Re: sidual dysplasia
From: Charlie Chambers (cchamber@gorge.net)
Sun Jan 4 23:14:35 2004
Karen
Sorry but I misunderstood. I thought you would be doing the Aldara
instead of the LEEP. How long till she gets the LEEP? If only a matter
of a few weeks then I don't see the harm.
On Jan 3, 2004, at 3:08 PM, Karen Lee wrote:
> --- Charlie Chambers <cchamber@gorge.net> wrote:
>> 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.
>
> Help me to understand how Aldara use could
> confound the pathology so as to obscure
> continguous areas of frank carcinoma. And thank
> you for taking the time with this. This is very
> helpful as I know I'm sticking my toe into theicy
> pond with great intentions, which often count for
> naught.
> Karen
>
> 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:
>>>>>
>>>>> Content-Type: multipart/alternative;
>>>>
>>>
>>
> boundary="-----------------------------1073081945"
>>>>>
>>>>> -------------------------------1073081945
>>>>> Content-Type: text/plain;
>> charset="US-ASCII"
>>>>> -------------------------------1073081945
>>>>> Content-Transfer-Encoding: 7bit
>>>>> 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
>>>>> Content-Type: text/html; charset="US-ASCII"
>>>>> -------------------------------1073081945
>>>>> Content-Transfer-Encoding: quoted-printable
>>>>>
>>>>> 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
>>>
>>
>
