OB GYN News back issues from May 2005:
Maryland poised for premium relief.(News)
May 01, 2005; ... For the past few months, Maryland physicians have been waiting for premium relief that was promised by the state's politicians. That relief may now be on the way after the state legislature passed an emergency bill to put into effect a rate stabilization fund for medical ...
CMS sees 4.3% drop in Medicare reimbursements: cut is expected due to rising medical costs.(News)(Centers for Medicare and Medicaid Services)
May 01, 2005; ... Physicians could face a 4.3% cut in their Medicare reimbursements next year due to the rising cost of medical spending, Mark McClellan, M.D., administrator for the Centers for Medicare and Medicaid Services, announced during a press briefing sponsored by CMS. The cut would come ...
New treatment approved for endometriosis pain.(News)
May 01, 2005; ... Subcutaneous medroxyprogesterone acetate has been approved for the treatment of endometriosis-related pelvic pain. It is the first new treatment to be approved for this indication in 15 years. Depo subQ provera 104 (DMPA-SC), which contains 104 mg medroxyprogesterone acetate, ...
Panel gives mixed recommendations on silicone implants.(News)
May 01, 2005; ... GAITHERSBURG, MD. -- After more than a decade, silicone gel-filled breast implants could soon be back on the market and widely available for women undergoing reconstructive, augmentation, and revision surgery. Last month, the Food and Drug Administration's General and Plastic ...
Planned C-section reduces second twin's risk.(News)
May 01, 2005; ... LOS ANGELES -- Planned cesarean sections could cut the risk of perinatal death of twins by 75%, according to a review of 8,073 twin births resulting in the delivery of 16,146 babies. Most perinatal deaths were due to intrapartum anoxia during vaginal delivery of second-born ...
Soft cheese made with raw milk risky in pregnancy.(News)(Brief Article)
May 01, 2005; ... Soft white cheeses made with raw milk present a health risk, the U.S. Food and Drug Administration has warned. Such cheeses can cause listeriosis, brucellosis, salmonellosis, and tuberculosis, and they pose a particular risk to pregnant women, newborns, older adults, and those with ...
A view from across the chasm.(LETTERS)(Letter to the Editor)
May 01, 2005; ... I found the Guest Editorial by plaintiff's attorney James S. Bostwick humorous at best ("The Chasm Between Physicians, Lawyers," March 15, p. 6). Its theme is essentially this: We lawyers and you doctors are not so different, so we should respect each other and get along. But I ...
We pay dearly for 'human mistakes'.(LETTERS)(Letter to the Editor)
May 01, 2005; ... James S. Bostwick, J.D., states most physicians are "very competent, caring physicians who just made a human mistake" ("The Chasm Between Physicians, Lawyers," Guest Editorial, March 15, 2005, p. 6). Exactly. Where does it say that when this happens, people are ...
Vaccinate and educate.(LETTERS)(Brief Article)
May 01, 2005; ... Dr. Jerome A. Klobutcher argues that the availability of a human papillomavirus vaccine might cause an increase in rates of sexually transmitted infections because HPV-vaccinated individuals may feel impervious to STIs and may therefore engage in risky sexual behaviors ("Will HPV Vaccine ...
The rest of your exercises.(LETTERS)(Brief Article)
May 01, 2005; ... I enjoyed the recent article on exercise and would like to add a few more tips that I share with my patients ("Adding Exercise to Your Routine," The Rest of Your Life, March 15, 2005, p. 38): * Make it fun. I recommend the physical education department at an adult extension ...
How to run effective office meetings.(GUEST EDITORIAL)(Editorial)
May 01, 2005; ... "What do you discuss at office meetings?" a colleague wrote me recently. "We used to hold them monthly, and I never thought we accomplished anything. So now we don't bother anymore." It's a comment I hear fairly often. Doctors and employees alike frequently dread staff ...
