-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Adolescent pap guidelines From: Rafael Haciski (haciski@earthlink.net) Wed Oct 25 17:02:33 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Andrew Folley: "Re: Hydroxyprogesterone" Previous message: Barbara Nicol: "Re: Adolescent pap guidelines" In reply to: Barbara Nicol: "Re: Adolescent pap guidelines" Next in thread: Zachariah Newton: "Re: Adolescent pap guidelines" That's where the "art of medicine" kicks in. You choose whom to omit from the testing based on your feeling of trust, pt compliance, etc. My preference would be to get the testing, trust not withstanding (studies show that 30% of pts lie outright, another 30% give white lies, leaving only 40% who are truthful) and be (as I always am, especially in the younger population) very conservative in treatment (meaning biopsies are rare and small, no whacking off of the cervix, or random 4 quadrant biopsies) I also stay away from cryo of the cervix as I have seen all too often retraction of the SCJ into the canal post cryo, making subsequent follow-up extremely difficult, if not impossible, leading to unnecessary cones. -- Rafael Haciski MD FACOG Palmetto, FL On Oct 25, 2006, at 5:38 PM, Barbara Nicol wrote: > Married, monogamous, both partners claim no other partners - > actually I think she is quite low risk, although I see that the > basis for that opinion wasn't in my original presentation. I > grant you that we get lied to daily by most of our patients, and we > therefore have to treat them all that way - yet I'm inclined to > trust this situation. > > Even if it weren't so, the ACOG opinion recommended against early > pap screening not because HPV isn't common - it is - but because > severe disease is so rare and overtreatment of HPV that will > spontaneously clear is quite common. > > My immediate reaction was of course to get out the pap materials; I > have the same training you do, but I'm trying to think this through > a bit more. Is there an actual benefit here? > > - Barb Nicol, M.D. Next message: Andrew Folley: "Re: Hydroxyprogesterone" Previous message: Barbara Nicol: "Re: Adolescent pap guidelines" In reply to: Barbara Nicol: "Re: Adolescent pap guidelines" Next in thread: Zachariah Newton: "Re: Adolescent pap guidelines"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Thu Oct 2 04:54:36 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.