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Biomedical subjects

Mayer B Davidson

Publications and source records attributed to Mayer B Davidson.

At least 37 records · Page 2Linked to original sources
PubMed2005

Efforts to improve subsequent treatment of cardiovascular risk factors in older patients with diabetes hospitalized for a cardiac event.

OBJECTIVE: To improve the treatment of risk factors of cardiovascular disease (CVD) for older patients with diabetes after a cardiac event by using a low-literacy reminder card describing these risk factors in community settings. STUDY DESIGN: A multicenter, randomized, interventional study. METHODS: Patients aged 55 years or older with diabetes hospitalized with an acute myocardial infarction, congestive heart failure exacerbation, or unstable angina were eligible to enter the study. Control and experimental patients were recruited from 4 sites and were enrolled in the study before discharge from the hospital. Experimental subjects received education and a reminder card describing risk factors of CVD. They were instructed to discuss the risk factors described on the reminder card with their primary care physician on their first appointment after discharge. Control subjects did not receive any intervention but were given consent to be able to review their charts. RESULTS: One hundred sixty patients completed the study, 82 in the control group and 78 in the experimental group. At the end of the study there was no difference in blood pressure control, lipid levels, and glycosylated hemoglobin levels between the control and experimental patients. Aspirin use and ACE inhibitor use were found to be significantly higher in the control group (P = .001 and .03, respectively). CONCLUSIONS: Reminder cards given to patients to discuss with their primary care providers in community settings did not improve process measures of CVD risk in patients with documented CVD and diabetes. Other approaches will be needed to improve the treatment of risk factors in these high-risk patients.

Aged↗
PubMed2004

ImmunoDip: an improved screening method for microalbuminuria.

BACKGROUND: It is important to test for microalbuminuria in patients with diabetes, hypertension and possible insulin resistance syndrome. Current screening methods are suboptimal. This study evaluates a new office screening test for microalbuminuria that utilizes a monoclonal antibody against human serum albumin (ImmunoDip). METHODS: 182 urine samples were collected from patients attending diabetes, nephrology or hypertension clinics. The ImmunoDip screening test was carried out in the 182 samples after which albumin and creatinine concentrations were measured quantitatively in a reference laboratory. RESULTS: Screening the 182 patient samples with ImmunoDip and designating an albumin:creatinine ratio of > or =30 microg/mg as positive yielded a sensitivity of 96%, a specificity of 80%, a positive predictive value (PPV) of 66% and a negative predictive value (NPV) of 98%. The reduced specificity and PPV were not due to an intrinsic inaccuracy with ImmunoDip screening of these samples, but rather was shown to be due to the discordance between the accepted upper limits of normal for the albumin:creatinine ratio (30 microg/mg) and the albumin concentration (20 mg/l), the latter corresponding to a ratio of 20 microg/mg. In 35 samples with albumin concentrations of 20-50 mg/l, ImmunoDip screening yielded only one false negative (FN) result. CONCLUSIONS: ImmunoDip is an excellent screening tool for microalbuminuria.

Albuminuria↗
PubMed2004

Effect of Pancreas Tonic (an ayurvedic herbal supplement) in type 2 diabetes mellitus.

Although there is widespread use of herbal dietary supplements that are believed to benefit type 2 diabetes mellitus, few have been proven to do so in properly designed randomized trials; their efficacy for intermediate-term glucose control remains unclear. Pancreas Tonic is a botanical mixture of traditional Indian Ayurvedic herbs currently available as a dietary supplement. We report the results of a single-center, randomized, double-blind, placebo-controlled 3-month trial of Pancreas Tonic in type 2 diabetic patients inadequately treated with diet/lifestyle or stable doses of sulfonylureas and/or metformin for at least 3 months. Patients with type 2 diabetes for >/= 1 year were entered into 2 strata of hemoglobin A(1c) (HbA(1c)) levels (stratum 1: 8.0% to 9.9%; stratum 2: 10.0% to 12.0%). All subjects began a 1-month single-blind placebo run-in phase, followed by randomization in a 2:1 ratio of active treatment: placebo, to 3 months of double-blind treatment with either Pancreas Tonic or matching placebo (2 capsules 3 times a day). Concurrent oral agents were continued unchanged throughout the study. The primary outcome was the change in HbA(1c) from randomization; results of each stratum were analyzed independently. The baseline characteristics of 36 subjects who completed the study were comparable between treatment groups. Nineteen subjects entered stratum 1 and 17 entered stratum 2. A statistically significant reduction of HbA(1c) from randomization to end-of-study was seen in the stratum 2 subjects (Pancreas Tonic: 10.1% +/- 1.0% to 8.8% +/- 1.9%, P =.004; placebo: 10.8% +/- 1.4% to 11.2% +/- 1.8%, not significant [NS]). No significant HbA(1c) reductions were seen in the stratum 1 subjects. There were no significant treatment-related differences in the fasting plasma glucose (FPG), lipids, body mass index (BMI), body composition, blood pressure, insulin sensitivity estimates using the minimal model, glucose and insulin responses to a meal challenge, quality of life, adverse events, or other safety indices between treatment groups. Pancreas Tonic was well tolerated. Treatment with Pancreas Tonic (2 capsules 3 times per day) for 3 months significantly improved glucose control in type 2 diabetic patients with HbA(1c) levels between 10.0% to 12.0%. This study represents the first properly designed, prospective intervention trial of therapy with an Ayurvedic herbal supplement for intermediate-term glucose control in type 2 diabetes.

Adult↗
PubMed2003

Tests of glycemia.

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Data Interpretation, Statistical↗