Continuous subcutaneous insulin infusion (CSII) in insulin-dependent diabetes.
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Diabetes Mellitus↗
Biomedical subjects
K Walshe
Publications and source records attributed to K Walshe.
The effect of intensive dietary therapy on serum high density lipoprotein cholesterol in patients with Type 2 (non-insulin-dependent) diabetes mellitus: a prospective study.
Intensive dietary therapy in 57 newly diagnosed Type 2 (non-insulin-dependent) diabetic patients led to an increase, compared with pre-treatment levels, in serum high density lipoprotein (HDL) cholesterol and the HDL/total cholesterol ratio after 3 and 6 months (0.05 less than p less than 0.1). The increase in HDL cholesterol was related to the degree of weight loss achieved. In 28 patients whose weight decreased by greater than or equal to 10% average body weight during the 6 months, HDL cholesterol rose from 1.22 +/- 0.06 to 1.36 +/- 0.06 mmol/l (p less than 0.001), whereas patients who lost less weight showed no significant increase in HDL cholesterol. The increase in mean serum HDL-cholesterol levels in female patients was associated with a mean weight reduction of 12.1% average body weight. Patients who were obese at diagnosis lost more weight during the study than non-obese patients (mean 13.2 versus 5.6% average body weight), and showed a significant increase in serum HDL-cholesterol levels. We conclude that intensive dietary therapy may lead to a less atherogenic lipid profile in Type 2 diabetes, particularly in patients who achieve a major weight reduction.
Adult↗
A sensitive immunoassay for flunitrazepam and metabolites.
The objective of this study was to develop an immunoassay that would be capable of detecting flunitrazepam and/or cross-reacting metabolites in urine and comparing the results with those obtained by gas chromatography-mass spectrometry. Doses of Rohypnol varying between 0.5 and 4 mg were given to volunteers, and urine was collected for up to two weeks postingestion. These samples were analyzed by an ELISA that was developed using an antibody raised to flunitrazepam and a drug-enzyme conjugate prepared by attaching 7-aminoflunitrazepam to horseradish peroxidase. Significant levels of flunitrazepam and/or cross-reacting metabolites were detected in urine for up to one week after ingestion. The immunoassay is selective with only diazepam cross-reacting at a level of 1000 microg/L.
Anti-Anxiety Agents↗
Regulating U.S. nursing homes: are we learning from experience?
The quality of care in U.S. nursing homes has been a recurrent matter of public concern and policy attention for more than thirty years. A complex regulatory system of state licensure and federal certification is in place, but problems of poor quality and neglect and abuse of patients still appear to be endemic. This paper describes how the current system of regulation developed, examines its impact, and draws on the wider literature on regulation to outline some characteristics that may have detracted from its effectiveness and contributed to its disappointing results. Future regulatory reform should pay more attention to the lessons of regulation in other settings and make more use of research and formative evaluation.
Aged↗
Quality and the new NHS.
In this article, the authors explore the concept of quality in health care and examine in detail some of the methods currently being used to assess and improve it.
Clinical Competence↗