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Maternal Child

Maternal Child HealthCCC Corner ‹ August 2007
OB/GYN CCC Corner - Maternal Child Health for American Indians and Alaska Natives

Volume 5, No. 7, August 2007

Direct Links to Topic Content

Links to Topic Summaries on This Page

Contents

Abstract of the Month

Within the Hidden Epidemic: STDs and HIV/AIDS Among AI/AN

Read More - Abstract of the Month

From Your Colleagues

Scott Giberson

  • Rapid HIV testing in emergency departments
  • Treating Antiretroviral-Experienced Patients: Case-based CME Program
  • Stop the Silence

James Holsinger Jr, Surgeon General Nominee

  • Physician professionalism for a new century

Favian Kennedy

  • How long does it take Nicotine to reach your brain after inhaling?
  • Northern Plains Tobacco Prevention Project: Spring Newsletter available online

Roberta Ward, Anchorage

  • All you need to know about food safety during pregnancy, FDA

Read More - From Your Colleagues

Back to table of contents

Hot Topics

Child Health

  • Physical Activity Alone May Not Reduce Obesity in Children
  • Obese Young Adults Face High Diabetes Risk
  • Increased risk of autism: associated with parental age and obstetric conditions
  • Physician Prompting Improves Asthma Preventive Care
  • Child adiposity at 3 years: New recommendations for gestational weight gain required?

Chronic Illness and Disease

  • Teratogenicity of SSRIs--serious concern or much ado about little?
  • American Native Suicide
  • Depression: Deadlier in the Spring
  • Rosiglitazone: seeking a balanced perspective
  • How much does exercise help in weight loss?

Obstetrics

  • VBAC: Labor induction outcome dependent on history of vaginal delivery and cervix
  • New Recommendation for Varicella Vaccine: Prenatal Assessment and Postpartum Vaccination
  • Postpartum Labial Adhesions
  • Administration of cefazolin prior to skin incision is superior to cefazolin at cord clamping
  • Simulation-based, hands-on training can identify recurring errors in emergencies

Gynecology

  • LEEP doubles risk of preterm delivery: Patients need to be informed
  • Treatment of bleeding irregularities induced by progestin only contraceptives: Effective
  • Clinic management of early pregnancy failure: Safe, cost-effective
  • Short-term superiority of effectiveness of transobturator tape reported
  • Women in their 50s: fecal incontinence not associated with parity or mode of delivery

Read More - Hot Topics

Back to table of contents

Features

American College of Obstetricians and Gynecologists

  • Management of Herpes in Pregnancy
  • Management of Adnexal Masses
  • Sterilization of Women, Including Those With Mental Disabilities
  • The Role of Cystourethroscopy in the Generalist Obstetrician Gynecologist Practice
  • Adoption

American Family Physician

  • Screening for Breast Cancer: Current Recommendations and Future Directions
  • ACS Recommendations on MRI and Mammography for Breast Cancer Screening
  • Ginger: An Overview
  • CDC Changes Treatment Guidelines for Gonorrhea
  • Headache (Chronic Tension-Type)

Agency for Healthcare Research and Quality

  • Use of high-risk medications by pregnant women is not uncommon
  • GI complaints in young women of low to normal weight may indicate eating disorders
  • Contribution of mammography and therapy to reducing breast cancer deaths from 1975 to 2000
  • PEDS with more knowledge of identifying and managing child abuse more likely to identify abuse
  • Oncologists communicate differently with breast cancer patients: age, race, education, income

Ask a Librarian

  • Scopus ™ : A New Database

Breastfeeding

  • My newborn likes the bottle better: What to do when
  • New IHS Breast feeding Family Support web page: Have pictures to share?
  • Cup feeding not be recommended over bottle feeding as a supplement to breastfeeding
  • Despite the benefits of early breastfeeding, many women find it unexpectedly difficult and painful

