OB GYN News back issues from February 2001:
Ductal Lavage Finds Early Breast Cancer.
Feb 01, 2001; ... SAN ANTONIO -- Breast ductal lavage detected premalignant or frankly cancerous cells in one-quarter of high-risk but mammographically negative women in a multicenter trial, Dr. William C. Dooley reported at a breast cancer symposium sponsored by the San Antonio Cancer Institute. ...
Low-Dose Estrogen Linked to Lower Heart Disease Risk.
Feb 01, 2001; ... Experts say estrogen's benefits outweigh increase in stroke risk with normal dose. Postmenopausal women on low-dose estrogen have a decreased risk of developing major coronary heart disease, compared with those who never used hormones, according to the latest results of the ...
Raloxifene Lowers Breast Cancer Risk by 72%.
Feb 01, 2001; ... Benefits increase with estrogen exposure. SAN ANTONIO -- Among women taking raloxifene, those with the highest lifetime exposure to estrogen had the greatest reduction in breast cancer risk. That was a key finding of an analysis of new data from the Multiple Outcomes ...
Syphilis Rates Reach All-Time Low.
Feb 01, 2001; ... MILWAUKEE -- Rates of primary and secondary syphilis in the United States have reached their lowest point since reporting began in 1941, according to a new report issued by the Centers for Disease Control and Prevention. The most recent syphilis epidemic peaked at 20.3 cases per ...
LETTERS.
Feb 01, 2001 ... Rules Deter Cholesterol Screening I would like to respond to the article "Cholesterol Tests Slip Past Ob. Gyns." (Oct. 15, 2000, p. 1). How can we put enough effort into screening our patients for cardiovascular disease when managed care guidelines prohibit our doing ...
To Treat or Not to Treat.
Feb 01, 2001; ... I was particularly troubled by a case presentation that was made recently during our morning resident conference. The case concerned a 42-year-old woman who had complained of menometrorrhagia for approximately 3 months. Endometrial biopsy had documented proliferative endometrium ...
PRO & CON.
Feb 01, 2001 ... Should Down syndrome screening standards be changed so that amniocentesis and chorionic villus sampling are offered on the basis of maternal serum screening results, not maternal age? YES The current practice of offering routine amniocentesis to those aged 35 or older without ...
Sacral Stimulation May Ease Interstitial Cystitis.
Feb 01, 2001; ... HILTON HEAD ISLAND, S.C. -- Sacral nerve stimulation used in the treatment of overactive bladder can also benefit related disorders of the pelvic floor, experts said at the annual meeting of the American Urogynecologic Society. "This therapy is extremely promising. Now we have ...
Tolterodine Safe, Effective When Taken Over a 2-Year Period.
Feb 01, 2001 ... HILTON HEAD ISLAND, S.C. -- Tolterodine tartrate given at a dosage of 2 mg twice daily for the treatment of overactive bladder maintains its efficacy over a 2-year period and becomes more tolerable with time, according to the results of a study of more than 700 patients. "The ...
Fewer Side Effects Noted With Experimental Oxybutynin Patch.
Feb 01, 2001 ... HILTON HEAD ISLAND, S.C. -- Patients treated with oxybutynin for incontinence due to overactive bladder experience fewer side effects but similar benefits when the drug is delivered via an experimental transdermal patch rather than a pill. "With the patch, we're changing the ...
Social Limitations Linger After Incontinence Tx.
Feb 01, 2001; ... HILTON HEAD ISLAND, S.C. -- Certain behaviors adopted by patients with urinary incontinence to cope with their disorder can often linger long after the disease has been successfully treated, Dr. Veronica Mallett said at the annual meeting of the American Urogyneco-logic Society. ...
Chemical Exposure Can Hasten Puberty in Girls.
Feb 01, 2001; ... A chemical accident in Michigan in the early 1970s has resulted in early menarche among girls who were exposed to polybrominated biphenyls, either in utero or through their mother's breast milk. More than 4,000 Michigan residents were exposed to polybrominated biphenyls (PBBs) ...
Topical Estrogen, Soaks Heal Urethral Prolapse.
Feb 01, 2001; ... BIG SKY, MONT. -- Have you ever wondered why girls' bicycles lack the top bar seen on frames for boys' bikes? "My mother used to say [it was] because of dresses," but there's another reason: to avoid bicycle straddling injuries, Dr. Lane J. Mercer said. Trauma to a young girl's ...
