OB GYN News back issues from February 2005:
Insurers set criteria for VBAC coverage.(News)
Feb 01, 2005; ... The malpractice insurance crisis is prompting a small number of professional liability insurers to institute strict standards for performing vaginal birth after cesarean section. And an Oklahoma insurer last month has gone as far as excluding coverage for the procedure, citing a ...
Median compensation for ob.gyns. rises more than 8%.(VITAL SIGNS)
Feb 01, 2005 ... Median Compensation for Ob.Gyns. Rises More Than 8% Notes: Based on 1,876 medical practices nationwide in ...
Maryland to create insurance rate stabilization fund: aimed at curbing malpractice premiums.(News)
Feb 01, 2005; ... As physicians push for professional liability reform at the national level, the Maryland legislature signed off on a bill aimed at halting rising malpractice premiums. The centerpiece of the legislation is a rate stabilization fund for medical professional liability insurance ...
Prenatal steroids may be justified at 23 weeks.(News)
Feb 01, 2005; ... SAN FRANCISCO -- New data suggest that giving prenatal steroids to women at risk of preterm delivery might be beneficial as early as 23 weeks' gestation, said Avroy A. Fanaroff, M.B. Currently, most physicians give prenatal corticosteroids to enhance fetal maturation in women at ...
Survey: scientists pressured into FDA approvals.(News)
Feb 01, 2005; ... Nearly one in five Food and Drug Administration scientists in a federal survey said they were pressured to approve or recommend approval for a drug despite reservations about its safety. Half of the 400 scientists who participated in this 2002 survey by the Department of Health ...
Groups push to obtain OTC status for Plan B.(News)
Feb 01, 2005; ... ROCKVILLE, MD. -- A coalition of women's groups recently called for the Food and Drug Administration to approve over-the-counter marketing status for the emergency contraceptive Plan B (levonorgestrel). Waving banners and colorful signs, member organizations of the "Morning ...
Tamoxifen-aromatase inhibitor combo improves Ca outcomes.(News)
Feb 01, 2005; ... SAN ANTONIO -- Switching postmenopausal breast cancer patients to an aromatase inhibitor following 2-3 years of adjuvant tamoxifen results in markedly better disease-free survival than the traditional 5 full years of tamoxifen, according to three major randomized trials presented at a ...
An alarming trend.(LETTERS)(Letter to the Editor)
Feb 01, 2005; ... The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and the trend toward widespread, worsening resistance with this particular organism pose a serious challenge to clinicians nationwide ("MRSA Emerging as Cause of Community-Acquired Infections, Studies Show" Dec. 1, 2004, ...
Pain relief in circumcision.(LETTERS)(Letter to the Editor)
Feb 01, 2005; ... I am not surprised by the findings of Praveen Kumar, M.D., of reluctance on the part of physicians to use adequate analgesia during circumcision ("No Analgesia Given in Most Circumcisions," Nov. 15, 2004, p. 4). My experience at the community hospital level revealed that there ...
Pain relievers.
Feb 01, 2005 ... "I'm prescribing a squiggly line, two slanted ...
Your hardest task.(GUEST EDITORIAL)
Feb 01, 2005; ... Firing an employee is arguably the most difficult task most employers face, and it is particularly tough on physicians. We hate doing it so much that many of us prefer to tolerate poor and marginal employees rather than replace them with good ones. That exacts a heavy toll on ...
Home visitation program benefits new mothers.(Obstetrics)
Feb 01, 2005; ... A program that sends nurses to visit economically disadvantaged, single mothers during pregnancy and for the child's first 2 years can have long-term benefits, recent data show. The analysis, which was recently commissioned by the Washington state legislature, shows the largest ...
Fetal origin hypothesis discounted.(Obstetrics)
Feb 01, 2005; ... Impaired fetal growth does not raise cholesterol levels in adulthood appreciably, according to Rachel Huxley, D.Phil., of the University of Sydney, and her associates. Proponents of the "fetal origins" hypothesis hold that fetal undernutrition is linked to higher risk of ...
Obstetric applications studied for heart failure test.(Obstetrics)
Feb 01, 2005; ... NEW ORLEANS -- Measurement of B-type natriuretic peptide levels in pregnancy shows promise for the management of preeclamptic patients, Vikas Bhalla, M.D., said during the annual scientific sessions of the American Heart Association. The plasma B-type natriuretic peptide (BNP) ...
