OB GYN News articles from November 2000

OB GYN News archives from November 2000

Paying to Escape On-Call Duty.
November 1, 2000... The 50 or so ob.gyns. on the medical staff at Santa Monica-UCLA Medical Center used to be required to take call at the emergency department for a full week once a year. Now, under an innovative "pay to play" system, 34 of them have no ER...

FDA Panel Backs Pregnancy Test for Accutane Users.
November 1, 2000... Recommends requiring negative test results before a prescription is filled. GAITHERSBURG, MD. -- Elements of the current voluntary pregnancy prevention program for Accutane users could become mandatory in an effort to finally stop pregnant...

Hysterectomy Guidelines Often Are Not Followed.
November 1, 2000... Too many abdominal surgeries performed. ST. Louis -- The collective impact of hysterectomy on American women could be reduced significantly if available practice guidelines on determining the appropriate route for surgery were followed,...

Calcium, Vitamin D May Prevent Osteoporotic Tooth Loss in Elderly.
November 1, 2000... TORONTO -- Physicians recommending calcium and vitamin D to prevent osteoporosis in their elderly patients can now point to another reason for taking the supplements--dental health. "This is an effective, inexpensive, and well-tolerated...

Pending USPSTF Report Confronts Evidence Gaps.
November 1, 2000... DALLAS - A glimpse into some of the likely forthcoming clinical recommendations of the third U.S. Preventive Services Task Force shows that the path toward rigorously evidence-based medical practice remains long and treacherous. As the...

Miscarriage Risk No Higher After Fertility Treatment.
November 1, 2000... Infertile women who conceive after fertility treatment have a similar risk of spontaneous abortion as do those who conceive without therapy and those with normal fertility, according to Dr. Kevin Pezeshki of Maimonides Medical Center, New York,...

Less Than a Word of Advice.
November 1, 2000... The recent 80th birthday celebration for my mentor, Dr. Alfred Sherman, occurred in the evening after he had performed two major gynecologic oncology cases that day. All of the guests were asked to relate a story about him. I spoke about the...

LETTERS.
November 1, 2000... A Clinical Catch-22 I generally agree with Dr. Flamm's philosophy and advice concerning the dilemma of image recording in the delivery of healthcare, but with several caveats ("Where Do We Draw the Line?" Aug. 1, 2000, p. 8). Having...

Ultrasonically Activated Scalpel Cuts Injury Risk.
November 1, 2000... WASHINGTON -- The ultrasonically activated scalpel offers distinct advantages over electrosurgical treatment for myomectomy, Dr. Roger Ferland said at the FIGO World Congress of Gynecology and Obstetrics. The scalpel's biggest advantage is...

Fewer Complications Seen With Balloon Ablation.
November 1, 2000... WASHINGTON -- Premenopausal women who underwent endometrial ablation with a balloon device for menorrhagia continued to express satisfaction with the outcome 24 months after the procedure, Dr. Charles E. Miller said at the FIGO World Congress...

Hip Fractures Often Don't Spur Osteoporosis Tx.
November 1, 2000... TORONTO -- Most hip fracture patients aren't subsequently treated for osteoporosis, leaving them open to yet another fracture, results of a recent study suggest. Of 502 hip fracture patients seen in four large multispecialty health care...

Pick Estrogen Cream Carefully for Lichen Sclerosus.
November 1, 2000... BIG SKY, MONT. -- Many patients with refractory lichen sclerosus simply aren't using their medications properly, Dr. Lane J. Mercer said at an ob.gyn. update sponsored by the University of Chicago. But by choosing the most appropriate...

Check for Vaginal Involvement in Endometriosis.
November 1, 2000... WASHINGTON -- Check for vaginal involvement in endometriosis patients who have not responded completely to standard treatments for the disorder. That was the message Dr. Safwat Tosson, consultant gynecologist at Hartlepool General...

