PubMed Health⌕ Search

Biomedical subjects

S Ayoubi

Publications and source records attributed to S Ayoubi.

12 recordsLinked to original sources
PubMed1998

[Prevalence of thyroid cancer in hot nodules].

The prevalence of thyroid cancer is not nodules is low, as it is estimated to be between 0 and 4% in adults. In order to more accurately estimate this prevalence and to recommend optimal treatment, 93 hot nodules operated between 1976 and 1995 were reviewed. 52 of these subjects (56%) were euthyroid, 11 (12%) suffered from clinical hyperthyroidism and 30 (32%) a presented subclinical hyperthyroidism. All patients were operated for a hot nodule, 1.5 to 6 cm in diameter. Two groups of patients were considered on the basis on the histological examination. Group I consisted of 47 patients (39 F, 8 M, mean age: 44 years +/- 15) with multinodular goitre; 16 (34%) of them underwent total thyroidectomy. Group II was composed of 46 patients (38 F, 8 M, mean age: 44 years +/- 15) with a solitary hot nodule; 39 (85%) patients underwent unilateral lobectomy. Microscopic carcinoma (diameter less tha 1 cm) ws discovered in 2(4%) patients of group 1 and 5 (11%) patients of group 11, corresponding to a total prevalence of 7/93 (7.5%). The microscopic carcinoma was located in the nodule or in the capsule in four cases, and away from the nodule but in the ipsilateral lobe in three cases. In every case, this was an incidental finding and no clinical features distinguished patients with or without microscopic carcinoma. This study suggests that the probability of discovering a microscopic carcinoma associated with a hot nodule is considerable. However, microscopic carcinoma is an incidental discovery in a number of subjects undergoing thyroidectomy and is present in 10 to 20% of autopsied thyroids. As surgical treatment is devoid of risks, it appears indicated, particularly when the nodule exceeds 3 cm in diameter.

Adolescent↗
PubMed1997

Neuroarthropathy of the shoulder of unexpected origin.

The authors describe the case of a 65-year-old woman who developed a sudden and painless palsy of right shoulder one month after a benign fall. Radiographs showed severe articular destruction. Neurologic examination revealed only a mild sensory loss of the right upper extremity. A diagnosis of syringomyelia was evoked and confirmed by spinal MRI. An upper extremity neuroarthropathy is usually caused by syringomyelia and is sometimes the first and leading symptom of this disease. Sensory neuropathy explains the incidence of this often painless osteoarthropathy. Treatment with bisphosphonate is discussed.

Acute Disease↗
PubMed1993

Audit in the management of gliomas.

A retrospective study of 139 glioma patients was conducted in an effort to audit management. Factors affecting survival were studied using a Cox Proportional Hazard Model. These factors included age, sex, location, grade, type of surgery, use of radiotherapy, presenting symptoms, Karnofsky score on admission and Karnofsky score 3 months following surgery. Lower grade, high Karnofsky score on admission, radiotherapy and frontal location were associated with better survival. There was statistically insignificant evidence that the other factors had an influence on survival. Patients presenting with a poor neurological score were treated with burrhole biopsy alone. Only 10% of these patients survived more than 6 months. On the other hand, 26% of patients who had craniotomy on the basis of reasonable clinical status lived less than 6 months. Sixty-six per cent of patients in this craniotomy group were aged 60 years or over, and 66% of those aged over 60 had a Karnofsky score of less than 70. We conclude that careful judgement is required before subjecting patients aged over 60, especially those with a low Karnofsky score, to radical therapy.

Adolescent↗
PubMed1992

The use of placenta in a microvascular exercise.

Twenty-five human placentas were studied for suitability in a microvascular exercise. The size and useful length of vessels were measured, and different microvascular anastomoses were performed. The size of the placenta vessels compared well with reported sizes of intracranial arteries. We suggest the use of placenta by neurosurgeons as complementary to experimental animals in microvascular training.

Anastomosis, Surgical↗
PubMed1991

Clinoidal meningiomas.

Clinoidal meningiomas have distinguishing clinical, radiological, and surgical considerations. They present a surgical challenge and have a notorious rate of recurrence. The best chance of their cure comes through total removal, but the fear of injury to cerebral vessels has led most surgeons to accept subtotal removal. We classify these tumours into three groups according to the presence or absence of an interfacing arachnoid membrane between the tumour and cerebral vessels. The presence or absence of this membrane depends on the origin of the tumour and its relation to the naked carotid segment lying outside the carotid cistern. In Group I, total removal is impossible and results are disappointing. In Groups II and III, total removal is possible and results are good despite arterial encasement by the tumour.

Adult↗
PubMed1991

Direct surgery of the cavernous sinus: patient selection.

The cavernous sinus is involved either in lesions arising primarily in the sinus or in lesions invading the sinus from surrounding structures. Experience with direct surgery of the cavernous sinus is encouraging, but no conclusive evidence exists concerning the roles of conservative, surgical, and radiological treatments in terms of effectiveness, morbidity, and long-term results. Consequently, management is individualized according to the patient and the lesions. We discuss these factors in patient selection for cavernous sinus surgery.

Brain Neoplasms↗
PubMed1991

The petrosal approach: indications, technique, and results.

Surgical access to the clivus and petrous apex remains a formidable challenge. Intradural tumours at the clivus and petroclival area are superbly exposed via the petrosal approach described here. To date, we have operated on 33 patients having benign tumours using this approach. Total removal was achieved in all patients except 3 with meningiomas. There was no mortality, morbidity included 1 patient with hemiparesis and several with cranial nerve deficits.

Brain Neoplasms↗
PubMed1990

Efficacy of tissue plasminogen activator in the lysis of thrombosis of the cerebral venous sinus.

Therapy for thrombo-occlusive disease of the cerebral venous sinuses remains controversial. Although several thrombolytic agents, such as urokinase and anticoagulants, are recommended for treatment, major significant risks include cerebral hemorrhage, especially in patients with venous infarction. Tissue plasminogen activator (tPA) has shown a high affinity for fibrin-bound plasminogen, while exhibiting a low affinity for circulating plasminogen. The purpose of this study was to evaluate this drug for use in cerebral sinus thrombo-occlusive disease. Eleven adult male rabbits were chosen as experimental animals. All animals underwent microsurgical dissection of their major dural venous sinuses. Direct compression was used to form a thrombus within the sinus. The presence of significant venous thrombosis was confirmed radiographically by iohexol sinography. Subsequently, tPA was delivered systemically via the marginal ear vein at a dose of 3000 units/h; the result was total lysis of the clot documented by a sinogram 1 hour after the drug was administered. Postmortem pathological examination confirmed total lysis in seven of eight animals. One animal showed partial retained clot fragments. No significant coagulopathic state was observed. In three control animals, saline was infused without clot lysis. We conclude that tPA is a highly effective agent for the lysis of acute induced venous sinus thrombosis in an experimental model.

Animals↗