Navigating Tx of bipolar disorder in pregnancy.(Obstetrics)
Feb 01, 2005; ... BOSTON -- Managing bipolar disorder during pregnancy requires balancing the competing risks and benefits to the woman and her fetus, said Adele Viguera, M.D. "Pregnancy, and particularly the postpartum period, is associated with a high risk of disease recurrence for women with ...
Expectant management of HELLP: prednisolone cuts exacerbations.(Obstetrics)
Feb 01, 2005; ... VIENNA -- Prolonged prednisolone administration reduces the risk of HELLP exacerbations in women undergoing expectant management remote from term, Pieter van Runnard Heimel, M.D., said at the 14th World Congress of the International Society for the Study of Hypertension in Pregnancy. ...
Isolated fetal intracardiac echogenic focus doesn't increase aneuploidy risk.(Obstetrics)
Feb 01, 2005; ... PHOENIX, ARIZ. -- The presence of an isolated intracardiac echogenic focus on fetal ultrasound does not increase the risk for aneuploidy in the absence of other risk factors in women younger than 35 years of age, Kathleen Bradley, M.D., reported at the annual meeting of the Pacific Coast ...
Total cesarean delivery rate.(DATA WATCH)
Feb 01, 2005 ... <Pre> Total Cesarean Delivery Rate 2003 27.6% 2002 26.1% Source: ...
Pitocin orders should match hospital's protocol.(Obstetrics)
Feb 01, 2005; ... SAN FRANCISCO -- Before you write an order for Pitocin administration to induce or augment labor, be sure you know your hospital's protocol for Pitocin use, Dennis J. Sinclitico, J.D., advised. In the three most recent obstetrical malpractice cases in which he served as a ...
Urinary PlGF predicts early-onset preeclampsia.(Obstetrics)
Feb 01, 2005; ... VIENNA -- Decreased urinary placental growth factor at midgestation is strongly associated with the subsequent development of early-onset preeclampsia, S. Ananth Karumanchi, M.D., reported. "Low urinary PIGF antedates the clinical diagnosis of preeclampsia and may serve as a ...
Hydroxychloroquine 'probably safe' in pregnancy.(Obstetrics)
Feb 01, 2005; ... DUSSELDORF, GERMANY -- The anti-inflammatory compound hydroxychloroquine appears to be relatively safe during pregnancy, according to a small number of studies totaling about 250 patients. But these studies have not provided overwhelming evidence proving the safety of this agent ...
Operative vaginal delivery strategies may curb risk.(Obstetrics)
Feb 01, 2005; ... SAN FRANCISCO -- Use of forceps or vacuum extractor during a vaginal delivery seldom is the sole cause of litigation, but you can reduce that risk even more, several speakers said at a conference on ob.gyn., perinatal medicine, neonatology, and the law. Operative vaginal ...
Researchers embrace sentinel lymph node biopsy.(Gynecology)
Feb 01, 2005; ... SAN ANTONIO -- Sentinel lymph node biopsy is as accurate as the traditional surgical practice of dissecting the entire axillary lymph node chain in women with breast cancer but inflicts far less nerve damage and fewer other complications. Mark Kissin, M.Chir., reported during a breast ...
Refined chemo benefits ER-negative patients.(Gynecology)
Feb 01, 2005; ... SAN ANTONIO -- Twenty years of refinements in adjuvant chemotherapy have brought dramatically improved outcomes in lymph node-positive breast cancer patients, but the benefit has been confined to those with estrogen receptor-negative tumors, Donald A. Berry, Ph.D., said at a breast cancer ...
Flaxseed supplements curbed hot flashes in study.(Gynecology)
Feb 01, 2005; ... SAN ANTONIO -- Flaxseed relieved vasomotor hot flashes in postmenopausal women in a randomized blinded crossover trial, Lorraine E. Turner, Ph.D., reported at the annual breast cancer symposium sponsored by the Cancer Therapy and Research Center. Although the study wasn't ...
CAM usage climbs with education level.(Gynecology)
Feb 01, 2005; ... SAN ANTONIO -- The more years of formal education a breast cancer patient has, the more likely she is to use complementary and alternative medicine in conjunction with adjuvant chemotherapy, Eleanor Glass reported at the annual breast cancer symposium sponsored by the Cancer Therapy and ...
Breast Ca patients need more calcium, vitamin D.(Gynecology)
Feb 01, 2005; ... SAN ANTONIO -- Inadequate calcium and vitamin D intake--and outright deficiencies--are even more common among breast cancer patients than in the general population, according to studies presented at the annual breast cancer symposium sponsored by the Cancer Therapy and Research Center. ...
