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Knight Steel

Publications and source records attributed to Knight Steel.

7 recordsLinked to original sources
PubMed2006

It's time to march.

Explore the source record for details and available documents.

Education, Medical↗
PubMed2005

A journey in reversing practice patterns: a multidisciplinary experience in implementing DOQI guidelines for vascular access.

BACKGROUND: The National Kidney Foundation has established detailed guidelines due to increasing morbidity and costs related to haemodialysis vascular access in the end-stage renal disease population. METHODS: A quality assurance multidisciplinary committee was formed to implement the Dialysis Outcome Quality Initiative (DOQI) guidelines in September, 1999. Beginning January 2000, a 'Save the Vein Programme' was implemented and native fistulae became the angioaccess of first choice for new patients. In addition, an effort was made to replace failed non-autogenous vascular accesses with autogenous fistulae. Shortly after, pre-operative evaluation of the vascular anatomy of the arm by Doppler ultrasound became the standard of care. The 1 year period prior to January 2000 was used for comparison. RESULTS: Total fistula creation in the year 1999 was 48. In the first year after the Save the Vein Programme was begun, 77 new fistulae were created and 96 fistulae in the following year. Concurrently, 50 grafts were constructed in 1999; this number decreased to 46 in 2000 and to 15 in 2001. The percentage of functional fistulae in incident patients increased from 20 to 60% (P<0.001). Similarly, in prevalent patients, functional fistulae increased from 24 to 44% (P<0.004). For all patients, there was a reduction in the hospitalization rate from 98 to 79% (P<0.001) and of vascular-related admissions from 67 to 53%. CONCLUSION: A reversal in practice pattern from graft to fistulae creation was achieved by the successful implementation of DOQI guidelines. This also resulted in a reduction in morbidity.

Aged↗
PubMed2005

The old-old-old.

Geriatricians have long distinguished aging from disease. Yet the separation of these two processes and these in turn from the effects of the environment is most difficult. Therefore, as the possibility of manipulating the aging process is considered, what the elder of tomorrow will look like can only be speculated about. Might it be possible to alter the effect of aging on one organ system and not others? Should we be stating that disease appears a certain number of years before the end of life rather than noting its onset from the moment of birth? If the phenomenon of aging can be manipulated, the distinction between aging and disease may become increasingly difficult except for conditions clearly caused by an infectious agent or an environmental toxin.

Acute Disease↗