OB GYN News articles from September 2003

OB GYN News archives from September 2003

ACOG: annual Pap not for all women: intervals of 2-3 years.
September 1, 2003... The annual Pap smear that has become a ritual for most American women is becoming a more risk-directed test and is no longer recommended by the American College of Obstetricians and Gynecologists for young, sexually active teenagers or healthy...

How closely do Americans follow health-related news?(Vital Signs)
September 1, 2003... How Closely Do Americans Follow Health-Related News? Very Closely Fair Closely SARS outbreak 42% 35% Mad cow disease 21% 33% outbreak Bush's proposal to...

GAO: malpractice awards linked to higher premiums; called primary contributor: government report also implicates other factors; consumer group says report flawed.
September 1, 2003... WASHINGTON -- Losses on malpractice claims may be driving up medical liability premiums. Multiple factors have contributed to the increases in medical malpractice premium rates, such as falling insurer investment income, a less competitive...

Primary elective C-section up 20% from 1999 to 2001; VBAC rate at 12.7%: overall C-section rate is at a record 26.1%.
September 1, 2003... The rate of primary elective cesarean sections is on the rise. Among women with no prior history of cesarean section, the rate rose almost 20% between 1999 and 2001, from 1.56% to 1.87%. Primary elective or "patient choice" C-sections now...

Diagnosing strep pharyngitis: simplified rules.(News)
September 1, 2003... A simplified version of Walsh Clinical Prediction Rules was practical and accurate for helping to diagnose streptococcal pharyngitis in an inner-city, ethnically diverse clinical setting, a prospective study suggests. Clinical prediction...

Lifetime drinking history linked to breast cancer risk; one to two drinks a day.(News)
September 1, 2003... WASHINGTON -- Lifetime consumption of alcohol averaging approximately one to two drinks per day was associated with a 40% increase in breast cancer risk in women and was particularly strong among those with a body mass index of less than 25 and...

Elevated cytokine levels predicted preterm delivery in study; better positive predictive value than fFN.(News)
September 1, 2003... PHILADELPHIA -- Testing for a pair of cytokines gave better diagnostic accuracy than the standard fetal fibronectin test for premature delivery, based on a study with 115 deliveries. Elevated levels of interleukin (IL)-6 and tumor necrosis...

Smoking tied to increased risk of gestational diabetes; dose response relationship.(News)
September 1, 2003... ATLANTA -- One more reason for women to quit smoking is to decrease their risk of gestational diabetes. In a subgroup analysis of the larger Calcium for Pre-Eclampsia Prevention study conducted in five U.S. medical centers in 1992-1995,...

Hormonal contraceptives tied to a 24% drop in BV risk; injections, implants, OCs.(News)
September 1, 2003... ATLANTA -- The use of hormonal contraceptives was associated with a 24% reduction in risk of bacterial vaginosis in a study conducted by the Longitudinal Vaginal Flora Study Group. "The significance of our findings is that a 24% reduction...

No adjustment for some overpayments: Medicare.(News)
September 1, 2003... Good news for physicians: The Centers for Medicare and Medicaid Services won't be collecting overpayments that resulted from a 2-month delay in the 2003 physician fee schedule. CMS had previously directed carriers to automatically adjust...

More proof needed.(Letters)
September 1, 2003... Dr. Lois Jovanovic has been getting plenty of exercise jumping to conclusions ("Continuous Monitoring Helps Manage Gestational Diabetes," July 1, 2003, p. 10). Her extensive clinical experience with 10 patients does not justify a statement...

Dementia and pinworms.(Letters)
September 1, 2003... The article "Combination HRT Linked to Dementia in Older Women" (July 1, 2003, p. 1) was based on a JAMA report (289[20]:2651-62, 2003) that presented only figures and nothing about how the women lived, whether singly in nursing homes or with...

Smallpox smokescreen.(Letters)
September 1, 2003... The headline "Smallpox Vaccination Expansion 'Unwise'" is an understatement (July 15, 2003, p. 2). Variola has joined the politically correct list of conditions--along with herpes, AIDS, and now SARS--that keep us off balance and in fear....

Talk back online.(Opinion)
September 1, 2003... TALK BACK ONLINE Should the National Resident Matching Program be discontinued? (Aug. 1, 2003, p. 23) YES 23% NO 77% To Talk Back, visit www.eobgynnews.com Note: Table made from pie chart.

