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OB/GYN CCC Corner - Maternal Child Health for American Indians and Alaska Natives

Volume 3, No. 8, August, 2005

New Features This Month

CCC Corner Digest - Print friendly Digest of the CCC Corner 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:
 

Contents

Abstract of the Month

Open access can work for any type of practice. It is the wave of the future

Read More - Abstract of the Month

From Your Colleagues

Sandy Haldane:

  • New IHS Women's Health and Advanced Practice Nurse Consultants
  • Public health approach to suicide prevention in an American Indian Tribal Nation
  • Healthy Native Communities Fellowship accepting applications for 2006
  • Cardiovascular Disease: The Kaw Nation and other minority populations
Ruth Lagerberg: Fetal cardiac echogenic foci on routine obstetric sonogram
Sheila Mahoney: Cord clamping: early versus delayed
Chuck North: Advances in Indian Health, 6th Annual
Miles Rudd: Relative value of physical exam of the breast as a screening tool
Jennifer Retsinas: Uterine fibroids: uterine artery embolization
Phil Smith: New Outreach: Updated educational materials about the Prescription Drug Benefit
Judy Thierry:
  • Many girls are at a literal standstill
  • Trends and Regional Differences: Latest available
  • Great resource: MCH Alert
  • "Weaving WIC into Our Traditional Families"
  • Child Protection Handbook 2004, IHS/BIA
Carol Treat: Brochure/support for sugar substitute and gestational DM

Read More - From Your Colleagues

Back to table of contents

Hot Topics

Obstetrics

  • Trial of Labor After Cesarean: Evidence based guidelines
  • Time of birth and risk of neonatal death: 12-16% increase in mortality at night
  • Parietal peritoneum closure during cesarean delivery decreases adhesions
  • Aerobic training increases exercise capacity, overcoming negative effects of pregnancy
  • Pre-pregnancy obesity: Increasing excess risk of fetal death with advancing gestation
  • Screening asymptomatic, low-risk pregnant women for hepatitis C virus not cost effective
  • …and more

Gynecology

  • Ovarian conservation benefits survival in women when undergoing hysterectomy
  • Hysterectomy Associated With Earlier Onset of Menopause
  • One in ten adult women perceives urinary incontinence to be barrier to exercise
  • Reclosure of the disrupted laparotomy wound is safe and successful in over 80%
  • Cervical cytology screening and evaluation - Clinical Expert Series
  • …and more

Child Health

  • AAP Releases Report on Excessive Sleepiness in Adolescents
  • High-Grade Cervical Lesions Progress in Adolescents at Similar Rate as in Adults
  • Reducing the Risk of SIDS Through Community Partnerships: Editorial
  • Fetal Alcohol Spectrum Disorders
  • Foreign Body Ingestion in Children
  • …and more

Chronic Illness and Disease

  • Guidelines for Improving Vaccination Rates Among High-Risk Adults, CDC
  • Bariatric Surgery Resolves Comorbid Conditions
  • Tobacco Cessation: Kicking the Habit in Alaska
  • Existing coronary heart disease is undiagnosed in half of women who have a first heart attack
  • …and more

Read More - Hot Topics

Back to table of contents

Features

AFP

  • Aspirin Prevents Stroke, but Not Cardiovascular Disease, in Women
  • Intensive Diet-Behavior-Physical Activity Program for Obesity in Children
  • NSAIDs Alone or with Opioids as Therapy for Cancer Pain: Cochrane for Clinicians
  • Health Literacy: The Gap Between Physicians and Patients

ACOG

  • Management of Endometrial Cancer ACOG Practice Bulletin
  • Health Care for Homeless Women
  • Two Major Women's Health Groups Call Attention to a Leading Reproductive Cancer

AHRQ

  • Despite revised guidelines, most OB/GYNs over-screen low-risk women for cervical cancer
  • Physician supply increases in States with caps on malpractice: greatest impact in rural areas
  • Women respond differently to medications than men, should be proactive about medication use
  • Efforts to help improve care for underserved patients: address communication and respect

