Volume 3, No. 4, April 2005

News Flash(s) Plan now

17th Annual IHS Research Conference and International

Meeting on Inuit and Native American Child Health:                 April 29-May 1, 2005

ACOG / IHS – Total Women’s Health and Neonatal Course:      June 19-23, 2005

New Perinatology Corner Module - Should you be using the quad screen?

Prenatal Genetic Screening – Serum and Ultrasound

New Feature: 

CCC Corner Digest - A print friendly digest of the CCC Corner that can be mailed to you, or 

your colleagues. Just send your address to nmurphy@scf.cc

Direct Links to Topic Content: Abstract of the Month | From Your Colleagues | Hot Topics | Features

Links to Topic Summaries:

Topic Summaries Abstract of the Month From Your Colleagues Hot Topics Features Miss Something?

Contents:

Abstract of the Month:

Human Papillomavirus - ACOG Practice Bulletin

NUMBER 61, APRIL 2005

From Your Colleagues:

Burt Attico: DMPA, Bone Mineral Density, and Teens: Recent and Reassuring Data

James Galloway: A previously under recognized disparity in CVD mortality exists for AIAN

Steve Holve: April Indian Child Health Notes: Highlights

Lori de Ravello: Reproductive Health 2005 - Call for Abstracts

Phil Smith: Commodity or Public Work? Two Perspectives on Health Care

Judy Thierry:

-School wellness (nutrition and PE focused) policies 

-Improve your effectiveness in home visits, family and new parent interactions

-Fitness in Kids by State

-SAMHSA Releases Garret Lee Smith Requests for Applications

-Send me your translation of "Make every mother and child count" in your tribal language

-The population you serve may be in a county represented by the National Children’s study

Hot Topics:

Obstetrics:

-Gestational Diabetes Rising at Alarming Rate in U.S. Women

-Ginger: effective and safe treatment in managing nausea and vomiting in pregnancy.

-Treatment for BV or T. vaginalis does not reduce of PTD or adverse perinatal outcomes

- Obstetric Anal Sphincter Injury Persists Over Long Term

- Effects of Discontinuing Epidurals in Late Labor: Cochrane Briefs

Gynecology:

-Antibiotics for Recurrent Urinary Tract Infections: Cochrane for Clinicians

-Two Criteria May Be Sufficient to Diagnose Bacterial Vaginosis

-Vaginal Tape vs. Surgery for Stress Incontinence

- Polycystic ovarian syndrome: marked differences in diagnosis and management

- Laparoscopic Radiofrequency Thermal Ablation Safe and Effective for Fibroids

Child Health:

-FASlink

- Prevalence of Overweight Among Children and Teenagers, by Age Group

Chronic Illness and Disease:

-Can Patients with Cancer Postpone Death for Important Events?

-Impact of Community-Based Yoga on Quality of Life

- Antioxidant Vitamin Supplements and Cardiovascular Disease Risk Reduction

- Comparison of Short-Term Treatments for GERD

- Parenteral dihydroergotamine for acute migraine headache: a systematic review

Features:

AFP:
-Raloxifene Reduces the Risk of Breast Cancer

-Trial of Labor Carries Small but Real Increase in Risk

-Bariatric Surgery Effective for Long-Term Weight Loss

ACOG:
-Appropriate Use of Laparoscopically Assisted Vaginal Hysterectomy

-Endometriosis in Adolescents - ACOG Committee Opinion No. 310

AHRQ:

-Compare and Contrast: AHRQ Web M + M

-Use of certain antidepressants may increase risk of hip fractures among older patients

Ask a Librarian
-Access to the NIH Library web resources availability being explored for Indian Health staff

Breastfeeding:
-Decline in breastfeeding rates: 2003 Ross breastfeeding stats

-Section on Breastfeeding: American Academy of Pediatrics

CCC Corner Digest:

Highlights include

-Use ‘Opt out’ HIV screening methods during pregnancy in Indian Country

-Routine Population-Wide HIV Screening May Be Cost-Effective

- What is the Indian Health policy for HIV screening in pregnancy?

