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J D Spiliotis

Publications and source records attributed to J D Spiliotis.

8 recordsLinked to original sources
PubMed2000

Relative risk of cancer in sonographically detected thyroid nodules with calcifications.

PURPOSE: The aim of this prospective study was to evaluate the significance of sonographically detected thyroid calcifications in the diagnosis of thyroid cancer. METHODS: One hundred eighty-eight patients with thyroid disease, including 37 with thyroid cancer, were included in the study. Each patient underwent preoperative, high-resolution sonography to evaluate the thyroid gland for the presence of calcifications. RESULTS: The highest incidence of calcification was found in thyroid cancer (54%), followed by multinodular goiter (40%), solitary nodular goiter (14%), and follicular adenomas (12%). The incidence of cancer was significantly higher in calcified nodules (29%) than in noncalcified nodules in the entire group (14%) (p = 0.019), with a relative risk of 2.5. In the group of solitary thyroid nodules, the incidence of cancer in the calcified nodules (55%) was higher than in the nodules without calcification (23%) (p = 0.016). Multiple noncalcified thyroid nodules harbored cancer in only 5% of cases. Compared with multiple noncalcified thyroid nodules, the solitary calcified nodules demonstrated a relative risk of 22.8. In both the solitary and multiple nodules, the relative risk in the presence of calcification was about the same, around 4. Patients younger than 40 years with calcified nodules constituted a high-risk group, with a relative risk of 3.8 versus 2.5 in patients older than 40 years with calcified nodules. CONCLUSIONS: The detection of thyroid calcifications by sonography is diagnostically valuable, especially in cases involving a solitary nodule or a young person. The presence of calcifications in these cases should raise the suspicion of malignancy. The low incidence of cancer in patients with multiple noncalcified thyroid nodules suggests that a more conservative approach may be appropriate in such cases.

Adult↗
PubMedDate not supplied

Intra-arterial versus systemic chemotherapy for non-operable hepatocellular carcinoma.

BACKGROUND/AIMS: To compare intra-arterial (regional) hepatic chemotherapy with doxorubicin, to the systemic (intravenous) one in patients with non-resectable (Stage IVA) hepatocellular carcinoma. METHODOLOGY: Seventy-two patients with inoperable hepatocellular carcinoma were randomized to receive doxorubicin 50 mg/m2 as a bolus infusion either via an implantable intra-arterial catheter (Group A) or as systemic chemotherapy (Group B) every 21-28 days. RESULTS: Patients of Group A had a higher rate of objective and subjective remissions and Karnofsky performance status improvement in comparison to Group B. The mean survival was 7 months (range: 2-16) for Group A and 6.5 months (range: 1-13) for Group B, but this difference was not statistically significant. The quality of life remained at an acceptable level until death in both groups. CONCLUSIONS: A slight but not statistically significant superiority of intra-arterial chemotherapy against the systemic one is concluded.

Aged↗
PubMedDate not supplied

Prognostic criteria in intra-abdominal sepsis.

Forty-two patients with proven intra-abdominal sepsis were studied in a prospective clinical trial. The following parameters were evaluated: (1) Nine parameters on admission: age, sex, obesity, malnutrition, history of cardiac, respiratory or renal disease, diabetes mellitus and malignant neoplasia. Four of these parameters had a prognostic value (p less than 0.05): age 65 years, diabetes mellitus and cardiac disease. (2) Thirty parameters representing the functional status of six organic systems during sepsis: respiratory, cardiovascular, nervous, kidneys, blood coagulation, liver. Six of these parameters had a prognostic values: PEEP 0-10 cm H2O to keep PaO2 greater than 60 mmHg (p less than 0.001), serum creatinine greater than 3.6 mg/dl (p less than 0.01), prothrombin time greater than 15'' or platelet count less than 100,000/mm3 (p less than 0.001), need of vasoconstrictive drug to keep arterial pressure greater than 100 mmHg (p less than 0.001), bilirubin greater than 3 mg/dl (p less than 0.01) and mental confusion. The combination of these ten statistically significant prognostic criteria for each patient showed that the mortality was 0 with 0-2 criteria, 36% with 3-5 criteria, 94% with 6-8 criteria and 100% with 8-10 criteria. Patients with more than five of these criteria had a significant higher mortality risk (p less than 0.001).

Abdomen↗
PubMedDate not supplied

Total parenteral nutrition--associated liver dysfunction.

We have reviewed all available data related to the development of liver dysfunction in patients receiving total parenteral nutrition (TPN). It seems that TPN-related liver dysfunction is multifactorial. Among all factors involved, two are most significant in the development of liver dysfunction, i.e. underlying disease and illness severity. In most cases, liver dysfunction is both self-limiting and reversible after cessation of TPN.

Cholestasis, Intrahepatic↗
PubMedDate not supplied

Ductectatic mucinous cystadenocarcinoma of the pancreas: a rare variant.

A rare case of the ductectatic variant of mucinous pancreatic cystadenocarcinoma in a 64 year-old man, presenting with painless obstructive jaundice, is reported. CT scan revealed a multicystic lesion of the pancreatic head, which caused biliary obstruction. Endoscopic retrograde pancreatography (ERP) revealed the characteristic grapelike cluster pattern of pancreatic ductectatic neoplasms. Pancreaticoduodenectomy was then successfully performed. Pancreatic ductectatic mucinous cystadenocarcinoma is a rare entity, presenting, usually, with obstructive pancreatitis, and is histologically indistinguishable from the classic malignant mucinous cystic neoplasm. ERP is the diagnostic method of choice and should be performed in any case of susceptible pancreatic lesions.

Biomarkers, Tumor↗