OB GYN News articles from October 2003

OB GYN News archives from October 2003

Glycemic index key to many new diets: what patients are reading.(News)
October 1, 2003... Diet books are perennially popular, even though the heroes and villains of the food world seem to change places every few years. Meats, eggs, and dairy products were vilified for years as the culprits in this country's growing obesity...

Drug approved for lowering herpes transmission risk: for use in heterosexuals: Valtrex cut transmissions to susceptible partners by 50%-75% in 8-month study.(News)
October 1, 2003... The Food and Drug Administration has approved valacyclovir for use as suppressive therapy to reduce the risk of heterosexual transmission of genital herpes to susceptible partners. The approval is limited to otherwise healthy adults with...

FDA approves first extended-cycle OC: available this month: may cause higher incidence of spotting.(News)
October 1, 2003... The Food and Drug Administration has approved Seasonale, a 91-day oral contraceptive designed to reduce a woman's menstrual periods to four per year. Although women may like the convenience of having fewer periods, they should be prepared...

How much time do you spend with patients?(Vital Signs)
October 1, 2003... Mean Time In Minutes Psychiatry 32.4 Cardiovascular Diseases 22.2 Internal Medicine 19.4 Family Practice ...

Paxil joins ranks of SSRIs for PMDD: controlled release.(News)
October 1, 2003... The controlled-release formulation of paroxetine was approved by the Food and Drug Administration for treating premenstrual dysphoric disorder, based on data in more than 1,000 women who met the DSM-IV criteria for the disorder. This is...

Low-dose estrogen raised BMD in small study; women over age 65.(News)
October 1, 2003... Older women treated with low-dose estrogen for 3 years had significantly increased bone mineral density and decreased bone turnover relative to untreated women in a small, randomized, double-blind, placebo-controlled study. The study is...

Dress rehearsal for disaster.(Guest Editorial)
October 1, 2003... When the lights suddenly went out in the late afternoon at Lenox Hill Hospital, a 652-bed community hospital in Manhattan's Upper East Side, nobody knew what had happened. By the time the Blackout of 2003 ended for us, more than 24 hours...

Is HIPAA helping in any way?(Pro & Con)
October 1, 2003... YES One of the positive things about the Health Insurance Portability and Accountability Act of 1996 (HIPAA) is that the statute outlines a set of minimum national requirements that people can follow. The statute makes it possible for...

Act fast to treat varicella in pregnancy: 96-hour window.(Obstetrics)
October 1, 2003... ASHEVILLE, N.C. -- Only about 10% of chickenpox cases occur in adults, but when a pregnant patient is exposed to the virus, quick action is necessary, Dr. Joseph M. Ernest III said at the annual Southern Obstetric and Gynecologic Seminar. ...

Small study: maternal parvovirus infection often asymptomatic: 4 of 25 women had symptoms.(Obstetrics)
October 1, 2003... HYANNIS, MASS. -- Parvovirus infection during pregnancy can be a contributing factor in heart failure and death for the developing fetus, but many women infected with parvovirus B19 experience no symptoms, a small, retrospective cohort study...

More ills of in utero isotretinoin exposure: cognitive impairment.(Obstetrics)
October 1, 2003... TAMPA, FLA. -- Children who were exposed to isotretinoin in utero but appear normal at birth are still at risk for later appearance of cognitive impairment and difficulties in psychosocial functioning, Dr. Jennifer Anne Lantz Gavin said at a...

Rapid HIV testing during labor may cut transmission; women with no prenatal care.(Obstetrics)
October 1, 2003... HYANNIS, MASS. -- A protocol using expedited enzyme-linked immunosorbent assay testing of women in labor who have not received prenatal care is useful in identifying HIV-1-positive patients, in whom intrapartum antiretroviral therapy can...

Maternal exposure to OR waste gas tied to deficits in child: small study.(Obstetrics)
October 1, 2003... PHILADELPHIA--Children of mothers who had occupational exposure to waste anesthetic gases in operating rooms during pregnancy may be at risk for minor neurologic and developmental deficits, results of a small study suggest. "The primary...

ART/HAART well tolerated in HIV-infected pregnancies: vertical transmission reduced.(Obstetrics)
October 1, 2003... HYANNIS, MASS. -- Antiretroviral therapy can markedly reduce vertical HIV transmission in pregnant women, but drug choices and dosages need to be carefully tailored to optimize efficacy and minimize potential toxicities, according to Dr....