Two-drug BV regimen urged in pregnancy.(Obstetrics)(Bacterial vaginosis)
May 01, 2005; ... HOUSTON -- Bacterial vaginosis in pregnant women requires a two-drug regimen to reduce the incidence of low-birth-weight and preterm babies, Dale Brown Jr., M.D., said at a conference on vulvo-vaginal diseases sponsored by Baylor College of Medicine. Dr. Brown, chair of clinical ...
Study shows increasing prevalence of GDM.(Obstetrics)(gestational diabetes mellitus)(Brief Article)
May 01, 2005; ... Gestational diabetes is on the rise. The finding is not surprising given the dramatic increases in obesity and type 2 diabetes in recent years, but until now few studies have examined trends in gestational diabetes mellitus (GDM) in populations other than the Pima Indians, reported Dana ...
Keep priorities straight when treating eclampsia.(Obstetrics)
May 01, 2005; ... NEW YORK -- Eclampsia has become increasingly rare in Western countries, but it still occurs in 1 in 2,000-3,500 pregnancies--and obstetric clinics must be prepared to treat it, Baha M. Sibai, M.D., said at an obstetrics symposium sponsored by Columbia University and New York Presbyterian ...
Warn patients about heart risks after preeclampsia: preeclampsia is a manifestation of underlying silent disease that will develop later into a clinical condition.(Obstetrics)
May 01, 2005; ... NEW YORK -- Women who develop preeclampsia should be counseled about the risk in subsequent gestations and strategies to contain these risks, according to Baha M. Sibai, M.D. In addition, more general implications about health in later life should be discussed with the patient, ...
VBAC attempts, failures linked to maternal age.(Obstetrics)
May 01, 2005; ... LOS ANGELES -- Older women are less likely to attempt vaginal birth after cesarean delivery and more likely to fail when they do, Sindhu K. Srinivas, M.D., said at the annual meeting of the Society for Gynecologic Investigation. Dr. Srinivas of the University of Pennsylvania, ...
Indomethacin, cervical length evaluation up birth weight in twins.(Obstetrics)(Brief Article)
May 01, 2005; ... RENO, NEV. -- The rate of very low birth weight in twin pregnancies can be reduced safely with a plan of care that includes cervical length evaluation at 23-25 weeks and long-term indomethacin therapy for women with a short, funneled cervix, Theodore Peck, M.D. reported in a poster session ...
VBAC is viable option after fetal demise, study suggests.(Obstetrics)
May 01, 2005; ... LOS ANGELES -- Vaginal delivery is a viable option for most women who've had a previous cesarean section and experience intrauterine fetal demise in a subsequent pregnancy, Mildred M. Ramirez, M.D., and her colleagues reported at the annual meeting of the Society for Gynecologic ...
3-D ultrasound reveals 'tremendous detail'.(Obstetrics)
May 01, 2005; ... NEW YORK -- Three-dimensional ultrasound represents an emerging advance in imaging with important applications in obstetrics, Alfred Z. Abuhamad, M.D., said at an obstetrics symposium that was sponsored by Columbia University and New York Presbyterian Hospital. The ability to ...
Aggressive Tx less cost effective for low-birth-weight infants.(Obstetrics)
May 01, 2005; ... RENO, NEV. -- From a societal perspective, the most cost-effective course of action for impending preterm delivery at 24 weeks' gestation is an unwillingness on the part of the physician to perform cesarean section, Gianni Cazan-London, M.D., and colleagues reported in a poster presented ...
Children of preeclamptic mothers at risk for pulmonary hypertension.(Obstetrics)(Brief Article)
May 01, 2005; ... SAN DIEGO -- Children born to preeclamptic mothers are more likely to have pulmonary hypertension, compared with children born from uncomplicated pregnancies, results from a small study have demonstrated. The finding provides "the very first evidence that preeclampsia leaves a ...
Fetal genetic disorders test being developed.(Obstetrics)
May 01, 2005; ... GRAPEVINE, TEX. -- Researchers are attempting to develop a first-trimester cervical swab test to detect fetal genetic disorders. While the test still is under development, if proven effective, it could provide noninvasive, earlier prenatal screening and possibly eliminate the ...
