Hospital medicine (London, England : 1998)
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Intensive insulin regimens can produce substantial clinical benefits for patients with type 1 and type 2 diabetes, but they are associated with an increased incidence of hypoglycaemia. This article discusses such regimens and whether the risk of hypoglycaemia can be reduced by using the new basal insulin analogue, insulin glargine.
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Recombinant tissue plasminogen activator (rt-PA, also known as alteplase; Actilyse) is the first and only licensed thrombolytic approved for use in acute ischaemic stroke in the UK. This article reviews the evidence for the role of rt-PA in acute stroke management and how it may improve long-term clinical outcome for selected patients as part of a comprehensive stroke service.
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There have recently been important changes in the procedures for handling performance issues among medical and dental employees. The author explains the background, explores the practicalities, and discusses the challenges and unresolved issues for medical managers.