Re: advice
From: Alenka Pretnar-Darovec (alenka.pretnar-darovec@guest.arnes.si)
Thu Apr 12 07:38:19 2001
Dear dr Paul,
if you decide to prescribe HRT to your thrombophillic patient, you will be accused if she
get thrombosis or TEO- connected with HRT or not. Strict indication for HRT is probably
osteoporosis- but you can prescribe her some etidronates if that is in question. For
atrophic urogenital changes local estrogen is harmless. Anyway- I wouldn't prescribe her
any HRT nor Tibolone, but some vitamins (E; C), gin- seng, soya beans etc.
dr Alenka
ob-gyn-l@obgyn.net wrote:
> OB-GYN-L Digest 1463
>
> Topics covered in this issue include:
>
> 1) FRI Business is business
> by DoctorJoe@aol.com
> 2) RE: Iron therapy
> by "Braun, R. Daniel" <rbraun@iupui.edu>
> 3) Re: Iron therapy
> by islesannie@yahoo.com (Joanne Bulley)
> 4) Re: Severe knee/hip pain at 20 wks GA - correction
> by elishyde@connix.com (Betsy Hyde)
> 5) Re: Severe knee/hip pain at 20 wks GA - correction
> by huladoula1@aol.com (S M Picard, RNC, CD, NM)
> 6) Iron therapy
> by "Dr. Rupak Ranjan Roy" <rupakroy@vsnl.com>
> 7) RE: Herpetic whitlow in pregnancy
> by "Richard Chudacoff, MD" <rchudacoff@mylinuxisp.com>
> 8) Post operative fever
> by rgayetri@bgl.vsnl.net.in (DR. Gayetri Radhakrishna)
> 9) Re: Post operative fever
> by DoctorJoe@aol.com
> 10) RE: Post operative fever
> by "Richard Chudacoff, MD" <rchudacoff@mylinuxisp.com>
> 11) RE: Hello? -- REPLY
> by Dean Huffman <jth@springnet1.com>
> 12) RE: Post operative fever
> by "Myer S. Bornstein, MD, MMM, CPE, FACOG" <mborn@massmed.org>
> 13) Re: Post operative fever
> by evsono@pipeline.com (art fougner, md)
> 14) Announcement: Pelvic Surgery Meeting, Orlando, July 5-7, 18 CMEs
> by marcop@agoron.com (Marco A. Pelosi, III, MD)
> 15) RE: Post operative fever
> by "Kevin D. Dew" <kdew@bellsouth.net>
> 16) RE: Re: Shoulder dystocia case -- A Diversity Of Juristiction
> by Case -- REPLY
> 17) Dean Huffman <jth@springnet1.com>
> by advice
> 18) Gratia <pgratia@pt.lu>
> by RE: Post operative fever
> 19) "Braun, R. Daniel" <rbraun@iupui.edu>
> by Re: Post operative fever
> 20) eramirez@icepr.com (Efrain Ramirez)
> by Re: advice
> 21) Larry Glazerman <l.glazerman@rcn.com>
> by
> ----------------------------------------------------------------------
>
> ----------------------------------------------------------------------
> Date: Tue, 10 Apr 2001 21:25:15 EDT
> ----------------------------------------------------------------------
> From: DoctorJoe@aol.com
> To: ob-gyn-l@obgyn.net
> Subject: FRI Business is business
> Message-ID: <e0.130f8f85.28050c7b@aol.com>
> MIME-Version: 1.0
> Content-Type: text/plain; charset="US-ASCII"
> Content-Transfer-Encoding: 7bit
>
> When Abraham Liebowitz gets to school
> he discovers that he is the only Jewish
> kid in the class. But it's a decent town and
> nobody really bothers him.
>
> One day the teacher asks the class
> "Who was the greatest person who
> ever lived? And why?"
> And to make it interesting she held a
> twenty dollar bill in the air and said
> "whoever gives the best answer will
> get this twenty dollars".
>
> All of the kids called out their guesses.
>
> One said "George Washington - because
> he was the father of our country."
>
> "That's excellent" said the teacher.
>
> Another said "Abraham Lincoln - because
> he freed the slaves."
>
> "That's also good" said the teacher, reluctant
> to bestow an excellent, but still being polite.
>
> One little girl said "Joan of Arc - because
> she saved France."
>
> Another excellent choice said the teacher.
