PubMed Health⌕ Search

Biomedical subjects

J A Dormandy

Publications and source records attributed to J A Dormandy.

At least 19 recordsLinked to original sources
PubMed1979

Haemorrheological response to plasma exchange in Raynaud's syndrome.

Eight patients with Raynaud's syndrome were treated by weekly plasma exchange for four weeks using a Haemonetics Model 30 Blood Processor. The mean whole-blood viscosity at a shear rate of 0.77/s was significantly lower after treatment, and the mean index of red-cell deformability was significantly improved. In four patients studied serially the mean percentage fall in whole-blood viscosity after a single plasma exchange was 49% at 0.77/s but only 14% at 91/s. All patients noticed symptomatic improvement including healing of ischaemic digital ulcers. In six patients the number of digital arterial segments containing detectable blood flow was measured by directional Doppler; in all six the number increased. It is concluded that plasma exchange is an effective means of haemorrheological treatment and may be beneficial in patients with digital ischaemia.

Blood Flow Velocity↗
PubMed1979

Increase in leg blood-flow by normovolaemic haemodilution in intermittent claudication.

Normovolaemic haemodilution down to a packed-cell volume of 35% was done in 10 patients with stable intermittent claudication. For a mean reducation in the packed-cell volume of 21.5% there was a 170% increase in peak calf blood-flow and a 111% increase in haemoglobin delivery. 7 of the 10 patients reported an increased walking distance. Normovolaemic haemodilution may be of use in the management of some patients with peripheral vascular disease.

Aged↗
PubMed1979

Preoperative haemoglobin as predictor of outcome of diabetic amputations.

Simple factors which may serve as predictors of the success or failure of amputations in the feet were examined in 59 consecutive diabetics. Age, sex, method of diabetic control, smoling, presence of neuropathy or peripheral pulses, preoperative blood-urea, and temperature did not correlate with success of amuptations. The average preoperative white-cell count and blood-sugar were higher in the failure group (p less than 0.01 and p less than 0.05 respectively), but there was considerable overlap between the groups. By contrast, the preoperative haemoglobin level was significantly lower (p less than 0.001) in patients whose amputations healed than in those with failure of healing, both at the digital and metatarsal or transmetatarsal levels; also, there was very little overlap in haemoglobin levels between the success and failure groups. All 18 amputations done in patients with a preoperative haemoglobin less than 12.0 g/dl were successful, whilst all 30 amputations in those with a preoperative level greater than 13.0 g/dl failed.

Aged↗
PubMed1979

Management of the diabetic foot.

If the diabetic foot fails to respond adequately to a short period of basic primary treatment surgery must be considered. The main factor determining its nature and extent is the severity of large-vessel disease. If investigation shows this to be of minor significance local surgery is usually successful. In the presence of definite large-vessel disease, however, major amputation is usually necessary, though arterial reconstruction with local distal amputation may occasionally be feasible. The factors to be taken into consideration in the choice of treatment are discussed.

Amputation, Surgical↗
PubMed1979

Effects of long-term treatment with suloctidil on blood viscosity, erythrocyte deformability and total fibrinogen plasma levels in diabetic patients.

1-(4-Isopropylthiophenyl)-2-n-octylaminopropanol (suloctidil, Sulocton), a drug introduced into clinical practice for the treatment of cerebral and peripheral vascular insufficiency and its complications, has been shown to decrease blood hyperviscosity after long-term treatment in diabetic patients. Suloctidil was particularly effective in lowering measured blood viscosity at high shear rate (230 s-1). At low shear rate (0.77 s-1) a decreasing effect was also observed but reached a statistically significant level only after one month. Since neither total plasma fibrinogen levels nor red blood cell deformability were modified by suloctidil treatment, its lowering effect on blood hyperviscosity could be due to a hitherto unrecognized mechansim of action.

Adult↗
PubMed1977

Is hyperviscosity a treatable component of diabetic microcirculatory disease?

Blood viscosity at low shear-rates was significantly higher in sixty-four patients with longstanding diabetes than in sixty-one matched non-diabetic controls. This increase was most striking in patients with either proliferative retinopathy or nephropathy, although it was present to a lesser extent in diabetic patients with evidence of myocardial or peripheral ischaemia. Erythrocyte deformability was lower in the fourteen diabetic patients with the most extensive microangiopathy than in twenty-two diabetics with slight or no complications or in controls. Hyperviscosity and reduced erythrocyte deformability may well be important and potentially treatable factors in the aetiology or progression of microcirculatory disease is diabetes.

Adult↗
PubMed1977

Treatment of severe intermittent claudication by controlled defibrination.

Fifteen patients with severe intermittent claudication were treated by therapeutic defibrination with subcutaneous injections of ancrod for 5 weeks. Mean plasma-fibrinogen was maintained below 50% of the initial value throughout the treatment period. This reduction in plasma-fibrinogen was accompanied by a parallel fall in whole-blood viscosity and a pronounced clinical improvement. Objective measurements showed maximum benefit on the 21st day of treatment, when the mean resting ankle/arm pressure index had increased by 37%, the post-exercise pressure index had increased by 50%, and the time taken for the pressure index to return to a resting value after a constant exercise had decreased by 33%. (The claudication-count had increased by 59%).

Ancrod↗
PubMed1977

Improvement in experimental vascular graft patency by controlled defibrinogenation.

A sensitive animal model was used to investigate treatment designed to improve vascular graft patency. A Dacron graft was inserted into the infrarenal vena cava of 30 rabbits. Half were treated with subcutaneous Arvin for 28 days after operation. This produced a significant lowering of the post operative plasma fibrinogen. The patency rate of the grafts in the treated rabbits was significantly greater than in the control rabbits.

Ancrod↗
PubMed1976

Abnormal blood viscosity in Raynaud's phenomenon.

The exact cause of Raynaud's phenomenon is still unknown. Since the principal feature of this condition is the precipitation of the attacks by cold, blood viscosity was measured in ten patients and in ten normal controls at 27 degrees C and 37 degrees C. The viscosity of the patients' blood was significantly higher (p less than 0.05) at 27 degrees C than that of the controls when measured at a low shear-rate (0.77 s-1). This, as well as the higher yield stress of the patients' blood, suggests that Raynaud's phenomenon may be caused by an abnormal local increase in the viscosity and yield stress of the blood in response to a fall in temperature.

Adolescent↗
PubMed1976

Impaired red cell deformability in peripheral vascular disease.

By means of a recently developed technique, red-cell deformability was measured in 44 patients with peripheral vascular disease and in 44 age and sex matched normal control subjects. 28 patients had intermittent claudication and 16 rest pain or gangrene. The ability of the red cells to deform was significantly reduced in patients and significantly less in patients with rest pain or gangrene than in those who only had intermittent claudication. A reduction in red-cell deformability by retarding blood-flow through the microcirculation may be an important factor in states of peripheral vascular insufficiency.

Aged↗