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D A Winfield

Publications and source records attributed to D A Winfield.

77 records · Page 5Linked to original sources
PubMedDate not supplied

A comparative analysis of radiological and surgical placement of central venous catheters.

PURPOSE: To compare the differences in practice and outcome of all radiologically and surgically placed central venous catheters retrospectively over a 2-year period simultaneously, at a single institution. METHODS: A total of 253 Hickman catheters were inserted in 209 patients; 120 were placed radiologically in 102 patients and 133 were placed surgically in 107 patients. The indication was chemotherapy in 76% of radiological and in 47% of surgical cases; the remainder were for total parenteral nutrition and venous access. RESULTS: There were 6 (4.5%) primary surgical failures and a further 17 (13%) surgical cases requiring multiple placement attempts. Pneumothorax occurred once (0.8%) surgically and four times (3.3%) radiologically. There were no radiological primary misplacements but there were five (3.7%) surgical ones. Catheter or central vein thrombosis occurred in four (3.3%) radiological and five (3.7%) surgical cases. The rate of infection per 1000 catheter-days was 1.9 in radiologically placed catheters and 4.0 in surgically placed ones (p < 0.001). Average catheter life-span was similar for the two placement methods (100 +/- 23 days). CONCLUSION: Radiological placement is consistently more reliable than surgical placement. There are fewer placement complications and fewer catheter infections overall.

Antineoplastic Agents↗
PubMedDate not supplied

Multiple myeloma.

Patients with multiple myeloma may present with insidious or acute clinical problems to wide variety of medical specialties. It is important for doctors to know how to diagnose myeloma accurately, to be aware of the clinical complications and to have some knowledge of the newer therapeutic approaches to chemotherapy and supportive treatment.

Bone Marrow Examination↗