OB GYN News back issues from May 2002:
Increase screening for 'prediabetes'. (HHS Recommendation).
May 01, 2002; ... WASHINGTON -- The epidemic growth of diabetes has prompted the Department of Health and Human Services to recommend screening all overweight people at age 45 for "prediabetes" and to consider screening younger, at-risk people such as those with a history of gestational diabetes. ...
Perinatal death risk in term VBAC pegged at 1:1,000; Risk was twice as high as that seen in other multiparous women, Scottish data show. (First Study of Uncomplicated Pregnancies).
May 01, 2002; ... LOS ANGELES -- The absolute risk of perinatal death due to any cause for a healthy singleton fetus in cephalic presentation at term in a woman attempting vaginal birth after a prior cesarean section is similar to the risk in nulliparous women. That risk--about 1 fetal death per ...
Coronary events decrease by 40% with Raloxifene: Results 'as good as in the statin trials'. (Preliminary Evidence of Heart Benefit).
May 01, 2002; ... ATLANTA -- Raloxifene shows exciting preliminary evidence of a powerful cardioprotective effect in postmenopausal women at high cardiovascular risk, Dr. Elizabeth Barrett-Conner reported at the annual meeting of the American College of Cardiology. A secondary analysis of 4-year ...
Vital Signs.
May 01, 2002 ... <Pre> VITAL SIGNS Physicians' Responses to Requests for Drugs Patients Saw AdvertisedGave the prescriptiondrug asked about 44% Recommended lifestyle changes 35% Recommended a different prescription drug 25% Recommended no ...
Ob.Gyn. News welcomes new board member. (News).
May 01, 2002 ... We are pleased to announce that Dr. Eric J. Bieber has joined the Editorial Advisory Board of OB.GYN. NEWS. Dr. Bieber recently was appointed as both chairman of the division of obstetrics and gynecology and medical director for the Women's Health Service Line at Geisinger ...
Korean Americans may not seek care for breast lump. (Cultural Differences).
May 01, 2002; ... BETHESDA, MD. -- Some Korean American women don't believe treatment can cure breast cancer and are likely to put off seeking medical attention if they discover a breast lump, Simona C. Kwon said at the annual meeting of the American Society of Preventive Oncology. Noting that ...
Letters.
May 01, 2002 ... Ready for Boutique Practice I had a chuckle when I read Dr. Ira Mandel's negative view regarding boutique medical practice ("Pro & Con: Is 'concierge' care an ethical alternative?" March 15, 2002, p. 5). I quit doing obstetrics 10 years ago because of the hassle ....
Pro & Con: Does minimal or mild endometriosis cause infertility? (Opinion).
May 01, 2002 ... YES There is evidence for a causal relationship between endometriosis and infertility. The prevalence of endometriosis is higher in subfertile women compared with fertile women. Secondly, an increased proportion of subfertile women have moderate to severe endometriosis compared ...
Strategies to lessen fetal risks during cancer Tx. (Excision, Nodal Sampling for Vulvar Ca).
May 01, 2002; ... BIG SKY, MONT. -- About 3% of breast and gynecologic cancers occur in conjunction with a pregnancy but many cancers can be adequately treated without jeopardizing the fetus, Dr. Lynn Montgomery said at an obstetrics meeting sponsored by Symposia Medicus. Cervical cancers occur ...
Induction rate doubled in the U.S. from 1990 to 1998. (Up from 9.5% to 19.4%).
May 01, 2002; ... The rate of labor inductions in the United States doubled from 1990 to 1998, reported Dr. Jun Zhang of the National Institutes of Health, Bethesda, Md., and associates. Labor inductions increased from 9.5% of all births nationwide in 1990 to 19.4% in 1998. If women who underwent ...
Salmeterol does not appear to be teratogenic. (Preliminary Data).
