OB GYN News articles from May 2003

OB GYN News archives from May 2003

Physicians keep an eye out for SARS. (Taking Extra Precautions).
May 15, 2003... Physicians in the United States have yet to sound the alarm about Severe Acute Respiratory Syndrome, but they're taking extra precautions--just in case. To date, Dr. Luis Sanz, an ob.gyn. in Chevy Chase, Md., hasn't seen any SARS patients...

Estrogen/androgen combo questioned for hot flashes: FDA; 'substantial evidence is lacking' that the combo works in estrogen nonresponders. (Company Defends its Products).
May 15, 2003... The Food and Drug Administration has begun a formal process to evaluate the efficacy of two estrogen / androgen combinations currently marketed for the treatment of moderate to severe menopausal hot flashes in women who don't respond to...

Dystocia rate constant despite risk factors: parity, c-section, birth weight studied.
May 15, 2003... WASHINGTON -- Shoulder dystocia appears to occur at a constant rate, despite increased cesarean sections and variations in other risk factors, Dr. Michael Lucas reported at the annual meeting of the Society for Gynecologic Investigation. ...

C-section linked to stillbirth in next pregnancy. (Adjusted Relative Risk of 1.67-2.57).
May 15, 2003... WASHINGTON -- Women who have a cesarean delivery are at increased risk for an unexplained stillbirth in their next pregnancy results of a large, retrospective study suggest. Abnormal placentation due to uterine scarring may be the cause of...

How to treat SARS in pregnant women. (Antibiotics Generally Safe).
May 15, 2003... The Centers for Disease Control and Prevention has not released specific recommendations for the treatment of severe acute respiratory syndrome, but encourages empiric therapy to cover organisms associated with any community-acquired pneumonia...

Intergel sales halted pending investigation of deaths, pain. (Antiadhesion Treatment).
May 15, 2003... The marketer of Intergel Adhesion Prevention Solution, an antiadhesion treatment for gynecologic surgery, has ceased its sale pending an investigation of reports of pain, repeat operations, and three deaths among women who received it. The...

Letters.
May 15, 2003... Laparoscopy Reimbursement In the article "Rise of TVT Shifts Focus Prom Laparoscopic to Vaginal Surgery," Dr. Mark D. Walters compared reimbursement for tension-free vaginal tape (TVT) and Burch procedures (Feb. 15, 2003, p. 11). ...

Limiting resident work hours. (Guest Editorial).
May 15, 2003... I strongly believe in the limits on resident work hours set forth in the new guidelines from the Accreditation Council for Graduate Medical Education, which take effect this July, but I strongly oppose micromanagement of resident work hours....

C-section for obstructed labor linked to incontinence. (Lower Risk with Elective C-Section).
May 15, 2003... SAN FRANCISCO -- Women who had an elective cesarean section with no trial of labor were less likely to develop postpartum urinary incontinence than were women who delivered either vaginally or by C-section after an obstructed trial of labor in...

Toradol cult narcotics, pain after cesareans. (Double-Blind, Randomized Study).
May 15, 2003... ANAHEIM, CALIF. -- Post-operative pain and narcotic use were significantly reduced in patients who received ketorolac tromethamine following cesarean section in a placebo-controlled, double-blind randomized study. Starting 1 hour after...

Asthma associated with planned cesarean. (Large Retrospective Study).
May 15, 2003... WASHINGTON -- Babies delivered by planned cesarean section are significantly more likely to require hospitalization for asthma during childhood than babies born vaginally, Dr. Gordon Smith reported at the annual meeting of the Society for...

Mom's anxiety raises fetal heart rate. (Small Study).
May 15, 2003... Fetal heart rate responses are positively correlated with the mother's level of chronic anxiety, said Catherine Monk, Ph.D., of Columbia University, New York, and her associates. In a study of 32 nonsmoking pregnant women with singleton...

Prophylactic antibiotics reduce C-section cost. (Given at Cord Clamp).
May 15, 2003... WASHINGTON -- Prophylactic antibiotic therapy during cesarean section reduces the cost of an uncomplicated elective procedure by about $30, Dr. David Chelmow reported in a poster session at the annual meeting of the Society for Gynecologic...

'Sense of impending doom' may signal AFE. (Warning Sign).
May 15, 2003... NEW YORK -- The mere thought of amniotic fluid embolism is enough to make many obstetricians break a cold sweat. Fatal more often than not, this rare complication of pregnancy is one that most obstetricians hope they never see. "Keep your...

Diagnosing, managing viral infections in pregnancy a challenge. (Some Expectant Mothers Asymptomatic).
May 15, 2003... KEY LARGO, FLA. -- Viral infections during pregnancy, such as cytomegalovirus, parvovirus B19, and smallpox, can be clinical challenges to diagnose and manage, Dr. Iffath Abbasi Hoskins said at an ob.gyn. update sponsored by the University of...

Breast-fed babies need vitamin D supplements. (Starting at 2 Months of Age).
May 15, 2003... Infants, whether they are breast-fed or not, should receive 200 IU of supplementary vitamin D daily from 2 months of age until they are drinking a minimum 17 ounces of vitamin D--fortified milk daily to prevent rickets, according to a recent...