>
> Then Abraham Liebowitz, raised his hand.
>
> So the teacher called on him. "Abraham,
> who do you think was
> the greatest person who ever lived, and why?"
>
> And Abraham said "Jesus Christ."
>
> The teacher was shocked. "Abraham,"
> she said "I'm very surprised.
> Class, I think we can all agree that Abraham
> should get the twenty dollars." And she
> handed Abraham Liebowitz the money.
>
> At recess, the teacher was still very impressed.
> So she asked Abraham why he said Jesus.
>
> Abraham said "Look, personally I think Moses
> was the greatest person who ever lived,
> but... business is business!"
>
> --
>
> Enjoy...
>
> Joe P.
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 10 Apr 2001 20:18:41 -0500
> ------------------------------
> From: "Braun, R. Daniel" <rbraun@iupui.edu>
> To: "'Zach Newton '" <zbnewton@mindspring.com>,
> "'Multiple recipients of list OB-GYN-L '" <ob-gyn-l@mail.medispecialty.com>
> Subject: RE: Iron therapy
> Message-ID: <916D2E5312EED311B98300508BC2179801C0AC52@iupuimbx05.uits.iupui.edu>
> MIME-Version: 1.0
> Content-Type: text/plain
>
> At our county hospital, I use FeSO4. (Little red pills). They work great
> and it is only once in a while that I get complaints about nausea or
> intolerance. We have the patient take them TID pc. The pc is most
> importatnt. When they complain about slight nausea, I tell them that we can
> prescribe something else, but they will have to pay for it and teh FeSO4 is
> "free". They usually say keep on with the FeSO4.
>
> Dan
>
> -----Original Message-----
> From: Zach NewtonTo: Multiple recipients of list OB-GYN-L
> Sent: 4/10/2001 6:37 PM
> Subject: Iron therapy
>
> Iron, as an over-the-counter product, is available by offerings from a
> multitude of product vendors. The basic and generic FeSO4 is the widest
> available, least expensive and, commercially, unpromoted. It works well
> for most. For some, minor symptoms of GI intolerance occur, but are
> tolerable. For others (few), intolerance rises to level of
> unacceptability. Nausea and constipation are heard most often.
>
> Drug reps tout enhanced products. Ferrous fumarate. Fe++ plus: ascorbic
> acid, B12 (cyanocobalmin), folic acid and so on. In U.S., OTC shifts to
> prescription required for folic acid above a declared threshold.
>
> What product provides the best value for recommendation for general use?
> Assumptions: Added value of ascorbic acid accepted. Other add-ons of no
> therapeutic value to most patients. Co-pay for prescription product
> under pharmacy benefit programs does not justify lower expense of OTC
> product in the U.S. The operative phrase: "general use."
>
> I am comfortable with several products, beyond pure generic. I recommend
> Slow Fe most frequently.
>
> Whatcha ya'all do?
>
> Zach Newton
> Z. B. Newton, III, M.D.
> Atlanta/Gyn
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 10 Apr 2001 21:20:49 -0500 (CDT)
> ------------------------------
> From: islesannie@yahoo.com (Joanne Bulley)
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: Iron therapy
> Message-ID: <200104110220.VAA03191@mail.medispecialty.com>
>
> As one who's hemoglobin got to 8-something before I was convinced to
> take the stuff - (because I had an awful time with it) - (I had NO gi
> problems with pregnancy, though) - I finally took home all the ones we
> had samples of and bought a few of the other OTC ones - Slow FE was the
> ONLY one that was tolerable for me. So ... from my personal anecdotal
> (no RCT) experience - I tell the patients MY experience when they look
> at me like I am crazy when I tell them they MUST take the stuff!
>
> Before I started taking the FE, I had climbed Mt Washington - the talles
> New England peak at 6000+ - with my skis and ski boots on my back & then
> skiied down. I just thought I was an out of shape 38 year old as my
> pulse would hit 180 and I'd take a rest - then go slower! But I made it!
> I think it was the next week when my internist came up behind me and
> said if I din't start taking it I was going to fall down!!!
>
> Joanne
>
> At Tue, 10 Apr 2001, Zach Newton wrote:
> >
> >Iron, as an over-the-counter product, is available by offerings from a
> >multitude of product vendors. The basic and generic FeSO4 is the widest
> >available, least expensive and, commercially, unpromoted. It works well
> >for most. For some, minor symptoms of GI intolerance occur, but are
> >tolerable. For others (few), intolerance rises to level of
> >unacceptability. Nausea and constipation are heard most often.