UAE edges myomectomy in terms of recovery.(Gynecology)
Feb 01, 2005; ... CHICAGO -- Uterine artery embolization appears to have a slight edge over myomectomy in terms of recovery after treatment of uterine fibroids, according to data presented during the annual meeting of the Radiological Society of North America. Uterine artery embolization (UAE) ...
Left upper quadrant called safe alternative for umbilicus entry.(Gynecology)
Feb 01, 2005; ... SAN FRANCISCO -- The ninth intercostal space in the left upper quadrant provides a safe alternative to umbilicus entry for laparoscopy when the patient has adhesions, Neena Agarwala, M.D., reported in a poster presentation during the annual meeting of the American Association of ...
Nerve-sparing technique said to cut complications in deep endometriosis.(Gynecology)
Feb 01, 2005; ... SAN FRANCISCO -- A laparoscopic procedure that preserves the hypogastric and pelvic splanchnic nerves appears to reduce urinary retention after treatment of deep pelvic endometriosis, Paulo Ayroza Ribeiro, M.D., reported at the annual meeting of the American Association of Gynecologic ...
Extended raloxifene use cuts risk of breast Ca.(Gynecology)
Feb 01, 2005; ... SAN ANTONIO -- Raloxifene continued to markedly reduce breast cancer incidence in postmenopausal osteoporotic women over the course of 8 years in an extension of the landmark Multiple Outcomes of Raloxifene Evaluation trial, according to Silvana Martino, D.O., of the John Wayne Cancer ...
High prevalence of fractures, reduced BMD in systemic lupus.(Gynecology)
Feb 01, 2005; ... Patients with systemic lupus erythematosus who are under the age of 50 have a high rate of fragility fractures, osteoporosis, and poor bone mineral density, according to new research. And as expected, steroid use was significantly linked to reduced bone mineral density (BMD), ...
Routine bone scans appropriate for some premenopausal women.(Gynecology)
Feb 01, 2005; ... HARROGATE, ENGLAND -- Targeted use of bone densitometry in premenopausal women can identify a significant number of patients who would benefit from bone protection, a study has shown. Of 301 premenopausal women referred to London's Queen Elizabeth Hospital during a 4-year period ...
BMD early in menopause predicts 10-year bone health: findings of this study support the role of bone density measurements in the first years after menopause.(Gynecology)
Feb 01, 2005; ... HARROGATE, ENGLAND -- A single bone mineral density measurement early in menopause is a strong predictor of future bone status in women not considered at risk for osteoporosis, a study has shown. Despite various rates of bone mineral loss among individuals and measurement sites, ...
Fracture risk increases with albumin, T3 deficiencies.(Gynecology)
Feb 01, 2005 ... HARROGATE, ENGLAND -- Low serum albumin and T3 levels are independently predictive of vertebral fractures in women older than 50 years, a 10-year prospective study has shown. Because albumin and T3 deficiencies are considered markers of frailty and sickness, the findings suggest ...
Analysis debunks age bias in bisphosphonate therapy for elderly.(Gynecology)
Feb 01, 2005 ... HARROGATE, ENGLAND -- Age and frailty should not deter physicians from offering very elderly osteoporotic patients antiresorptive therapy, despite age-associated increases in comorbid conditions, said Steven Boonen, M.D The results of a pooled analysis from three randomized, ...
IUD advocated for women using antiepileptics.(Gynecology)
Feb 01, 2005; ... NEW ORLEANS -- The best contraceptive choices for women on antiepileptic medications are probably a progesterone-eluting intrauterine device or intramuscular medroxyprogesterone, with the higher doses of oral contraceptives running in second place, Anne Davis, M.D., said at the annual ...
Outcomes of assisted reproductive technology cycles.(DATA WATCH)
Feb 01, 2005 ... <Pre> Outcomes of Assisted Reproductive Technology Cycles. Single-Fetus Pregnancy19.9% Multiple-Fetus Pregnancy 12.4% Indeterminate Number of Fetuses* 2% Ectopic Pregnancy 0.7% No Pregnancy 65% * Number of fetuses not ...
Review of 28 studies links HT to higher stroke risk.(Gynecology)
Feb 01, 2005; ... Hormone therapy is associated with a significantly increased risk of stroke, based on studies involving nearly 40,000 patients. A review of 28 studies ranging in size from 59 to 16,608 adults and with follow-up times of 0.7-6.8 years showed a significant association between HT ...