-Early epidural provided shorter labor and did not increase cesarean delivery

-How many deliveries does a provider need to maintain active privileges?

-What is the significance of the latest NEJM article on trial of labor after cesarean?

-Vaginal pH for Diagnosing Status of Menopause

-Pregnancy, Birth, and Abortion Rates Decline for Teenagers Aged 15-17 Years

- Emergency OB Drills: The Phoenix Indian Medical Center Experience

Domestic Violence:

-IHS Child Abuse Project: Training Deadline extended

-The Truth About Rape

Elder Care News:

-Helping elderly drivers stay on the road: Signs of an unsafe driver

-One-time screening for abdominal aortic aneurysm: B Recommendation

Family Planning:

-‘The patch’: Trouble getting it on your formulary?

-One half of women who express desire for postpartum sterilization do not get procedure.

-Post-vasectomy semen analysis: are men following up?

Frequently asked questions:

-In pregnancy, is a one hr. screening result > 185 or > 200 mg/dL diagnostic for GDM?

-Are there alternatives to the oral glucose tolerance test? A breakfast tolerance test?

-What is the value of biochemical markers in diagnosis or treatment of osteoporosis?

-What are some of the issues involved with vacuum assisted deliveries?

-What are the issues involved in adoption of an American Indian or Alaska Native child? 

Hormone Replacement Update:

-Modifiable Lifestyle Factors That May Affect Hot Flashes

Information Technology:

-Free Native American Continuing Education online

-EHR INTRODUCTORY COURSE ANNOUNCEMENT

-IHS Technology Conference June 27 - July 1, 2005 - Save the Dates!! 

International Health:

-Patients’ Beliefs About Racism, Preferences for Physician Race, Satisfaction With Care

-Spectrum of dysfunctional organizational cultures can be diagnosed and managed

MCH Alert

-Ethical implications of health literacy and the steps needed to promote it

-Suicidal behavior in the family and adolescent risk behavior

Medscape

Midwives Corner

-Midwifery care of poor and vulnerable women, 1925-2003

Office of Women’s Health, CDC:

-Methicillin-resistant Staphylococcus aureus Toxic Shock Syndrome

-Host a Women’s Health Fair - National Women's Health Week of May 9th 2005

Osteoporosis:

-Osteoporosis and Fracture Prevention in the Indian Health System

-Osteoporosis: Strategies for Screening and Intervention

Patient Education:

-Pregnancy: Keeping Yourself and Your Baby Healthy

-What Can You Do To Make Rheumatoid Arthritis (RA) Less Debilitating?

Primary Care Discussion Forum:

-Methamphetamine use in Indian Country – still can join in

STD Corner :

-Natural mentoring relationships and adolescent health: evidence from a national study

-Syphilis Elimination Effort (SEE) Toolkit

-Outbreak of Infectious Syphilis in Alaska--Follow-up

-HIV Infection in Alaska, 2004

Barbara Stillwater, Alaska Diabetes Prevention and Control:

-A Decline in Life Expectancy in the US

-Dark Chocolate Improves Insulin Sensitivity/Resistance and Blood Pressure

-Yogurt Promotes Fat Loss

-Physical Activity Increases Insulin Sensitivity 44%

-Knowing One's Hgb A1c Can Improve Results

What’s new on the ITU MCH web pages:

-New Perinatology Corner module – Should you be using quad screen?

        FREE CEUs, CME  Prenatal Genetic Screening – Serum and Ultrasound

-Osteoporosis in Indian Health - A Systems Approach

-Osteoporosis: Strategies for Screening and Prevention

Save the Dates: Upcoming events of interest                

Did you miss something in the last OB/GYN

Chief Clinical Consultant Corner?