> >
> >Drug reps tout enhanced products. Ferrous fumarate. Fe++ plus: ascorbic
> >acid, B12 (cyanocobalmin), folic acid and so on. In U.S., OTC shifts to
> >prescription required for folic acid above a declared threshold.
> >
> >What product provides the best value for recommendation for general use?
> >Assumptions: Added value of ascorbic acid accepted. Other add-ons of no
> >therapeutic value to most patients. Co-pay for prescription product
> >under pharmacy benefit programs does not justify lower expense of OTC
> >product in the U.S. The operative phrase: "general use."
> >
> >I am comfortable with several products, beyond pure generic. I recommend
> >Slow Fe most frequently.
> >
> >Whatcha ya'all do?
> >
> >--
> >Zach Newton
> >Z. B. Newton, III, M.D.
> >Atlanta/Gyn
> >
>
> --
> Joanne Bulley, MD, FACOG
> Keene, NH, USA
>
> ------------------------------
>
> ------------------------------
> Date: Tue, 10 Apr 2001 23:01:54 -0400
> ------------------------------
> From: elishyde@connix.com (Betsy Hyde)
> To: ob-gyn-l@obgyn.net,
> Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
> Subject: Re: Severe knee/hip pain at 20 wks GA - correction
> Message-ID: <v02140b07b6f978197028@[209.66.144.97]>
> Mime-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"
>
> At 7:10 PM 4/10/01, S M Picard, RNC, CD, NM wrote:
>
> >
> >CORRECTION - that's 327
>
> 327g protein in a 24 hour urine??? Are you sure you don't mean 327 mg?
>
> Betsy Hyde CNM
> Branford, CT
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 05:06:29 -0500 (CDT)
> ------------------------------
> From: huladoula1@aol.com (S M Picard, RNC, CD, NM)
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: Severe knee/hip pain at 20 wks GA - correction
> Message-ID: <200104111006.FAA05449@mail.medispecialty.com>
>
> CORRECTION - that's 327MG
>
> At 41 - I think its time to go for that eye exam.....!
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 17:10:32 +0530
> ------------------------------
> From: "Dr. Rupak Ranjan Roy" <rupakroy@vsnl.com>
> To: <ob-gyn-l@obgyn.net>
> Subject: Iron therapy
> Message-ID: <003701c0c27c$927a5d80$ed73c5cb@vsnl.net.in>
> MIME-Version: 1.0
> Content-Type: multipart/alternative;
> boundary="----=_NextPart_000_0034_01C0C2AA.513F36A0"
>
> ------=_NextPart_000_0034_01C0C2AA.513F36A0
> Content-Type: text/plain;
> charset="iso-8859-1"
> Content-Transfer-Encoding: quoted-printable
>
> I normally put women on Ferrous fumarate - 300 mgs (100 mgs of elemental > iron). Usually well tolerated.
> Sometimes, not frequently though, I need to change to a lower dose > containing preparation.
>
> I am not too keen on the sustained release ones because they contain (at > least in our country) less amount of iron (anything from 30 - 60 mgs of > elemental iron) and more importantly, being slow release ones, they > surely take the iron past the area of best absorption and release it in > an environment least suitable for absorption of iron.
> So, no wonder they cause less side effects.
>
> Drug reps however push these drugs enormously and these cost at least 2 > - 3 times more.