U.S. widely misses target for maternal mortality: data from 1991-1999.(Obstetrics)
October 1, 2003... SAN FRANCISCO -- The overall U.S. maternal mortality rate was pegged at 12 deaths per 100,000 pregnant women during the period between 1991 and 1999, according to data from the Centers for Disease Control and Prevention. That rate is a far...

Three R's speed response to prolonged hypoxia: rate, route, room.(Obstetrics)
October 1, 2003... SAN FRANCISCO -- Organize your thoughts when faced with complicated fetal heart rate tracings by remembering the three R's--rate, route, and room. Clinicians commonly respond to fetal heart rate tracings suggestive of unremitting hypoxia...

Play it safe: counsel before conception: health and legal issues.(Obstetrics)
October 1, 2003... ASHEVILLE, N.C. -- Preconception counseling promotes healthier pregnancies and better outcomes, and can also provide legal protection for physicians, Dr. Martin E. Olsen said at the annual Southern Obstetric and Gynecologic Seminar. Courts...

Cigarette smoking.(Drugs, Pregnancy, And Lactation)
October 1, 2003... About 15%-29% of pregnant women smoke in pregnancy, which can cause significant fetal and infant toxicity and lead to other adverse outcomes that may persist long after birth. Many physicians aren't aware of all the problems associated...

Studies clash on GI-event risk of bisphosphonates: Fosamax, Actonel.(Gynecology)
October 1, 2003... SAN DIEGO -- Men and women older than 65 who started bisphosphonate therapy with alendronate had about a 1.5-fold greater risk for gastrointestinal events after 4 months, compared with those who started therapy with risedronate, results from a...

Easy screening test available for osteoporosis: five-item questionnaire.(Gynecology)
October 1, 2003... LOS ANGELES -- A brief questionnaire is proving to be a highly effective screening test for osteoporosis. The Osteoporosis Risk Assessment Tool (ORAT) consists of five questions that patients can answer in the waiting room. It was developed...

Higher-dose estrogen patch may prevent migraine: after medical oophorectomy.(Gynecology)
October 1, 2003... CHICAGO -- Dosage maybe an important factor in the use of transdermal estradiol for prevention of headache in female migraineurs, Dr. Vincent T. Martin said at the annual meeting of the American Headache Society. He reported new evidence...

Depressive symptoms called barrier to breast, cervical Ca screening: women aged 42-52.(Gynecology)
October 1, 2003... VANCOUVER, B.C. -- A high burden of depressive symptoms is an independent predictor of reduced odds of undergoing appropriate screening for breast and cervical cancer, Dr. Paul A. Pirraglia said at the annual meeting of the Society of General...

PET imaging with fluorine-18 fluoroestradiol may help predict breast cancer response to hormone therapy: early research.(Gynecology)
October 1, 2003... NEW ORLEANS -- Physicians may now have a tool to help predict which patients with recurrent or metastatic breast cancer will respond to hormone therapy, early research suggests. PET imaging-using fluorine-18 fluoroestradiol (FES) appears to...

BRCA test referrals low in minorities: ongoing Bronx study.(Gynecology)
October 1, 2003... SAN DIEGO -- The number of genetic counseling referrals for BRCA1 and BRCA2 testing among Hispanic and African American women is disproportionately low for the underlying demographics of a catchment area based in the Bronx area of New York,...

Urethral obstruction managed with urethrolysis: postsurgical intervention.(Gynecology)
October 1, 2003... FORT LAUDERDALE, FLA. -- Don't hesitate to intervene surgically if a patient is having significant voiding problems after anti-incontinence surgery, Dr. Victor Nitti said at a symposium on pelvic floor disorders sponsored by the Cleveland...

BV raises HSV-2 susceptibility: study of 670 women.(Gynecology)
October 1, 2003... Bacterial vaginosis increases susceptibility to herpes simplex virus type 2, Dr. Thomas L. Cherpes and his colleagues at the University of Pittsburgh reported. Of 670 sexually active, HSV-2-seronegative women (aged 18-20 years), 32 (5%)...