Ask a Librarian

  • The Known and the Unknown - Clinical Evidence Summarized

Breastfeeding

  • Fentanyl During Labor May Impede Establishment of Breastfeeding

Case Manager’s Corner

  • Stress and verbal abuse in nursing

CCC Corner Digest, Last Month's Digest

Highlights include

  • USPSTF recommends that clinicians screen all pregnant women for HIV
  • Simple Educational Handouts - Kat Franklin, Sante Fe
  • Elective Repeat Cesarean Delivery May Negatively Affect Neonatal Outcomes
  • Benzocaine spray does not offer effective pain control during per endometrial biopsy
  • OCPs are more effective than placebo for relieving dysmenorrhea in adolescents
  • Death rates for CVD are higher among AI/AN than other U.S. groups
  • Pregnancy and Depression: What Women Need to Know
  • What is an RN Case Manager?
  • 2 positive blood cultures found in a postpartum patient with a fever
  • Benefits of low-fat dairy products on weight loss
  • What Makes a Drug Over the Counter (OTC)? The case of Plan B
  • Active management of the third stage of labor among American Indian women
  • Racial / Ethnic Disparities in Infant Mortality: No significant improvement in AI / AN
  • Use the talk / sing test during exercise during pregnancy
  • Here is a good web based calcium screening tool
  • Can chlamydia be stopped?

Domestic Violence

  • Developing Leaders in Violence Prevention - Travel funding available
  • Cultural Competency for Non-Native Advocates: Ending Violence Against Native Women Training
  • The 2006 PREVENT Institute: Developing Leaders in Violence Prevention

Elder Care News

  • Toward optimal screening strategies for older women: Should cost matter the most?

Family Planning

  • Over-The-Counter Sales of Emergency Contraception Do Not Increase Unsafe Sex

Frequently asked questions

  • Q. Is there any help or assistance with infertility through the Indian Health System?

Indian Child Health Notes

  • Pediatric sleep apnea - you know more than you think
  • Sleepy teenagers - they are not just slugs, they're victims of biology
  • TB in AI/AN is down, but not out

Information Technology

  • VHA Pharmacy Benefits Management (PBM) Strategic Healthcare Group page
  • Free Online CME from Thomson Healthcare

International Health

  • Increase the interdisciplinary and transdisciplinary focus in primary health care research
  • Unite For Sight's 3rd Annual International Health Conference

MCH Alert

  • New edition of the Women's Health Data Book Released

Medical Mystery Tour

  • Follow-up 2 positive blood cultures found in a postpartum patient with a fever: The answer

Medscape

  • Eating Disorders and Body Image Distress in Women at Midlife - CME

Menopause Management

  • USPSTF Hormone Therapy for the Prevention of Chronic Conditions in Postmenopausal Women

Midwives Corner

  • Please help us build the Midwives Indian Health Patient Education Resources page
  • Women and Health Care: A National Profile

Navajo News

  • Is the patch more dangerous than the pill?

Office of Women’s Health, CDC

  • Publications and Materials - Many Women's Health Topics

Oklahoma Perspective

  • Who do you contact in Oklahoma for MCH issues?

Osteoporosis

  • Ultralow-Dose Estradiol and BMD in Postmenopausal Women

Patient Education

  • Brochure/support for sugar substitute and gestational DM
  • What to Do If Your Child Swallows Something?

Perinatology Picks

  • Glyburide for gestational diabetes in a large managed care organization
  • Overweight and obese in gestational diabetes: the impact on pregnancy outcome
  • Glargine use in pregnancy?

Primary Care Discussion Forum

  • Appropriate use of narcotics for chronic non-malignant (non-cancer) pain

STD Corner

  • Condom effectiveness for prevention of Chlamydia trachomatis infection
  • The percentage of male teens who reported ever having sexual intercourse
  • Prenatal screening and treatment needed to identify women with asymptomatic chlamydia

Barbara Stillwater, Alaska Dibaetes Prevention and Control

  • Women the stronger gender? Men more carbohydrate intolerant / less physical endurance
  • Teen Inactivity Leads to Obesity for Girls
  • Relationship of Obesity and Fitness Level to Cardiovascular Risk and Diabetes
  • New CERTs Program Brief on Women's Health Is Available

Read More - Features

Back to table of contents


What’s new on the ITU MCH web pages

Q. Is there any help or assistance with infertility through the Indian Health System?

http://www.ihs.gov/MedicalPrograms/MCH/M/documents/Infertility81105.doc

Prescription Opioids: Good, bad, and ugly, Sidney Schnoll MD PHD

Eve Espey M.D. - Breast Cancer Screening

2005 IHS/ACOG Obstetric, Neonatal and Gynecologic Care Postgraduate Course

There are several upcoming Conferences

and Online CME/CEU resources, etc . . .

and the latest Perinatology Corners (free online CME from IHS)

