Volume 3, No. 3, March 2005

News Flash(s) Plan now

IHS Domestic Violence Prevention / Intentional Injuries April 5-8, 2005

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 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:

#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?

From Your Colleagues:

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:

-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:

-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:

-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:

-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:

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 APRIL 2005 MCH EPI GRAND ROUNDS

-Primary Care Discussion Forum: Domestic Violence in AI/AN - Just finished

-Assaults during pregnancy: both immediate and long-term adverse neonatal outcomes

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:

Save the Dates: Upcoming events of interest                

Did you miss something in the last OB/GYN

Chief Clinical Consultant Corner?

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

http://www.ihs.gov/MedicalPrograms/MCH/M/obgyn0205.cfm

Volume 3, No. 2, February, 2005

Abstract of the Month:        page 3

LEEP Treatment Increases Risk of Preterm Delivery in Future Pregnancies

From your colleagues:       page 4
Elaine Locke: Free Job Postings for Indian Facilities on ACOG Career Connection

Sandra Haldane: Web portal linking all HHS.gov sites to breast cancer information

-Women and Medication Safety: Special Journal Issue Is Available Online

Steve Holve: How common is Methamphetamine use in your area? Feb ’05 ICHN available

Jean Howe: Announcing the new Deputy Chief Clinical Consultant

Yolanda Meza: Routine suctioning of meconium-stained before delivery of the shoulders?

Suzan Murphy: Methamphetamine abuse and breastfeeding

Chuck North: Patients with more than one medical condition: How can guidelines help?

-Single digit need to treat (NNT) obesity are remarkable statistics - should spur us on           

Lori de Ravello: Contraceptive Methods Among Women: Quickstats

Judy Thierry: Discourage use of infant car seats as long term sleep environments

-Training for Nursery Room Nurses on Back to Sleep

-Tony Dekker, M.D. New Addiction Medicine Chief Clinical Consultant (CCC)

-The Chief Clinical consultants - are available for your consultation

-What is the definition of ‘preventable or avoidable maternal death?

Judy Whitecrane: It makes it easy for moms to remember:  2 days, 2 weeks, and 2 months

Hot Topics:          

Obstetrics:          page 10

-Severe Preeclampsia and Eclampsia: Systolic Hypertension Is Also Important

-Progesterone Treatment Decreases Preterm Birth Rate

-Ripening of the Cervix and Risk for Later Preterm Birth

-Ginger May Relieve Nausea During Early Pregnancy

-Effect of Episiotomy on Pelvic Floor Weakness

Gynecology:          page 12

-Sexual Function After Hysterectomy

-Screening for Ovarian Cancer: Recommendation Statement

-Limitations of Screening Tests for Asymptomatic Chlamydia

-Abnormal Uterine Bleeding: Surgical or Medical Therapy?

-Endometriosis and Subfertility: Is the Relationship Resolved?

Child Health:          page 13

-Gender bias in child growth evaluations may miss disease in girls

-Recommended Childhood and Adolescent Immunization Schedule, United States, 2005

-Protective effects of firearm storage practices for children

-Dramatic decline in varicella related mortality: Impact of vaccine

-Oral health is looking to better capture the topical fluoride applications

Chronic Illness and Disease:        page 14

-Quality of Care May Decline as Physicians Age

-Chronic disease antecedents arise in utero and infancy

-JAMA Editorialist recommends the "low fad" approach

-Diabetes Mellitus in Women: Adolescence Through Pregnancy and Menopause

-Irritable Bowel Syndrome: Clinical Evidence Concise - BMJ

Features:          page 17

American Family Physician

-Radio-Frequency Endometrial Ablation for Menorrhagia

-Esterified Estrogen and Venous Thrombotic Risk

-Physical Therapy and Stress Urinary Incontinence

-Lactobacillus Does Not Prevent Post-Antibiotic Vaginitis

-Antidepressants and Smoking Cessation

ACOG

Coping With the Stress of Medical Professional Liability Litigation

AHRQ

-Computerized Order Entry Leads to Unwanted Testing- Web M + M - Clinical Ethics

-Women who have given birth only via cesarean are less likely than those with vaginal -deliveries to report stress incontinence

Ask a Librarian

-Infant Mortality:  Bad News, Good News

Breastfeeding

-American Academy of Pediatrics Revised policy on Breastfeeding

CCC Corner Digest

-A compact digest of last month’s CCC Corner - Highlights include:

Depo Provera and bone loss

Oral rehydration solution – reverse transfer of technology

What maneuver is in best in shoulder dystocia?

Midwives serving in Indian Country

Marriage may be good for you

Consumer Reports evaluates condoms, and 16 other contraceptive methods

Bariatric surgery may be a viable treatment option in severe obesity, etc…

Domestic Violence

-Intimate Partner Violence During Pregnancy APRIL 2005 MCH EPI GRAND ROUNDS

-Primary Care Discussion Forum: Domestic Violence in AI/AN - Just finished

-Assaults during pregnancy: both immediate and long-term adverse neonatal outcomes

Elder Care News

-Caring for elders at home: what is the best bath strategy?

-Cultural Diversity at the End of Life: Issues and Guidelines

-Management of Hypertension in Older Persons

-White House Conference on Aging

Family Planning

-Do combination hormonal contraceptives cause weight gain?

-Availability and Use of Publicly Funded Family Planning Clinics

Frequently asked questions

What is the Indian Health policy on use of chaperones?

How does one manage possible exposure to hand foot and mouth disease in pregnancy?

The ‘quad’ second trimester screening test is expensive. Is it worth it?

.How can you predict if a placenta previa will persist based on US at 15-24 weeks?

Hormone Replacement Update

Benefits and Risks of Estrogen in Postmenopausal Women

Information Technology

Free CME from Harvard to 60 of our providers

International Health

Institute for OneWorld Health -- A Not-for-Profit Pharmaceutical Company

MCH Alert

-Entire supplement on sleep in children: Cultural impacts

Medscape

Midwives Corner

Office of Women’s Health, CDC

-Cesarean Rate Highest Ever

Osteoporosis

-“Uncertain Role” of Biochemical Markers Use in Osteoporosis Therapy

-Fracture Protection Lost Five Years After Stopping Hormone Replacement Therapy

-Impact of Intense Exercise on Early Osteopenia in Women

Patient Education

-Painful Menstrual Periods

-Urinary Tract Infections

-Pelvic Floor Muscle Exercises

-Microscopic Hematuria

-Heart Palpitations

Primary Care Discussion Forum

-April 1, 2005: Methamphetamine use in Indian Country

STD Corner

-Men have often been overlooked for routine chlamydia screening

Barbara Stillwater, Alaska Diabetes Prevention and Control

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

-Fit And Fat Not Good Enough

-15-Year Study Shows Link Between Fast Food, Obesity and Insulin Resistance

-How Well Do Adults Follow Prescriptions for insulin?

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

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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.