>
> Rupak Ranjan Roy
> MRCOG
>
> ------=_NextPart_000_0034_01C0C2AA.513F36A0
> Content-Type: text/html;
> charset="iso-8859-1"
> Content-Transfer-Encoding: quoted-printable
>
> <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
> <HTML><HEAD>
> <META http-equiv=Content-Type content="text/html; > charset=iso-8859-1">
> <META content="MSHTML 5.50.4134.600" name=GENERATOR>
> <STYLE></STYLE>
> </HEAD>
> <BODY bgColor=#ffffff>
> <DIV>I normally put women on Ferrous fumarate - 300 mgs (100 mgs of > elemental
> iron). Usually well tolerated.</DIV>
> <DIV>Sometimes, not frequently though, I need to change to a lower dose
> containing preparation.</DIV>
> <DIV> </DIV>
> <DIV>I am not too keen on the sustained release ones because they > contain (at
> least in our country) less amount of iron (anything from 30 - 60 mgs of
> elemental iron) and more importantly, being slow release ones, they > surely take
> the iron past the area of best absorption and release it in an > environment least
> suitable for absorption of iron. </DIV>
> <DIV>So, no wonder they cause less side effects.</DIV>
> <DIV> </DIV>
> <DIV>Drug reps however push these drugs enormously and these cost at > least 2 - 3
> times more.</DIV>
> <DIV> </DIV>
> <DIV>Rupak Ranjan Roy<BR>MRCOG</DIV></BODY></HTML>
>
> ------=_NextPart_000_0034_01C0C2AA.513F36A0--
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 08:25:39 -0500
> ------------------------------
> From: "Richard Chudacoff, MD" <rchudacoff@mylinuxisp.com>
> To: <ob-gyn-l@obgyn.net>
> Subject: RE: Herpetic whitlow in pregnancy
> Message-ID: <LAEEJEBMFIKDMOCFFABMCEECCMAA.rchudacoff@mylinuxisp.com>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="US-ASCII"
> Content-Transfer-Encoding: 7bit
>
> I tend to use either Valcyclovir or Famcyclovir, less dosing per day. If the
> lesions resolve, why change her due date? Just keep her on suppressive
> doses.
>
> Richard Chudacoff, MD
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of
> DoctorJoe@aol.com
> Sent: Tuesday, April 10, 2001 3:57 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: Herpetic whitlow in pregnancy
>
> In a message dated 4/10/01 12:28, jane@seasonedsystems.com writes:
> << Any suggestions? I'm inclined to start acyclovir (which she doesn't
> want) and consider moving up her elective c/s to 38 weeks. >>
>
> Acyclovir sounds good, but why move delivery UP???
>
> Joe P.
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 12:58:49 -0500 (CDT)
> ------------------------------
> From: rgayetri@bgl.vsnl.net.in (DR. Gayetri Radhakrishna)
> To: OB-GYN-L@OBGYN.NET
> Subject: Post operative fever
> Message-ID: <200104111758.MAA20910@mail.medispecialty.com>
>
> A patient had massive post partum haemmorhage following which she had a
> hysterectomy.She developed fever from the 7th postoperative day and
> still continues to have fever -high grade fever one month later and
> except for deranged renal function tests and disorientation has no other
> signs . Can a swab or a gauze left in the abdomen cause high grade
> fever without any abdominal signs or discharge from the abdominal wound?
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 14:16:55 EDT
> ------------------------------
> From: DoctorJoe@aol.com
> To: ob-gyn-l@obgyn.net
> Subject: Re: Post operative fever
> Message-ID: <48.141d2b59.2805f997@aol.com>
> MIME-Version: 1.0
> Content-Type: text/plain; charset="US-ASCII"
> Content-Transfer-Encoding: 7bit
>
> In a message dated 4/11/01 12:59:43, rgayetri@bgl.vsnl.net.in writes:
>
> << A patient had massive post partum haemmorhage following which she had a
> hysterectomy.She developed fever from the 7th postoperative day and
> still continues to have fever -high grade fever one month later and
> except for deranged renal function tests and disorientation has no other
> signs . Can a swab or a gauze left in the abdomen cause high grade
> fever without any abdominal signs or discharge from the abdominal wound? >>
>
> Absolutely. If it is walled off somewhere, it won't necessarily drain from
> the abdomincal wound. She needs a detailed examination and probably imaging
> studies to look for a pocket or abscess or foreign body...
>
> Joe P.
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 13:41:02 -0500
> ------------------------------
> From: "Richard Chudacoff, MD" <rchudacoff@mylinuxisp.com>
> To: <ob-gyn-l@obgyn.net>
> Subject: RE: Post operative fever
> Message-ID: <LAEEJEBMFIKDMOCFFABMIEEHCMAA.rchudacoff@mylinuxisp.com>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="US-ASCII"
> Content-Transfer-Encoding: 7bit
>
> Ureteral obstruction or injury and bowel injury can cause the same clinical
> picture. I'd evaluate the renal and GI system, and look for a pelvic vein
> thrombophlebitis. Has she gotten a trial of heparin? Can you get a CT scan
> or MRI on her? IVP, GI series and venogram would work, too.