. . . or just take a look at the What’s New page

Save the Dates: Upcoming events of interest

Treatment and Management of HIV Infection in the United States

  • September 15-18, 2005
  • Atlanta , Georgia
  • 16.5 Credits, Univ. of California @ San Francisco / VA Administration
  • First domestic conference of its kind. Mark your calendar
  • http://www.USHIVconference.org/

National Indian Health Board: Youth and Tradition - Our Greatest Resources

Centering Pregnancy - Group Prenatal Care

Advances in Indian Health, 6 th Annual

Native Peoples of North America HIV/AIDS Conference

ACOG 2006 Annual Clinical Meeting (ACM)

Back to table of contents

Did you miss something in the last OB/GYN Chief Clinical Consultant Corner?

July 2005 OB/GYN CCC Corner

Volume 3, No. 7, July, 2005

Abstract of the Month

USPSTF recommends that clinicians screen all pregnant women for HIV

From your colleagues

Katherine Palatianos: Brachial plexus injury: Permanent in 1 of every 10,000 deliveries
Terry Cullen: Native Peoples of North America HIV/AIDS Conference
Kat Franklin: Simple Patient Education Handouts
Sandy Haldane: Science and Leadership: Women With Heart Disease
Steve Holve: July 2005 Indian Child Health Notes
Harvey Huddleston: Interested in part-time or locums tenens
Phil Smith: Encouraging Onsite Mammography: New mammography standards for HSP
Roy Teramoto: HPV and Cervical Cancer: An Update on Prevention Strategies
Judy Thierry:
-Useful atlas for injury causes of AIAN morbidity and mortality when citing stats
-Ribavirin pregnancy registry - seeking enrollment Hepatitis C
-Rural/Frontier Women's Health Coordinating Centers (RFCCs) RFP is Out
-RFP for SIDS Training and Outreach in the AI/AN Communities
-Mean length stay for delivery hospitalization among AI/AN

Hot Topics

Obstetrics
-Treatment of GDM reduces perinatal morbidity, may improve health-related quality of life
-Elective Repeat Cesarean Delivery May Negatively Affect Neonatal Outcomes
-Indomethacin tocolysis not associated with increased risk of adverse neonatal outcomes
-Diabetic Retinopathy Occurs in Pre-Diabetes : Implications in GDM
-No benefit to hospitalization in women with arrested preterm labor and intact membranes
…and more

Gynecology
-High Intake of Calcium, Vitamin D May Reduce the Risk of Premenstrual Syndrome
-Pediatric Torsed Ovaries May Be More Salvageable Than Previously Reported
-Benzocaine spray does not offer effective pain control during per endometrial biopsy
- US exam of the perineum after childbirth improves diagnosis of anal sphincter tears
-Short-term results of the TVT procedure encouraging, but long-term is disappointing
…and more

Child Health
-OCPs more effective than placebo treatment for relieving dysmenorrhea in adolescents
-How to get your child off the couch? Evidence based physical activity for youth
-Children’s adaptation to a fat reduced diet
-Adolescent Pregnancy: Current Trends and Issues: American Academy of Pediatrics
-Suicide Prevention among AI/AN Adolescents Evaluated: Public Health Approach
…and more

Chronic Illness and Disease
-Death rates for CVD are higher among AI/AN than other U.S. groups (AHRQ)
-Each Pound of Weight Lost May Reduce Knee Load per Step Fourfold
-Most parents want to quit smoking but they need assistance. Learn how to help
-European study confirms red meat link with bowel cancer
-Self-Monitoring in Type 2 Diabetes Not on Insulin: A waste of money?
…and more

Features

American Family Physician
-Three Days of Ciprofloxacin Better for Uncomplicated UTI
-Gonorrhea
-Low-Molecular-Weight Heparin for Initial Treatment of Venous Thromboembolism
-Follow-up After Surgically Treated Breast Cancer

American College of Obstetricians and Gynecologists
-Hemoglobinopathies in Pregnancy
-Pregnancy and Depression: What Women Need to Know

Agency for Healthcare Research and Quality
-Breast cancer risk and the effects of tamoxifen prophylaxis among women in primary care
-Acupuncture appears promising for the treatment of depression during pregnancy

Ask a Librarian
A new quick and easy way to find best clinical articles: PubMed Clinical Queries

Breastfeeding
-1st week of life critical window for ingestion of maternal "diabetic" breast milk
-Medication Use During Pregnancy and Breastfeeding
-Breastfeeding may be associated with a reduced risk of atherosclerosis

Case Manager’s Corner
What is an RN Case Manager?

