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.

Following the identification of functional activities to record the recovery patterns of the amputee, a preliminary survey was carried out over a 12-month period, to monitor these patterns following lower limb amputation. Four hundred and fifty-nine returns were received and the profile of the sample was found to be in line with the UK amputee data.The results show that basic bed activities that is, moving about the bed, moving from the lying to sitting position and being able to sit up unaided, were the easiest activities for the sample to achieve independently and took between one to two weeks. Transferring the upper body and dressing the upper body independently were more difficult and took between three to four weeks to achieve and dressing the lower body took, on average, three to five weeks to master following the amputation.A number of the patients were either transferred or discharged from the site of the operation from the second week postoperatively and were not followed up by the physiotherapists at the acute site. This resulted in the data on the later milestones of recovery, either using an early walking aid or a prosthesis, being less accurate. A further study that takes these facts into account is recommended to conclusively establish the milestones of recovery for this group of disabled patients.

Evidence suggests that the color changes of Raynaud's phenomenon (RP) are initiated by spasm of the digital arteries. High-frequency A-mode ultrasound can be used to measure digital artery diameters, and in a group of patients suffering RP, the authors used it to monitor the development of digital artery spasm in fingers that had been progressively cooled. The present study evaluated the reproducibility and value of the temperature at which digital artery spasm occurs (digital-artery-closing temperature) as an objective index of RP severity. Forty-five subjects suffering RP were included (32 suffering primary RP and 13 secondary RP). All were assessed clinically by an independent physician and classified as suffering mild, moderate, or severe RR In 3 of these subjects, digital-artery-closing temperatures were determined on five separate days. The coefficients of variation for digital-artery-closing temperatures recorded in the 3 subjects were low (< 4%), confirming reproducibility. The technique failed in 1 subject suffering severe RP. In the 44 remaining subjects, digital-artery-closing temperatures correlated with clinical assessment. The mean digital-artery-closing temperatures and standard deviations for the three groups were: mild=18.31±1.07°C; moderate=20.83±1.32°C; severe = 25.53±1.38°C. The differences in closing temperatures between the groups were highly significant (P < 0.001, Mann Whitney). The maximum digital artery diameters recorded in the primary RP (including vibration white finger) subjects (Mean±Std Dev=1.21±0.14 mm) were larger than those in the secondary RP subjects (Mean±Std Dev=0.88±0.17 mm). This difference was highly significant (P < 0.001, Mann Whitney).