CCC Corner Digest

  • A new management category: ‘First Trimester GDM’
  • Control over schedule: Most important predictor of staff work-life balance / burnout
  • Placental problems with previous caesarean delivery: Abruptio, previa
  • Discharge 24 Hours After Vaginal Hysterectomy Safe, Acceptable
  • Guidelines for School-Based STD Screening in Indian Country
  • Malabsorption of Oral Antibiotics in Pregnancy after Gastric Bypass Surgery
  • Seeking and Giving Consultation
  • Long-Term Breastfeeding among Native American Women
  • The failure to protect Indigenous women from sexual violence in the USA
  • Reasons for unprotected intercourse
  • What are the Unnecessary Tests?
  • Improve HIV screening in pregnancy? Preliminary GPRA Related Results
  • Social context of maternal deaths and morbidity
  • Improve the system - Improve the care: Underpinnings
  • Which Indian Health facilities lead the U.S. in national benchmarks?
  • Earlier hormone therapy closer to menopause tended to have reduced CHD risk
  • Adjustable Urethral Slings: Hope for Patients with Complex Incontinence
  • Personal Digital Assistants: Practical Advice for Nurses in 2007
  • Placental cultures and histology poor predictors of infectious amniotic fluid
  • Electronic Health Record (EHR) Implementation: Worth the effort?
  • Fluoroquinolones No Longer Recommended for Gonococcal Infections
  • High rate of DM among indigenous people ?not due to thrifty gene
  • Women’s Early Drinking Problems More Likely to Escape Diagnosis

Domestic Violence

  • IHS-ACF DV Project: Conference CD
  • Family Violence Prevention Funds Screen to End Abuse Video
  • Perceptions of Adult Patients’ History of Child Abuse
  • Study finds connection between teenage violence and domestic violence
  • SANE: Is there a center near you?

Elder Care News

  • Reporting Medical Conditions That May Affect Driving Competency: AAN Guidelines
  • Elderly patients with low health literacy receive little tangible support for their health care needs

Family Planning

  • Waiting until the menses to start hormonal contraceptives: Needless Obstacle
  • One In Four with Unplanned Pregnancy Experience Gaps In BCM Or Do Not Use A Method
  • Little variation in the frequency of reported symptoms among oral contraceptive pills
  • FDA Approves Contraceptive for Continuous Use
  • Implanon and bone mineral density

Featured Web Site

  • Contraception Online
  • Last Special Issue on Methamphetamine in Indian Country: Now online
  • Wrong link for National Sexual Violence Resource Center

Frequently asked questions

  • Can oral or sublingual misoprostol be used for postpartum hemorrhage?
  • How should you greet your patients?
  • How can I better counsel my patient to adhere to therapy?
  • Should patients use sweat lodges during pregnancy?
  • What is recommended about peyote use in pregnancy

Indian Child Health Notes - July 2006 Highlights

  • Lactose intolerance in infants, children, and adolescents
  • Influenza activity, 2006-7
  • Inhalant abuse
  • Fatal Injuries Among Children by Race and Ethnicity

Information Technology

  • Integrated case management software application release
  • iCare Training

International Health

  • Maternal survival redux: a view from Malawi - Failure of justice
  • Malarial drugs in early pregnancy
  • Malaria Preventive Therapy Useful for Pregnant Women Despite Resistance
  • Multivitamins should be considered for all pregnant women in developing countries

MCH Alert

  • Who needs liquor stores when parents will do?
  • Home visiting associated with decreased infant death
  • Resident fathers’ prenatal behaviors, pregnancy intentions and involvement with infants
  • Office based motivational interviewing to prevent overweight in children
  • Association between confidential services and parent adolescent communiciation

MCH Headlines

  • Taking a harder line on blood transfusions
  • Are you interested in the bigger picture of Indian Health care? Join a listserv
  • Do you know your state's teen-driving-laws?
  • Program for At-Risk Infants and Mothers Recognized
  • Adolescent Pregnancy Prevention Knowledge Path

Medical Mystery Tour

  • Nausea and Vomiting in Pregnancy

Medscape

  • Public Health Impact of HPV Vaccination: Aligning Policy With Science
  • Premenstrual Dysphoric Disorder: A New Treatment Paradigm
  • Hormone Therapy Safer in Younger Women? A Best Evidence Review

Menopause Management

  • Hormone Replacement Therapy Linked to Ovarian Cancer 
  • Menopause Linked to Elevated Fasting Plasma Glucose Levels in Nondiabetic Women
  • Exercise Plus Isoflavones May Improve Body Composition in Postmenopausal Women
  • Relation of Cortisol Levels and BMD Among Premenopausal Women With Depression 
  • New Guidelines Issued for Treatment of Vaginal Atrophy: NAMS