Emergency contraception.(Guest Editorial)
September 1, 2003... As physicians with a special interest in women's health, we have a duty to advise our patients about their full range of contraceptive options, including emergency contraception. Emergency contraception (EC) is safe and effective and should...

Correction.(Opinion)
September 1, 2003... In "Paxil Tied to Drop in Hot Flash Severity, Frequency" (July 15, 2003, p. 11), the required level of FSH levels was more than 40 mlIU/mL.

Would reimporting drugs compromise public health?(Pro & Con)
September 1, 2003... YES The reimportation legislation recently passed by the House of Representatives will leave America's patients in grave danger. The bill would not include the same safeguards for reimported drugs that we currently have on prescription...

Report: classes best way to promote breast-feeding: start in prenatal period.(Obstetrics)
September 1, 2003... Breast-feeding education classes with a nurse or a midwife are the most effective way to increase the number of women who initiate breast-feeding and sustain it for up to 3 months, according to an evidence review by the US Preventive Services...

Pyschological Tx eases postpartum depression; short-term effects.(Obstetrics)
September 1, 2003... Psychological intervention results in short-term improvement of symptoms of postpartum depression, reported Peter J. Cooper, Ph.D., of the University of Reading, England, and his colleagues. A group of 193 women who met DSM-III-R criteria...

Bipolar disorder.(Drugs, Pregnancy, And Lactation)
September 1, 2003... As the use of anticonvulsants to treat bipolar illness has grown over the past decade, so has the number of women successfully treated with these medications who have questions about whether they should discontinue these drugs before they...

Inhaled corticosteroids called top Tx option in pregnancy; moderate, persistent asthma.(Obstetrics)
September 1, 2003... TORONTO -- Inhaled corticosteroids such as budesonide and beclomethasone are the best bet for treating moderate, persistent asthma in pregnant women, according to Dr. Scott Osur. Studies have indicated that inhaled corticosteroids are...

Public demand for teratogen information: labeling at issue.(Obstetrics)
September 1, 2003... PHILADELPHIA -- Acetaminophen and pseudoephedrine were the two medications that pregnant women and other concerned callers inquired about most frequently with regard to safety of use in pregnancy, in a study of more than 9,000 inquiries made to...

Fetal cells, DNA eyed for new screening tests; genetic disorders, preeclampsia.(Obstetrics)
September 1, 2003... LISB0N -- The relatively recent discovery that fetal cells and fetal DNA enter the maternal circulation is laying the groundwork for several new fetal and maternal screening tests. Initial efforts to use fetal cell levels in maternal blood...

Persuade patients to get fetal kick counts: reduces stillbirth rate.(Obstetrics)
September 1, 2003... SAN FRANCISCO -- Close to 90% of Dr. William M. Gilbert's pregnant patients comply with his request that they record fetal kick counts starting at 28 weeks' gestation. How does he get so many women to keep track of fetal kicks every day?...

Vaginal stenosis common after gynecologic cancer: pelvic, vaginal radiotherapy.(Gynecology)
September 1, 2003... CHARLOTTETOWN, P.E.I -- Vaginal stenosis is a common compli cation after pelvic and vaginal radiotherapy that occurs in 38% of patients, but physicians are not being proactive about promoting vaginal dilation therapy to counteract the problem,...

Assess HIV-positive women for vulvar, vaginal intraepithelial neoplasia: colposcopy, vulvoscopy key.(Gynecology)
September 1, 2003... BETHESDA, MD. -- HIV-positive women should be assessed for vulvar and vaginal intraepithelial neoplasia, not just cervical intraepithelial neoplasia, according to Dr. Berthe Hollwitz. Vulvar intraepithelial neoplasia (VIN) and vaginal...

Perspectives on laparoscopy in gynecologic oncology: patient selection key.(Gynecology)
September 1, 2003... KEY LARGO, FLA. -- Operator experience and careful patient selection are keys to successful use of laparoscopy for gynecologic oncology, according to Dr. Luis E. Mendez. He gave his perspective on the advantages, disadvantages, and...