Genital Herpes Vaccine Promising Only in Women.
November 1, 2000... TORONTO -- The first vaccine to show efficacy in preventing genital herpes disease has two problems: It works only in women and only in those who are seronegative for both herpes simplex viruses 1 and 2. Given that a large proportion of the...

Telogen Effluvium: The Cause Can Be Elusive.
November 1, 2000... ANAHEIM, CALIF. -- Of all the skin disorders related to pregnancy and the postpartum period, telogen effluvium may be the most challenging for clinicians to diagnose, Dr. Kathleen Behr said at a meeting on controversies in women's health...

Fetal Markers Seen on Ultrasound Can Help Assess Down Syndrome Risk.
November 1, 2000... WASHINGTON -- The risk of a patient having a fetus with Down syndrome can be assessed noninvasively using fetal markers seen on ultrasound. While not in widespread routine use, such an approach has proved useful in research studies. "Some...

Underwater Delivery Does Not Appear to Raise Group B Strep Risk in Mothers or Their Children.
November 1, 2000... WASHINGTON -- Underwater delivery does not appear to place mothers or their children at increased risk for acquiring group B streptococcus infection, Dr. Rosanna A. Zanetti Dallenbach said at the FIGO World Congress of Gynecology and...

'Unfounded' Concerns Curb Walking Epidurals.
November 1, 2000... BALTIMORE -- Walking epidurals are extremely popular in England but have yet to gain a strong following in this country due to "unfounded" safety concerns, Dr. Chet I. Wyman said at a recent update on obstetric anesthesia. There is plenty...

Pediatric Take on HSV Vertical Transmission.
November 1, 2000... ASPEN, COLO. -- Herpes simplex virus has tormented humans since at least the time of the ancient Greeks, but questions still linger concerning how to prevent its transmission from mothers to infants. Obstetricians and pediatricians see eye...

Asthma Drugs.
November 1, 2000... Because the consequences of uncontrolled asthma during pregnancy can be so devastating, drug therapy, which is aimed at maintaining control of the chronic condition and preventing acute exacerbations, is a lesser risk in almost all cases. ...

Antidepressants in Breast Milk Appear Safe.
November 1, 2000... ANAHEIM, CALIF. - There may be some promising news in the future for mothers concerned about breast-feeding while taking antidepressants. Preliminary results from an ongoing 5year study suggest that there are no adverse clinical outcomes in...

Perinatal AZT Not Linked to Cardiotoxicity.
November 1, 2000... Perinatal exposure to zidovudine did not adversely affect infants' cardiac structure or function, reported Dr. Steven E. Lipshultz of the University of Rochester (New York) and his associates. The investigators followed from birth to 14...

Cardiac Morbidity in Women.
November 1, 2000... The risk of a fatal myocardial infarction in women with a 15- to 20-year history of diabetes is similar to that conferred by a prior myocardial infarction, Dr. Frank B. Hu reported at the annual scientific session of the American Diabetes...

Diabetes Screening and Obesity.
November 1, 2000... Screening for type 2 diabetes needs to be intensified in obese young adults, Dr. Teresa A. Hillier said at the annual scientific session of the American Diabetes Association. Compared with adults diagnosed with type 2 diabetes after age 45,...

Aggressive Depression Therapy.
November 1, 2000... Chronic depression must be approached aggressively, even in its "milder" forms, Dr. David L. Dunner said at a psychopharmacology meeting sponsored by New York University and Bellevue Hospital Center. All of the newer antidepressants appear...

Alzheimer's and Cognition.
November 1, 2000... The mild cognitive impairment, including memory decline, that is widely attributed to normal aging is in many cases an early manifestation of Alzheimer's disease, Dr. David A. Bennett said at the World Alzheimer Congress. In a longitudinal...

Stenting in Women.
November 1, 2000... Women have significantly worse outcomes than men after coronary stenting, Alan Porritt reported at an international conference on women, heart disease, and stroke. In his observational study, the age-adjusted rate of angina within 30 days...