Patients who have had invasive procedures more open to carrier testing.(Obstetrics)
May 01, 2005 ... GRAPEVINE, TEX. -- Patients referred for genetic testing are more likely to agree to carrier status testing if they already have accepted an invasive procedure. A study of 3,131 patients referred for genetic testing found that individuals were more likely to accept cystic ...
Couples accept prenatal genetic testing with CMA: there was a 71% acceptance rate of chromosome microarray analysis in those undergoing amnio or CVS.(Obstetrics)
May 01, 2005 ... GRAPEVINE, TEX. -- Chromosome microarray analysis may play a vital role in the diagnosis of genetic disorders prenatally, Christine Eng, M.D., commented during a meeting that was sponsored by the American College of Medical Genetics. Although chromosome microarray analysis (CMA) ...
Treatment urged for all pregnant HIV patients.(Obstetrics)
May 01, 2005; ... HOUSTON -- Pregnant women should be treated for human immunodeficiency virus infections even if they are asymptomatic with normal CD4 counts and have a low viral load, said Hunter A. Hammill, M.D. Pregnancy itself does not affect the course of the disease. The woman's condition ...
Maternal morbidity tied to prolonged MgS[O.sub.4] tocolysis.(Obstetrics)(Brief Article)
May 01, 2005; ... RENO, NEV. -- Increased maternal morbidity is significantly associated with magnesium sulfate tocolysis that lasts longer than 48 hours, a retrospective study has demonstrated. Investigators compared 78 women who received MgS[O.sub.4] tocolysis for longer than 48 hours with 77 ...
Risk of major complication greater with VBAC.(Obstetrics)(vaginal birth after a cesarean)
May 01, 2005; ... LOS ANGELES -- Women who choose vaginal birth after a cesarean section have a 2.5 times greater risk of major complications than if they were to opt for a second elective cesarean section, according to a poster presentation at the annual meeting of the Society for Gynecologic ...
Manometry offers useful diagnostic information.(Gynecology)
May 01, 2005; ... FORT LAUDERDALE, FLA. -- Anal manometry is a useful tool for the evaluation of patients with abnormal anorectal physiology, including those presenting with constipation, fecal incontinence, proctalgia, or rectal prolapse, according to Dana R. Sands, M.D. Manometry provides ...
Patients need not stop clopidogrel before surgery.(Gynecology)(Brief Article)
May 01, 2005; ... WASHINGTON -- Patients on long-term clopidogrel treatment don't need to stop the drug before surgery, Richard E. Kuntz, M.D., said at a meeting that was sponsored by the Cardiovascular Research Institute at Washington Hospital Center. "There is growing experience that it's safe ...
Uterosacral vaginal vault suspension advocated: expert says it's his preferred treatment for older patients who have apical prolapse and low risk of recurrence.(Gynecology)
May 01, 2005; ... FORT LAUDERDALE, FLA. -- Uterosacral vaginal vault suspension is the treatment of choice for patients with apical prolapse and a low risk of recurrence, Matthew Barber, M.D., said at a symposium on pelvic floor disorders that was sponsored by the Cleveland Clinic Florida. "This ...
Rectovaginal fistulas can pose treatment challenges.(Gynecology)
May 01, 2005; ... FORT LAUDERDALE, FLA. -- Obstetric trauma is the most common cause of rectovaginal fistulas, Eric G. Weiss, M.D., said at a symposium on pelvic floor disorders sponsored by the Cleveland Clinic Florida. Reported series suggest such trauma accounts for 50%-90% of fistulas, said ...
Tamoxifen alone discouraged as adjuvant Tx.(Gynecology)
May 01, 2005; ... HOLLYWOOD, FLA. -- An aromatase inhibitor, either alone or after tamoxifen therapy, is better than tamoxifen alone for the long-term prevention of breast cancer in postmenopausal women with invasive breast cancer, according to updated treatment guidelines from the National Comprehensive ...