Myomas larger than 5 cm linked to obstetric woes. (Shoulder Dystocia).
May 15, 2003... WASHINGTON--Uterine myomas larger than 5 cm are associated with fetal mal-presentation, placenta previa, and higher rates of cesarean section due to shoulder dystocia, Dr. Patrizia Vergani reported in a poster session at the annual meeting of...

Type-specific HSV tests help guide management in pregnancy. (Transmission Risk Less with HSV-2).
May 15, 2003... WASHINGTON -- The new type-specific herpes simplex virus serology tests may turn out to be particularly useful in helping guide obstetric management of women who experience outbreaks during pregnancy and in counseling couples who are discordant...

Daily glucose monitoring linked to smaller babies. (Gestational Diabetes).
May 15, 2003... WASHINGTON -- Women with gestational diabetes who monitored their own blood glucose levels four times a day during pregnancy gained less weight and delivered smaller babies than women who had weekly glucose monitoring at a clinic, according to...

Low plasma volume, high cholesterol predict recurrent HT. (Hellp Syndrome, Iugr, Preeclampsia).
May 15, 2003... WASHINGTON - Low plasma volume and hypercholesterolemia post partum were good predictors of recurrent hypertensive disease in a subsequent pregnancy in a study of 99 women. Affected women whose subsequent pregnancies were also complicated...

Laparoscopic fibroid Tx clips uterine arteries. (New Procedure: Little Data).
May 15, 2003... SCOTTSDALE, ARIZ. -- Gynecologists are looking toward clamping or clipping the uterine arteries--temporarily or permanently--as less painful alternatives to uterine artery embolization for the treatment of uterine fibroids. Preliminary...

Public Citizen issues warning against Forteo. (Cancer Implications Questioned).
May 15, 2003... An alert issued by the consumer watchdog group Public Citizen warns consumers to avoid using the osteoporosis drug teriparatide, because studies in rats have linked it to an increased risk of bone cancer. But the drug's manufacturer, Eli...

Osteoporosis prevention dismal in patients with IBD. (Only 7% on Bisphosphonate Therapy).
May 15, 2003... MANCHESTER, ENGLAND -- Only 7% of patients with inflammatory bowel disease were on appropriate bisphosphonate therapy in a case-control study, Dr. Nigel Arden said during the annual meeting of the British Society for Rheumatology. Given...

Monitor fatigue as a vital sign in cancer patients. (Updated Guidelines).
May 15, 2003... HOLLYWOOD, FLA.--Fatigue should be evaluated as a vital sign at every encounter with cancer patients, according to updated treatment guidelines issued at the annual conference of the National Comprehensive Cancer Network. Many studies have...

Better diagnostic, Tx options needed for trich. (Some Metronidazole Resistance).
May 15, 2003... WASHINGTON -- Diagnosis and treatment of trichomoniasis can be tricky, Dr. Anne Rompalo said at an update on sexually transmitted diseases sponsored by OB.GYN. NEWS and Boston University. "We think we know a lot about trichomonas, but we...

Look for causes other than Candida to explain recurrent vulvovaginal symptoms. (Examine Vulva, Vestuble).
May 15, 2003... WASHINGTON -- Recurrent vulvovaginal candidiasis often isn't. Recurrent bacterial vaginosis, genital herpes, and contact dermatitis are among the many entities that tend to be misdiagnosed as candida infections in women with recurrent...

How to handle substance abuse in a colleague. (Never Confront the Person Alone).
May 15, 2003... Last year, Dr. Dana Ware was stunned when a fellow physician arrived for work clearly impaired. "If he came into the ER as a patient, you would say, 'this person is under the influence of something,'" recalled Dr. Ware, a family physician...

HIV Screening. (Policy & Practice).
May 15, 2003... HIV SCREENING Saying HIV prevention efforts have not been successful enough, the Bush administration is spending $35 million in an effort to encourage doctors to offer routine HIV screening to all their patients, especially pregnant women. Dr....

Genome Project Completed. (Policy & Practice).
May 15, 2003... GENOME PROJECT COMPLETED An international effort to sequence the 3 billion DNA letters in the human genome has been completed almost 2 years ahead of schedule. The finished sequence produced by the Human Genome Project covers about 99% of the...

Philip Morris Saved. (Policy & Practice).
May 15, 2003... PHILIP MORRIS SAVED An Illinois judge cut in half the bond that tobacco maker Philip Morris USA must deposit to appeal a $10.1 billion judgment that it deceived smokers into thinking "light" cigarettes were less harmful than regular ones. Now...

Unlicensed Pharmacies. (Policy & Practice).
May 15, 2003... UNLICENSED PHARMACIES Half of the popular online pharmacies included in a recent survey are unlicensed, and one-third do not have adequate privacy measures in place to protect patients, according to PharmacyChecker.com. Of a dozen online...

