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Biomedical subjects

Thomas P Connolly

Publications and source records attributed to Thomas P Connolly.

7 recordsLinked to original sources
PubMed2005

Atypical Papanicolaou smear in pregnancy.

Atypical glandular cells (AGC) in Papanicolaou (Pap) smears can be associated with premalignant and malignant cervical and endometrial lesions. AGC is difficult to diagnose in pregnancy due to confusion with normal cellular changes that accompany graviditas. While guidelines have been established for management of AGC cases in the non-pregnant patient, special considerations are required when this is discovered during a pregnancy. A routine Pap smear performed on a 29-year-old woman being seen for a history of infertility yielded AGC and a high-grade squamous intraepithelial lesion. The patient achieved pregnancy 1 month later. Satisfactory colposcopic exam was performed with cytobrush sampling of the endocervical canal, in addition to 2 exocervical biopsies at 11 weeks gestation. Positive diagnosis of endocervical adenocarcinoma in situ resulted in a risk-informed decision to proceed with a cold knife conization of the cervix. Final pathology showed complete resection of the lesion with negative margins and an additional area of squamous dysplasia (cervical intraepithelial neoplasia, grade II to III). Appropriate follow-up was recommended. AGC found upon Pap smear during a pregnancy can be associated with significant pathology for which an aggressive management approach is warranted.

Adult↗
PubMed2004

Necrotizing surgical site infection after tension-free vaginal tape.

BACKGROUND: Infectious morbidity after tension-free vaginal tape (TVT) treatment of urinary stress incontinence may be a potential concern. CASE: A 53-year-old obese woman with a 7-year history of urinary incontinence consented to TVT placement. Two days after discharge the patient presented with suspected cellulitis. Dicloxacillin, ciprofloxacin, ampicillin/sulbactam, and metronidazole were ineffective. Removal of the tape, surgical debridement, dressing changes, ceftriaxone, and clindamycin followed by levofloxacin and metronidazole, repeat wound debridement, and vacuum assisted closure were required. Frozen section revealed gangrenous soft tissue with areas of skin necrosis, but no fasciitis. CONCLUSION: This is the first case of necrotizing surgical site infection after TVT placement. Infectious morbidity risks need to be considered in these procedures.

Anti-Bacterial Agents↗
PubMed2003

Cyclooxygenase-2 inhibitors in gynecologic practice.

Treatment of pain and inflammation associated with dysmenorrhea, endometriosis, ovarian cancers and operative procedures is an ongoing challenge in gynecology. Understanding the roles of prostanoids and estrogen in these conditions and appropriate treatment approaches have advanced beyond traditional nonsteroidal anti-inflammatory drugs. In this article, the author describes some of the basic mechanisms of nonspecific nonsteroidal anti-inflammatory drugs and newer cyclooxygenase-2 inhibitors, especially as they are used in the obstetrics/gynecology practice.

Cyclooxygenase Inhibitors↗
PubMed2003

Unplanned return to operating room in a community hospital-based obstetrics and gynecology residency.

The American College of Obstetricians and Gynecologists clinical indicator for unplanned return to the operating room during the same admission in an obstetrics and gynecology residency is reviewed in this article. A retrospective chart review of all gynecologic surgeries during a 3-year period was evaluated for this indicator. An incidence of 0.03% was noted, with 3 of 1,492 procedures meeting the definition of this indicator. The incidence of this clinical indicator is uncommon in a community hospital-based obstetrics and gynecology residency.

Female↗