No 'safe zone' for low transverse incisions: ilioinguinal and iliohypogastric nerves.(Gynecology)
September 1, 2003... ANAHEIM, CALIF. -- There is no "safe zone" for placement of low transverse incisions that will reliably avoid the ilioinguinal and iliohypogastric nerves, although careful placement of lower abdominal laparoscopic trocars can minimize the...

MRI of pelvic floor good for presurgical exam of cystocele: expert opinion.(Gynecology)
September 1, 2003... FORT LAUDERDALE, FLA. -- An MRI study of the pelvic floor is noninvasive and useful for presurgical evaluation of a cystocele, Dr. Sandip Vasavada said at a symposium on pelvic floor disorders sponsored by the Cleveland Clinic Florida. ...

New device could eliminate some blind uterine surgeries; not yet marketed in U.S.(Gynecology)
September 1, 2003... MONTREAL -- A new device that's not yet on the market in the United States could eliminate the need for some blind uterine procedures, according to Dr. Steven Goldstein. Transvaginal ultrasound assisted gynecology surgery (TUACS) has the...

Encourage use of condoms, barriers after PID: fewer recurrences.(Gynecology)
September 1, 2003... OTTAWA -- All women who experience an episode of pelvic inflammatory disease should be encouraged to use condoms consistently, Dr. Roberta B. Ness said at a congress of the International Society for Sexually Transmitted Disease Research. ...

HPV vaccine may prevent 70% of invasive cervical ca cases; phase III trials.(Gynecology)
September 1, 2003... OTTAWA -- A tetravalent human papillomavirus vaccine now in international phase III trials is expected to prevent up to 70% of invasive cervical cancers, Dr. Laura A. Koutsky said at a congress of the International Society for Sexually...

Brisk walking stimulates increase in BMD; postmenopausal women.(Gynecology)
September 1, 2003... PHILADELPHIA -- Walking at a brisk pace increased bone mineral density while a slower or moderate pace was negatively correlated with a change in BMD, in a study of postmenopausal women. "BMD increased at intensities above 110% of...

Lower BMD in premenopausal type 1 diabetics: fracture risk.(Gynecology)
September 1, 2003... NEW ORLEANS -- Premenopausal women with type 1 diabetes have lower bone mineral density than do nondiabetic women, Dr. Elsa Strotmeyer said at the annual scientific sessions of the American Diabetes Association. The finding is of concern...

Ultrasound, Doppler flag suspicious leiomyomas; detecting leiomyosarcomas.(Gynecology)
September 1, 2003... SCOTTSDALE, ARIZ. -- Ultrasonography and color flow Doppler imaging can tip off physicians that a suspected leiomyoma may in fact be a leiomyosarcoma, Dr. Caterina Exacoustos said at an international congress on uterine fibroids. She and...

Submucous myomas: resect or vaporize? Take your pick.(Gynecology)
September 1, 2003... SCOTTSDALE, ARIZ. -- There are not enough data to determine whether it's best to resect or vaporize submucous myomas, so physicians should use the technique with which they feel most comfortable, Dr. Richard J. Gimpelson recommended. With...

High-dose estrogen-progestin Tx stops DUB in adolescents; small study.(Gynecology)
September 1, 2003... PHILADELPHIA -- Treatment with a high dose of estrogen plus progestin stopped dysfunctional uterine bleeding in a high proportion of adolescent girls with this disorder in a single-center study of 34 patients. No patient required...

Topical estrogen resolves labial adhesions in girls; avoiding surgery.(Gynecology)
September 1, 2003... PHILADELPHIA -- Labial adhesions in prepubertal girls were successfully treated with topical estrogen without the need for surgery in a series of 36 patients at a single center. "Manual separation after thinning with estrogen cream is an...

Chinese herb fo-ti has estradiol-like activity; laboratory tests.(Gynecology)
September 1, 2003... PHILADELPHIA -- The ancient Chinese herb fo-ti has estradiol-like activity in laboratory tests, Dr. Karen Klein said in a poster presentation at the annual meeting of the Endocrine Society. The discovery is a first-time finding and adds...

Verbal memory may improve with ERT; menopause transition.(Gynecology)
September 1, 2003... PHILADELPHIA -- Estrogen replacement therapy was linked to modest improvement in one measurement of verbal memory but did not improve other measures of cognitive function in a small study of perimenopausal or recently menopausal women. The...

