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Biomedical subjects

A Yoskovitch

Publications and source records attributed to A Yoskovitch.

26 records · Page 2Linked to original sources
PubMed1998

Cystic thyroid lesions in children.

BACKGROUND/PURPOSE: Cystic lesions of the thyroid encompass a wide and heterogeneous group of disease states in children, ranging from benign purely cystic entities to malignant tumors. The purpose of this study was to study both the presentation and management of cystic thyroid lesions in the pediatric population. METHODS: A retrospective review of all thyroid masses presenting between 1978 and 1996 and found to be purely or partially cystic on ultrasound examination was conducted, looking at presentation, family history, laboratory values, ultrasound scan and radionuclide imaging, and pathological and cytological evaluation. RESULTS: Twenty-four patients (19 girls, 5 boys) aged 6 to 18 years received the diagnosis of cystic lesions of the thyroid. Of these, 23 presented with painless neck masses, 21 were clinically euthyroid, only one had a single abnormal thyroid function test, only two had mildly positive antithyroid antibody test results, and nearly 30% had a positive family history of thyroid disease. Ultrasonography showed pure cysts in five patients and mixed solid cystic lesions in 19 patients. On scintiscan, six lesions were hot, 13 were cold, three showed normal uptake, and two were mixed. Treatment included either observation, aspiration, cyst sclerosis, surgery, or combinations thereof. Pathological and cytological results included follicular adenoma (n = 9), cystic degeneration (n = 6), multinodular goiter (n = 4), carcinoma (n = 2), branchial cleft cyst (n = 1), and undetermined (n = 2). CONCLUSIONS: Thyroid cysts are often thought to represent benign degenerative disease. Our study, which is the first in the literature to specifically address thyroid cysts in children, shows that ultrasound scan is useful in evaluating thyroid masses, whereas laboratory and radionuclide are of less value, and that single lesions of mixed echogeneity are likely to represent neoplasms, a significant percentage of which are malignant.

Adolescent↗
PubMed1998

Cytomegalovirus infection presenting as chronic sinusitis and nasal polyposis: a case report.

Cytomegalovirus (CMV) is the most common viral opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS), affecting up to 90% of patients. CMV can manifest as primary, latent or chronic persistent infection, most commonly appearing as retinitis, encephalitis or gastrointestinal disease. Other less common presentations, including otolaryngologic expression of the virus, have also been noted. Described here is the first known documented case of CMV with both chronic sinusitis and nasal polyposis in an AIDS patient.

AIDS-Related Opportunistic Infections↗
PubMed1998

Sinonasal schneiderian papilloma.

OBJECTIVE: Schneiderian papilloma of the paranasal sinuses is a locally aggressive benign epithelial tumour with malignant potential. METHOD: A retrospective analysis of 72 patients as seen at our institution from 1978 to 1997 was conducted. RESULTS: The most frequent symptoms at time of presentation were nasal obstruction, presence of a nasal mass, and nasal discharge. The most common sites of involvement were the maxillary antrum (58.3%), lateral nasal wall (41.7%) and ethmoid sinus (37.5%). Histologic examination confirmed all 72 instances of schneiderian papilloma, with 55/72 (76.4%) being of the inverted type, 13/72 (18.1%) being the fungiform type, and 4/72 (5.5%) being the cylindrical type. An associated malignancy or potential premalignant condition was present in 15 patients (20.8%), with 8 (11.1%) exhibiting dysplastic changes, 4 patients (5.5%) found to have carcinoma in situ, and 3 patients (4.2%) found to have invasive carcinoma. Conservative surgical excision was performed in 37 (51.4%) with more radical surgery, including lateral rhinotomy and medial maxillectomy performed in 35 (48.6%) patients. Recurrence was seen in 17/37 (45.9%) patients treated conservatively compared to 0/35 (0.0%) patients treated aggressively. CONCLUSIONS: Our results indicate that more aggressive surgery is associated with a more definitive treatment and significantly less recurrence and, as such, is the management of choice in cases of schneiderian papilloma. Furthermore, our results indicate the need for long-term follow-up, and the applicability of sinus endoscopy in doing so.

Adult↗
PubMed1993

Mycobacterial infections of the head and neck.

Despite the decline of pulmonary tuberculosis in the Western world, the incidence of cervical mycobacterial infections has remained relatively unaffected. A retrospective review was conducted of 20 patients treated for head and neck tuberculosis from 1984 to 1991. They were mostly an immigrant group coming from underdeveloped countries close to the equator. All cases were treated with antituberculous chemotherapy; 18 patients also underwent surgical excision of their lymphadenopathy. Sixteen patients showed complete response to combined treatment and one relapse was successfully retreated with antituberculous medication. Three patients died from unrelated causes--two from human immunodeficiency virus infection and one from nasopharyngeal carcinoma. The most reliable indicator of mycobacterial infection was the pathologic specimen, making the need for surgical intervention an important diagnostic consideration. As with other reports, most patients in our series had negative chest x-ray films, variable responses to skin testing, and negative cultures. The epidemiology, pathogenesis, and management of this disease are discussed.

Adult↗
PubMedDate not supplied

Neonatal intestinal perforation caused by intestinal muscularis defect associated with vascular ectasia.

We describe a rare case of a viable preterm infant who developed a spontaneous localized perforation of the small bowel caused by a segmental absence of the intestinal musculature and associated with vascular ectasia. The findings may support a causal relationship between absence of the intestinal muscle coat and a vascular network disorder which may be responsible for the gastroenteric defect.

Actins↗
PubMedDate not supplied

Endoscopic sinus surgery in previously irradiated patients.

PURPOSE: Our purpose was to evaluate the safety and efficacy of endoscopic sinus surgery in irradiated patients with absolute indications for sinus surgery. PATIENTS AND METHODS: During 5 years at a tertiary referral center, more than 200 patients received irradiation to a field that included the paranasal sinuses. Complaints related to the sinuses are common in such patients and often include crusting and increased mucus drainage. Six patients presented with significant sinus infections in the absence of tumor recurrence and failed medical management. Additional problems included epiphora and nasal obstruction caused by cicatricial choanal stricture. Surgical interventions included ethmoidectomy, multiple osteotomies, debridement of scarred or devitalized tissue, and dacryocystorhinostomy. Outcome measures included intraoperative findings and complications, length of hospital stays, endoscopic assessments of the healing over 6 months post-operatively, and improvement or persistence of symptoms over 2 to 3 years of follow-up. RESULTS: Surgery can be technically difficult because of derangements of normal anatomy and dehiscence of important structures. Although bleeding problems, prolonged admission, and delayed healing were noted in certain cases, they did not result in long-term morbidity. CONCLUSIONS: Endoscopic sinus surgery has become an invaluable tool in the treatment of refractory sinusitis. Our literature review has revealed no information, however, regarding endoscopic sinus surgery in previously irradiated patients. Theoretically, such patients are at risk for healing problems and anatomic derangements, which could lead to complications. There is, nevertheless, a theoretical benefit to avoiding external approaches in patients who might heal poorly.

Adolescent↗