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Biomedical subjects

D P Clarke

Publications and source records attributed to D P Clarke.

10 recordsLinked to original sources
PubMed1997

Superior vena cava obstruction: a modern management strategy.

Superior vena cava obstruction (SVCO) is a distressing syndrome. The condition may present to specialists in many branches of medicine, but patients have traditionally been referred on to clinical oncologists for management, as malignancy is the main aetiological factor. Treatment without a histological diagnosis is no longer justified, because management needs to be tailored to the underlying disease. This article reviews the causes, symptoms, methods of diagnosis and therapy options. The role of stenting in SVCO is discussed and a management algorithm is proposed.

Algorithms↗
PubMed1987

Real-time ultrasound scanning in the planning and guidance of pericardiocentesis.

Real-time ultrasound scanning is a rapid and readily available way of detecting pericardial fluid. We have successfully and safely used real-time ultrasound scanning to plan and guide pericardiocentesis on 24 occasions in the last 2 years, in each case for therapeutic purposes in patients with malignant pericardial effusions. The procedure may be readily performed in the ultrasound department or on the ward. We advise the use of real-time ultrasound guidance in all instances of pericardiocentesis.

Adult↗
PubMed1986

The doughnut sign in patients with multiple myeloma.

Bone lesions with a ring-shaped appearance (the doughnut sign) have been encountered during routine reporting of bone scintigrams performed on patients with multiple myeloma. Such a ring-shaped appearance has been revealed in four (8%) of the last 50 bone scintigrams performed on patients with myeloma at the Royal Marsden Hospital. In contrast, a review of the last 300 bone scintigrams performed on patients with bone metastases failed to reveal any such ring-shaped appearance. Examination of the case notes and radiographs of the multiple myeloma patients did not reveal any correlation between the presence of the ring-shaped appearances and the histology, biochemistry, treatment, or course of the disease nor were any specific radiographic features noted. Three of the four patients have had local radiotherapy to the sites of the lesions. We conclude that the ring-shaped appearance on bone scintigrams is usually related to myelomatous bone lesions, particularly following local radiotherapy to these lesions. The reason for this appearance in three of the four scintigrams may be the stimulation of vascularity and osteoblastic activity around the periphery of the myelomatous lesions by the response of the lesions to radiotherapy.

Bone Neoplasms↗