Estrogen May Help Endothelial Dysfunction.
Feb 01, 2001; ... WASHINGTON -- Estrogen replacement therapy appears to improve endothelial dysfunction in postmenopausal women with hypertension, Dr. Yukhito Higashi said at the annual conference of the American Heart Association's Council for High Blood Pressure Research. In a study of 50 ...
Laparoscopy for Obstetric Vesicovaginal Fistula.
Feb 01, 2001; ... SAN DIEGO -- Operative laparoscopy can be an alternative to laparotomy for managing high obstetric vesicovaginal fistula, Dr. Ceana Nezhat reported in a poster session at the annual meeting of the American Society for Reproductive Medicine. Obstetric vesicovaginal fistula is a ...
Laparoscopy Cost Effective For Hysterectomy.
Feb 01, 2001; ... ORLANDO, FLA. -- Laparoscopymay take longer to perform, but it is more cost effective than open surgery for pefforming hysterectomy and retropubic suspension, Dr. Gerard Pregenzer reported at the annual meeting of the American Association of Gynecologic Laparoscopists. In a ...
Laparoscopic Hysteroplasty Without Hysteroscopy.
Feb 01, 2001; ... ORLANDO, FLA. -- Laparoscopic hysteroplasty is an effective alternative to hysterectomy in women with menorrhagia and myomas who want to preserve their uterus, Dr. Michael L. Moore said during the annual meeting of the American Association of Gynecologic Laparoscopists. The ...
Cavaterm Appears Safe for Menorrhagia.
Feb 01, 2001 ... ORLANDO, FLA. -- Cavaterm thermal balloon endometrial ablation appears to be safe and effective for the treatment of menorrhagia, according to several studies presented during the annual meeting of the American Association of Gynecologic Laparoscopists. The Cavaterm balloon ...
Laparoscope Size Does Not Affect Postoperative Course.
Feb 01, 2001 ... ORLANDO, FLA. -- Laparoscope size had no effect on postoperative pain or recovery time in a small study of patients evaluated for infertility under general anesthesia, Dr. Jeffrey M. Goldberg reported at the annual meeting of the American Association of Gynecologic Laparoscopists. ...
FDA Approves Letrozole for Advanced Breast Ca.
Feb 01, 2001; ... BETHESDA, MD. -- Letrozole, an oral estrogen-blocking drug, has been approved as a first-line agent in treating postmenopausal women with advanced breast cancer. The Food and Drug Administration approved the drug in January for treating hormone receptor--positive or "hormone ...
Follow-Up Poor After Negative Breast Biopsy.
Feb 01, 2001; ... CHICAGO -- Two-thirds of women with negative breast biopsies will return for follow-up assessments, and another 20% will seek follow-up after being sent a reminder letter. Follow-up assessments are needed when women have negative breast biopsies. The biopsy result is not a ...
Elective C-Section Rates Vary by Hospital Type.
Feb 01, 2001; ... KAMUELA, HAWAII -- Corporate hospitals had the highest elective primary cesarean delivery rates, and Kaiser hospitals had the lowest in a study of hospital discharge records in California during 1995. Malpresentation was by far the most common indication for an elective primary ...
Indomethacin Reduces Narcotic Use by 40%.
Feb 01, 2001; ... KAMUELA, HAWAII -- Regular administration of indomethacin rectal suppositories reduced narcotic use by almost 40% in postoperative cesarean section patients treated in an Idaho community hospital, Dr. Frederick P. Ambrose reported. Dr. Ambrose, one of six obstetricians who ...
Echocardiography Unreliable in Detecting Pulmonary Ailments.
Feb 01, 2001; ... KAMUELA, HAWAII -- Echocardiography miclsassfied pulmonary artery pressure in 37% of pregnant patients with suspected pulmonary hypertension in one study, Dr. Kelly Robinson reported. The noninvasive test misclassified 8 of 27 patients with heart disease as having pulmonary ...
DRUGS, PREGNANCY, AND LACTATION.
Feb 01, 2001; ... [Histamine.sub.2] Blockers and Proton Pump Inhibitors None of the four [histamine.sub.2] blockers currently available are teratogenic or carcinogenic in animals, nor are they mutagenic. They are rated pregnancy category B drugs, but there are limited or no human data for two of ...
IV Dexamethasone Speeds Recovery From HELLP.