Scant outcome data on metformin in PCOS teens; expert opinion.(Gynecology)
October 1, 2003... SEATTLE -- Physicians may have become too eager to add metformin reflexively to treatment of adolescent patients with polycystic ovary syndrome, Dr. S. Jean Emans said at the annual meeting of the Society for Adolescent Medicine. "I don't...

Older age may be obstacle to cancer referral, treatment: underrepresented in trials.(Gynecology)
October 1, 2003... CHICAGO -- A patient's older age is a handicap when it comes to cancer treatment, referrals, and clinical research, according to findings presented at the annual meeting of the American Society of Clinical Oncology. In a study of disease...

Malpractice crisis hinders medical error reporting; state reporting programs surveyed.(Practice Trends)
October 1, 2003... PORTLAND, ORE. -- Concern about litigation poses a disincentive for states to report statistics on medical errors, Mimi Marchev said at the annual conference of the National Academy for State Health Policy. Twenty-one states currently have...

Malpractice insurers focusing on risk management; tightened reporting requirements.(Practice Trends)
October 1, 2003... PMA Medical Specialists, a 24 physician multispecialty practice in suburban Philadelphia, was facing a crisis. Since buying out the previous owners--the University of Pennsylvania--in 2002, PMA had been struggling to get malpractice insurance....

Savvy strategies can control problems with office staff; find out what motivates them.(Practice Trends)
October 1, 2003... HOLLYWOOD, FLA. -- When office staff feud or become unproductive under stress, step in and make positive requests to change the behavior of the most troublesome employees, said Larry Harmon, Ph.D., a psychologist with a private practice in...

Medical school applications once again on the rise: reversal of a 6-year decline.(Practice Trends)
October 1, 2003... Medical schools are seeing the reversal of a 6-year decline in applications as the economy sags and students gravitate toward careers of service. At press time, the Association of American Medical Colleges expected this year's final number...

Ob.Gyn. dissatisfaction.(Policy & Practice)
October 1, 2003... While most ob.gyns. are satisfied with their careers, about a quarter report that they are somewhat or very dissatisfied, Dr. Richard L. Kravitz of the University of California, Davis, and his colleagues say (Obstet. Gynecol. 102[3]:463-470,...

Oregon's malpractice premiums.(Policy & Practice)
October 1, 2003... Rural obstetricians in Oregon will soon get a break on their malpractice insurance premium rates due to legislation about to be signed by the governor. Under the legislation, the State Accident Insurance Fund (SAIF) Corporation would provide a...

'Global gag rule'.(Policy & Practice)
October 1, 2003... 'GLOBAL GAG RULE' The federal government is expanding its policy of withholding family planning funding to foreign, nongovernmental groups that use other funds to perform abortions or to counsel women on the procedure, according to a White...

Disparities in CHD care.(Policy & Practice)
October 1, 2003... Black women are more likely to die from coronary heart disease than white women, and they are less likely to receive some standard treatments, Dr. Ashish K. Jha, of Brigham and Women's Hospital, Boston, and colleagues say (Circulation...

Concentrated ART.(Policy & Practice)
October 1, 2003... Nearly half of the assisted reproductive technology (ART) procedures performed in 2000 took place in a handful of states. Women in California, New York, Massachusetts, Illinois, and New Jersey accounted for 45,303 of the 99,629 ART procedures...

Physicians switching to preferred Medicaid drugs: some hassles remain.(Practice Trends)
October 1, 2003... PORTLAND, ORE. -- It isn't always easy to prescribe drugs from a preferred list for Medicaid patients, but more physicians are making the effort, several speakers said at the annual conference of the National Academy for State Health Policy....

Salmeterol warning cites risk of asthma deaths: add inhaled corticosteroids.(Clinical Rounds)
October 1, 2003... The labels of three GlaxoSmithKline asthma products containing salmeterol now have boxed warnings citing a "small but significant increase in asthma-related deaths," based on recommendations from the Food and Drug Administration. The...

Plenty of influenza vaccine available this year: no tiered schedule.(Clinical Rounds)
October 1, 2003... This flu season, there's no need to skimp on shots. The Centers for Disease Control and Prevention announced a sufficient supply of vaccines for the 2003-2004 flu season. This means that anyone--healthy or at high risk--who wants a flu shot...