Value of direct-to-consumer advertisements questioned; Senate Committee hearing.(Practice Trends)
September 1, 2003... WASHINGTON -- Direct-to-consumer pharmaceutical advertising is an educational service of great value to patients--or a venue for misleading statements designed solely to increase a drug's market share, depending on who you talk to. Both...

State legislatures tackle budget cuts, tort reform; Medicaid, SCHIP.(Practice Trends)
September 1, 2003... WASHINGTON -- Budget cuts and tort reform are the hot health care items on legislators' plates so far this year, just as they were last year, Susan Laudicina said at a press briefing sponsored by the Blue Cross and Blue Shield Association. ...

No abortion-cancer link.(Policy & Practice)
September 1, 2003... There's no evidence that induced abortion causes breast cancer, the American College of Obstetricians and Gynecologists (ACOG) says. Studies on this issue were inconsistent and difficult to interpret, according to ACOG. The most recent studies...

Breast implant safety.(Policy & Practice)
September 1, 2003... The Food and Drug Administration should consider long-term safety questions before approving new silicone breast implants, says Dr. Sidney Wolfe, director of Public Citizen's Health Research Group. Public Citizen joined the National...

Research excludes women.(Policy & Practice)
September 1, 2003... Research into the diagnosis and treatment of coronary heart disease often has either limited participation from women or excludes them completely, according to two new evidence reviews. The reviews were conducted for the Department of Health...

Cord blood bank.(Policy & Practice)
September 1, 2003... New legislation would create a national inventory of stem cells from placentas and umbilical cords. This national umbilical cord blood bank would be aimed at providing genetically diverse treatments and stem cells for research, according to...

Abortion costs.(Policy & Practice)
September 1, 2003... Alabama will have to pay the cost of production and distribution for any abortion education materials that the state requires providers to give to women before an abortion. The ruling was ordered by Chief Judge M. Harold Albritton of the Middle...

New safety goals.(Policy & Practice)
September 1, 2003... Health care organizations will have to reduce the risk of nosocomial infection if they want to be accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The task is part of JCAHO's 2004 National Patient Safety...

For-profit patient-assistance firms under fire: fees for free medicines?(Practice Trends)
September 1, 2003... A for-profit industry is springing up to help patients apply for free medications from pharmaceutical manufacturers' patient assistance programs, a development that has engendered controversy. Proponents of the industry claim that they help...

Report: states offer greater access to EC pills, less to abortion; reproductive health services.(Practice Trends)
September 1, 2003... WASHINGTON -- Access to reproductive health services is being both expanded and contracted, health advocates said at a women's health policy briefing sponsored by the Kaiser Family Foundation. Access to emergency contraception is improving,...

Depression may hurt reproductive health; tied to earlier onset of perimenopause.(Clinical Rounds)
September 1, 2003... CHARLOTTETOWN, PEI -- Women's mental health may have direct repercussions on their reproductive and endocrine health, Dr. Roger McIntyre said at the annual clinical meeting of the Society of Obstetricians and Gynaecologists of Canada. ...

Seasonal allergies.(Women's Health Adviser)
September 1, 2003... Seasonal allergies affect up to 40 million people in the United States and cost an estimated $4.5 billion in medical care annually. In addition to causing almost 4 million missed school and workdays every year, these allergies can be associated...

Brief questionnaire helps screen for migraine; three simple questions.(Clinical Rounds)
September 1, 2003... CHICAGO -- A simple, three-question screening tool has been developed for use in primary care settings to flag patients who are likely to have migraine. The ID Migraine screener asks patients with headache complaints to answer these...

CV risk factors predict poor response to antidepressant Tx; response reduced by 15%.(Clinical Rounds)
September 1, 2003... SAN FRANCISCO -- The total burden of cardiovascular risk factors in a patient with major depressive disorder is an independent predictor of lack of response to antidepressant therapy with fluoxetine, Dr. Dan V. Iosifescu reported at the annual...

Eletriptan (40 mg or 80 mg) beats sumatriptan (100 mg) for acute migraine; pooled data.(Clinical Rounds)
September 1, 2003... CHICAGO -- Eletriptan, at both 40 mg and 80 mg dosages, provides superior relief of acute migraine than sumatriptan at 100 mg, according to a poster presentation at the annual meeting of the American Headache Society. Data were pooled from...