Feb 01, 2001; ... CHICAGO -- Intravenous dexamethasone provides more rapid recovery of liver function, arterial blood pressure, and urinary output in patients with prepartum HELLP syndrome, compared with betamethasone, Dr. Christy M. Isler said at the annual meeting of the Central Association of ...
Bringing a Bit of Home to the Antepartum Unit.
Feb 01, 2001; ... SARASOTA, FLA. -- No one at Sarasota Memorial Hospital objected when a patient's family carried a dog in a picnic basket into the antepartum unit. "I said, 'Sounds like a good slide,' and headed over to the ward to take some photos, Dr. Washington Hill, director of ...
Off-Label Use of Misoprostol Called Safe For Cervical Ripening, Induction.
Feb 01, 2001; ... SARASOTA, FLA. -- Misoprostol is a safe and effective agent when used off label for both cervical ripening and labor induction, according to a recently published meta-analysis of 47 studies of the drug. "It appears relatively safe for both mother and newborn and also results in ...
Midtrimester PPROM Poses Difficult Choices.
Feb 01, 2001 ... SARASOTA, FLA. -- The gray areas of medicine are often the hardest to navigate, and midtrimester preterm premature rupture of membranes is one of them, according to Dr. Washington Hill, director of maternal-fetal medicine at Sarasota Memorial Hospital. Dr. Hill described the ...
Avoid Misoprostol in VBAC Patients.
Feb 01, 2001; ... Caution may be the best medicine when considering misoprostol use in patients undergoing a trial of labor after a prior caesarian delivery, according to Dr. Sanchez Ramos. He and his associate reviewed 18 cohort studies looking at the incidence of uterine rupture in patients ...
'Deadly Quartet' in Women.
Feb 01, 2001; ... The "deadly quartet" of cardiovascular risk factors that characterize the multiple metabolic syndrome--hypertension, obesity, hyperrriglyceridemia, and diabetes--is far more lethal in women than men with known coronary disease. This was the central finding in a study of more ...
Sporadic Workouts and CV Deaths.
Feb 01, 2001; ... A little bit of exercise can be a dangerous thing. Nearly half of all cardiovascular (CV) deaths over a 2-year period at one of the nation's largest commercial health club chains occurred in members who exercised less than once per week. Three-quarters of those who died had visited the dub ...
'Connectedness' and Suicide Risk.
Feb 01, 2001; ... The gender disparity in suicide--women are less likely to commit suicide than men--may be explained by such "protective factors" as the social connectedness of women, Dr. George Murphy said at the annual meeting of the American Academy of Clinical Psychiatrists in St. Louis. An ...
Sertraline vs. Imipramine.
Feb 01, 2001; ... If given a choice between sertraline and imipramine for treating chronic depression, physicians should prescribe the former for women and the latter for men, according to results of a randomized, double-blind study. Of 400 women and 235 men diagnosed with chronic major ...
Obesity Ups Arthritis Risk.
Feb 01, 2001; ... Women who are obese at age 18 have up to a 7.3-fold increased risk of severe hip osteoarthritis later in life compared with leaner women, Dr. Elizabeth Karlson said at the annual meeting of the American College of Rheumatology in Philadelphia. Given the epidemic of obesity among ...
Valvular Abnormalities and Fen-Phen.
Feb 01, 2001; ... The natural history of valvular heart abnormalities in patients treated with dexfenfluramine or the fenfluramine and phenterimine combination called "fen-phen" appears more reassuring than earlier feared, according to the results of the largest controlled, blinded study to date. ...
Perennial Allergic Rhinitis.
Feb 01, 2001; ... Patients with perennial allergic rhinitis are more likely than those with seasonal allergic rhinitis to have asthma and to use an intranasal steroid in addition to a second-generation antihistamine, according to an analysis of information in a medical insurance claims database. ...
The Hazards of Henna Use.
Feb 01, 2001; ... Women who use henna for cosmetic purposes are at risk for allergic reactions ranging from contact dermatitis to angioedema. A case report presented in a poster session at the ninth Congress of the European Academy of Dermatology and Venereology in Geneva added further support to the ...
New Medical Privacy Rules May Pose Significant Challenges.
Feb 01, 2001; ... Sweeping new rules were issued to protect the privacy of Americans' medical records in the final days of the Clinton administration. Several years in the making, the final privacy rules apply to health care providers, hospitals, health plans, insurers, and health care ...
Managing Your Receivables Key to Fiscal Fitness.