>
> Richard Chudacoff, MD
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of
> DoctorJoe@aol.com
> Sent: Wednesday, April 11, 2001 1:19 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: Post operative fever
>
> In a message dated 4/11/01 12:59:43, rgayetri@bgl.vsnl.net.in writes:
>
> << A patient had massive post partum haemmorhage following which she had a
> hysterectomy.She developed fever from the 7th postoperative day and
> still continues to have fever -high grade fever one month later and
> except for deranged renal function tests and disorientation has no other
> signs . Can a swab or a gauze left in the abdomen cause high grade
> fever without any abdominal signs or discharge from the abdominal wound? >>
>
> Absolutely. If it is walled off somewhere, it won't necessarily drain from
> the abdomincal wound. She needs a detailed examination and probably imaging
> studies to look for a pocket or abscess or foreign body...
>
> Joe P.
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 13:54:48 -0500
> ------------------------------
> From: Dean Huffman <jth@springnet1.com>
> To: ob-gyn-l@obgyn.net
> Cc: scrawfmd@zoomnet.net
> Subject: RE: Hello? -- REPLY
> Message-ID: <3.0.6.32.20010411135448.007d04c0@springnet1.com>
> Mime-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"
>
> .
>
> The list is alive and well.
>
> If you are not receiving e-mail, you should
>
> 1) Re-subscribe
>
> 2) Check <http://forums.obgyn.net/ob-gyn-l/OBGYNL.0104/date.html> for
> messages from 01 (year) 04 (month).
>
> Dean Huffman
>
> - - - -
>
> Hello?
> From: Steven W Crawford (scrawfmd@zoomnet.net)
> Sun, 08 Apr 2001 10:58:40 -0400
>
> ----------------------------------------------------------------------------
> ----
> ----------------------------------------------------------------------------
> I have received nothing from the List.
> ----------------------------------------------------------------------------
> Please e-mail me, someone, if the List is still alive!
>
> Steve Crawford, MD
>
> ----------------------------------------------------------------------------
> ----
> ----------------------------------------------------------------------------
>
> ----------------------------------------------------------------------------
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 15:10:09 -0400
> ------------------------------
> From: "Myer S. Bornstein, MD, MMM, CPE, FACOG" <mborn@massmed.org>
> To: <ob-gyn-l@obgyn.net>
> Subject: RE: Post operative fever
> Message-ID: <HLEHJCELBLLDBMMHLGHJKEJJCEAA.mborn@massmed.org>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="us-ascii"
> Content-Transfer-Encoding: 7bit
>
> I agree with both Richard and Joe. Needs further workup with Cat Scan or
> MRI. But if not available, then perform an IVP and a Flat and Upright KUB.
> What are her lab data?
> Myer S. Bornstein, MD, MMM, CPE, FACOG
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Richard
> Chudacoff, MD
> Sent: Wednesday, April 11, 2001 2:33 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: RE: Post operative fever
>
> Ureteral obstruction or injury and bowel injury can cause the same clinical
> picture. I'd evaluate the renal and GI system, and look for a pelvic vein
> thrombophlebitis. Has she gotten a trial of heparin? Can you get a CT scan
> or MRI on her? IVP, GI series and venogram would work, too.
>
> Richard Chudacoff, MD
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of
> DoctorJoe@aol.com
> Sent: Wednesday, April 11, 2001 1:19 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: Post operative fever
>
> In a message dated 4/11/01 12:59:43, rgayetri@bgl.vsnl.net.in writes:
>
> << A patient had massive post partum haemmorhage following which she had a
> hysterectomy.She developed fever from the 7th postoperative day and
> still continues to have fever -high grade fever one month later and
> except for deranged renal function tests and disorientation has no other
> signs . Can a swab or a gauze left in the abdomen cause high grade
> fever without any abdominal signs or discharge from the abdominal wound? >>
>
> Absolutely. If it is walled off somewhere, it won't necessarily drain from
> the abdomincal wound. She needs a detailed examination and probably imaging
> studies to look for a pocket or abscess or foreign body...
>
> Joe P.
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 14:19:29 -0500 (CDT)
> ------------------------------
> From: evsono@pipeline.com (art fougner, md)
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: Post operative fever
> Message-ID: <200104111919.OAA16979@mail.medispecialty.com>
>
> any hydronephrosis? persistent fever and abnormal renal function
> following hysterectomy suggests confirming the integrity of the urinary
> tract.