Multivitamins linked to lower risk of rectal ca: cut by 34% at 15 years.(Clinical Rounds)
October 1, 2003... WASHINGTON -- Adults who reported taking multivitamins for at least 15 years had a 34% reduction in their risk for developing rectal cancer, Esther K. Wei, Ph.D., reported at the annual meeting of the American Association for Cancer Research....

U.S. Preventive Services Task Force issues new blood pressure screening guidelines: updates 1996 document.(Clinical Rounds)
October 1, 2003... A cautious endorsement of ambulatory monitoring and an emphasis on isolated systolic hypertension in the elderly are among the new items in the U.S. Preventive Services Task Force's updated guidelines on screening for high blood pressure. ...

Submissive style linked to more severe IBS: interpersonal stress.(Clinical Rounds)
October 1, 2003... ORLANDO, FLA. -- Identification of irritable bowel syndrome patients who have certain interpersonal problems could help clinicians target those at higher risk of more severe disease, according to a presentation at the annual Digestive Disease...

Cipro-resistant campylobacter infections rising: overall infections down.(Clinical Rounds)
October 1, 2003... BETHESDA, MD. -- The incidence of campylobacter infections has dropped since the late 1990s, but at the same time the proportion of infections resistant to ciprofloxacin has risen, Jennifer M. Nelson said at an annual conference on...

Chronic pain common in major depression: large primary care study.(Clinical Rounds)
October 1, 2003... SAN FRANCISCO -- Fully two-thirds of patients with major depression seen in primary care settings report comorbid chronic pain, Bruce A. Arnow, Ph.D., said at the annual meeting of the American Psychiatric Association. This "stunning"...

Exercise.(Women's Health Adviser)
October 1, 2003... Exercise can never be too little or too late. Older women, especially those with sedentary lifestyles, may be surprised to hear that, but the facts are indisputable: Regardless of a woman's age or health status, exercise reaps a host of...

Medical examination lights.(Products)
October 1, 2003... The MedicaLights are a series of mobile examination lights designed for physicians. The lights have weighted caster bases, plug-in transformers, and vented shades. A blue filter option is available. For more information, contact Sunnex Inc.,...

Saliva-based ovulation test.(Products)
October 1, 2003... The OvuLook ovulation test uses saliva to help women predict ovulation. For more information, contact TCI Optics, 866-688-5284, www.ovulook.com.

Intranasal flu vaccine.(Products)
October 1, 2003... FluMist (influenza virus vaccine live, intranasal) is now available for the 2003-2004 flu season. The vaccine is administered nasally and is approved for the prevention of illness caused by influenza A and B viruses in healthy children and...

Patient education brochures.(Products)
October 1, 2003... Four patient education brochures are available from The Medical Letter on Drugs and Therapeutics. The brochures discuss cholesterol drugs, dietary supplements, smallpox vaccine, and insect repellants. A package of 100 copies of a single topic...

Extended-release Wellbutrin.(Products)
October 1, 2003... Wellbutrin XL (bupropion hydrochloride) extended-release tablets are available for the treatment of major depressive disorder in patients aged 18 and older. The tablets are supplied in 150-mg and 300-mg strengths. Contact GlaxoSmithKline,...

Lumbar support.(Products)
October 1, 2003... The Thermoskin lumbar support brace uses heat and compression to relieve pain in the lower back. For more information, contact United Pacific Inc., 800-706-1520, www.thermoskin.com.

Generic EMLA cream approved.(Products)
October 1, 2003... Lidocaine hydrochloride cream (lidocaine 2.5%/prilocaine 2.5%) is approved as a generic to EMLA anesthetic cream (AstraZeneca). For more information on this generic product, contact Geneva Pharmaceuticals Inc., 800-525-8747, www. genevarx.com.

Oral moisturizer.(Products)
October 1, 2003... Salivart is an over-the-counter oral moisturizer for the relief of dry mouth often associated with antidepressant use. For more information on this product, contact Gebauer Co., 800-321-9348, www. gebauerco.com.

Acne treatment pads.(Products)
October 1, 2003... Triaz pads contain benzoyl peroxide for the topical treatment of acne vulgaris. For more information on this product, contact Medicis, 602-808-8800, customer_service@medicis.com.