Study identifies novel breast cancer prognostic markers.(Gynecology)
May 01, 2005; ... ATLANTA -- New data suggest that the Notch signaling genes--Notch1 and Jagged1--are potential novel prognostic markers for breast cancer, Michael Reedijk, M.D., FACS, reported at a symposium sponsored by the Society of Surgical Oncology. "Patients expressing high levels of ...
Blacks just as likely as whites to pursue BRCA test.(Gynecology)(breast cancer)
May 01, 2005; ... GRAPEVINE, TEX. -- African American women are almost as likely to pursue genetic testing for breast cancer as are white women, North Carolina researchers report. "There is a perception in the genetic counseling field that African Americans are less likely to pursue genetic ...
Possible genetic basis for racial disparities in endometrial Ca.(Gynecology)
May 01, 2005; ... Differences in gene expression may be at least partially responsible for the differences in endometrial cancer survival rates and tumor aggression seen between black and white women, results of two studies suggest. Many previous studies have ascribed racial disparities in ...
Be aware of low bone density in the young.(Gynecology)
May 01, 2005; ... NEW ORLEANS -- Bone health experts offered their share of helpful clinical insights at the annual meeting of the International Society for Clinical Densitometry. Here are some of the highlights: Low Bone Density in the Young Low bone density is not ...
Partial-breast irradiation can provide good cosmetic results.(Gynecology)
May 01, 2005; ... ATLANTA -- When partial-breast irradiation was delivered with the MammoSite balloon catheter system after lumpectomy, the majority of patients showed good to excellent cosmetic results and had no local recurrences of cancer at 2 years, according to the first analysis of MammoSite Registry ...
Simvastatin trial suggests statins may treat PCOS.(Gynecology)(polycystic ovarian syndrome)
May 01, 2005; ... LOS ANGELES -- Simvastatin lowered testosterone levels by 41%, normalized gonadotropin levels, and reduced cardiovascular risk factors in a small, randomized, controlled trial, suggesting that statins may be a potential treatment for polycystic ovarian syndrome. "Statins would ...
Medical management is first step in treating constipation: thorough history, exam are important for each case, and every complaint of bleeding and obstruction should be investigated.(Gynecology)
May 01, 2005; ... FORT LAUDERDALE, FLA. -- Constipation is a common complaint, and the causes for this condition are varied, Dana R. Sands, M.D., said during a symposium on pelvic floor disorders that was sponsored by the Cleveland Clinic Florida. In a survey of more than 10,000 people, nearly ...
Options emerge for fecal incontinence, but results uncertain for long term.(Gynecology)
May 01, 2005; ... FORT LAUDERDALE, FLA. -- Anterior overlapping sphincter repair is commonly performed in patients with fecal incontinence secondary to an anterior defect in the sphincter complex, but long-term outcomes are questionable. In the short term, 50%-75% of patients achieve good control ...
For vulvar contusions, cold packs often suffice.(Gynecology)
May 01, 2005; ... NEW YORK -- A vulvar injury in a child is likely to heal without major intervention, even if a large hematoma is present and the patient complains of severe pain, David Muram, M.D., said at a gynecology conference sponsored by Mount Sinai School of Medicine. Typical vulvar ...
One expert's opinion: Burch colposuspension still has its place.(Gynecology)
May 01, 2005; ... FORT LAUDERDALE, FLA. -- Burch colposuspension isn't the newest or fanciest of the ever-expanding surgical options for treating urinary stress incontinence, but it does have a solid place in the surgical armamentarium for this condition, Matthew Barber, M.D., said at a symposium on pelvic ...
Aerosolized microbes may pose contamination hazard in OR.(Gynecology)(operating room)
May 01, 2005; ... TUCSON, ARIZ. -- Nasopharyngeal shedding of aerosolized microbes may be a vector for perioperative contamination in the operating room, Charles E. Edmiston Jr., Ph.D., reported at the annual meeting of the Central Surgical Association. Barriers to contamination, such as surgical ...
