Re: sidual dysplasia
From: Charlie Chambers (cchamber@gorge.net)
Sat Jan 3 11:03:45 2004
I think it's a dangerous proposition. One of the reasons to do the LEEP
is for treatment, but the other is to insure that no contiguous areas
of frank carcinoma are present. You are using an "experimental"
treatment at best for someone with an increased risk of cervical
carcinoma. The only way that I could see this happening is with
informed consent and with IRB approval. Different story with someone
with LGSIL who you are observing to allow spontaneous resolution, and
then hoping to expedite with the Aldara.
On Jan 3, 2004, at 9:42 AM, Karen Lee wrote:
> So, this week I had a 22yo who had 2 N Paps in
> the last 2 years. The recent one was LGSIL; colp
> with 2 Bx, both HGSIL with glandular involvement!
> So, of course she will have LEEP. I discussed
> this with the Doc I refer these to and wondered
> how he felt about my Tx her with Aldara while
> awaiting the LEEP. He wasn't troubled by it, so
> yesterday she had her first Tx. What do you all
> think?
>
> Karen Lee, ARNP
>
> --- "art fougner, md" <evsono@pipeline.com>
> wrote:
>> I don't believe MgSO4 was approved for
>> eclampsia. and ASA antedates the
>> FDA. OTH off label indications put the onus
>> totally on the practitioner
>> so ...
>>
>> art
>>
>> At Fri, 2 Jan 2004, RModugno@aol.com wrote:
>>>
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>>
> boundary="-----------------------------1073081945"
>>>
>>> -------------------------------1073081945
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>>> -------------------------------1073081945
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>>> In a message dated 1/2/2004 1:58:24 PM Eastern
>> Standard Time,
>>> cchamber@gorge.net writes:
>>> I was then chastised
>>>> by a physician because I was using this off
>> label
>>>> and was very liable for lawsuit. I discussed
>> it
>>>> with the Aldara rep who, of course, could
>> not
>>>> recommend that usage.
>>>
>>> Once a drug is apporved by the FDA - you can
>> use it for "off-label" uses
>>> provided there is medical literature to back
>> up this use.
>>> e.g.terbutaline is not approved for the
>> treatment of premature labor.
>>>
>>> Robert Modugno MD MBA FACOG
>>> Marietta, GA
>>> http://www.novaobgyn.yourmd.com
>>>
>>> -------------------------------1073081945
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>>>
>>> In a message dated 1/2/2004 1:58:24 PM Eastern
>> Standard Time, cchamber gorge.net writes:
>>> I was then chastised> by a physician b cause I
>> was using this off label> and was very liable
>> for lawsuit. I discussed it> with the Aldara
>> rep who, of course, could not> ecommend that
>> usage.
>>> Once a drug is apporved by the FDA - you can
>> use it for "off-label" us s provided there is
>> medical literature to back up this use.
>>> e.g.terbutaline is not approved for the
>> treatment of premature labor.
>>>
>>> Robert Modugno MD MBA FACOG
>>> Marietta, GA
>>> http://www.novaobgyn.yourmd.com
>>>
>>> -------------------------------1073081945--
>>>
>>> -------------------------------1073081945--
>>
>> --
>> art fougner, md
>> ich bin ein New Yorker
>
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