Surgical suction liner.(Products)
October 1, 2003... The newly available ReliaFlex surgical suction liner system provides 200 standard cubic feet per hour of airflow at 16 inches of mercury. For more information about this product, contact Deroyal, 888-938-7828,...

Malpractice woes haven't cut access: government report.(News)
October 15, 2003... Physician responses to the malpractice crisis have not contributed to widespread health care access problems, a General Accounting Office report has concluded. Instead, actions taken by providers in response to rising premiums have...

Office visits by specialty in 2001.(Vital Signs)
October 15, 2003... [GRAPHIC OMITTED]

Doctors rethink impact of WHI on clinical practice: menopause group issues report: research suggests that timing may be key to treatment success, fewer adverse events.(News)
October 15, 2003... MIAMI BEACH -- The definitive study on the risks and benefits of hormone therapy may not be so definitive after all. After more than a year of confusion and controversy in the wake of the Women's Health Initiative's early results,...

CMS says noncompliant claims will be processed: HIPAA regulations: 'contingency plan' for Medicare claims.(News)
October 15, 2003... Physicians can continue to submit noncompliant electronic transactions after the Oct. 16 Health Insurance Portability and Accountability Act transaction and code sets deadline, the Centers for Medicare and Medicaid Services announced. This...

Remembering Jack O. Scher: founding publisher.(News)
October 15, 2003... Jack O. Scher, founding publisher of the six medical specialty newspapers that became the building blocks of the International Medical News Group, died on June 4 at his home in Faber, Va. He was 76 years old. Mr. Scher launched his first...

Two West Nile cases tied to tranfused blood: watch for fever, headache, encephalitis.(News)
October 15, 2003... Nucleic acid screening of the nation's blood supply successfully intercepted more than 600 units of West Nile virus-contaminated blood during the past summer, but the tests are not perfect. At least two patients were newly diagnosed with...

One-fourth of malformations seen on first-trimester US: study of almost 10,000 women.(News)
October 15, 2003... PARIS -- Although current ultra-sonographic approaches can detect a large proportion of anomalies during the first trimester, most will still remain undetected until later in gestation or after birth, reported Dr. Anne-Catherine Shalmi of...

St. John's wort + OCs may increase breakthrough bleeding: preliminary findings.(News)
October 15, 2003... LA JOLLA, CALIF. -- Taking St. John's wort with oral contraceptives causes significantly more breakthrough bleeding, as well as a trend toward less ovarian suppression, the development of more preovulatory follicles, and an increased tendency...

NAMS report.(News)
October 15, 2003... The 2003 position statement of the North American Menopause Society contains recommendations for estrogen and progestogen use in peri- and postmenopausal women: * An individual risk profile is essential for every woman contemplating...

Hardship a part of life.(Letters)
October 15, 2003... Appropriately enough, an academic from Harvard Medical School speaking in Canada indicted health care financing in the United States because people have bankruptcies related to medical costs ("Survey: Medical Issues at Root of 55% of All...

The stigma of depression.(Letters)
October 15, 2003... I agree with Dr. Morton M. Silverman's guest editorial "Destigmatize Physician Depression" (Aug. 15, p. 5). In addition to the state licensure barriers he mentions, there are issues with hospital privileges and obtaining disability...

Pap guidelines questioned.(Letters)
October 15, 2003... The American College of Obstetricians and Gynecologists is making a huge mistake in trying to modify the intervals at which women should have Pap smears, no matter how sound the reasoning ("ACOG: Annual Pap Smear Not for All Women," Sept. 1,...

Are you in compliance with the HIPAA rule on electronic health transactions?(Talk Back Online)
October 15, 2003... (Sept. 15, 2003, p. 2) NO 43% YES 57% To Talk Back, visit www.eobgynnews.com

Should physicians conduct spiritual histories of their patients?(Pro & Con)
October 15, 2003... There is growing research that religion makes a difference in physical and psychological health, prevention, and recovery. It also gives patients a more optimistic view of death and illness, and is a powerful source of meaning and purpose. ...

Mind/body approach may help ease infertility: target depression.(Gynecology)
October 15, 2003... Stopping the downward spiral of emotions associated with infertility can be a key factor to successfully overcoming the condition, according to Alice D. Domar, Ph.D. Research throughout the world during the past 10-15 years has made it...