May 01, 2002; ... NEW YORK -- The asthma drug salmeterol does not appear to be a major human teratogen, Dr. Kenneth Lyons Jones reported at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. Data are preliminary, however. Researchers with the multicenter Organization ...
Accutane Teratogenicity Program called inadequate. (Voluntary Provisions seen as Problematic).
May 01, 2002; ... MAUI, HAWAII -- SMART, the new teratogenicity management program for Accutane, does not go far enough because too many of the provisions are voluntary, Dr. Kenneth L. Jones said at the annual Hawaii dermatology seminar sponsored by the Skin Disease Education Foundation. "I think ...
Cancer drugs. (Drugs, Pregnancy, and Lactation).
May 01, 2002; ... Cancer in pregnancy is an extremely stressful, complex situation. First, the issues of whether the cancer affects the pregnancy and whether the pregnancy affects the cancer should be considered. For example, breast cancer, which is probably the most common cancer diagnosed in pregnancy may ...
Cerclage in PPROM may be safe if no infection. (No Data to Show if Latency is Lengthened).
May 01, 2002; ... BIG SKY, MONT. - Prolene cerclages can safely be left in place in a woman who has preterm premature rupture of membranes and no sign of infection, said Dr. Lynn Montgomery, director of obstetrics and maternal-fetal medicine at Rocky Mountain Perinatal Center in Missoula, Mont. ...
Laparoscopy in pregnancy as safe as laparotomy. (Retrospective Chart Review).
May 01, 2002; ... DALLAS -- Laparoscopy increasingly is finding a role in the management of pelvic disease during pregnancy, Dr. James F. Carter reported at the annual meeting of the Society of Gynecologic Surgeons. In a systematic, retrospective chart review of pregnant women undergoing ...
Early induction after fetal death minimizes stress. (Less Endomyometritis).
May 01, 2002; ... Early labor induction after fetal death can minimize the incidence of endomyometritis and psychological stress, said Dr. Sharon M. Salamat of the University of Miami and her associates. The investigators studied 100 women who underwent early labor induction and 108 women who ...
Miscarriage tied to later ischemic heart disease. (Risk up by 50% After One or Two Miscarriages).
May 01, 2002; ... LOS ANGELES -- Women who have had one or two miscarriages before delivery of a live baby are 50% more likely to develop ischemic heart disease later in life than are their counterparts who haven't miscarried, a recent study suggested. Women who experienced at least three ...
Data don't support 'July phenomenon'. (Obstetric Residents).
May 01, 2002; ... DALLAS -- There's no 'July phenomenon m obstetrics, Dr. Thomas D. Myles said at the annual meeting of the Council on Resident Education in Obstetrics and Gynecology and the Association of Professors of Gynecology and Obstetrics. Every July, a new group of residents begins ...
Gestational diabetes guidelines: use with caution. (Patients Who Don't Need Screening).
May 01, 2002; ... LAKE TAHOE, NEV. -- Physicians need to be careful about using recently released guidelines to identify low-risk patients who can avoid screening for gestational diabetes, Dr. Andrew Combs warned at an obstetrics and gynecology conference sponsored by the University of California, Davis. ...
Prenatal reality check may cut risk of postpartum depression. (Inquire about Hopes, Expectations).
May 01, 2002; ... NEW YORK -- A little prenatal candor can go a long way in preventing or minimizing the impact of postpartum depression, Dr. Diana Dell said at a press briefing sponsored by the American College of Obstetricians and Gynecologists. "Women are under tremendous pressure to make ...
Postterm pregnancy risks may be underestimated. (Expectant Management Questioned).
May 01, 2002; ... BIG SKY, MONT. -- The rate of perinatal morbidity and mortality is significantly higher in postterm pregnancy, according to the results of a literature review conducted by Dr. David A. Miller. This finding should be a deterrent to expectant management and a strong argument for ...
Low birth weight is risk factor for ADHD. (Large Case-Control Study).
