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Re: Bilateral dermoidsFrom: Elrod, Darryl G Maj 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)Fri Mar 9 17:26:24 2007
KOONINGS, PAUL P. MD; PLATT, LAWRENCE D. MD; WALLACE, ROBERT MD Institution
>From the Department of Obstetrics and Gynecology, University of Southern Title Incidental Adnexal Neoplasms at Cesarean Section.[Article] Source Obstetrics & Gynecology. 72(5):767-769, November 1988. Local Message DGMC Library Owns Some Years -- Check journal list or MEDWEB for exact dates Abstract A 10-year retrospective review was conducted of incidental adnexal neoplasms found at the time of cesarean section. During the 10-year period between July 1,1976 and June 30, 1986, 17,902 cesarean sections were performed at Women's Hospital of the Los Angeles County/University of Southern California Medical Center. Adnexal neoplasms were identified with an incidence of one neoplasm per 197 cesarean sections. When a neoplasm is discovered during surgery, conservative surgery is recommended. (C) 1988 The American College of Obstetricians and Gynecologists Here is the only journal article I could find on management of adnexal masses found incidentally at c-section. I don't have access to the full article, but it looks like this article suggests conservative surgery at c-section. Glen //SIGNED// D. Glen Elrod, Maj., USAF, MC Obstetrician/Gynecologist Chief of Obstetrics 48 MDOS/SGOBO RAF Lakenheath, England Telephone DSN: 314-226-8130 Comm: +44 (0) 1638 52 8130 Notice of Confidentiality Under the Privacy Act of 1974, you must safeguard all information reflected on this e-mail and, if applicable, all attachments. Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI 37-132, AFI 33-219, and PL 93-579" This e-mail message including any attachments is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Any questions pertaining to disclosure should be directed to the privacy officer. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Friday, March 09, 2007 11:58 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Bilateral dermoids My gray hairs are smiling at your comments! Garry I don't think
>we give bad care by any means, but I think rare things (such as this)
>need someone with time under their belt to have the knowledge of how to
>deal with them.
>
>Glen
>
>//SIGNED//
>
>D. Glen Elrod, Maj., USAF, MC
>
>Obstetrician/Gynecologist
>
>Chief of Obstetrics
>
>48 MDOS/SGOBO
>
>RAF Lakenheath, England
>
>Telephone DSN: 314-226-8130
>
> Comm: +44 (0) 1638 52 8130
>
>Notice of Confidentiality
>Under the Privacy Act of 1974, you must safeguard all information
>reflected on this e-mail and, if applicable, all attachments.
>Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131,
>37-132, AFI 33-219, and PL 93-579"
>This e-mail message including any attachments is for the sole use of
>intended recipient(s) and may contain confidential and privileged
>information. Any unauthorized review, use, disclosure or distribution
>prohibited. If you are not the intended recipient, please contact the
>sender by reply e-mail and destroy all copies of the original message.
>Any questions pertaining to disclosure should be directed to the
>officer.
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr
>Eberhard Lisse
>Sent: Friday, March 09, 2007 10:14 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Bilateral dermoids
>
>Andrew,
>
>with all due respect, you haven't got a silly clue who you are talking
>to or about. I've actually met the man. And I know people having worked
>with him.
>
>Never mind what you are talking about. To misquote Independence Day, I
>can not imagine that they have let you out much :-)-O, but to state
>the US health system is the best or even among the top is simply
>nonsense, and contrary to all available evidence.
>
>Infant mortality, maternal mortality, teenage pregnancies are neither
>the top in absolute figures, nor in relative figures, taking
>into account. Access to health care? Disposable income by Ob&Gyns?
>
>And the list could go on and on.
>
>I would love very much to have access to your resources, or just have
>the same resources I have for a minority of my patients in the one
>hospital available for the majority of my patients in the other (State
>Hospital).
>
>Or even only having more that four Drape Packs available for this
>weekend, and I used one already this afternoon. But as we say here:
>"We'll make a Plan" and try to cross this bridge when we come nearer to
>it :-)-O.
>
>But not only is it my country, I actually like it here, in spite of all
>its issues.
>
>Or maybe because.
>
>So this translates into Me Three :-)-O These things come out. Right
>In any case since she is under a spinal you can even get verbal
>
>By the way, this is Lakenheath, and I am quite sure the Air Force has a
>regulation for this particular situation.
>
>el
>
>on 3/9/07 11:23 PM Efrain Ramirez said the following:
>> Me too - leaving bilateral dermoids makes no sense - as I said -
>another
>> anesthesia, etc... I don't see Andy's point about "keep in mind that
>> you are setting this patient up for a potentially devastating
>infection
>> with tubo ovarian abcess formation and hysterectomy." ??
>>
>> And I am not sure about USA having the best "medical system" in the
>> world..
>>
>>> Ef
>>
>>> At Fri, 9 Mar 2007, art fougner, md wrote:
>>>
>>> I actually have to side with Steve on this one ... tortuous
>>> interference has not enhanced clinical acumen.
>>>
>>> Art
>>>
>>> At Fri, 9 Mar 2007, Andrew Folley wrote:
>>>> Stephen,
>>>> as you mature you will come to realize that medicine is both art
>science
>>>> and there are often times several right ways to approach a problem.
>I think
>>>> you misjudge the american system.
>>>> It is still the best medical system in the world. I sense a great
>deal of
>>>> frustration and anger in your thread. Lets use this wonderful
>internet
>>>> exchange tool to be gentleman and colleagues. andrew
>>>>
>>>>> From: "Raymond Stephen" <stephen.raymond@dhhs.tas.gov.au>
>>>>>
>>>>> There is no doubt from the description that they were dermoids,
>>>>> washings and other hand-wringing grandma type fussing is just
>weasel
>>>>> madness from an American system so stuffed up by the fear of
>litigation
>>>>> that the patients suffer. If you had taken washings and aspirated
>and then
>>>>> left them and had to go back afterwards for them the patient would
>have
>>>>> been quite justified if she had sued you for unnecessary surgery!
>>>>>
>>>>> I can't believe the absolute lack of clinical acumen and judgement
>that
>>>>> seems to have come out of this thread.
>>>>>
>>>>> Steve
>
>--
>Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
>el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
>PO Box 8421 \ / Please do NOT email to this address
>Bachbrecht, Namibia ;____/ if it is DNS related in ANY way
>
--
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