>
> art
>
> At Wed, 11 Apr 2001, DoctorJoe@aol.com wrote:
> >
> >In a message dated 4/11/01 12:59:43, rgayetri@bgl.vsnl.net.in writes:
> >
> ><< A patient had massive post partum haemmorhage following which she had a
> >hysterectomy.She developed fever from the 7th postoperative day and
> >still continues to have fever -high grade fever one month later and
> >except for deranged renal function tests and disorientation has no other
> >signs . Can a swab or a gauze left in the abdomen cause high grade
> >fever without any abdominal signs or discharge from the abdominal wound? >>
> >
> >Absolutely. If it is walled off somewhere, it won't necessarily drain from
> >the abdomincal wound. She needs a detailed examination and probably imaging
> >studies to look for a pocket or abscess or foreign body...
> >
> >Joe P.
>
> --
> art fougner, md
>
> A series of 1000 cases begins with but a single anecdote.
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 14:45:55 -0500 (CDT)
> ------------------------------
> From: marcop@agoron.com (Marco A. Pelosi, III, MD)
> To: OB-GYN-L@OBGYN.NET
> Subject: Announcement: Pelvic Surgery Meeting, Orlando, July 5-7, 18 CMEs
> Message-ID: <200104111945.OAA06455@mail.medispecialty.com>
>
> FYI
>
> 40+ leading gyn & colorectal surgeons will cover a variety of practical
> surgical topics July 5,6,7, 2001 at a combined scientific session of the
> International College of Surgeons - United States Section and the
> One-Kilo Club at the Hyatt Regency Grand Cypress, Orlando, Florida.
>
> Attendance is open to all interested physicians. Registration forms and
> fee schedule are available online at http://www.ics-us.com following the link
> for "Meetings" to "US Section Meetings".
>
> The OBGYN program is divided into 3 six-hour sessions detailed below:
>
> http://www.onekiloclub.org/icsjuly2000.htm
>
> --
> Marco A. Pelosi, III, MD, FACOG, FACS, FICS
> Chairman, Obstetrics & Gynecology Specialty Group
> International College of Surgeons - United States Section
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 15:58:54 -0500
> ------------------------------
> From: "Kevin D. Dew" <kdew@bellsouth.net>
> To: <ob-gyn-l@obgyn.net>
> Subject: RE: Post operative fever
> Message-ID: <MABBJGFBPGNOCJAGGPCGCECPCAAA.kdew@bellsouth.net>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="iso-8859-1"
> Content-Transfer-Encoding: 7bit
>
> good thought about the ureters. They're pretty easy targets in the
> post-partum hysterectomy
>
> Kevin D. Dew
> OB/GYN
> Bardstown, KY
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 15:06:34 -0500
> ------------------------------
> From: Dean Huffman <jth@springnet1.com>
> To: ob-gyn-l@obgyn.net
> Cc: Malcolm.Griffiths@ldh-tr.anglox.nhs.uk
> Subject: RE: Re: Shoulder dystocia case -- A Diversity Of Juristiction
> Case -- REPLY
> Message-ID: <3.0.6.32.20010411150634.009c76d0@springnet1.com>
> Mime-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"
>
> .
>
> Could be any number of reasons.
>
> - Federal courts are generally (but not always) slower in civil cases than
> state courts since they generally have fewer judges, a heave docket, and
> must give priority to criminal cases, of which may are drug cases.
> Furthermore, the federal bench is short a large number of judges. In the
> federal system, judges are appointed by the President and confirmed by the
> Senate. Since the President (Clinton) was of a different party than the
> Senate, few judges were confirmed in the past eight years. This might
> change now that Bush is in office.
>
> - Rules of civil evidence are different in state and federal cases. Dr.
> Pryor brought up a good issue in a previous post. Although in diversity
> cases federal courts are obligated to apply the law of the state under
> which the civil case is filed, I think that they still apply the federal
> rules of evidence. [Note, I am not absolutely certain on this point and
> will have to ask someone or research the answer myself. I will get back to
> you on that later.] This is why, in Sampsel, the federal court asked the
> state supreme court whether the Kansas legislative cap on tort damages was
> constitutional under the Kansas constitution. The famous Bendectin birth
> defects US Supreme Court case, Daubert v. Merrell Dow Pharmaceuticals, 509
> U.S. 579 (1993), No. 92-102, might answer the question about application of
> federal laws of civil procedure in a diversity case. I will re-read it.
