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M Glanz

Publications and source records attributed to M Glanz.

6 recordsLinked to original sources

Meta-analysis of studies using selective alpha1-blockers in patients with hypertension and type 2 diabetes.

This meta-analysis of published studies evaluated the effect of selective alpha1-blockers on lipid and carbohydrate profiles and blood pressure (BP) as well as tolerability in patients with hypertension and type 2 diabetes. Publications identified via MEDLINE were used. Text and bibliographies of retrieved articles were examined for additional references. Clinical trials with a randomised comparative structure (placebo and active treatment arms) and controlled studies with other structures were included. Of the 27 citations identified, 22 studies were selected for inclusion, and five were rejected. Efficacy and safety data, lipid and carbohydrate profiles, and study and patient characteristics were extracted by two investigators independently. The mean pooled results showed beneficial effects of selective alpha1-blockers on total serum cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and systolic and diastolic BP. The results also showed doxazosin had beneficial effects on fasting glucose levels, insulin sensitivity, TC, HDL cholesterol, low-density lipoprotein (LDL) cholesterol, HDL/TC ratio, and systolic and diastolic BP. The risk difference was equivalent between the alpha1-blocker group and the control group for postural hypotension or syncope. This meta-analysis demonstrates a number of favourable effects of therapy with selective alpha1-blockers in hypertensive patients with type 2 diabetes. These agents provide an effective modality for reducing BP, with favourable effects on lipid, no deterioration in glycaemic control, and little risk of orthostatic hypotension.

Adrenergic alpha-Antagonists↗

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Hospitals, Teaching↗

Methadone vs. L-alpha-acetylmethadol (LAAM) in the treatment of opiate addiction. A meta-analysis of the randomized, controlled trials.

The authors conducted a meta-analysis of the reported randomized, controlled trials comparing methadone to L-alpha-acetylmethadol (LAAM) to assess the efficacy of LAAM relative to methadone in the treatment of opiate addiction. All studies were conducted in standard outpatient opiate addiction treatment clinics. Most patients were men from lower socioeconomic strata. A statistically significant risk difference favoring methadone was detected for retention-in-treatment and discontinuation of treatment because of side effects. The risk difference for illicit drug use favored LAAM, but was not significant. A small treatment difference in favor of methadone was noted. LAAM does appear to be a relatively effective alternative in the treatment of opiate addiction, more so in certain select situations.

Adult↗

Functional electrostimulation in poststroke rehabilitation: a meta-analysis of the randomized controlled trials.

OBJECTIVE: To assess the efficacy of functional electrical stimulation (FES) in the rehabilitation of hemiparesis in stroke. DESIGN: A meta-analysis combined the reported randomized controlled trials of FES in stroke, using the effect size method of Glass, and the DerSimonian-Laird Random Effects Method for pooling studies. SETTING: The included studies were published between 1978 and 1992. They were conducted in academic rehabilitation medicine settings. PATIENTS: In all included studies, patients were in poststroke rehabilitation. The mean time after stroke varied from 1.5 to 29.2 months. INTERVENTION: FES applied to a muscle or associated nerve in a hemiparetic extremity was compared to No FES. MAIN OUTCOME MEASURE: Change in paretic muscle force of contraction following FES was compared to change without FES. RESULTS: For the four included studies, the mean effect size was .63 (95% CI: .29, .98). This result was statistically significant (p < .05). CONCLUSION: Pooling from randomized trials supports FES as promoting recovery of muscle strength after stroke. This effect is statistically significant. There is a reasonable likelihood of clinical significance as well.

Aged↗

Biofeedback therapy in poststroke rehabilitation: a meta-analysis of the randomized controlled trials.

OBJECTIVE: To assess the efficacy of biofeedback therapy in poststroke rehabilitation. DESIGN: A meta-analysis of the reported randomized control trials of biofeedback therapy in poststroke rehabilitation was performed. Data were analyzed using the effect size method and pooled using the Der Simonian-Laird Random Effects Model. Study quality was assessed according to the method of Chalmers. SETTING: All included studies were conducted in academically based rehabilitation settings. PATIENTS: Patients were in the rehabilitative phase of their illness. The timing of the intervention from the acute event did vary greatly between and within studies. INTERVENTION: Biofeedback therapy was applied to a paretic limb of patients in the study group. Both treatment and control groups received standard physical therapy. MAIN OUTCOME MEASURE: Change in range of motion of a joint of a paretic limb as a result of treatment was examined. This measure was chosen after the eligible studies were evaluated for combinable end points. RESULTS: A total of eight studies were included in the analysis. The mean effect size for change in lower extremity range of motion as a result of biofeedback therapy was 1.50 (95% confidence interval [CI]: -0.59, 3.59). For the upper extremity the effect size was 2.30 (95% CI: -1.06, 5.66). Both results were not significant at the p < .05 level. Statistical tests showed significant heterogeneity among studies, validating the use of the Random Effects Model. CONCLUSION: Results of pooling available randomized control trials do not support the efficacy of biofeedback in restoring the range of motion of hemiparetic joints. Nevertheless, because the calculated mean effect sizes were large, with associated wide confidence intervals, the possibility of a type II error masking an important clinical benefit needs to be considered in evaluating this result.

Arm↗