West Nile virus prognosis linked to symptoms: neurological manifestations.(Clinical Rounds)
September 1, 2003... The poliomyelitis-like syndrome that is sometimes associated with West Nile virus is linked with a poor long-term outcome and may be irreversible, researchers reported in the Journal of the American Medical Association in two articles that...

Menopause Guidebook.(Products)
September 1, 2003... The North American Menopause Society has updated the "Menopause Guidebook." The guidebook discusses health, emotional, and lifestyle issues related to menopause. The guide can be previewed online, ordered as part of the free MenoPak ($5...

Umbilical clamp and cutter.(Products)
September 1, 2003... The Joey tool cuts the umbilical cord and clamps the maternal and infant sides at the same time, shielding blood spray. It allows for one-handed use: For more information, contact Maternus Partners Ltd., 210-479-4001, www.maternusmedical.com.

Disinfecting wipes.(Products)
September 1, 2003... WetTask wipes can be used to disinfect and sanitize surfaces. A plastic dispenser is available for use with the wipes and disinfectant solution. For more information, contact Kimberly-Clark Corp., 888-346-4652, www.kcprofessional.com.

Safety capillary samplers.(Products)
September 1, 2003... A new line of plastic capillary samplers, safeCLINITUBES, reduces the risk of breakage. The samplers are also coated with electrolyte-balanced heparin to ensure accurate testing. For more information about the device, contact Radiometer America...

Premarin for osteoporosis.(Products)
September 1, 2003... Premarin (conjugated estrogens) tablets are approved for the prevention of postmenopausal osteoporosis. The tablets are available in 0.3 mg and 0.45 mg dosage strengths. For more information, contact Wyeth Pharmaceuticals, 800-934-5556,...

DNA colorectal cancer test.(Products)
September 1, 2003... The PreGen-Plus colorectal cancer screening test identifies the presence of altered or mutated DNA that is shed by malignant and premalignant colon tumors into the patient's stool. For more information, contact Exact Sciences Corporation,...

Antimicrobial hand wipes.(Products)
September 1, 2003... Sani-Dex antimicrobial hand wipes contain 65.9% ethyl alcohol by volume. The wipes are formulated to comply with federal guidelines for hand hygiene in health care settings. For more information, contact Professional Disposables International,...

Aesthetic laser.(Products)
September 1, 2003... The GentleLASE family of lasers has received marketing clearance for permanent hair reduction for an skin types and for the treatment of benign pigmented lesions. For more information, contact Candela Corp., 800-733-8550, www. candelalaser.com....

Patient Guide to health literacy.(Products)
September 1, 2003... The DrPEN Patient Guides are a series of publications designed for physicians to give to patients to provide more information about specific conditions. The books are pocket sized and cover a range of conditions, such as depression and...

New doses of Climara approved.(Products)
September 1, 2003... Climara (estradiol transdermal system) patches are approved in 0.0375 mg and 0.06 mg doses for the relief of symptoms following a hysterectomy or during menopause. For more information, contact Berlex Laboratories Inc., 888-237-5394 (press...

SARS prognosis in gravidas guarded: two of seven patients died.
September 15, 2003... HYANNIS, MASS.--The clinical presentation of severe acute respiratory syndrome in pregnant women is similar to that seen in nongravid patients, but the prognosis may be more guarded. That finding emerged from a case series of seven pregnant...

Few patients willing to pay higher premiums for higher quality care.(Vital Signs)
September 15, 2003... Few Patients Willing to Pay Higher Premiums For Higher Quality Care Would pay significantly more 16% Not sure 23% Would not pay 60% Note: Table made from pie chart. ...

Studies confirm adverse effects of combination HRT: more WHI data: estrogen-only formulations also implicated in breast ca, worsening of atherosclerosis.
September 15, 2003... For anyone who held out some hope that the Women's Health Initiative would show that combination hormone replacement therapy isn't so bad in certain subgroups of women, that hope is fading fast. Results from two recent studies in the New...

Most doctors not ready for Oct. 16 HIPAA deadline: feds ease standards slightly: Stransmitting electronic claims at issue.
September 15, 2003... Harry Reynolds is worried. Mr. Reynolds is responsible for making sure that his health plan, BlueCross BlueShield of North Carolina, is ready on Oct. 16, the deadline for complying with the part of the Health Insurance Portability and...