May 01, 2002; ... Low birth weight is an independent risk factor for attention-deficit hyperactivity disorder and could account for as much as 13.8% of all ADHD cases in the United States, reported Eric Mick, Sc.D., of Harvard Medical School, Boston, and his colleagues. Despite the correlation, ...
Misoprostol appears safe for inducing twins. (Large Study).
May 01, 2002; ... LOS ANGELES -- The largest study to date of labor induction with misoprostol for twin gestations found the drug to be as safe and effective as oxytocin, Dr. Melissa Bush reported in a poster presentation at the annual meeting of the Society for Gynecologic Investigation. ...
Placental disease causes most high MSAFP cases. (Expert Opinion).
May 01, 2002; ... SARASOTA, FLA. -- The first clinical sign of antiphospholipid syndrome may be a second-trimester elevation in maternal serum alpha-feroprotein, Dr. Anthony M. Vintzileos said at a symposium on high-risk pregnancy sponsored by Symposia Medicus. "In my view the most common reason ...
Maternal smoking raises offspring's risk of diabetes. (Also Ups Obesity Risk).
May 01, 2002; ... Children of women who smoked after the fourth month of pregnancy have greater independent risks of developing early-onset diabetes and obesity said Scott M. Montgomery, Ph.D., and Anders Ekbom, Ph.D., of the Karolinska Institute, Stockholm. Of 4,917 children, 28 developed ...
Expert offers tips on tackling shoulder dystocia. (All-Fours Maneuver may be Advantageous).
May 01, 2002; ... LAKE TAHOE, NEV. -- Because there's no sure away of predicting shoulder dystocia, physicians would do better to shift their focus from trying to avoid it to learning the best strategies to deal with it, Dr. Thomas Benedetti said at an obstetrics and gynecology conference sponsored by the ...
Anthrax vaccine doesn't affect birth rate, outcomes. (Army Study).
May 01, 2002; ... Anthrax vaccination had no significant effect on the rates of pregnancy, birth, or adverse birth outcomes among reproductive-aged women in the U.S. Army, reported Dr. Andrew Wiesen and Dr. Christopher Littell of Madigan Army Medical Center, Tacoma, Wash. In the wake of ...
New anabolic agent may revamp osteoporsis Tx. (Teriparatide Awaits FDA Approval).
May 01, 2002; ... HONOLULU -- The anticipated Food and Drug Administration approval of an anabolic agent, teriparatide, for the treatment of osteoporosis offers an intriguing opportunity to begin combining drugs or using them sequentially for enhanced effect, a number of speakers suggested at an ...
Teriparatide studies underscore bone strengthening power. (Anabolic Therapy for Osteoporosis).
May 01, 2002; ... HONOLULU -- New research unveiled at an international symposium sponsored by the National Osteoporosis Foundation emphasized the mechanistic differences between anabolic therapy and currently approved osteoporosis drugs, including bisphosphonates, all of which slow bone turnover and ...
Thrombocytosis linked to aggressive ovarian ca. (Cancer Recurrence Increased).
May 01, 2002; ... MIAMI BEACH - Thrombocytosis is associated with more aggressive tumor biology in patients with epithelial ovarian cancer, according to a recent retrospective study. That finding has immediate implications for the management of ovarian cancer patients with thrombocytosis ....
Certain genes may help HRT raise HDL, cut coronary risk. (May be able to predict HRT Response).
May 01, 2002; ... The right genes may amplify hormone replacement therapy's ability to boost MDL cholesterol levels and could give some postmenopausal women an edge in the fight against heart disease, reported Dr. David M. Herrington and associates at Wake Forest University; Winston-Salem, N.C. ...
Observation called for in HIV-positive women who have low-grade SIL. (Treatment Likely to Fail).
May 01, 2002; ... SEATTLE -- HIV-infected patients with low-grade cervical squamous intraepithelial lesions can be observed in the same manner as other patients, even though their chances are much lower for lesion regression, Dr. Tedd V Ellerbrock said at the Ninth Conference on Retroviruses and ...
