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Biomedical subjects

M D Flynn

Publications and source records attributed to M D Flynn.

25 records · Page 2Linked to original sources
PubMed1984

Abnormalities of liver function and the predictive value of liver function tests in infection and outcome of acutely ill elderly patients.

In a prospective study of 79 acute admissions of elderly patients to a Geriatric Unit, elevated alkaline phosphatase levels were commonly associated with the presence of extrahepatic bacterial infections. The changes were attributed to alkaline phosphatase liver isoenzymes. There was no significant change in aspartate transaminase levels or in bilirubin levels in infection. Such frequent abnormalities of alkaline phosphatase disproportionate to bilirubin and aspartate transaminase are not described in younger patients with infection. These findings may reflect age-related changes in liver function. In the same series, both bilirubin and albumin were predictors of outcome.

Aged↗
PubMed1983

Acute sacral epidural abscess following local anaesthetic injection.

Spinal epidural abscesses are uncommon infections of the central nervous system. Delay in making the diagnosis increases the morbidity and mortality because irreversible neurological damage occurs during this time. We report a 45-year-old male who developed an acute sacral epidural abscess following a local anaesthetic injection given for the relief of low back pain. We believe this is the first documented case of a local anaesthetic injection causing an acute sacral epidural abscess.

Abscess↗
PubMedDate not supplied

Raised ankle/brachial pressure index in insulin-treated diabetic patients.

The ankle/brachial blood pressure index (A/B PI) is important in the vascular laboratory assessment of peripheral vascular disease. However it is falsely elevated in diabetes, hence underestimating the true severity of disease. We have therefore examined the influence of diabetes on the A/B PI in 2092 patients, 538 with diabetes, all referred for evaluation of peripheral vascular disease. The prevalence of a raised A/B PI (greater than or equal to 1.5) in insulin-treated patients (18.3%) was much higher (p less than 0.001) than that in both non-insulin-treated diabetic patients (4.5%) and patients with no diabetes (2.8%). Insulin-treated patients with a duration of diabetes of greater than 30 years had a higher prevalence of raised A/B PI than those with a duration of less than or equal to 9 years. No significant age effects were seen.

Ankle↗
PubMedDate not supplied

The effect of insulin infusion on capillary blood flow in the diabetic neuropathic foot.

The effect of a short-term improvement in glycaemic control induced by insulin infusion on foot skin capillary blood flow was previously unknown. In seven Type 2 (non-insulin-dependent) diabetic subjects with neuropathy capillary blood flow was measured in the great toe nailfold by television microscopy. An estimate of arteriovenous shunt flow was obtained simultaneously in the pulp of the great toe by laser Doppler flowmetry. After omission of oral hypoglycaemic therapy for 24 h mean blood glucose was 15.7 +/- 0.7 (SEM) mmol l-1. A priming infusion of 0.1 U kg-1 of insulin was given intravenously over 15 min, followed by a variable rate insulin infusion adjusted to steadily reduce blood glucose avoiding hypoglycaemia. At the end of the study blood glucose was reduced to 6.9 +/- 0.7 mmol l-1 (p less than 0.001). During the insulin infusion, capillary blood velocity increased by 28.8% (p less than 0.05), and the diameter of the capillary erythrocyte column increased from 7.6 +/- 0.2 to 9.2 +/- 0.3 micron (p less than 0.01). Thus during the insulin infusion, the calculated capillary flow increased to 226 +/- 36% above basal values (p less than 0.01). Laser Doppler flow did not change significantly, suggesting that during insulin infusion skin blood flow is redistributed with an increase in capillary flow relative to arteriovenous shunt flow.

Blood Flow Velocity↗
PubMedDate not supplied

Clinical television microscopy.

The technique of television microscopy is the only available technique for the direct quantitative measurement of skin capillary blood flow. Television microscopy has applications in both research and clinical practice, and has attracted considerable interest from clinical groups attempting to study capillary blood flow. The critical requirements for a functioning system are difficult to ascertain from the published literature. The aim of this article is therefore to describe the individual components of a television microscope system, outline the current methods of analysis and briefly describe some of the clinical applications of television microscopy.

Blood Flow Velocity↗
PubMedDate not supplied

Saving the diabetic foot.

Diabetic foot ulceration is both preventable and treatable. The management of diabetic foot disease is best achieved through implementation of local protocols involving the primary care team, community care and the multidisciplinary diabetic team. It is important that the feet the assessed as part of the overall assessment of a diabetic patient at any clinical presentation. The initial management of the acute diabetic foot may present to a general practitioner or general physician, and involves the urgent assessment and treatment of infection, foot elevation, wound debridement and, where appropriate, referral for urgent vascular assessment in a specialist centre.

Amputation, Surgical↗