Feb 01, 2001; ... LANCASTER, PA. -- Maintain an "accounts receivable" mind-set to help maintain the optimum financial health of your practice, Elizabeth Clark advised at a meeting on family practice management. Accounts receivable is usually the largest financial asset on the office balance ...
Confidentiality and Treating the Adolescent Patient.
Feb 01, 2001; ... HILTON HEAD ISLAND, S.C. -- Adolescent patients and their parents deserve a straightforward explanation about a patient's right to confidentiality and the circumstances under which that confidentiality may be breached, Dr. Tomas Silber said at a pediatric meeting sponsored by Contemporary ...
Value of Annual Pap Smears Questioned.
Feb 15, 2001; ... Many postmenopausal U.S. women are needlessly screened with an annual cervical smear. When postmenopausal women have a cervical smear taken within 2 years of a previously normal smear, the problem is not just that the second smear wastes time and money. It also risks a ...
State Abortion Laws May Apply to Mifepristone Use.
Feb 15, 2001; ... Office-based physicians who perform medical abortions may be affected. Now that the abortive agent mifepristone is on the market, some physicians who are interested in offering medical abortion but who weren't previously offering surgical abortion may find themselves facing ...
RDAs for Iron, Vitamin A, Other Nutrients Revised.
Feb 15, 2001; ... More iron needed for women under age 50. WASHINGTON -- New dietary goals for iron include increased requirements for women aged 50 and under--a change that reflects concern about the risk of iron deficiency in women. An Institute of Medicine (IOM) panel made the ...
FDA Advises Pregnant, Nursing Women to Avoid Certain Fish.
Feb 15, 2001; ... WASHINGTON -- Pregnant and lactating women should exclude shark, swordfish, king mackerel, and tilefish from their diets, the Food and Drug Administration said in a warning issued last month. The warning also applies to women of childbearing age who might become pregnant. ...
Protocols for Administering Mifepristone Can Be Modified.
Feb 15, 2001; ... ALBUQUERQUE--NOW that mifepristone is available for use in medical abortion, physicians who intend to offer the procedure face some practical issues in patient care, Dr. Linda W Prine said at a conference on patient education sponsored by the Society of Teachers of Family Medicine and the ...
Lactic Acidosis With HIV Drugs Reported.
Feb 15, 2001; ... Three cases at fatal lactic acidosis have been reported in pregnant women using stavudine and didanosine with other anti-HIV drugs, the Food and Drug Administration noted in a warning. "The combination of stavudine (Zerit) and didanosine (Videx or Videx EC) should be used with ...
LETTERS.
Feb 15, 2001 ... Let the Sun Shine on Babies? My husband is the physician in the family, but I enjoy OB.GYN. NEWS as well. However, I found the article on rickets misleading ("Breast-Fed Infants Require Vitamin D Supplements," Dec. 15, 2000, p.5). Dr. Susan S. Baker's broad and ...
Chlamydia, HPV Rates Skyrocket in Young People.
Feb 15, 2001; ... MILWAUKEE -- The rates of Chlamydia trachomatis and human papillomavirus are skyrocketing among young people, in part because health care providers are missing opportunities for counseling them about their risk, said Dr. Judith Wasserheit of the Centers for Disease Control and Prevention ...
Persistent Chlamydia May Go Undetected.
Feb 15, 2001; ... Persistent chlamydia infection was identified in seven women with three or more recurrences over a 2- to 5-year time span, in a 10-year retrospective analysis of STD clinic samples. Four of the women harbored the same genotype of Chlamydia trachomatis over the entire recurrence ...
Ultrasound Under Study as Treatment for Breast Ca.
Feb 15, 2001; ... CHICAGO -- An ultrasound technique could become a treatment option for breast cancer patients, according to researchers at St. Luc Hospital, Montreal. Dr. David Gianfelice reported that 17 of 22 breast cancer patients (77%) are tumor free after undergoing one or two treatments ...
GnRH Agonist Regimen May Reduce Breast Cancer Risk.
Feb 15, 2001; ... SAN ANTONIO -- A GnRH agonist-based hormonal chemo-prevention regimen shows early promise in young women who are at high risk for breast cancer, Dr. Jeffrey N. Weitzel reported at a breast cancer symposium sponsored by the San Antonio Cancer Institute. The prototype regimen ...
Microwave Ablation Appears Safe for Menorrhagia.
