally killed their patients without detection have resulted in the need for a more strict, thorough process of credentialing and privileging, said Dr. John W. Thompson Jr. of Tulane...

Arbitration Is Good Alternative to Jury Trials.
May 1, 2001... SAN DIEGO -- When facing a malpractice lawsuit, consider binding arbitration instead of a traditional jury trial, Kenneth Zuetel advised at the annual meeting of the American Academy of Cosmetic Surgery. But don't expect your defense lawyer...

Long-Term SSRI Use Tied to Apathy Syndrome.
May 1, 2001... HOUSTON -- Depression is a highly cyclic disorder, but not every apparent return of symptoms represents a true recurrence of the disorder. Late emerging adverse effects, discontinuation phenomena, or drug interacdons may be the true...

Rosacea Responds Favorably to Oral Azithromycin.
May 1, 2001... WASHINGTON -- Oral azithromycin produced "moderate to marked" improvement in acne rosacea patients without causing the gastrointestinal side effects typical of other macrolide antibiotics, Dr. Adolfo Fernandez-Obregon reported in a poster...

Systolic Hypertension Missed.
May 1, 2001... Many primary care physicians overlook systolic hypertension in their patients, based on a review of 21 U.S. physicians. The review included 270 patient visits; in 93% of these visits, the patients had a systolic blood pressure of 140 mm Hg...

Salt Sensitivity and BP.
May 1, 2001... People with normal blood pressure who are salt sensitive have the same increased mortality risk as people with frank hypertension, Dr. Myron H. Weinberger reported at the annual conference of the American Heart Association's Council on High...

Curbing Antibiotic Resistance.
May 1, 2001... If you want to play a role in curbing antibiotic resistance, then "just say no" to unnecessary use of antibiotics, Dr. George Kent advised at the annual meeting of the California Academy of Family Physicians. He offered these practical...

Bacterial Cultures Misleading.
May 1, 2001... Curbing antibiotic overuse will require that physicians become better informed consumers of data from the microbiology laboratory, Dr. William J. Burman commented during an update on infectious diseases sponsored by the University of Colorado....

Adapalene for Acne.
May 1, 2001... Adapalene was as effective as tretinoin for the treatment of mild to moderate acne, while producing significantly less irritation, Dr. W.J. Cunliffe reported in a poster session during the annual meeting of the American Academy of Dermatology....

Off-Label Hirsutism Treatments.
May 1, 2001... Women troubled by hirsutism who find mechanical removal methods and local treatments ineffective have several systemic--though off-label--medical options, Dr. Anne Lucky said at the annual meeting of the American Academy of Dermatology. ...

FDA Seeks to End T-Score Disparities.
May 15, 2001... VAIL, COLO. -- Big changes are afoot in how bone mineral density is used to diagnose osteoporosis. The Food and Drug Administration has decided that the present situation must go; it's unacceptable to have 26 bone mineral density...

Broader Antibiotic Regimen Can Curb Endometritis.
May 15, 2001... Coverage for Ureaplasma urealyticum also leads to shorter hospital stays. TORONTO -- Postcesarean endometritis can be reduced if the standard prophylactic antibiotic regimen given at the time of cesarean section were expanded to include...

Panel Advocates Routine Chlamydia Screening.
May 15, 2001... Sexually active women under 25 targeted. A federally appointed expert panel has issued a strong endorsement of targeted screening of women for chlamydia infection. All sexually active women aged 25 and younger--and those over 25 with...

Overreliance on T Scores Can Lead to Undertreatment of Those at Risk for Fractures.
May 15, 2001... VAIL, COLD. -- Dr. Paul D. Miler recently had an office visit from a woman with a history of two vertebral fractures and a hip fracture despite a "normal" bone mineral density T score of -1.4 standard deviations at the femoral neck. This...

Femoral Neck BMD Best Predicts Hip Fracture Risk.
May 15, 2001... Bone mineral density measured at the femoral neck by dual-energy x-ray absorptiometry is the best predictor of hip fracture, according to a new report on osteoporosis in postmenopausal women. Authors of the report, which was issued by the...

