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Biomedical subjects

R W Curry

Publications and source records attributed to R W Curry.

15 recordsLinked to original sources
PubMed1992

Treatment of type I diabetes with a combination of glyburide and insulin.

OBJECTIVE: To assess the ability of a combination of insulin and an oral hypoglycemic agent (glyburide) to improve the overall glycemic control in a population of patients with type I diabetes. DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: Community-based, university-affiliated, family medicine group. PATIENTS: Men and women between 18 and 68 years of age with type I diabetes. INTERVENTIONS: Subjects were observed and titrated on an insulin-only regimen for 12 weeks (phase I). Subjects were then randomized to receive either placebo or glyburide 10 mg/d for an additional 12 weeks (phase II). MAIN OUTCOME MEASURES: Glucose measurements were taken at breakfast, lunch, supper, and bedtime. Each patient also was followed sequentially for serum lipids, glycosylated hemoglobin, (Hb A1c) and daily insulin utilization. RESULTS: Average fasting blood glucose (FBG) measurements were significantly lower in the glyburide-treated group during phase II (9.22 +/- 0.55 mmol/L) compared with baseline (10.27 +/- 0.93 mmol/L) and phase I (10.41 +/- 0.55 mmol/L). A decrease in the average Hb A1c concentration in the glyburide group was evident by week 4 and was sustained for the duration of the study. The average daily insulin dose rose significantly in the glyburide but not the placebo group compared with baseline. Total cholesterol, triglycerides, and low-density lipoprotein cholesterol did not change significantly in either group over the course of the study. High-density lipoprotein cholesterol increased significantly over baseline in the glyburide group during phase II. Several patients experienced dramatic improvements in glycemic parameters after the addition of glyburide to their insulin regimens. CONCLUSIONS: Improvements were observed in the FBG and Hb A1c measurements of this heterogeneous population of patients with type I diabetes after the addition of glyburide to their insulin regimens. The study failed to find consistent trends in glycemic control when evaluating mean changes in FBG measurements.

Adolescent↗
PubMed1988

Evaluation and treatment of impotence: a pragmatic approach addressing organic and psychogenic components.

Twelve patient referrals for evaluation of impotence comprise the subjects of a pilot study examining psychogenic and biogenic factors of erectile dysfunction. A structured interview format (KCII) was developed which allowed the clinician to estimate the likelihood of the presence of three organic factors (hormonal, neurological, cardiovascular) and three psychogenic factors (intrapsychic, relational, and behavioral) as well as the presence of relevant lifestyle factors (alcohol, smoking, exercise patterns). The results demonstrated a good ability of the KCII to accurately identify impotent patients (on the basis of history) who would have positive or negative signs of hormonal factor or neurological factor confirmed by laboratory results or physical examination. The sample of patients who had significant vascular findings did not allow for adequate comparison with interview findings. The majority of patients had significant psychogenic components to their impotence and might have been incorrectly classified as "solely psychogenic" if they had not been simultaneously evaluated for organic factors. The most important finding was that impotence, in most cases, involved multifactorial etiological components and required a comprehensive evaluation and treatment program.

Adult↗
PubMed1987

Interpretation of chest roentgenograms by primary care physicians.

In a prospective study, radiologists judged chest x-ray interpretations of family practice physicians. Though discrepancies were frequent, they led to no demonstrable clinical consequences. Potentially significant misreadings did occur, and clinically insignificant errors may still be worth noting for academic as well as patient advocacy reasons.

Diagnostic Errors↗
PubMed1987

Effect of new Vacutainer blood collection tubes on plasma lidocaine concentrations.

This study was designed to establish whether plasma lidocaine concentrations changed subsequent to contact with a new formulation of rubber-stopper Vacutainer collection tubes. Plasma lidocaine concentrations from blood samples exposed to rubber stoppers for one hour were compared with concentrations from blood samples which were not exposed to rubber stoppers. Plasma lidocaine concentrations remained essentially unchanged following one-hour exposure to Vacutainer rubber stoppers. The new formulation of "red-top" Vacutainer may be used reliably in lidocaine therapeutic drug monitoring.

Blood Specimen Collection↗
PubMed1987

Computerized electrocardiogram interpretations: are they useful for the family physician?

Computerized electrocardiogram (ECG) interpretation programs have become increasingly popular in this country, especially in hospital settings. In general, they reliably calculate heart rate, intervals, and mean QRS axis. When the computer interprets an ECG as normal, it is usually correct. The second opinion provided by computerized readings further benefits the primary care physician by suggesting findings not initially considered, and by forcing careful scrutiny of the original interpretation. Speed of interpretation may be greatly increased, particularly for the more experienced electrocardiographer who has a high volume of tracings to interpret. Each computer statement, however, must be carefully overread by the physician, for failure to do so may result in overlooking significant electrocardiographic findings. It is important that the family physician appreciate the strengths and weaknesses of computerized ECG interpretations so that he or she derives the greatest benefit from this diagnostic tool.

Diagnosis, Computer-Assisted↗
PubMed1978

Recurrent ergotism: a case report.

A patient was seen with absent pulses and vague symptoms. History and clinical findings supported a diagnosis of ergotism due to heavy use of ergotamine suppositories. The patient continued to use ergotamine despite warnings and was seen on two additional occasions with ergotism. Previously a heavy user of ergotamine, she became sensitive to small doses, demonstrating marked vasospasm after only one suppository. This phenomenon, not previously reported, is postulated secondarily to drug interaction. The patient is presented with a review of the pharmacology, toxicity, and treatment of ergotamine-induced ergotism. Alerted to the possibility of drug interactions, physicians may safely use ergotamine in the treatment of migraine headache with careful monitoring for signs and symptoms of early toxicity.

Adult↗
PubMedDate not supplied

Levothyroxine sodium tablets: chemical equivalence and bioequivalence.

Two brands of levothyroxine sodium tablets were compared in vivo for bioequivalence in a double-blind, randomized study. The tablets were identical in levothyroxine content. Evaluation was by means of triiodothyronine (uptake), tetraiodothyronine, free thyroxine index, total triiodothyronine by radioimmunoassay, and thyroid-stimulating hormone measurements. No differences in clinical response were found in a study with a high statistical power. It was concluded that the two brands were bioequivalent because of chemical equivalence, use of micronized levothyroxine powder in tablet production with at least one of the brands, and scrupulous attention to quality control during the manufacturing process, all of which contributed to assurance of homogeneity of the products and close adherence (+/- five percent) to the claimed potency.

Adolescent↗
PubMedDate not supplied

Potential benefits of a computer ECG interpretation system for primary care physicians in a community hospital.

One hundred fifteen ECGs from a hospital service were interpreted by 2 primary care physicians and 2 expert electrocardiographers. When their interpretations were compared with one another and with the Marquette MAC II ECG Interpretation Program, there was great variability. Computer ECG interpretations appeared to benefit primary care physicians most by providing a backup opinion. This second opinion was also of use to expert electrocardiographers. Additional long-term benefits that may be derived from computer systems include improvement of physician interpretation ability, reduction in interpretation time, and standardization of electrocardiographic nomenclature and criteria.

Diagnosis, Computer-Assisted↗