Enterococcus behind many UTIs in elderly; Tx resistance rises with age.(Gynecology)
Feb 01, 2005; ... SAN FRANCISCO -- The culprit behind most noncomplicated urinary tract infections in outpatients--Escherichia coli--plays less of a role as patients age, a study of 2,751 urine cultures showed. Other pathogens, particularly enterococcus, played a greater role in urinary tract ...
Guidelines: cut calories and salt; Exercise more.(Clinical Rounds)
Feb 01, 2005; ... The nation's newly revised dietary guidelines call on Americans to double their exercise, cut back on calories, and limit sodium consumption to 1 teaspoon or less each day. The "Dietary Guidelines for Americans 2005" document stresses the importance of personal responsibility ...
Primary care physicians assigned front line in obesity Tx.(Clinical Rounds)
Feb 01, 2005; ... LAS VEGAS -- In theory, team management of obese patients makes a lot of sense. But in the real world, it may not be possible, because the obesity epidemic is too big, trained specialists too few, and resources too scarce, Arthur Frank, M.D., said at the annual meeting of North ...
Calories count despite debate on best weight-loss plans.(Clinical Rounds)
Feb 01, 2005; ... NEW ORLEANS -- Calorie restriction, rather than the carbohydrate or fat content or the glycemic index of the diet, is of great importance in losing weight, Ernst J. Schaefer, M.D., said at the annual scientific sessions of the American Heart Association. "There's a lot of ...
Uncomplicated obesity linked to compromised aortic elasticity.(Clinical Rounds)
Feb 01, 2005; ... NEW ORLEANS -- Obese individuals with no other complicating diseases have an abnormally stiff aorta, predisposing them to heart failure and other cardiovascular diseases, Monique Robinson, M.B., said at the annual scientific sessions of the American Heart Association. "Being ...
Exercises to speed breast Ca surgery recovery: slow is definitely the way to go when it comes to exercise after surgery to prevent muscle atrophy.(EXERCISE RX)
Feb 01, 2005; ... A major problem in patients who are undergoing rehabilitation after cancer surgery or chemotherapy is that platelet counts go down, and patients develop thrombopenia and bleed easily. In addition, the peripheral nervous system may be impaired, and patients may lose some ...
Pumping iron hones glycemic control in type 2 diabetes.(Clinical Rounds)
Feb 01, 2005; ... KEYSTONE, COLO. -- Weight lifting is an attractive option to improve glycemic control in patients with type 2 diabetes, Richard Weil said at a conference on management of diabetes in youth. The great majority of research on the metabolic benefits of exercise in patients with ...
New DNA test: prescription for genetic precision.(Clinical Rounds)
Feb 01, 2005; ... Food and Drug Administration approval of the first DNA microarray test will allow physicians to consider patient-specific genetic information before prescribing medications for a variety of conditions such as cardiac disease, psychiatric disease, and cancer. The new test offers ...
CV risks rise among Native Americans.(Clinical Rounds)
Feb 01, 2005; ... ATLANTA -- The prevalence of cardiovascular risk factors and cardiovascular disease is alarmingly high and continues to rise in Native Americans, according to several reports at a prevention conference on heart disease and stroke sponsored by the Centers for Disease Control and Prevention ....
Post-MI depression most common in younger women.(Clinical Rounds)
Feb 01, 2005; ... NEW ORLEANS -- Younger women with acute MI are a particularly high-priority target population in terms of screening for and treatment of postinfarct depression, Susmita Mallik, M.D., said at the annual scientific sessions of the American Heart Association. She reported on 2,501 ...
Medicare poised to help seniors kick the habit.(Clinical Rounds)
Feb 01, 2005; ... Medicare is investigating ways to help its beneficiaries quit smoking. The Centers for Medicare and Medicaid Services proposed to extend smoking cessation coverage to beneficiaries who smoke and have been diagnosed with a smoking-related disease--or who are taking certain drugs ...
Smoking, salt increase risk of GERD.(Clinical Rounds)
Feb 01, 2005; ... Smoking and high salt intake increase the risk of developing gastroesophageal reflux disease, while a high-fiber diet and regular physical exercise decrease it, a study of two large Norwegian surveys suggests. The study, conducted by Magnus Nilsson, M.D., of the Karolinska ...
Smoking cessation.(WOMEN'S HEALTH ADVISER)
Feb 01, 2005; ... About 21% of American women, or more than 20 million, smoke cigarettes, with prevalence being the highest, about 32%, among Native American women. According to the Office of the Surgeon General, smoking is probably the most important preventable cause of poor pregnancy outcomes ...