Antibiotic failure may point to missed pelvic mass. (Reserve Heparin for Very Large Thrombi).
May 01, 2002; ... VAIL, COLO. -- When a seemingly straightforward pelvic infection fails to respond to empiric broad-spectrum intravenous antibiotic therapy, think "pelvic mass," Dr. Ronald S. Gibbs said at a conference on obstetrics and gynecology sponsored by the University of Colorado. ...
Occult malignancy common at oophorectomy. (Prophylactic Surgery).
May 01, 2002; ... MIAMI BEACH -- Occult malignancy is a common finding at the time of prophylactic oophorectomy, and occult tumors are not limited to ovarian origin, according to pathologic findings in specimens from 30 women who underwent the procedure. Furthermore, in a majority of cases the ...
Borderline ovarian tumors can mimic more aggressive malignancies. (Pathology Report Critical).
May 01, 2002; ... LAKE TAHOE, NEV. -- Borderline ovarian tumors often present very similarly to frank ovarian cancer, but their treatment is more straightforward and survival rates are substantially better, according to one expert. Symptoms and imaging may not give many clues to help ...
Classic error in ovarian ca diagnosis: no pelvic exam. (Don't Disregard Vague Symptoms).
May 01, 2002; ... KAUAI, HAWAII -- The best tool you have to detect ovarian cancer is your suspicion. Family history; CA 125 testing, and ultrasound are ineffective or impractical for screening the general population for ovarian cancer. Your best bet is to pay attention when a patient says, ...
Search for more familial breast ca genes heats up. (80% of Risk Still Unexplained).
May 01, 2002; ... SAN ANTONIO -- The BRCA1 and 2 mutations together account for only 15%-20% of the excess familial risk of breast cancer, Dr. Bruce Ponder said at the annual breast cancer symposium sponsored by the San Antonio Cancer Institute. An intensive search is underway for the genetic ...
Those who read the most mammograms miss fewest cancers. (Study of U.S., British Radiologists).
May 01, 2002; ... KAUAI, HAWAII -- Radiologists who read the most mammograms found the most and missed the fewest breast cancers, compared with their counterparts who interpreted fewer of the imaging tests, Dr. Laura J. Esserman said. In a study of radiologists, those who read more than 300 ...
Excise pelvic lesions to confirm endometriosis. (Miminal Disease Tough to Spot Clinically).
May 01, 2002; ... SAN DIEGO -- It's better to rely on surgical resection than eyesight alone when trying to determine whether a pelvic lesion is endometriosis, Dr. Pamela Stratton said at the World Congress on Endometriosis. A study of lesions excised from 67 women surgically treated for ...
New-onset endometriosis seen in many postmenopausal women. (57% had No History of the Disorder).
May 01, 2002 ... SAN DIEGO -- A majority of 50 postmenopausal women diagnosed with endometriosis had no previous history of the disease, a review of cases treated over a 5-year period at one institution found. Endometriosis is not just a disease of the childbearing years. When pelvic pain, ...
Histologic patterns may reveal stage, prognosis of endometriosis. (May Help Predict Response to Therapy).
May 01, 2002 ... SAN DIEGO -- Endometriosis with an undifferentiated or mixed histologic pattern was more often associated with stage III-IV disease, more severe pain before treatment, and a less favorable prognosis after treatment, compared with endometriosis showing a stromal or well-differentiated ...
Asymptomatic endometriosis may not need Tx. (No Increased Risk of Pelvic Pain).
May 01, 2002; ... SAN DIEGO -- Women with asymptomatic endometriosis were no more likely to develop pelvic pain over a 13-year period than were those without the disease at the start of a longitudinal study, Dr. Mette H. Moen reported at the World Congress on Endometriosis. This finding suggests ...
Vaginal excisions can leave debilitating strictures. (Shortening of Vagina also a Problem).