OCs called 'fabulous' adjunctive Tx for acne.(Gynecology)(Oral contraceptives)
May 01, 2005; ... NEW ORLEANS -- Oral contraceptives are a safe and effective treatment for acne but are best used as adjunct therapy, Julie C. Harper, M.D., reported at the annual meeting of the American Academy of Dermatology. Topical retinoids such as adapalene, tazarotene, and tretinoin ...
Physicians urged to adopt office hysteroscopy.(Gynecology)
May 01, 2005; ... SANTA FE, N.M. -- One hundred thirty-five years after Pantaleoni performed the first hysteroscopy, Stephen M. Cohen, M.D., urged physicians to move the diagnostic procedure from the operating room to the office. New technology makes office hysteroscopy more effective, less ...
Cervical screening guidelines are evolving for adolescents.(Gynecology)
May 01, 2005; ... NEW YORK -- With revisions to the consensus guidelines for the management of women with cervical cytological abnormalities expected in 2006, experts are taking a hard look at ways the guidelines might be tailored to be more age specific. Much less is known about the natural ...
OC use not linked to depression in adolescents.(Gynecology)(Oral contraceptive)
May 01, 2005; ... LOS ANGELES -- Oral contraceptive pills do not cause mood swings or depression in most adolescents. On the contrary, overall, it appears that oral contraceptives increase positive mood and decrease negative mood, Mary A. Ott, M.D., said at the annual meeting of the Society for Adolescent ...
Outpatient PID treatment dicey with adolescents.(Gynecology)(Brief Article)
May 01, 2005; ... LOS ANGELES -- Adolescents treated for pelvic inflammatory disease are not likely to complete a 14-day course of antibiotics nor return for 72-hour evaluation, according to a study designed to see if implementation of a rigorous institutional protocol could improve care. The ...
Embolotherapy eases pelvic congestion: in 131 women who had the procedure, 85% reported improvement at a mean 45 months' follow-up.(Gynecology)
May 01, 2005; ... Pelvic congestion syndrome is a real disease entity that affects up to 16% of American women, and can be successfully treated with transfemoral embolotherapy, according to researchers who presented data at the annual meeting of the Society of Interventional Radiology. About 10% ...
Treating pelvic congestion eases leg venous reflux pain.(Gynecology)
May 01, 2005; ... Pelvic pain related to pelvic venous congestion often occurs in women with symptomatic lower extremity venous reflux. Treating ovarian venous incompetence with embolotherapy can not only reduce associated pelvic pain, but can also significantly reduce the pain associated with lower ...
Don't overlook diagnosis of mullerian agenesis.(Gynecology)
May 01, 2005; ... PORTLAND, ORE. -- Some cases of apparent imperforate hymen are actually mullerian agenesis, and that possibility should be in the differential diagnosis, David M. Lee, M.D., said at a conference sponsored by the North Pacific Pediatric Society. He described one case of a ...
Congress goes beyond hill for health care Rx.(Practice Trends)
May 01, 2005; ... WASHINGTON -- Sen. Ron Wyden (D-Ore.) says that the answer to America's health care problem does not lie with Congress--at least, not initially. "I spent 2 years studying what went wrong in the Clinton debacle," he said at a meeting sponsored by America's Health Insurance ...
Controversial abstinence site.(POLICY & PRACTICE)(www.4parents.gov)(Brief Article)
May 01, 2005; ... A new government Web site aimed at helping parents talk to their teens about sex and abstinence is drawing fire from reproductive-rights advocates. The Web site, www.4parents.gov, features interactive tools, statistics, and conversation starters to enable parents to discuss sex and ...
EC legislation fails.(POLICY & PRACTICE)(Brief Article)
May 01, 2005; ... Colorado Governor Bill Owens (R) vetoed legislation last month that would have required all hospitals in his state to provide rape victims with information about the availability of emergency contraception. Gov. Owens said he objected to the legislation because it would not have provided ...