>
> - The jury might be pulled from a different pool. Remember the Los Angeles
> case against the police who allegedly beat Rodney King. The first trial was
> in a state court with the jury pool coming from Los Angeles (county, I
> think). The second trial was in federal court and the jury pool was from
> southern California, a much larger, more educated, more affluent jury pool.
> If OJ had been tried in federal rather than state court, he probably would
> have been convicted.
>
> - The judge will be different. There is a judge (who will not be named). I
> is commonly known that this judge leans very heavily in favor of
> corporations, physicians, etc. If you are defending a professional
> liability case, it will significantly improve your chances of winning, and
> your position if you negotiate a settlement, if you can get the case into
> this judge's court. Federal judges are appointed for life. State judges
> genreally must face re-election periodically.
>
> - The appelate process is different and goes theough differnt courts.
>
> - I am sure there are other issues that play a role in chances of winning /
> losing / settling in federal vs. state courts, but these are the major ones
> that I can think of.
>
> - - - -
>
> Re: Shoulder dystocia case -- A Diversity Of Juristiction Case
> From: Griffiths Malcolm (Malcolm.Griffiths@ldh-tr.anglox.nhs.uk)
> Mon, 9 Apr 2001 13:37:30 +0100
>
> ----------------------------------------------------------------------------
> ----
> ----------------------------------------------------------------------------
>
> ----------------------------------------------------------------------------
> We have cases in UK heard in County courts and the High Court. The
> distinction there is solely on the basis of the value of the claim.
>
> In your jurisdiction why might there be an advantage to the plaintiff for
> the case to be heard in a Federal (rather than State) court?
>
> -----Original Message----- From: Dean Huffman [mailto:jth@springnet1.com]
> Sent: 08 April 2001 22:07 To: Multiple recipients of list OB-GYN-L Subject:
> Re: Shoulder dystocia case -- A Diversity Of Juristiction Case
>
> .
>
> The answer to your question is "diversity of juristiction". In cases where
> the parties are residents of different states, the United States
> Consitiution provides that Congress can make laws whereby the case.
> although is is a case involving state issues and state law, can be tried in
> federal rather than state court. I presume the reason for this provision is
> that when the constituion was drafted, there was worry that an out-of-state
> party might not get fair treatment in a state court when the other party is
> a resident of that state. Therefore, the constituion provided for the case
> to be tried in a federal court. Currently such cases are limited, I
> believe, to cases where there is at least $50,000.00 involved, not
> difficult in a medical liability case. A party to a case will often try to
> get the case into a federal court if he thinks it is a better forum in
> which to litigate. The opinion, in the second paragraph, states, "The
> Costantinos filed a diversity action against Dr. Herzog in the United
> States District Court for the Eastern District of New York ..."
>
> ----------------------------------------------------------------------------
> ----
> ----------------------------------------------------------------------------
>
> ----------------------------------------------------------------------------
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 23:11:38 +0200
> ------------------------------
> From: Gratia <pgratia@pt.lu>
> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com>
> Subject: advice
> Message-ID: <5.0.0.25.0.20010411230932.00a628c0@mailsvr.pt.lu>
> Mime-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"; format=flowed
>
> Dear colleagues,
> I would like to have your advice on HRT in postmenopausal women carriers of
> a thrombophilic gene mutation
> ( Factor Leiden and others ). Do replacement therapies outweigh the risks
> of a thrombotic event?
> Can an HRT be continued in case of detection of a gene mutation?
> Discussion of SERM's in this constellation ( and Tibolone more and more
> used in Europe )
>
> Thanks for your response Dr. Paul
> Gratia
> Centre
> Hospitalier Luxembourg
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 16:01:36 -0500
> ------------------------------
> From: "Braun, R. Daniel" <rbraun@iupui.edu>
> To: "'ob-gyn-l@obgyn.net'" <ob-gyn-l@obgyn.net>
> Subject: RE: Post operative fever
> Message-ID: <916D2E5312EED311B98300508BC2179801C0AC5D@iupuimbx05.uits.iupui.edu>
> MIME-Version: 1.0
> Content-Type: text/plain
>
> Possibly it could. An X-ray should answer that question.