Risk Factors After Surgery.
November 1, 2000... Women often fail to reduce their cardiac risk factors following coronary artery bypass surgery, according to a study presented by Jerilyn Allen, Sc.D., at a meeting on cardiovascular disease and stroke sponsored by the American Heart...

Sarcoidosis Signs.
November 1, 2000... Consider the diagnosis of sarcoidosis in any patient, especially a young woman who complains of vague, persistent lung symptoms, Dr. Michael Richardson said at the annual meeting of the National Medical Association. Sarcoidosis is vastly...

FEWER UNINSURED AMERICANS.
November 1, 2000... For the first time in 12 years, the number of people without health insurance has decreased, the U.S. Census Bureau reported. Between 1998 and 1999, the number of Americans without health coverage dropped from 44.3 million to 42.6 million. This...

STOPPING DOMESTIC VIOLENCE.
November 1, 2000... A bill that reauthorizes federal programs to prevent domestic violence against women recently passed the U.S. House of Representatives. The Violence Against Women Act (VAWA) 2000 builds upon programs set up under the original VAWA 1994. In...

BREAST-FEEDING ON THE JOB.
November 1, 2000... A bill that would give women the legal right to breast-feed on the job was recently introduced in the Senate. The Pregnancy Discrimination Act Amendments of 2000, introduced by Sen. Olympia Snowe (R-Maine), would amend the Civil Rights Act of...

BLACKS MORE AT RISK FOR PTD.
November 1, 2000... Although the preterm delivery gap between black and white women in the United States is narrowing, black women are still at 1.5-2.4 times the risk of white women for preterm delivery, according to data from the Centers for Disease Control and...

OUT-OF-WEDLOCK BIRTHS.
November 1, 2000... Four states and the District of Columbia will split $100 million as an award for having the nation's lowest proportion of out-of-wedlock births to all live births. The money will be given by the Department of Health and Human Services as a...

Managed Care Plans Earned Higher Clinical Quality Scores in 1999.
November 1, 2000... WASHINGTON -- Managed care plans have achieved substantial improvement in some of the clinical quality measures examined each year by the National Committee for Quality Assurance. "This is the greatest level of improvement we've seen in...

Two Exams Assess Competency of Health Care Providers in the Field of Menopause Medicine.
November 1, 2000... ORLANDO, FLA. -- The North American Menopause Society has launched two new written examinations intended to demonstrate the competency of health care providers in the specialized field of menopause medicine. "We felt there was a need to...

Patient Communication on Med Schools' Agenda.
November 1, 2000... Most students encounter a cadaver on their first day of medical school. At the University of Pittsburgh, students' first exposure to medicine comes by observing physicians as they meet and interview real, breathing patients. The complex...

No Single Method Works Best To Teach Communication Skills.
November 1, 2000... When Allan Platt began a search for audiovisual materials on communication skills, he was shocked at how few materials on the topic existed. "I was using some videos made back in the 1960s. Everyone was wearing bell bottoms and looked like...

Mum's the Word if You're Sued for Malpractice.
November 1, 2000... BOSTON -- The first reaction of any competent physician slapped with a lawsuit would be to pick up the phone, but you should resist the temptation unless the number you're dialing is your own, Dr. Abel Torres advised physicians at a meeting on...

Surgical Mesh.
November 1, 2000... Sepramesh Biosurgical Composite is a prosthetic surgical mesh designed to be sutured into place along the abdominal wall to support and strengthen hernia repairs. It contains a bioresorbable barrier that separates the mesh from underlying...

Skin-Numbing Spray.
November 1, 2000... Gebauer's Ethyl Chloride temporarily numbs the skin to produce a local anesthetic effect for minor surgery and outpatient procedures such as incisions, lancing boils, and draining small abscesses. This topical skin refrigerant has a...

Controlling Nausea.
November 1, 2000... Compro (prochlorperazine suppositories 25 mg) is indicated for use in controlling severe nausea and vomiting in adults. The suppositories are contraindicated in patients in a comatose state, those taking central nervous system depressants, and...