The March 2005 OB/GYN CCC Corner is available at:

http://www.ihs.gov/MedicalPrograms/MCH/M/obgyn0305.cfm

Volume 3, No. 3, March, 2005

Abstract(s) of the Month:                                                                                         page 3

#1 Use ‘Opt out’ HIV screening methods during pregnancy in Indian Country

Routine Population-Wide HIV Screening May Be Cost-Effective

Q. What is the Indian Health policy for HIV screening in pregnancy?

#2 Early epidural provided shorter labor and did not increase cesarean delivery                  page 5

From your colleagues:                                                                           page 7

Burt Attico: 3 items on Pre-eclampsia from BMJ; Physicians May Be Ignoring Guidelines for Gestational Weight Gain

Katy Ciacco-Palatianos: Health Literacy Fellowship

Terry Cullen: IHS Domestic Violence Prevention / Intentional Injuries Course

Sandra Dodge: How many deliveries does a provider need to maintain active privileges?

Mara Fusfield: What are some good resources to develop guidelines from? 

Jim Galloway: Women’s Health Cardiology Resources Available

Steve Holve: What are some of the issues in adoption of an American Indian child?

March Indian Child Health Notes

Elaine Locke: Job Postings on ACOG Career Connection

Kathleen Masis: U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy

Kate McCarthy: The Public’s Health and the Law in the 21st Century:  4th Annual Partnership

Neil Murphy: Take two Clomid and call me in the morning: A true story

Jane Powers: IHS Child Abuse Project Website has just been updated

Robert Stockburger: Locum tenens availability

Scott Sunde:  What is the significance of the latest NEJM article on trial of labor after cesarean?

Judy Thierry: 

-How would you like to be the Czarina of Women’s Health in Indian Country?

-Good FAS web site

-U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy

-Potential Economic Benefits of the National Children's Study

-How does your state rank in fitness in Children?

Judy Whitecrane:  Native American Women's Health: Leadership for Change Conference

Hot Topics:

Obstetrics:                                                                                                                                      page 12

-Misoprostol decreases oxytocin use largely due to labor within the ripening period

-Overweight and obese women with single cephalic term pregnancies have increased risk

-Fast-Absorbing Sutures Better for Postpartum Perineal Repair

-Severe Preeclampsia and Eclampsia: Systolic Hypertension Is Also Important

-Perinatal HIV Transmission Now Most Likely to Occur in Utero

-And more

Gynecology:                                                                                                                                  page 15

-Vaginal pH for Diagnosing Status of Menopause

-Surgical or Medical Treatment for Refractory Menorrhagia?

-Symptom Experiences of Chronically Constipated Women With Pelvic Floor Disorders

Child Health:                                                                                                                                  page 16

-Pregnancy, Birth, and Abortion Rates Decline for Teenagers Aged 15-17 Years

-Are children born after assisted reproductive technology at increased risk for adverse health outcomes?

Chronic Illness and Disease:                                                                                                              page 16

-Low-dose aspirin can prevent cardiovascular disease in older women

-Antiplatelet Therapy and Anticoagulation in Patients with Hypertension

-Cardiovascular risk higher among patients with migraine

-Control of Cardiovascular Risk Factors - Diabetic Women Compared to Men

-Insulin Monotherapy vs. Combination Therapy

-And more

Features:                                                                                                                                page 18

AFP

-Does Melatonin Improve Sleep in Asthmatic Women?

ACOG

- Pregestational diabetes mellitus, ACOG Practice Bulletin No. 60

AHRQ

-Follow-up of newborns after hospital discharge: Critical to preventjaundice and other problems

Ask a Librarian

- Salmonella from Pet Turtles-Again

Breastfeeding

-Resurgence of kernicterus attributed primarily to early discharge of newborns

CCC Corner Digest

-LEEP Treatment Increases Risk of Preterm Delivery in Future Pregnancies

-New OB/GYN Deputy Chief Clinical Consultant IHS

-Progesterone Treatment Decreases Preterm Birth Rate

-Radio-Frequency Endometrial Ablation for Menorrhagia

-Hormonal Contraceptives and Weight Gain

-Walk 2000 More Steps a Day and Never Gain Another Pound

Domestic Violence

-Intimate Partner Violence During Pregnancy

-Homicide is the 2nd leading cause of injury-related deaths among pregnant and women

-An easy palm-based downloadable domestic violence assessment tool

Elder Care News

-Palliative care and hospice training in Anchorage, Alaska - May 10-12, 2005

Family Planning

-Women continue to die from unintended pregnancy

-Effects of Contraception on Bone Mineral Density

Frequently asked questions

-What is the Indian Health policy for HIV screening in pregnancy?