Contraceptive access.(POLICY & PRACTICE)(Brief Article)
May 01, 2005; ... Elsewhere in the states, Illinois Governor Rod Blagojevich (D) filed an emergency rule last month clarifying that state pharmacies that sell contraceptives must accept and fill such prescriptions without delay. The action comes after complaints filed against a licensed Illinois pharmacy ...
STDs among lesbians.(POLICY & PRACTICE)(sexually transmitted diseases)(Brief Article)
May 01, 2005; ... Lesbians and bisexual women who participated in a focus group reported that the need to protect against sexually transmitted diseases (STDs) is primarily a concern for heterosexual women, according to a study published in the March issue of Perspectives on Sexual and Reproductive Health ...
Prenatal testing legislation.(POLICY & PRACTICE)(Brief Article)
May 01, 2005; ... New federal legislation aims to improve the information that expectant parents receive when a prenatal test is positive for conditions such as Down syndrome and spina bifida. The Prenatally Diagnosed Condition Awareness Act (S. 609/H.R. 1353) is sponsored by Sen. Sam Brownback (R-Kan.) and ...
Group raises concerns about Medicare Part B.(Practice Trends)
May 01, 2005; ... WASHINGTON -- Members of a Medicare physician advisory group have reservations about the Centers for Medicare and Medicaid Services' proposed new program for paying for physician-administered outpatient drugs under Medicare Part B. Medicare currently pays physicians the average ...
Hospital midwives seek right to certify false labor: EMTALA's guidelines leave it up to the hospital to determine whether doctors should examine the patient.(Practice Trends)
May 01, 2005; ... WASHINGTON -- Federal regulations should recognize the expertise of nurse-midwives in certifying false-labor cases in the hospital, Deanne Williams, a certified nurse-midwife, testified at a meeting of the Department of Health and Human Services technical advisory group on the Emergency ...
Industry expert: health savings accounts engage consumers in care.(Practice Trends)
May 01, 2005; ... Health savings accounts and other consumer-directed insurance products can help lower health care utilization and encourage better health behaviors, according to an industry expert. Consumers "begin to recognize that the behaviors that they have can lead to a health outcome that ...
Exercises for type 2 diabetes patients.(EXERCISE RX)
May 01, 2005; ... Type 2 diabetes is becoming increasingly common in the United States across all ages and ethnicities. This kind of diabetes, which is not dependent on insulin, can be controlled in many people by better attention to exercise and weight management. Weight control is important for ...
HHS focuses on flu pandemic preparedness plan.(Clinical Rounds)
May 01, 2005; ... BALTIMORE -- Acknowledging that "flu has a huge news factor," Bruce Gellin, M.D., spelled out the federal influenza pandemic preparedness plan at a biodefense research meeting sponsored by the American Society for Microbiology. The Department of Health and Human Services' draft ...
Many high-risk patients got flu shots this year.(Clinical Rounds)
May 01, 2005; ... WASHINGTON -- Despite the severe shortage of influenza vaccine this winter, the elderly, young children, and others at risk were able to find and receive shots, officials said at the National Immunization Conference sponsored by the Centers for Disease Control and Prevention. ...
Pepper extract provides relief for pruritus ani.(Clinical Rounds)
May 01, 2005; ... NEW ORLEANS -- A specially compounded ointment containing 0.006% capsaicin extract is effective at relieving recalcitrant pruritus ani, as well as pruritus of the vulva and scrotum, Timothy Berger, M.D., reported at the annual meeting of the American Academy of Dermatology. ...
Study quantifies injury to bowel from NSAID use.(Clinical Rounds)(Brief Article)
May 01, 2005; ... A study of 41 people aged 22-66 years found evidence of small-bowel injury on capsule endoscopy in 71% of those taking a nonsteroidal anti-inflammatory drug for at least 3 months. By comparison, 10% of control patients not taking NSAIDs had such injuries--a highly significant ...