Patch for Osteoporosis.
November 1, 2000... Vivelle (estradiol transdermal system) is now indicated for prevention of postmenopausal osteoporosis and is available in four dosage strengths (0.0375, 0.05, 0.075 and 0.1 mg/day). A transdermal estrogen patch about the size of a quarter,...

Hand Antiseptic.
November 1, 2000... Avagard instant hand antiseptic is waterless and designed to reduce dryness and maintain skin integrity It won't deactivate chlorhexidene gluconate, an antimicrobial agent, and it kills more than 99% of harmful bacteria within 15 seconds,...

Breast Milk Leakage.
November 1, 2000... The blis (breast leakage inhibitor system) is a nonpharmacologic, noninvasive method to control breast milk leakage. It consists of a soft plastic shield with a cotton insert that applies gentle pressure on the nipple. The blis can be used by...

BMD Testing Scan.
November 1, 2000... The Alara MetriScan is a tabletop device that allows physicians to scan patients' fingers to estimate bone mineral density (BMD). The device calculates and displays a T-score in less than 45 seconds. The company offers a "fee per scan" leasing...

Hospitals Restrict Misoprostol Use.
November 15, 2000... The off-label use of an antiulcer drug is threatening to curtail the widespread availability of medical abortions--right on the eve of mifepristone's closely watched rollout. A recent warning from Searle not to use misoprostol (Gytotec) in...

New Residency Rules to Offer Greater Flexibility.
November 15, 2000... Tailor residency to interests, do primary care training in ob.gyn. departments. Newly approved requirements for ob.gyn. residency training programs have been created to stem the tide of discontent among program directors who earlier this...

Medicare to Cover Electrical Stimulation, Biofeedback.
November 15, 2000... Stress or urge urinary incontinence targeted. Biofeedback and pelvic floor electrical stimulation have been approved for Medicare coverage in incontinent patients who fail traditional pelvic floor exercise therapy. The two modalities...

Endometrial Ca Aggressive in Tamoxifen Users.
November 15, 2000... When women who use tamoxifen develop endometrial cancer their tumors typically are not early stage and do not have histologically favorable traits, contrary to current opinion, according to Dr. Liesbeth Bergman of the Netherlands Cancer...

Dealing With Deselection.
November 15, 2000... Four our years ago there was a wave of activity by many of the larger HMOs to deselect "expensive" physicians from their panels, even physicians who contracted with HMOs through independent practice associations. Although the number of...

PRO & CON.
November 15, 2000... Should the postcoital test be part of the standard infertility work-up? YES A review of the literature published a decade ago (Am. J. Obstet. Gynecol. 162[3]:615-20, 1990) showed that the postcoital test lacks validity in terms of its...

Recurrent UTI and Urgency? Consider Urethral Diverticulum.
November 15, 2000... ST. Louis -- Think of urethral diverticulum when a woman has a history of recurrent urinary tract infection and also presents with symptoms such as urgency, frequency, dysuria, and dyspareunia. An estimated 3% of women have urethral...

Embolization Not for Large Fibroids.
November 15, 2000... WASHINGTON -- Large submucous myomata should not be treated with uterine artery embolization, Dr. Jacques-Henri Ravina said at the FIGO World Congress of Gynecology and Obstetrics. Since uterine artery embolization (UAE) was first...

Check Label for Amount of Elemental Calcium.
November 15, 2000... ANAHEIM, CALIF. -- Instruct patients who are shopping for calcium supplements to look for the amount of elemental calcium noted on the product label, not the amount of calcium carbonate, calcium citrate, or calcium phosphate, Dr. Gail Greendale...

Raise Protein to Avert Bone Loss.
November 15, 2000... TORONTO -- Insufficient nutrition, especially low protein intake, exacerbates bone loss and increases fracture risk in elderly patients, said Dr. Rene Rizzoli of Hospital Cantonal, Geneva. Geriatricians are considering a change in the...