DVT Prophylaxis in Pregnancy.
May 15, 2001... We all know that pregnancy is a risk factor for venous thromboembolism. The incidence is up to 500% higher for pregnant women than for nonpregnant women. One study reported up to a 3% incidence of deep vein thrombosis post partum and about a...

LETTERS.
May 15, 2001... Forgotten but Not Gone I contracted pertussis from an 11-year-old patient with an unusual cough on my last day of work at my pediatric practice before I went on maternity leave. I subsequently went into labor 6 days later and delivered my...

Test May Allow Individualized HRT Regimens.
May 15, 2001... JANCIN, BRUCE VAIL, COLO. -- Basal estrogen measurement in menopause may eventually provide a practical tool for individualizing hormone replacement therapy regimens, Dr. Kenneth Faber said at a conference on obstetrics and gynecology...

Future HRT Regimens Will Allow Tailored Therapy.
May 15, 2001... SOUTH LAKE TAHOE, NEV. -- The large number of new products in development for hormone replacement therapy portends a dramatic shift in the way hormone replacement is prescribed. No woman will stay with a single regimen indefinitely Dr....

Patients on Androgen Replacement Need Careful Monitoring.
May 15, 2001... TORONTO -- Postmenopausal women on androgen replacement therapy should be carefully monitored to avoid androgenic side effects, Dr. Cristin Slater said at the annual meeting of the Society for Gynecologic Investigation. "A lot of women are...

Defecography Spots Defects Not Found on Exam.
May 15, 2001... SCOTTSDALE, ARIZ. -- Approximately 15% of the time that Dr. Dee E. Fenner thinks she knows whether a patient has an enterocele, defecography proves her wrong, she said at a urogynecology conference sponsored by the Mayo Clinic Scottsdale. ...

Relaxation During Bladder Filling Increases Diagnostic Yield.
May 15, 2001... SCOTTSDALE, ARIZ. -- There are new instructions for patients whose bladders are being filled for urodynamic testing: Instead of "Try to hold it in," tell them, "Relax." In a prospective study of 42 patients with irritative lower urinary...

Transplanted Ovary Ovulates; Oocytes Retrieved.
May 15, 2001... TORONTO -- Researchers who transplanted a cervical cancer patient's ovary into her forearm last year have now successfully stimulated ovulation and retrieved oocytes from it, according to the head of the team. However, they were...

Metformin May Be Only Drug Needed for Ovulation in PCOS.
May 15, 2001... TORONTO -- Metformin is often the only drug needed to achieve ovulation and conception in patients with polycystic ovary syndrome, according to a study presented at the annual meeting of the Society for Gynecologic Investigation. And even...

Inadequate Immunization Leaves Women at Risk.
May 15, 2001... NEW YORK -- Pregnancy should not be an obstacle to vaccination against "childhood" diseases such as varicella and measles. Yet because of inadequate immunization, a large pool of susceptible women of childbearing age is now at risk for...

Multiple Thrombophilias Increase the Risk of Fetal Loss.
May 15, 2001... RENO, NEV. -- Women with multiple inherited thrombophilias are at higher risk for adverse pregnancy outcomes, compared with those with just one such abnormality. That was the conclusion of a retrospective cohort study presented at the...

Colposcopy May Rule Out Biopsy in Pregnancy.
May 15, 2001... SOUTH LAKE TAHOE, NEV. -- Colposcopy can rule out the need for a biopsy in pregriant patients with cervical dysplasia, Dr. Gary S. Leiserowitz said at an obstetrics and gynecology conference sponsored by the University of California, Davis. ...

Propylthiouracil Preferred for Hyperthyroidism.
May 15, 2001... SAN FRANCISCO -- Propylthiouracil poses less risk to the fetus than does methimazole when treating hyperthyroidism in a pregnant patient, Dr. Peter P.B. Yeo said at a meeting on endocrinology and metabolism sponsored by the University of...