May 01, 2002; ... BALTIMORE -- Thousands of women have severe vaginal shortening or strictures resulting from "surgical misadventures," speakers said in separate presentations at a urogynecology meeting sponsored by Johns Hopkins University. "Unfortunately somewhere along the way someone taught ...
Beads for urethral bulking prove good 'quick fix'. (Less Invasive than Incontinence Surgery).
May 01, 2002; ... BALTIMORE -- Urethral bulking procedures remain a good treatment choice for incompetent urinary sphincter, and they yield similar results whether the injected material is collagen or microcarbon beads, Dr. Ananias Diokno said at a urogynecology meeting sponsored by Johns Hopkins ...
'Prescribe' strategies to treat incontinence. (Behavioral Approaches).
May 01, 2002; ... BALTIMORE -- Behavioral approaches to urinary incontinence will be more successful if the treatment is "prescribed" in much the same way medication is, Dr. Ananias Diokno said at a urogynecology meeting sponsored by Johns Hopkins University. National surveys indicate that 38% of ...
Drug update: Long-term control of moderate to severe, persistent asthma. (Primary Care).
May 01, 2002; ... Inhaled corticosteroids are still considered the most important medications for treating persistent asthma. They have a long track record, and they are the only class of drugs that is proved to prevent death from asthma. Recently, some experts have become more comfortable with ...
Daily orange juice may reduce blood pressure. (Two Glasses Daily Cut Systolic Pressure).
May 01, 2002; ... ATLANTA -- Quaffing 2 cups of orange juice daily results in a clinically meaningful reduction in blood pressure, Dr. Dennis L. Sprecher reported at the annual meeting of the American College of Cardiology. He reported on 24 hypertensive patients with stable coronary artery ...
Patients unaware of risks of high systolic reading. (Detroit-Area Study).
May 01, 2002; ... ATLANTA -- Most hypertensive patients don't adequately understand the risks imposed by an elevated systolic blood pressure, Susan A. Olivieria, Sc.D., said at the annual meeting of the American College of Cardiology. She presented a Bristol-Myers Squibb Co.--sponsored telephone ...
Losartan trumps atenolol. (Primary Care: Cardiology).
May 01, 2002; ... Losartan was associated with marked reductions in stroke and new-onset diabetes, compared with atenolol, in a landmark clinical trial of patients with hypertension. "I think these results have immediate applicability to clinical practice. The message is that it matters how you ...
ACE inhibitor allergy alert. (Primary Care: Cardiology).
May 01, 2002; ... ACE inhibitors, aspirin, and alcohol each appear to increase the risk for an anaphylactic reaction in adults with food allergies, Dr. Denise-Anne Moneret-Vautrin reported at the annual meeting of the American Academy of Allergy Asthma, and Immunology. Avoiding those substances ...
Generic vs. Original Fluoxetine. (Primary Care: Mental Health).
May 01, 2002; ... Leaders in the field of psychopharmacology are receiving widespread anecdotal reports that generic versions of fluoxetine may have diminished bioequivalence, compared with brand name Prozac, said Dr. Alan J. Gelenberg of the University of Arizona, Tucson. Generic versions of ...
Watch for caffeine interactions. (Primary Care: Mental Health).
May 01, 2002; ... Caffeine interacts with a number of psychoactive medications, and physicians must be alert to potentially serious consequences, Marilyn R. Semenchuk, Pharm.D., said at a psychopharmacology conference sponsored by the University of Arizona. "We need to pay more critical attention ...
Treat early to prevent damage. (Primary Care: Musculoskeletal).
May 01, 2002; ... Treatment delays of as little as 6 months can result in irreversible, radiologically evident joint damage in patients with severe inflammatory polyarthritis, according to the results of a British observational study. Dr. Deborah P.M. Symmons of the University of Manchester ...
New arthritis pain guidelines. (Primary Care: Musculoskeletal).