Endometrial Biopsy Not a Good Screen for Cancer.
November 15, 2000... Both endometrial biopsy and transvaginal sonography of the endometrium are ineffective cancer screens for asymptomatic women on tamoxifen, researchers reported in separate studies. Neither technique was useful in detecting endometrial...

FDA Approves Monthly Injectable Contraceptive.
November 15, 2000... Lunelle, a combination of medroxyprogesterone acetate and estradiol cypionate, is a good option for women "interested in the pill, but not interested in daily pill taking," according to the lead investigator in U.S. trials of the recently...

A Fifth of Women Regret Decision to Sterilize.
November 15, 2000... WASHINGTON -- Regardless of parity, one in five women under age 30 who undergoes tubal sterilization later regrets having the procedure, Dr. Herbert Peterson said at the FIGO World Congress of Gynecology and Obstetrics. This was one of the...

Racial Differences Seen in Causes of Infertility.
November 15, 2000... WASHINGTON -- Ovulatory dysfunction is the leading cause of infertility in white women, while tubal factors are most likely to blame in blacks. That was the conclusion of a retrospective chart review performed by Dr. Michael A. Thomas and...

Wait to Conceive After Testicular Ca Treatment.
November 15, 2000... SACRAMENTO - Women whose partner has undergone etoposide therapy for testicular cancer should wait at least 100 days after the procedure before trying to conceive a child, Francesco Marchetti, Ph.D., said at a cancer symposium sponsored by the...

Pregnancy, Childbirth Outcomes Usually Good in Women With Spina Bifida.
November 15, 2000... Women with spina bifida who become pregnant generally have positive outcomes, so physicians can reassure such patients that their prospects for pregnancy and childbirth are good, according to Dr. Margarita Arata and her associates at Royal...

Screen for Genetic Mutations In Women With a History Of Late Pregnancy Loss.
November 15, 2000... Women with a history of late pregnancy loss should be screened for mutations in the genes that code for the coagulation factors prothrombin and factor V Leiden, according to Italian researchers. Women with a history of late pregnancy loss...

Enviromental, Genetic Factors May Play Causal Role in Preeclampsia.
November 15, 2000... WASHINGTON -- Several genes and environmental factors appear to influence maternal predisposition for developing preeclampsia, said Dr. James J. Walker at the FIGO World Congress of Gynecology and Obstetrics. Preeclampsia is increasingly...

No Single Intervention Will Cut Preterm Birth Rates.
November 15, 2000... INCLINE VILLAGE, NEV. -- The etiology of preterm birth differs markedly from hospital to hospital even within the same city, Dr. James A. McGregor said at the annual meeting of the Infectious Diseases Society for Obstetrics and Gynecology. ...

Congenital Defects Tied to Extreme Stress.
November 15, 2000... Pregnant women who undergo extreme stress are at increased risk of giving birth to infants with congenital malformations in organs derived from the cranial neural crest, according to Dr. Dorthe Hansen of the John F. Kennedy Institute in...

Ask Lactating Women About Herb Use.
November 15, 2000... Herbs and breast-feeding can create a potent mix, so be sure to ask breast-feeding mothers about them. Although many herbs are touted as improving milk supply, there are no placebo-controlled studies to back up those claims. "People gobble...

Hepatitis C Infection Occurs at Delivery.
November 15, 2000... Vertical transmission of hepatitis C appears to occur predominantly at the time of delivery, rather than during pregnancy because elective cesarean section appears to prevent it, according to Dr. D.M. Gibb of the Medical Research Council's...

Chorioamnionitis Linked To Cerebral Palsy.
November 15, 2000... Preterm and term infants with clinical chorioamnionitis are significantly more likely than those without the infection to develop cerebral palsy, results of a metaanalysis suggest. "A growing body of evidence supports the notion that fetal...