Injectable sumatriptan works after oral form fails.(Clinical Rounds)
Feb 01, 2005; ... VANCOUVER, B.C. -- When migraine patients who need sumatriptan to abort their headaches fail to respond to it, they should try the injectable form, Seymour Diamond, M.D., said at the annual meeting of the American Headache Society. In an open-label study in 43 patients, ...
Study: migraine underdiagnosed in HMO population.(Clinical Rounds)
Feb 01, 2005; ... VANCOUVER, B.C. -- Even in a health maintenance organization, few patients with migraine are identified, diagnosed, and treated--even fewer than previous epidemiologic studies of the population have suggested, Marcelo E. Bigal, M.D., reported during the annual meeting of the American ...
FDA approves a new, nonnarcotic sleep aid.(Clinical Rounds)
Feb 01, 2005; ... The Food and Drug Administration has approved a new, nonnarcotic therapy for insomnia, eszopiclone. Most sleep aids are approved for only short-term use of a week to 10 days, but eszopiclone can be safely prescribed for longer, according to the FDA. Formerly known as Estorra and ...
FDA issues new warning for ADHD drug.(Clinical Rounds)
Feb 01, 2005; ... The Food and Drug Administration has issued a new warning for atomoxetine HCI concerning the potential for severe liver injury. The drug, indicated for the treatment of attention-deficit hyperactivity disorder in adults and children, has been available since 2002. Two cases of ...
Program aims to treat disruptive physicians.(Practice Trends)
Feb 01, 2005; ... More than 4 years ago, Raymond M. Pomm, M.D., started to see a pattern of disruptive behavior occurring in physicians across Florida, where he is the medical director for the state's Impaired Professionals Program. Hospitals were reporting a range of inappropriate and disruptive ...
Health disparities in minority women vary by ethnic group.(Practice Trends)
Feb 01, 2005; ... WASHINGTON -- More programs need to be developed to address the specific health needs of minority women, Elena Cohen said during the annual meeting of the American Public Health Association. "Racial minorities are projected to make up almost half the population by 2050," said ...
Does Medicaid managed care deliver savings?(Practice Trends)
Feb 01, 2005; ... WASHINGTON -- Medicaid managed care doesn't appear to be living up to its reputation for cost savings, at least not in South Carolina, Walter Jones, Ph.D., said at the annual meeting of the American Public Health Association. Dr. Jones and his colleagues looked at 2 years' worth ...
Plan B decision delay spawns lawsuit.(POLICY & PRACTICE)
Feb 01, 2005; ... An advocacy group is suing the Food and Drug Administration for delaying its decision on over-the-counter status for the emergency contraceptive Plan B (levonorgestrel). "Half of the 3 million pregnancies in the U.S. are unintended each year. By denying women over-the-counter access to a ...
Emergency contraception omitted.(POLICY & PRACTICE)
Feb 01, 2005; ... A coalition of abortion rights advocates and health care professionals is urging the U.S. Department of Justice to add information about emergency contraception to its "National Protocol for Sexual Assault Medical Forensic Examination." The group is asking the Justice Department to revise ...
Misleading ads.(POLICY & PRACTICE)
Feb 01, 2005; ... The Food and Drug Administration recently warned Barr Research that one of its advertisements for the oral contraceptive Seasonale (levonorgestrel/ethinyl estradiol) was misleading consumers. "By omitting and minimizing the risks associated with Seasonale, the TV ad misleadingly suggests ...
HIV prevention.(POLICY & PRACTICE)
Feb 01, 2005; ... Although current law allows for the delivery and financing of HIV-prevention programs through Medicaid and the Ryan White Comprehensive AIDS Resources Emergency Act grants, neither program delivers a significant level of services, according to an analysis by the Kaiser Family Foundation ....
The malpractice debate.(POLICY & PRACTICE)
Feb 01, 2005; ... President Bush hit the road in January to drum up support for his medical liability reform legislation. The president traveled to Illinois to draw attention to the problem of frivolous lawsuits and called on Congress to enact a $250,000 cap on noneconomic damages in medical malpractice ...
Full-time work no protection from medical debt.(Practice Trends)
Feb 01, 2005; ... WASHINGTON -- Medical debt is more common among families with full-time workers than among families whose members work part-time, according to University of Iowa researchers at the annual meeting of the American Public Health Association. "Medical debt can result in credit ...