Midwives Corner

  • Midwifery’s approach to pre-labor SROM supported by professional organization’s journal
  • Let it pulse—the cord that is
  • Upright position during the first stage of labor did not contribute towards a shorten labor
  • Cesarean rate can be reduced by health workers in analyzing and modifying their practice
  • Midwives’ perspectives improves risk assessment in early pregnancy

Navajo News

  • The evolution of management of Actinomyces on a Pap report

Nurses Corner

  • Health Care Without Harm: Nurses Take Action
  • A Complementary Approach to Pain Management

Office of Women’s Health, CDC

  • One Test. Two Lives Campaign
  • Human Papillomavirus: HPV Information for Clinicians

Oklahoma Perspective

  • Preconception Health of Women Delivering Live-Born Infants — Oklahoma, 2000–2003

Osteoporosis

  • Dietary calcium is better than supplements at protecting bone health
  • Calcium, Vitamin D supplements may help prevent weight gain in postmenopausal women
  • Down to the Bone: Issues in the Maintenance and Evaluation of Bone Health: CME

Patient Education

  • Heavy Periods (Menorrhagia)

Perinatology Picks

  • Anemia in Pregnancy Briefly: The Common to the Unusual – including IV therapy
  • Contingent sequential screening is the most cost-effective form of Down syndrome
  • Aspirin during pregnancy could reduce risk of pre-eclampsia
  • Abnormal Doppler is the best predictor of adverse perinatal outcome in IUGR
  • Changes in prepregnancy BMI between the first and second pregnancies and risk of LGA

Primary Care Discussion Forum

  • Chronic Renal Disease: How is Primary Care Effected? Andy Narva, September 1 st

STD Corner

  • Updated Screening for Chlamydial Infection Recommendations, USPSTF
  • Sexually active women benefit from HPV vaccine
  • HPV vaccine against human papillomavirus to prevent anogenital diseases
  • Vulvar Vaccinia Infection After Sexual Contact with a Military Smallpox Vaccinee
  • A Series on Adolescence Sexual Activity

Barbara Stillwater, Alaska Dibaetes Prevention and Control

  • -(How) can we prevent type 2 diabetes?
  • Prenatal Omega 3 Fatty Acid Consumption Improves Infant Problem Solving
  • More Women than Men Having Mid-Life Stroke
  • Diabetes Reduces Life Expectancy by 8 Years
  • GDM represents a significant risk factor for future DM development regardless of ethnicity

Women’s Health Headlines

  • Why do Native American women have the poorest 5-year survival rate for breast cancer?
  • Motivational Interviewing training and Promoting Motivational Incentives: NIDA
  • Aiming Higher: Results from a State Scorecard on Health System Performance
  • Women's emotional health and wellness materials
  • Native American Rehabilitation Association: Children, Youth & Family Services Director

Read More - Features

Back to table of contents

What’s new on the ITU MCH web pages

Q. Should patients use sweat lodges during pregnancy?
http://www.ihs.gov/MedicalPrograms/MCH/M/Sfaqs.cfm#sweatLodge

New Breast feeding Family Support web page: Have pictures to share?
http://www.ihs.gov/MedicalPrograms/MCH/M/bfFamily.cfm


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

Native Women’s Health and MCH Conference

3rd Annual American Indian and Alaska Native Long Term Care Conference

I.H.S. / A.C.O.G. Obstetric, Neonatal, and Gynecologic Care Course

  • September 16 – 19, 2007
  • Denver , CO
  • Contact Yvonne Malloy at 202-863-2580 or YMalloy@acog.org

Second National Summit on Preconception Health and Health Care

Back to table of contents

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

June/July 2007 OB/GYN CCC Corner

Volume 5, No. 6, June/July 2007

Abstract of the Month

  • A new diagnostic category: ‘First Trimester GDM’

From Your Colleagues

Gordon Belcourt

  • FTC Releases Reports on Cigarettes and Smokeless Tobacco

Ben Garnett

  • Control over schedule: Most important predictor of provider work-life balance and burnout

Scott Giberson

  • Names-Based Reporting for All U.S. States by End of 2007
  • Medicare Part D still has to make improvements for HIV patients and providers
  • U.S. AIDS Drug Assistance Program Waiting Lists growing
  • HRSA’s Special Projects of National Significance
  • Behavioral Health HIV/AIDS Collaborative Training

Roberta Ward

  • FDA Proposes New Warning Labeling About Suicidal Thinking / Behavior In Young Adults