> Check for Sheehan's syndrome. The one I had responded just lie this.
> Dan
>
> -----Original Message-----
> From: rgayetri@bgl.vsnl.net.in [mailto:rgayetri@bgl.vsnl.net.in]
> Sent: Wednesday, April 11, 2001 1:00 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: Post operative fever
>
> A patient had massive post partum haemmorhage following which she had a
> hysterectomy.She developed fever from the 7th postoperative day and
> still continues to have fever -high grade fever one month later and
> except for deranged renal function tests and disorientation has no other
> signs . Can a swab or a gauze left in the abdomen cause high grade
> fever without any abdominal signs or discharge from the abdominal wound?
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 19:04:01 -0500 (CDT)
> ------------------------------
> From: eramirez@icepr.com (Efrain Ramirez)
> To: OB-GYN-L@OBGYN.NET
> Subject: Re: Post operative fever
> Message-ID: <200104120004.TAA11674@mail.medispecialty.com>
>
> IVP-CT scan--
>
> At Wed, 11 Apr 2001, Richard Chudacoff, MD wrote:
> >
> >Ureteral obstruction or injury and bowel injury can cause the same clinical
> >picture. I'd evaluate the renal and GI system, and look for a pelvic vein
> >thrombophlebitis. Has she gotten a trial of heparin? Can you get a CT scan
> >or MRI on her? IVP, GI series and venogram would work, too.
> >
> >--
> >Richard Chudacoff, MD
> >
> >-----Original Message-----
> >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of
> >DoctorJoe@aol.com
> >Sent: Wednesday, April 11, 2001 1:19 PM
> >To: Multiple recipients of list OB-GYN-L
> >Subject: Re: Post operative fever
> >
> >In a message dated 4/11/01 12:59:43, rgayetri@bgl.vsnl.net.in writes:
> >
> ><< A patient had massive post partum haemmorhage following which she had a
> >hysterectomy.She developed fever from the 7th postoperative day and
> >still continues to have fever -high grade fever one month later and
> >except for deranged renal function tests and disorientation has no other
> >signs . Can a swab or a gauze left in the abdomen cause high grade
> >fever without any abdominal signs or discharge from the abdominal wound? >>
> >
> >Absolutely. If it is walled off somewhere, it won't necessarily drain from
> >the abdomincal wound. She needs a detailed examination and probably imaging
> >studies to look for a pocket or abscess or foreign body...
> >
> >Joe P.
> >
>
> --
> "Life is neither the notes nor the silence between the notes, but the music that
> arises out of sound and silence felt as a living whole. Stop choosing...between
> chaos and order, and live at the boundary between them, where rest and action
> move together..." David Whyte
>
> ------------------------------
>
> ------------------------------
> Date: Wed, 11 Apr 2001 21:19:26 -0400
> ------------------------------
> From: Larry Glazerman <l.glazerman@rcn.com>
> To: ob-gyn-l@obgyn.net
> Subject: Re: advice
> Message-ID: <5.0.2.1.2.20010411211826.0208c3f0@pop.rcn.com>
> Mime-Version: 1.0
> Content-Type: text/plain; charset="us-ascii"; format=flowed
>
> There is certainly a risk of thrombosis with HRT, probably higher in this
> population than in others. I'm not sure it absolutely contraindicates the
> use of HRT, though.
>
> My understanding is that the evidence that exists is clear that the SERMs
> have the same risk of thromboembolic disease as traditional HRT
>
> At 04:13 PM 4/11/01 -0500, you wrote:
> >Dear colleagues,
> >I would like to have your advice on HRT in postmenopausal women carriers
> >of a thrombophilic gene mutation
> >( Factor Leiden and others ). Do replacement therapies outweigh the risks
> >of a thrombotic event?
> >Can an HRT be continued in case of detection of a gene mutation?
> >Discussion of SERM's in this constellation ( and Tibolone more and more
> >used in Europe )
> >
> >Thanks for your response Dr. Paul
> >Gratia
> >
> >Centre Hospitalier Luxembourg
>
> Larry R. Glazerman, MD
> Ob-Gyn at Trexlertown
> 610-402-0161
> l.glazerman@rcn.com
>
> ------------------------------
>
> ------------------------------
> End of OB-GYN-L Digest 1463
> ------------------------------
> ***************************
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