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Biomedical subjects

C T Flynn

Publications and source records attributed to C T Flynn.

7 recordsLinked to original sources

Patient and technique survival for blind and sighted diabetics on continuous ambulatory peritoneal dialysis: a ten-year analysis.

A retrospective analysis of patient and technique survival over 10 years in a group of 66 diabetics (40 being blind) and 71 non-diabetics was undertaken. Patient survival profiles showed that the blind diabetics lived longer than the sighted, but for a shorter time than the nondiabetics. In technique success, the sighted diabetics out did the blind and the non-diabetics, long term. Short term, the blind performed better than sighted diabetics. The key to success and longer survival on CAPD depended on motivation on the part of the patient, patient's acceptance of given disability, family (social) support, and willingness on the part of renal care personnel to train the disabled diabetic to perform CAPD. With adequate education and support, blind diabetics did CAPD as well as sighted patients. There was no increased frequency of peritonitis in blind diabetics compared to sighted diabetics. Both blind diabetics and non-diabetics had fewer episodes than sighted diabetics. Intraperitoneal route of insulin administration achieved good glycemic control in diabetic population. Refractory congestive cardiac failure and/or fatal arrhythmias was the most common cardiac cause of death in diabetics on CAPD.

Attitude to Health

Advantages of continuous ambulatory peritoneal dialysis to the diabetic with renal failure.

Among the diabetic patients we have treated with dialysis blood pressure and blood sugar control have been poor and vascular disease progressive. Intermittent peritoneal dialysis did not improve these problems compared with haemodialysis. Continuous ambulatory peritoneal dialysis was undertaken in three patients as a last resort and electively in another two patients. Insulin was given by the intraperitoneal route and none was used systemically. Self-care was taught from the first using the spouse if visual problems were present. Serum creatinine levels fell and haemoglobin levels rose. Blood pressure was controlled without diet or drugs. Blood sugar levels were controlled without symptomatic hypoglycaemia or rebound hyperglycaemia. The procedure had a demoralising effect on helper spouses, and self-care had to be achieved even with severe visual problems. The advantages of continuous ambulatory peritoneal dialysis to the diabetic with renal failure are greatly improved control of blood pressure and blood sugar.

Aged

Improvement in lacrimal and salivary secretions after alkali therapy in Sjøgren's syndrome with renal tubular acidosis.

A patient with Sjøgren's syndrome developed renal tubular acidosis which led to systemic acidosis and potassium depletion. Treatment with Shohl's solution and potassium supplements was followed by subjective improvement in tear flow, salivary flow, and by disappearance of bronchitic symptoms. Detailed objective assessments were then made during the next year, twice on treatment and twice without. These confirmed the subjective impression of improvement.

Acidosis, Renal Tubular