-Should I prescribe Depo Provera as a long term agent for more than 2 years?

-What preventive therapy is recommended for patients at high risk for pre-eclampsia?

-My patient is not doing too well with her hormone replacement therapy. Options?

-What are some of the opportunities to provide care in Indian women’s health?

Hormone Replacement Update

-Estrogen with or without progestin should not be prescribed for relief of incontinence

Information Technology

-Computerized order entry system may increase risk of medication errors

-Intranet-based prenatal record improves communication

-UpToDate Version 13.1 Now Available; Includes Pediatrics

-Tribal Connections

-Native Web.org: Resource Database / Health

International Health

-Women, inequality, and the burden of HIV

-Physician Missions With Doctors Without Borders:

-UN Predicts Global Population of 9.1 Billion by 2050

MCH Alert

-Task Force presents recommendations for reducing violence

Medscape

-Genital Herpes and Pregnancy: Preventing Neonatal Transmission

Midwives Corner

- Emergency OB Drills: The Phoenix Indian Medical Center Experience

-Concern over rising cesarean delivery rate: ACNM approaches Congress

-Alternative Medicines' Popularity Prompts Concern

Office of Women’s Health, CDC

-Spread the Word - National Women's Health Week, May 8-14, 2005

Osteoporosis

-How best to start good bone health?

-Clinical Rules Don't Predict Osteoporosis in Women

Patient Education

-Consumer Health: Indian Health

-What Should I Know About Cholesterol?

-Vertigo-A Type of Dizziness

Primary Care Discussion Forum

-April 1, 2005: Methamphetamine use in Indian

STD Corner

-Women's Sexual Health and Sexually Transmitted Diseases – May 13, 2005

-Expedited treatment of sex partners on persistent gonorrhea or chlamydial infection

Barbara Stillwater, Alaska Diabetes Prevention and Control

-Postmenopausal Women and Visceral Fat Loss through Exercise

-Minding the gender gap: The divergence between men's and women's health research

-Omitting breakfast on insulin sensitivity and fasting lipid: Deleterious effects

-Beginning Exercise Routine Later in Life Still Reduces Heart Disease, Diabetes risk

-Blood Pressure, Insulin Sensitivity Linked to Waist Circumference

What’s new on the ITU MCH web pages                                                                                page 28

The past CCC Corners are archived at:

http://www.ihs.gov/MedicalPrograms/M C H/M/OBGYN02.cfm#top

The CCC Corner is good way to inform ITU providers about recent updates, while decreasing the number of e-mail messages.

Let me know if you want to add something to next month's CCC Corner at nmurphy@SouthCentralFoundation.com

or 907 729 3154 (with voicemail)

*The opinions expressed in the OB/GYN CCC Corner are strictly those of the authors, and not necessarily those of the Indian Health System, or the author of this newsletter. If you have any comments, please share them by joining the Primary Care Discussion Forum where this topic was recently discussed. To join the Primary Care Listserv, click on ‘Subscribe' here http://www.ihs.gov/MedicalPrograms/MCH/M/MCHdiscuss.asp

Back to table of contents

OB/GYN

Dr. Neil Murphy is the Obstetrics and Gynecology Chief Clinical Consultant (OB/GYN C.C.C.). Dr. Murphy is very interested in establishing a dialogue and/or networking with anyone involved in women's health or maternal child health, especially as it applies to Native or indigenous peoples around the world. Please don't hesitate to contact him by e-mail or phone at 907-729-3154.