Maternal DHA Supplements of Little Benefit to Nursing Infants.
November 15, 2000... PROVIDENCE, R.I. -- Maternal docosahexaenoic acid supplementation may modestly enhance psychomotor development of breast-fed infants, but it confers no benefit with respect to mental development, Dr. Robert Voigt said at the annual meeting of...

Margarine Enhances Statin Benefits.
November 15, 2000... Margarine enriched with a plant sterol reduced low-density lipoprotein cholesterol levels by an additional 10%-15% when used in conjunction with a statin, Dr. H. Andrew Neil reported at the 22nd Congress of the European Society of Cardiology....

Angina Red Herring.
November 15, 2000... Myofascial chest pain syndrome frequently masquerades as angina pectoris in women, Dr. Ronald S. Baigrie said at an international conference on women, heart disease, and stroke. As a result, a large number of women with noncardiac chest...

Quinolone-Resistant GI Bugs.
November 15, 2000... Gastrointestinal bacterial infections increasingly are resistant to quinolones, a popular antibiotic choice for treating severe diarrheal infections. The prevalence of quinolone-resistant Campylobacter soared during the late 1990s, and new...

H. pylori and Skin.
November 15, 2000... Patients with several treatment-resistant skin conditions had significant improvement when treated for Helicobacter pylori infection, Dr. Mikihase Sakurane reported in a poster presentation at the annual meeting of the Society for Investigative...

Celecoxib and Sulfa Drug Allergy.
November 15, 2000... Celecoxib is technically a sulfonamide, but it should not be automatically contraindicated in patients with a history of allergy to sulfa drugs, Dr. Neil H. Shear said at the American Academy of Dermatology's Academy 2000. The sulfonamide...

New Sinusitis Guidelines.
November 15, 2000... The first set of treatment guidelines for acute bacterial rhinosinusitis has been published by the Sinus and Allergy Health Partnership. The evidence-based guidelines (Otolaryngol. Head Neck Surg. 123[1, pt. 2]:5-31, 2000) can be put to...

MDs: Get Your Flu Shot.
November 15, 2000... Most physicians and other health care workers are not doing their part to stop influenza transmission: They're not getting an annual flu shot. A survey of staff members at seven U.S. hospitals in 1996 and 1997 showed that 40% of physicians...

RSV Mimics Influenza in Adults.
November 15, 2000... What appears to be influenza in adults often turns out to be a respiratory syncytial virus infection. The implications for adult care are simple: Confirm that an infection is influenza when prescribing an antiviral drug, Dr. Ann R. Falsey...

Altace.
November 15, 2000... (ramipril, Wyeth-Ayerst, King Pharmaceuticals) An angiotensin-converting enzyme inhibitor for reducing the risk of MI, stroke, and death from cardiovascular causes in people aged 55 and over who are at high risk of a major cardiovascular...

Fosamax.
November 15, 2000... (alendronate, Merck) A bisphosphonate to increase bone mass in men with osteoporosis. The first drug approved to treat osteoporosis in men. * Recommended Dosage: 10 mg once a day (the same dose approved for post-menopausal...

SCHIP FUNDS PREGNANCY.
November 15, 2000... States may now use state children's health insurance program waiver funds to cover low-income pregnant women and mothers and fathers of eligible children, according to the United States Department of Health and Human Services. States must first...

MALPRACTICE PREMIUMS UP.
November 15, 2000... Malpractice premiums are rising as professional liability insurers raise their rates, a study shows. Increasing frequency of claims, severity of injuries, and medical cost inflation are driving the rate increase. The study, conducted by the...

OIG GUIDELINES FINALIZED.
November 15, 2000... Final guidelines intended to help small physician practices comply with Medicare and other federal health care program regulations have been released by the Department of Health and Human Service's Office of the Inspector General. The agency...

BREAST CANCER COVERAGE.
November 15, 2000... Legislation that provides medical assistance to low-income or uninsured women diagnosed with breast or cervical cancer was recently passed in the U.S. Senate. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 amends the Social...