Microbicide Research. (Policy & Practice).
May 15, 2003... MICROBICIDE RESEARCH Sen. Jon Corzine (D-N.J.) has introduced legislation to create a Microbicide Research and Development Branch within the National Institutes of Health to increase funding for microbicide research at NIH, the Centers for...

Medical group calls for reimbursement for e-mail. (Communicating with Patients).
May 15, 2003... SAN DIEGO -- The American College of Physicians is calling on Medicare and private insurers to reimburse physicians for certain types of e-mail consultations. Some private insurers already have begun to pay their physicians for e-mail...

Ten Commandments for dealing with difficult patients. (There's Always the Supply Closet).
May 15, 2003... SAN DIEGO -- Before you lose your temper with a patient, Dr. Michael F. Lubin suggests that you try this four-step procedure: 1. Tell the patient someone is paging you. 2. Go to a supply closet. 3. Place folded sheets on a gurney....

Modern factors may boost smallpox vaccine risk. (Infection of Secondary Contacts).
May 15, 2003... DENVER -- "Should I get vaccinated for smallpox?" Physicians report that an increasing number of patients are asking this question since the U.S. government launched a drive last year to vaccinate up to 450,000 health care workers and 10...

Statin may curb events in normolipidemic HT. (Primary Prevention Trial).
May 15, 2003... CHICAGO -- Atorvastatin at 10 mg/day reduced cardiovascular events in a large randomized primary prevention trial of well-controlled hypertensive patients without dyslipidemia. In the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) the...

Breast implants tied to suicide risk. (Look for Subtle Signs).
May 15, 2003... Women who have breast implants are significantly more likely to commit suicide than women who do not have implants, said Dr. V.C.M. Koot of University Medical Centre in Utrecht, the Netherlands, and associates. In a prospective study of...

Patient resources for handheld computers. (Digital Assistance).
May 15, 2003... Overview: Many handheld computer applications are now available for personal health management. Personal medical information databases, electronic reference documents for self education, and more elaborate disease management products may...

Albumin cobalt binding (ACB) test. (New & Approved: Albumin Cobalt Binding Test, Somavert).
May 15, 2003... (Ischemia Technologies Inc.) A biochemical test for use as an adjunct to the electrocardiogram and troponin blood test, to rule out MI in patients presenting to the emergency department with chest pain. The first blood test approved for...

Somavert. (New & Approved: Albumin Cobalt Binding Test, Somavert).
May 15, 2003... (pegvisomant for injection, Pharmacia) A growth hormone receptor antagonist for acromegaly, in people who have had an inadequate response to existing treatments (surgery, radiation treatment, and other medical therapies), or when these...

CV risk may warrant oral glucose tolerance test. (Type Diabetes).
May 15, 2003... CHICAGO -- The epidemic of type 2 diabetes has grown to the point that it may be worthwhile to perform an oral glucose tolerance test on everyone at increased risk for cardiovascular disease, Dr. Robert Calif. asserted at the annual meeting of...

Neutraceuticals protective for osteoarthritis. (Glucosamine, Chondroitin).
May 15, 2003... ORLANDO, FLA. -- Dismissed a decade ago as "snake oil," glucosamine and chondroitin sulfate have gained respect as treatments for osteoarthritis, Dr. David Hungerford said at a symposium on hip and knee arthroplasty sponsored by the Current...

Online nutrition resource. (Products).
May 15, 2003... A new nutrition Web site offers information from the 2000 National Nutrition Summit and the 1969 White House Conference on Food, Nutrition, and Health. The Web site includes speeches and videocasts from the summit, along with subsequent journal...

Quality measures web site. (Products).
May 15, 2003... The Agency for Healthcare Research and Quality has launched a Web-based National Quality Measures Clearinghouse where users can search for measures that target a particular disease, treatment, age range, gender, vulnerable population, setting...

Palliative Care for HIV/AIDS. (Products).
May 15, 2003... The Department of Health and Human Services has released "A Clinical Guide to Supportive and Palliative Care for HIV/AIDS." It provides practical guidelines for providing palliative care and supportive services to patients with HIV/AIDS. The...

Spina Bifida initiative. (Products).
May 15, 2003... The Spina Bifida Association of America has launched a Web initiative called "Got a Minute?" for health care providers. The campaign reminds physicians that it takes only a few seconds to counsel female patients that folic acid reduces the risk...

Smallpox Web site. (Products).
May 15, 2003... The U.S. Department of Health and Human Services has launched a new Web site, wwwsmallpox.gov, to provide information about smallpox. The site includes information about the disease and the vaccine for the public and physicians, and is provided...

ADHD in girls and women. (Products).
May 15, 2003... A new report from the National Women's Health Resource Center describes how attention-deficit hyperactivity disorder (ADHD) affects girls and women. "ADHD and Women's Health" details research on the disorder, medication and other treatments,...

Clinical Pearls. (Cesarean Section).
May 15, 2003... This is the fourth Clinical Pearls column devoted to cesarean delivery. The emphasis on this procedure seems reasonable, since it remains the most commonly performed major operation in the United States. The National Center for Health...