Liability concerns impact prescribing: survey.(News)
September 15, 2003... More than 40% of physicians in a recent survey say they have avoided prescribing an appropriate medication because they knew that the drug might be involved in a product liability lawsuit. In a telephone survey sponsored by the U.S. Chamber...

Antibiotic resistance up in perinatal group B strep: alternative therapies needed.(News)
September 15, 2003... BETHESDA, MD.--Resistance to antibiotics, particularly clindamycin, is increasing among perinatal group B streptococcal infections, Dr. Paul M. Southern said at the annual conference on antimicrobial resistance sponsored by the National...

Urogenital infection with M. pneumoniae documented: persistent symptoms.(News)
September 15, 2003... OTTAWA--The list of pathogens that produce clinically significant disease in the female urogenital tract should be expanded to include Mycoplasma pneumoniae. This pathogen, which most commonly infects the lower respiratory tract, was...

Physician group reignites debate over single-payer plan: nearly 8,000 doctors sign on.(News)
September 15, 2003... WASHINGTON--The more things change, the more they stay the same. When a group of 430 physicians introduced a proposal for a single-payer national health insurance system at the American Medical Association House of Delegates meeting in...

Study suggests smallpox vaccine may provide lifelong immunity: degrades only slightly over time.(News)
September 15, 2003... Contrary to popular belief, the smallpox vaccine appears to provide lifelong immunity, according to Erika Hammarlund of the Oregon Health & Science University Vaccine and Gene Therapy Institute in Beaverton, and her associates. The...

West Nile virus spreads west, as predicted: peak disease season.(News)
September 15, 2003... West Nile virus case counts rose exponentially during August as the arbovirus made its predicted shift to the western United States, and health officials braced for an onslaught of new cases throughout the warm, mosquito-friendly months of...

Package labeling targets trans fat.(Guest Editorial)
September 15, 2003... Trans fat is one of the most dangerous players in the human diet for cardiovascular disease risk. The move by the Food and Drug Administration in July to require labeling for trans fat on packaged foods by 2006 was a very important step forward...

Have your patiens complained to you regarding HIPAA-related paperwork?(Talk Back Online)
September 15, 2003... Have your patiens complained to you regarding HIPAA-related paperwork? (August 15, 2003, p. 2) NO 29% YES 71% Note: Table made from pie graph. To Talk Back, visit www.eobgynnews.com

Is obesity a disease?(Pro & Con)
September 15, 2003... YES Many people think of eating as a matter of choice, but there is a complex biologic system that controls food intake and makes it hard to lose weight. Studies suggest that there are at least 40-50 difference substances--hormones,...

M. genitalium tied to pelvic inflammatory disease: sexual transmission.(Gynecology)
September 15, 2003... OTTAWA--Growing evidence linking Mycoplasma genitalium and pelvic inflammatory disease shouldn't be ignored, Dr. Jonathan Ross said at a congress of the International Society for Sexually Transmitted Disease Research. This pathogen has...

Vaginal neutrophils still best clue to subacute pelvic inflammatory disease: better tests sought.(Gynecology)
September 15, 2003... OTTAWA--Detection of vaginal neutrophils remains the most sensitive test of subacute pelvic inflammatory disease, Sharon L. Hillier, Ph.D., said at a congress of the International Society for Sexually Transmitted Diseases Research. The...

HSV-2 underrecognized in HIV-positive patients: subclinical infection.(Gynecology)
September 15, 2003... OTTAWA--Herpes simplex virus type 2 infection is prevalent--and largely unrecognized--among HIV-positive patients. Epidemiologists have recognized for two decades that the presence of genital ulcers heightens the risk for transmission of...

Menstrual migraines not harder to treat: response to initial treatment.(Gynecology)
September 15, 2003... CHICAGO--A new study suggests there is no significant difference in the way menstrual-related and nonmenstrual migraines respond to initial treatment. There was no significant difference between the two groups in associated symptoms,...

Zolmitriptan effective in menstrual migraine patients: first randomized, controlled trial.(Gynecology)
September 15, 2003... CHICAGO--The first randomized controlled trial to prospectively evaluate the efficacy of a triptan in the acute treatment of true menstrual migraine found that oral zolmitriptan provides significant and sustained relief, said Dr. Michael...