Nipple discharge? Clinical history is essential to diagnosis: look to color for clues.(Gynecology)
October 15, 2003... SAN DIEGO -- Clinical history is the most important factor in determining if nipple discharge is significant, Dr. Julia A. Files said at the annual meeting of the American College of Physicians. "Nipple discharge is an alarming symptom to...

Duloxetine may improve stress incontinence: drug under FDA review.(Gynecology)
October 15, 2003... HOLLYWOOD, FLA. -- Significantly more women with urodynamic stress incontinence reported improvement and reconsidered surgery after 8 weeks of duloxetine treatment, compared with those taking a placebo, in a study of 109 women. This is the...

Drug update: overactive bladder.(Gynecology)
October 15, 2003... Health professionals increasingly recognize that an overactive bladder (OAB) presents significant quality-of-life problems for patients and warrants aggressive treatment. More medications are now available for treatment, including a...

Diurnal cortisol levels affect breast ca survival: metastatic disease.(Gynecology)
October 15, 2003... WAIKOLOA, HAWAII -- Supportive-expressive group therapy helps emotionally constrained women with metastatic breast cancer handle their negative feelings, an ability that has been linked to maintenance of normal diurnal cortisol patterns, Dr....

Simple concept helps explain WHI to patients: focus on attributable risk.(Gynecology)
October 15, 2003... CHARLOTTETOWN, P.E.I. -- One simple change in the way risk is explained could have avoided much of the confusion that still surrounds results published last year from the Women's Health Initiative, according to Dr. Robert Reid. "Patients...

Extended-use OCs pose 'educational challenge': warn about breakthrough bleeding.(Gynecology)
October 15, 2003... LA JOLLA, CALIF. -- Suppressing menstrual periods with extended-use hormonal contraceptives such as the recently approved Seasonale sounds great, but isn't that unhealthy? "The answer is a resounding 'no,'" Dr. Andrew Kaunitz said at the...

Protocol supports immediate start of DMPA at first visit: don't wait until next menses.(Gynecology)
October 15, 2003... LA JOLLA, CALIF. -- Most current depot medroxyprogesterone acetate protocols mandate that women who are not within 7 days of the onset of menses should return during their next menses to initiate contraception with the injectable, while using...

Trio of strategies may help prevent preterm birth: high-risk women.(Obstetrics)
October 15, 2003... LISBON -- There are three main questions you should ask yourself when faced with a woman at risk of preterm labor and delivery, experts agreed at a world congress sponsored by the Fetal Medicine Foundation. The questions are: 1. Should...

Use multiple modalities for monitoring in growth-restricted fetuses: Doppler, biophysical profiles.(Obstetrics)
October 15, 2003... LISBON -- Use a combination of monitoring techniques to help determine the appropriate timing for delivery of a growth-restricted fetus, Dr. Ahmet Baschat advised at a world congress sponsored by the Fetal Medicine Foundation. Besides...

UCSF's experience with vaginal breech delivery: data from 1980 to 1991.(Obstetrics)
October 15, 2003... SAN FRANCISCO -- Selected term singletons in breech position can be safely delivered vaginally at appropriate facilities, according to Dr. Linda M. Hopkins. Her assertion contrasts with a American College of Obstetricians and...

Medical abortions on the rise: planned parenthood.(Obstetrics)
October 15, 2003... LA JOLLA, CALIF. -- Planned Parenthood clinics provided mifepristone medical abortions to 48,120 patients between Jan. 1, 2001 and March 31, 2003, Mary Fjerstad reported at the annual meeting of the Association of Reproductive Health...

Infection quelled with short-term antibiotics: single postpartum dose.(Obstetrics)
October 15, 2003... HYANNIS, MASS. -- One postpartum dose of a broad-spectrum combination of antibiotics in addition to intrapartum treatment is sufficient therapy for women with chorioamnionitis, a randomized clinical trial has shown. Current routine...

Screen prenatally to assess patients' risk of postpartum depression: one-page checklist available.(Obstetrics)
October 15, 2003... SAN FRANCISCO -- A one-page checklist can help identify women at risk for postpartum depression even before they give birth, Holly Powell Kennedy, Ph.D., said at a meeting on antepartum and intrapartum management. The checklist includes...