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Re: Oral Cytotec From: Luis Sanchez-Ramos, MD (luis.sanchez@jax.ufl.edu) Thu Nov 2 13:13:55 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: Trich revisited" Previous message: Dr. Lynn Montgomery: "Re: Oral Cytotec" Next in thread: Garry Siegel: "Re: Coding question" Reply: Garry Siegel: "Re: Coding question" I notice that you failed to answer the specific questions asked:how many patients have you induced with misoprostol ? (the fact that you do X number of inductions per month doesn't tell us how many were performed with that specific drug). You totally ignored the question related to the definition of success. Interestingly, your dosage of misoprostol now includes multiple and frequent doses of 25 and 50 mcg, and in fact, for the first time state that you use doses of 100 mcg!. This description of your protocol is different than that orignally described. As far as the "smoozing" and "kissing up" required to publish in the medical literature, I can only say that I have never done that. It seems like a poor excuse in response to rejection of poorly written or designed studies. I commend you for using misoprostol and for informing us that doses as small as 25 mcg orally are highly effective in almost all patients. LSR At Thu, 2 Nov 2000, Dr. Lynn Montgomery wrote: > >I induce approximately 2 patients per month, sometimes more. Have been >using cytotec orally for over four years and was doing more inductions in >the earlier part of the 4 years. Use 25-50 mcg orally every four hours, >with occasionally going to 100 mcg depending on the response. Patients >routinely rest without much uterine activity following the first two doses, >then begin to labor following the third dose and progress nicely, seldom >requiring supplemental pitocin. I have influenced three labor decks toward >this usage, just by my use (no active campaign). All have adopted this >regimen and all with excellent success. >As to statements regarding numbers, I have been in the academic setting and >the private sector and found there is by far more smoke blown up back sides >in the academic setting. Out here in the trenches, we just do what works. >Ya, maybe alot of the things I do should be published, but I have chosen to >practice rather than publish, primarily because I have experienced the >politics of publishing and have a realistic understanding of the smoozing >and kissing up required to be successful. Out here, I kiss nobody's >bottom... >Sorry for the sarcasm, but I am offended by the suggestion from one in >academics that one of us simple folks in private practice would sink to >exaggeration to make a point. >Lynn > >-----Original Message----- >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Luis >Sanchez-Ramos, MD >Sent: Wednesday, November 01, 2000 12:35 PM >To: Multiple recipients of list OB-GYN-L >Subject: Re: Oral Cytotec > >At Wed, 1 Nov 2000, Dr. Lynn Montgomery wrote: > >>>All the patients I induced with misoprostol over the last four years must >have just been going into spontaneous labor then cause it works fine for >me?<< > >How many is "All" ? and what is your definition of "works fine for me"? >If 25 mcg of orally administered misoprostol leads to a vaginal delivery >within 24 hours in the majority of patients then that should have been >published. One hundred micrograms orally barely works as well as 25 mcg >vaginally which works less well than 50 mcg vaginally. >In the past I have heard statements such as ..for me it works all the >time (2 cases)! > >LSR Next message: DoctorJoe@aol.com: "Re: Trich revisited" Previous message: Dr. Lynn Montgomery: "Re: Oral Cytotec" Next in thread: Garry Siegel: "Re: Coding question" Reply: Garry Siegel: "Re: Coding question"

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