Biomedical subjects

Timothy P Canavan

Publications and source records attributed to Timothy P Canavan.

5 recordsLinked to original sources

PubMed2006

Innate immune function of the human decidual cell at the maternal-fetal interface.

The aim of the study was to investigate the innate immune function of decidual cells from term unlabored pregnancies by determining Toll-like receptor presence and function. Using immunohistochemistry, reverse transcriptase polymerase chain reaction and NF-kappaB-luciferase plasmid transfection, Toll-like receptor presence and function was determined. Decidual cells express Toll-like receptors 1, 2, 4 and 6 which respond to lipopolysaccharide and peptidoglycan stimulation producing Interleukin-8. Decidual cells from women at term have innate immune function and are capable of producing Interleukin responses to bacterial ligands.

Decidua↗

PubMed2005

Preterm premature rupture of membranes: diagnosis, evaluation and management strategies.

Preterm premature rupture of the membranes (PPROM) is responsible for one-third of all preterm births and affects 120,000 pregnancies in the United States each year. Effective treatment relies on accurate diagnosis and is gestational age dependent. The diagnosis of PPROM is made by a combination of clinical suspicion, patient history and some simple tests. PPROM is associated with significant maternal and neonatal morbidity and mortality from infection, umbilical cord compression, placental abruption and preterm birth. Subclinical intrauterine infection has been implicated as a major aetiological factor in the pathogenesis and subsequent maternal and neonatal morbidity associated with PPROM. The frequency of positive cultures obtained by transabdominal amniocentesis at the time of presentation with PPROM in the absence of labour is 25-40%. The majority of amniotic fluid infection in the setting of PPROM does not produce the signs and symptoms traditionally used as diagnostic criteria for clinical chorioamnionitis. Any evidence of infection by amniocentesis should be considered carefully as an indication for delivery. Documentation of amniotic fluid infection in women who present with PPROM enables us to triage our therapeutic decision making rationally. In PPROM, the optimal interval for delivery occurs when the risks of immaturity are outweighed by the risks of pregnancy prolongation (infection, abruption and cord accident). Lung maturity assessment may be a useful guide when planning delivery in the 32- to 34-week interval. A gestational age approach to therapy is important and should be adjusted for each hospital's neonatal intensive care unit. Antenatal antibiotics and corticosteroid therapies have clear benefits and should be offered to all women without contraindications. During conservative management, women should be monitored closely for placental abruption, infection, labour and a non-reassuring fetal status. Women with PPROM after 32 weeks of gestation should be considered for delivery, and after 34 weeks the benefits of delivery clearly outweigh the risks.

Adrenal Cortex Hormones↗

PubMed2004

An evidence-based approach to the evaluation and treatment of premature rupture of membranes: Part I.

UNLABELLED: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for one third of all preterm births. PPROM will affect 120,000 women in the United States each year. It is associated with significant maternal, fetal, and neonatal morbidity and mortality resulting from infection, umbilical cord compression, abruptio placentae, and prematurity. The etiology is multifactorial, but the most significant risk factors are previous preterm birth and previous preterm premature rupture of membranes. Accurate diagnosis is extremely important to assure proper treatment. Evaluation is based on patient history and clinical examination. This review presents the available evidence and grades it according to the U.S. Preventative Task Force recommendations. In part I of this review, the definition, pathophysiology, and methods of PPROM diagnosis are presented. In part II, the management, treatment, neonatal outcome, and the maternal and fetal evaluation of women with PPROM in the presence of cerclage and medical complications is reviewed. LEARNING OBJECTIVES: After completion of this article, the reader should be able to define the term: preterm premature rupture of membranes, to list the factors associated with premature rupture of membranes, and to outline the tests available for the diagnosis of intra-amniotic infection.

Amniocentesis↗

PubMed2004

An evidence-based approach to the evaluation and treatment of premature rupture of membranes: Part II.

UNLABELLED: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for one third of all preterm births. In part I of this series, the definition, pathophysiology, and diagnosis of PPROM was reviewed. In this part, treatment is discussed. Adjunctive antibiotic and corticosteroid therapy has the strongest evidence for improving neonatal outcome. Treatment is gestational age-dependent and will be influenced by local neonatal intensive-care unit (NICU) survival statistics. This review presents the available evidence and grades it according to the U.S. Preventative Task Force recommendations. LEARNING OBJECTIVES: After completion of this article, the reader should be able to summarize the data on the use of labor inhibition in the setting of PPROM, list potential antibiotics regimens that are recommended for prophylaxis in patients with PPROM, to describe the benefits of corticosteroid administration in patients with PPROM, and to outline potential management strategies for patients with PPROM based on gestational age.

Adrenal Cortex Hormones↗

PubMed2002

Vulvar cancer.

Vulvar cancer was reported in 3,200 women in 1998, resulting in 800 deaths. Recent evidence suggests that vulvar cancer comprises two separate diseases. The first type may develop from vulvar intraepithelial neoplasia caused by human papillomavirus infection and is increasing in prevalence among young women. The second type, which more often afflicts older women, may develop from vulvar non-neoplastic epithelial disorders as a result of chronic inflammation (the itch-scratch-lichen sclerosus hypothesis). Although vulvar cancer is relatively uncommon, early detection remains crucial given its significant impact on sexuality. Diagnosis is based on histology; therefore, any suspicious lesions of the vulva must be biopsied. Excisional or punch biopsy can be performed in the physician's office. Clinicians must closely monitor suspicious lesions because delayed biopsy and diagnosis are common. Once diagnosed, vulvar cancer is staged using the TNM classification system. Treatment is surgical resection, with the goal being complete removal of the tumor. There has been a recent trend toward more conservative surgery to decrease psychosexual complications.

Carcinoma in Situ↗