Feb 15, 2001; ... ORLANDO, FLA. -- Microwave endometrial ablation continues to show promise for the safe and effective treatment of menorrhagia, Dr. Kevin G. Cooper said at the annual meeting of the American Association of Gynecologic Laparoscopists. The procedure involves the destruction of the ...
Repeat Resection Of Endometrium Safe and Effective.
Feb 15, 2001; ... ORLANDO, FLA. -- Repeat resection of the endometrium following a failed resection is safe and worthwhile in most cases, Dr. Olav Istre said at the annual meeting of the American Association of Gynecologic Laparoscopists. Of 750 women who underwent primary transcervical resection ...
Bone Anchors Present Small Osteomyelitis Risk.
Feb 15, 2001; ... HILTON HEAD ISLAND, S.C. -- Osteomyelites following bone-anchor procedures is rare but can be easily missed, so physicians should be on the lookout for it, according to one expert. "The risk is small, but there's serious morbidity with major reoperations, removal of infected ...
Fluoroscopic Guidance Improves Accuracy of Durasphere Injection.
Feb 15, 2001; ... HILTON HEAD ISLAND, S.C -- Fluoroscopic guidance can help physicians more accurately inject Durasphere, a bulking agent used to treat women with stress urinary incontinence due to intrinsic sphincter deficiency, according to Dr. James Lukban. Injection of Durasphere at the ...
Try Multiple Strategies Simultaneously To Treat Stress Urinary Incontinence.
Feb 15, 2001; ... CHICAGO -- Shotgun approaches to the treatment of stress urinary incontinence are a surefire way to fail. That's because no single modality can address enough aspects of this complex, multifactorial disorder, and, after several failed treatment attempts, patients are likely to ...
Sacroiliac Dysfunction May Worsen Cystitis.
Feb 15, 2001; ... HILTON HEAD, S.C. -- Sacroiliac dysfunction, a malalignment of the sacrum and innominate bones of the hip and pelvis, may be an underrecognized component in some cases of interstitial cystitis. In a pilot study, 16 women with interstitial cystitis (IC) were diagnosed with and ...
Most Forceps Deliveries Carry Acceptable Risks.
Feb 15, 2001; ... SAN JUAN, P.R. -- Operative vaginal deliveries involving forceps don't necessarily deserve their bad rap, but those involving rotations over 45 degrees should probably be avoided, according to one expert. The risks of morbidity that are associated with low-forceps and outlet ...
Document Management Efforts in Asphyxia Cases.
Feb 15, 2001; ... SAN JUAN, P.R. -- Recent data suggest that only 6% of cerebral palsy cases are associated with birth asphyxia, yet when medical malpractice cases involving the disorder go to trial, plaintiffs' lawyers blame most of them on birth asphyxia, according to Luke M. Pittoni, J.D. ...
Training, Comfort Guide Dystocia Management.
Feb 15, 2001; ... SAN JUAN, P.R. -- When it comes to managing shoulder dystocia, do what works for you, Dr. Gary D.V Hankins said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law. The most appropriate maneuvers are those that the physician is trained in and ...
Urogynecologists More Likely to Have a C-Section.
Feb 15, 2001; ... HILTON HEAD ISLAND, S.C. -- Doctors who have seen what vaginal birth can do to the pelvic floor are more likely than other physicians to choose cesarean delivery for themselves or their partner, study results suggest. "These physicians are more familiar with the effects that ...
High Caffeine Intake Raises Miscarriage Risk.
Feb 15, 2001; ... Daily ingestion of at least 500 mg of caffeine, which is equivalent to about three 8-ounce cups of coffee, can almost double a nonsmoker's risk of miscarriage in the first trimester, Swedish investigators reported. A case group of 562 women who had miscarried at 6-12 weeks of ...
Community Hospital Lowers C-Section Rate to 11%.
Feb 15, 2001; ... KAMUELA, HAWAII -- Ten willing obstetricians and a supportive nursing staff reduced the cesarean section rate at their community hospital from 16.59% to 10.92% over a 10-year period by implementing active management of labor guidelines, reported Dr. John Naiden of Yakima Valley Memorial ...
Starlix.
Feb 15, 2001; ... (nategilnide, Novartis) An oral antidiabetic agent for use as monotherapy, with diet and exercise to improve glycemic control in people with type 2 diabetes. Also approved for use in combination with metformin (Glucophage) when that drug does not adequately control ...