Hot Topics

Obstetrics

  • Placental problems with previous caesarean delivery: Abruptio, previa
  • Late Pregnancy Bleeding (ALSO serialization)
  • Admission for nephrolithiasis during pregnancy: 80% risk of preterm delivery
  • Postpartum Depression Screening: Recommendations for Practice
  • Fetal or infant death a traumatic event for parents: Assist grieving parents

Gynecology

  • Discharge 24 Hours After Vaginal Hysterectomy Safe, Acceptable
  • Laparoscopic and fixed multiple dose methotrexate most effective for ectopic
  • Extended Oral Contraceptives Decrease Premenstrual Symptoms
  • Fluoroquinolones No Longer Recommended for Treatment of Gonococcal Infections
  • Interventions to Reduce Hemorrhage During Myomectomy for Fibroids

Child Health

  • Forty percent of 3-month-olds watch TV, DVDs, or videos
  • Guidelines for School-Based STD Screening in Indian Country
  • Urinary symptoms in adolescent females: STI or UTI?
  • Sexually transmitted infections in preadolescent children
  • Adjustments in opthalmia neonatorum (ON): Gonorrhea in pregnancy

Chronic Illness and Disease

  • Malabsorption of Oral Antibiotics in Pregnancy after Gastric Bypass Surgery
  • Sleeping Poorly ... and Maybe Depressed: Co morbidity in Formal Sleep Studies
  • Barriers to Smoking Cessation Services in Underserved Communities
  • Management of Hypertriglyceridemia
  • AHA Guidelines for CVD Prevention in Women Focus on Lifetime Risk Factors

Features

American College of Obstetricians and Gynecologists

  • Endometrial ablation. ACOG Practice Bulletin
  • Seeking and Giving Consultation
  • Disruptive Behavior
  • Patents, Medicine, and the Interests of Patients

American Family Physician

  • Therapies for Overactive Bladder- Nonpharmacologic vs. Anticholinergic
  • Exercise Is an Effective Intervention in Overweight and Obese Patients
  • Evaluation and Treatment of Acute Low Back Pain
  • Restless Legs Syndrome: Pramipexole

Agency for Healthcare Research and Quality

  • AHRQ breastfeeding evidence review

Ask a Librarian

  • Quick Check for Drugs and Lactation

Breastfeeding

  • Long-Term Breastfeeding among Native American Women
  • Systematic review and meta-analysis confirms long-term positive effects of breastfeeding
  • FAQs - Breastfeeding and maternal illness
  • RCT of very early mother-infant skin-to-skin contact and breastfeeding status

CCC Corner Digest

  • Social Change Might Save More Lives Than Medical Advances
  • New HPV Brochures for Clinicians, CDC
  • More stillbirths after previous cesarean delivery
  • Young women with CIN: Any treatment increases preterm delivery - LEEP
  • Public Opinion vs. Science Concerning Sex Education
  • New Guideline for Screening Mammography for Women 40 to 49 Yrs
  • Premature Rupture of Membranes, Practice Bulletin
  • Quick Check for Drugs and Lactation
  • Breastfeeding - it’s all about synergy
  • Extended OCP Regimen; Acceptable Breakthrough Bleeding
  • Must See Website: Indian Health Service HIV-AIDS Program
  • Ethics of medicine with economically vulnerable populations: 2nd in series
  • Do you walk around your vehicle before getting in it? You should
  • Which Indian Health facilities lead the U.S. in national benchmarks?
  • Emergence of a range of nonhormonal treatments for vasomotor symptoms
  • Ultrasound affects mice brains in negative ways
  • BTL: Nearly 1/2 of women under 25 yo request information on reversal
  • Two summer programs for high school students
  • Calcium Supplementation May Not Benefit Healthy Children
  • Preconception counseling for women with DM and HTN: Which meds?
  • Electronic Health Record (EHR) Implementation: Worth the effort?
  • HIV/AIDS among AI/AN Fact Sheet
  • New recommendations for gestational weight gain may be required
  • Weaving it all together: 2007 Behavioral Health Conference

Domestic Violence

  • The failure to protect Indigenous women from sexual violence in the USA
  • Adverse sequelae of physical and sexual abuse in adulthood
  • WH Pregnancy and DV education online session
  • Domestic Violence and Your Patient's Health: Asking the Right Questions

Elder Care News

  • Gynecologic Assessment of the Elderly Patient

Family Planning

  • Reasons for unprotected intercourse
  • Adolescent sexual behavior: Strategies for reducing pregnancy and childbearing
  • Effect of Medicaid Family Planning Expansions on Unplanned Births
  • Guidelines for Selection of Contraception in Women with Rheumatic Diseases

Featured Web Site

  • MCHB Launches Web Site to Increase Awareness of Perinatal Depression

Frequently asked questions

  • What are the Unnecessary Tests done in Obstetrics and Gynecology?