CCC Corner Digest
-Have you had your ‘morning after’ antiretroviral cocktail yet?
-Why Prozac is okay during pregnancy and not for breastfeeding…. and why Zoloft is
-Slight delay in umbilical cord clamping better for preterm infants
-Transdermal contraceptive promising for reducing bleeding and delaying menses
-Risk of Autism: Parent, Pregnancy, and Birth Factors Found Possible Associations
-Women with pregnancy induced HTN: Increased risk for metabolic syndrome later
-Urinary Incontinence in Women: Practice Bulletin NUMBER 63, JUNE 2005
-AskUs Live! Available to all Indian Health Staff
-Being overweight may increase the risk of becoming pregnant while using OCs
-Follow-up: Answer to the May Mystery Question
-Screening for Genital Herpes: USPSTF
-West Nile Virus in Women
-Appropriate use of narcotics for chronic non-malignant (non-cancer) pain
-Screening for Gonorrhea: USPSTF Recommendation Statement
-Any new solutions to Nausea and Vomiting in Pregnancy?
-New Perinatology Corner Free CEU / CME Module

Domestic Violence
-Women who declined survey regarding DV at risk for adverse pregnancy outcome
- Juvenile Justice Issues - Coordinating Council - Key Programs Advancing Youth

Elder Care News
-2nd Annual Alzheimer's Disease and Dementia Update Conference 
-Secondary Prevention of Coronary Heart Disease in Elderly Patients
-Nursing Guide to Prevention / Management of Falls in Patients in Long-term Care Settings
-2005 ASCP Foundation Interdisciplinary GeroPsych/Behavioral Disorders Traineeship
-Prevention of Falls in Older Patients

Family Planning
Low-dose oral contraceptives increase cardiovascular disease risk

Frequently asked questions
-Do you know of any good links to simple patient education?
-What are some good paper based women’s resources for Advanced Practice Nurses?

Information Technology
Computer-assisted cognitive therapy effectively treats depression: RCT

International Health
Medical Investigations of Homicides of Prisoners of War in Iraq and Afghanistan
Association between subsidized housing and children’s nutritional status

MCH Alert
Health Care Insurance (SCHIP) Improves racial / ethnic health disparities

Medical Mystery Tour
2 positive blood cultures found in a postpartum patient with a fever

Medscape
Mammography: Is Early Detection Really the Best Form of Prevention?

Menopause Management
-Benefits of low-fat dairy products on weight loss
-Testosterone Patch Helps Surgically Menopausal With Hypoactive Sexual Desire: RCT
-SSRIs Ineffective for the Management of Hot Flashes
-Hormone replacement therapy plummeted after findings from the WHI trial (AHRQ)

Midwives Corner
-USPSTF Issues Revised Guidelines for Routing Gonorrhea Screening
-What Makes a Drug Over the Counter (OTC)? The case of Plan B
-The Nursing Mothers Herbal
-Current Resources for Evidence-Based Practice
-National Indian Health Board Conference - Oct. 16-19, 2005, Phoenix

Navajo News
-Active management of the third stage of labor among American Indian women
-Annual Navajo Area Women’s Health Provider Meeting
-Upcoming ALSO Course in Shiprock

Office of Women’s Health, CDC
Racial / Ethnic Disparities in Infant Mortality: No significant improvement in AI / AN

Oklahoma Perspective
Patient should be capable of talking or singing during exercise during pregnancy

Osteoporosis
-Here is a good web based calcium screening tool
-Benefits and limitations of quantitative heel ultrasound in screening for osteoporosis

Patient Education
-Simple Patient Education Handouts
-Endometriosis, from WebMD Health
-Guide to Endometriosis - More Printable Patient FAQ's

Primary Care Discussion Forum
August 1, 2005 Appropriate use of narcotics for chronic non-malignant (non-cancer) pain

STD Corner
-Can chlamydia be stopped?
-Chlamydia trachomatis infection in a colposcopy unit

Barbara Stillwater, Alaska Diabetes Prevention and Control
Waist Circumference Can Exclude Insulin Resistance and Identify Those At Greatest Risk

Save the Dates: Upcoming events of interest

What’s new on the ITU MCH web pages
-Simple Patient Education Handouts
-Active management of the third stage of labor among American Indian women
-Atlas of Heart Disease and Stroke in AI/AN

Back to table of contents

Past CCC Corners

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

 

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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.

This file last modified: Friday January 6, 2006  1:22 PM