May 01, 2002; ... Memo As a first-line drug therapy, acetaminophen is effective only for mild osteoarthritis pain without inflammation, according to evidence-based-guidelines released at the annual meeting of the American Pain Society. New guidelines on the treatment of arthritis pain ...
Limit antibiotics for acne. (Primary Care: Dermatology).
May 01, 2002; ... Prolonged courses of antibiotics may contribute to the evolution of bacterial resistance in general. Isotretinoin (Accutane) may be associated with an increased risk of suicide. Which is worse? Dr. Bruce Thiers believes that the evolving bacterial resistance to antibiotics is ...
Melanoma vigilance in blacks. (Primary Care: Dermatology).
May 01, 2002; ... Despite the rarity of melanoma in blacks, patients and physicians need to be more vigilant about performing regular skin checks in this population, Dr. Katina M. Byrd said at an international symposium sponsored by the L'Oreal Institute for Ethnic Hair and Skin Research. ...
State budget cuts threaten Medicaid Rx coverage. (Some Drugstores could Drop Medicaid).
May 01, 2002; ... Drugstores nationwide are threatening to stop filling prescriptions for Medicaid patients as states scale back their payments to pharmacies. Under budgetary pressure from the recession, states are looking for ways to save money, and pharmacies are easy targets, said Crystal ...
AMA's critics unmoved by offer of free CPT code searches. (Exclusive Rights Under Fire).
May 01, 2002; ... Since February, the American Medical Association has been offering free searches of its online CPT coding manual, including listings of the amounts paid by Medicare for each service, to anyone who fills out its online registration form. Users are limited to 10 searches per day ....
Patient-friendly offices may lower liability risks. (Follow-Up for at-Risk Patients in Crucial).
May 01, 2002; ... KAUAI, HAWAII -- When jurors in some medical malpractice cases "send a message" with a judgment of $10 million or more, on the surface they're judging the physician or the practice on trial. But they also may be sending a message about their own physicians who don't return phone ...
California HMOs must cover ECs. (Policy & Practice).
May 01, 2002; ... California Gov. Gray Davis has instructed all HMOs in the state to cover the cost of emergency contraceptives. Many California HMOs already provide reimbursement for ECs. The Democratic governor's directive is intended to ensure regulatory clarity for HMOs, to educate patients, and to ...
Judicial nominee rejected. (Policy & Practice).
May 01, 2002; ... Reproductive rights organizations are praising the Senate Judiciary Committee's decision to reject the nomination of Mississippi Judge Charles W. Pickering Sr. to the United States Circuit Court of Appeals for the Fifth Circuit. The committee voted 10-9 against the nomination. Judge ...
Legislators write to CMS. (Policy & Practice).
May 01, 2002; ... Legislators are asking the Centers for Medicare and Medicaid Services to fix the way the agency has estimated the cost of payments to physicians. In a letter to CMS administrator Tom Scully, Rep. Bill Thomas (R-Calif.), chairman of the House Ways and Means Committee, and Rep. Nancy Johnson ...
Two tapped for health posts. (Policy & Practice).
May 01, 2002; ... Physician groups are hailing President Bush's new appointments to key health posts. The American Medical Association calls the nomination of Dr. Richard Carmona to be surgeon general "a natural choice." Dr. Carmona, a trauma surgeon, is nationally known for his work in critical care and ...
The long wait. (Policy & Practice).
May 01, 2002; ... Americans are having more trouble than ever scheduling appointments with physicians, the Center for Studying Health System Change says in a study. The percentage of people who have to wait more than 7 days to get an appointment increased from 22.2% in 1997 to 28% in 2001. There are also ...
Training bolsters forceps use after graduation. (Vacuum Delivery Rates Unchanged).
May 01, 2002; ... DALLAS -- Emphasis upon teaching operative vaginal delivery techniques during residency appears to translate into increased use of these skills after entry into ob.gyn. practice, said Dr. Pamela A. Promecene of the University of Texas, Houston. This educational emphasis may ...