Indian Child Health Notes

  • Acute pain relief in children
  • Pertussis: Secular Trends in the United States
  • Persistence of racial disparities in fatal injuries to very young children

Information Technology

  • How can we improve HIV screening in pregnancy? Preliminary GPRA Related Results

International Health

  • Social context of maternal deaths and morbidity

MCH Alert

  • Progress toward meeting Healthy People 2010 Maternal, Infant, and Child objectives
  • Mental disorders and nicotine dependence among pregnant women

MCH Headlines

  • Improve the system - Improve the care: Underpinnings
  • Drive It Right Kits
  • Have you heard of: ‘the Baby bottle tooth decay germ’ aka Streptococcus mutans? 
  • Newly completed Pregnancy and Postpartum Quitline Toolkit
  • K-12 Oral Health Education Curriculum

Medical Mystery Tour

  • Which Indian Health facilities lead the entire U.S. in obstetric benchmarks?

Medscape

  • Urinary Tract Infections: A Primer for Clinicians
  • Management of Breast Cysts Revisited
  • CDC Issues New Treatment Recommendations for Gonorrhea 
  • Optimizing Once-Daily Antiretroviral Regimens for Treatment-Naive Patients With HIV

Menopause Management

  • Earlier hormone therapy closer to menopause tended to have reduced CHD risk
  • Low dose transdermal estradiol gel effective for postmenopausal symptoms
  • Updated Statement on Hormone Therapy 

Midwives Corner

  • Ultrasound affects mice brains in negative ways: First, do no harm

Navajo News

  • Adjustable Urethral Slings Offer Hope for Complex Incontinence Problems

Nurses Corner

  • Personal Digital Assistants: Practical Advice for Nurses in 2007

Office of Women’s Health, CDC

  • CDC’s Pregnancy Information Center
  • Lead Exposure Among Females of Childbearing Age

Oklahoma Perspective

  • Cesarean Delivery on Maternal Request

Osteoporosis

  • Let’s put DEXA and other radiation risks into perspective
  • Cortisol Levels and BMD Among Premenopausal Women With Depression 

Patient Education

  • Hypertriglyceridemia: What You Should Know
  • Low Back Pain

Perinatology Picks

  • Placental cultures and histology poor predictors of infectious status of the amniotic fluid
  • Free beta-HCG outperforms intact HCG in a multimarker protocol
  • Forum: Periodontal Health and Birth Outcomes - HRSA MCHB
  • PREMAG inconclusive, but improvements of outcome are of potential significance
  • Insulin Glargine Use During Pregnancy Not Linked to Fetal Morbidity

Primary Care Discussion Forum

  • Electronic Health Record (EHR) Implementation: Worth the effort?

STD Corner

  • Guidelines for School-Based STD Screening in Indian Country
  • Fluoroquinolones No Longer Recommended for Treatment of Gonococcal Infections
  • Let's talk about HIV counseling and testing – New Facilitators' guide
  • Does your lab have capacity to culture N gonorrhoeae for treatment failures? 
  • Urinary symptoms in adolescent females: STI or UTI?

Barbara Stillwater, Alaska Dibaetes Prevention and Control

  • High rate of diabetes among indigenous people not due to thrifty gene
  • Aspirin may be less effective heart treatment for women than men
  • Cholesterol Could be Key to Treating Fetal Alcohol Syndrome
  • Apples during pregnancy could reduce asthma risk in offspring

Women’s Health Headlines

  • Women’s Early Drinking Problems More Likely to Escape Diagnosis
  • Women and Health Coverage: The Affordability Gap
  • WomenHeart Symposium 2007
  • Save the Dates: Upcoming events of interest page 59
  • What’s new on the ITU MCH web pages page 59
  • Implementation and Use of an Electronic Health Record within IHS

Save the Dates: Upcoming events of interest

What’s new on the ITU MCH web pages

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 MCHdiscuss.cfm

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.

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