Biomedical subjects

J Matts

Publications and source records attributed to J Matts.

9 recordsLinked to original sources

PubMed2005

Quality of life in HIV-infected individuals receiving antiretroviral therapy is related to adherence.

This study assesses changes in quality of life (QoL) over time among HIV-infected individuals receiving antiretroviral therapy (ART) and evaluates how this relates to ARTadherence. Prospective, longitudinal data were examined from 1050 participants in two large, randomized, multi-centre antiretroviral clinical trials. QoL was assessed by the SF-12; adherence by the Terry Beirn Community Programs for Clinical Research on AIDS Antiretroviral Medication Self-report. Participants included 20% women, 53% African Americans, 16% Latinos; mean age was 39 years; mean baseline CD4+ cell count 230 cells/mm3; 89% were ART-naïve at entry. Baseline physical and mental health summary QoL scores were 45.4 and 42.9, comparable to scores reported in other advanced HIV populations. Significant improvements in mean QoL scores were seen for the group as a whole after 1 to 4 months on new ART regimens, and persisted for 12 months. Participants reporting 100% ART adherence achieved significantly higher QoL scores at 12 months compared to those with poorer adherence, particularly if 100% adherence was consistent (p < 0.001). Those with at least 80% ART adherence had smaller gains in QoL at 12 months when compared to baseline, while those with < 80% adherence had worsening of QoL. In this analysis, ART adherence was associated with improved QoL, particularly if adherence was sustained.

Adult↗

PubMed1987

Comparison of exercise-positive with recovery-positive treadmill graded exercise tests.

A treadmill exercise test response may become positive because a diagnostic electrocardiographic ST-segment shift occurred during exercise, or, less often, because it occurred only during the recovery period after exercise had been completed. Factors that may be related to these 2 different responses in subjects enrolled in the Program of Surgical Control of Hyperlipidemia were investigated. No differences were found with regard to age, sex, level or location of Minnesota electrocardiographic Q-QS codes, number of narrowed coronary arteries, presence of collateral coronary artery circulation, ejection fraction, number of abnormally moving left ventricular wall segments, heart rate, systolic and diastolic blood pressure, double product, total exercise time, exercise-induced angina, or maximally achieved exercise heart rate or double product. Thus, the same significance should be attributed to a recovery-positive as to an exercise-positive treadmill test, and electrocardiographic, hemodynamic and angiocardiographic variables do not distinguish between subjects who exhibit these 2 different responses.

Adult↗

PubMed1987

Residual myocardial jeopardy in patients with Q-wave and non-Q-wave infarctions.

The correlation between the presence of areas of jeopardized myocardium and the electrocardiographic patterns of anterior and inferior Q-wave and non-Q-wave infarctions was studied in 486 patients who had had stable symptoms for at least six months after a single myocardial infarction. Myocardial jeopardy was identified on a ventriculogram in the right anterior oblique position if normal or hypokinetic wall motion was seen in all segments distal to a lesion that caused stenosis of greater than 50% and less than 100% in the proximal or mid left anterior descending coronary artery (anterior jeopardy), or in the proximal or mid right coronary artery or proximal circumflex coronary artery in a left dominant circulation (inferior jeopardy). Patients with non-Q-wave anterior infarctions had a significant increase in the frequency of jeopardized myocardium when compared with patients with Q-wave inferior or anterior infarctions. The group with non-Q-wave anterior infarction also had a significantly lower percentage of myocardial segments with absent wall motion in the area of infarction than all other groups. This combination of coronary narrowing with retained wall motion may contribute to the increased frequency of reinfarction seen in some studies of non-Q-wave infarction.

Adrenergic beta-Antagonists↗

PubMed1987

Randomization and efficiency in Zelen's single-consent design.

The "single-consent design" was devised by Zelen to circumvent the reluctance of some patients and physicians to participate in certain types of randomized clinical trials. Crucial to the validity of Zelen's design is randomized allocation of patients. Randomization theory is therefore the key theoretical base of the approach taken in this paper to an examination of the efficiency of this design.

Analysis of Variance↗

PubMed1986

Relation between Q-QS changes on the rest electrocardiogram and left ventricular function with healed myocardial infarction.

In the Program of Surgical Control of Hyperlipidemia, the relation of the Minnesota Q-QS codes for rest electrocardiograms to left ventricular (LV) function was studied in patients with healed myocardial infarction (MI). Of 838 subjects enrolled in the study, 477 (57%) had codable Q-QS patterns at the time of randomization. There was an extremely high correlation between the level of the Minnesota code and concurrent LV function, the latter being determined on left ventriculography by both ejection fraction and the number of segmental wall motion abnormalities. Subjects without a Q-QS code had less myocardial damage than did those with a code present in a single cardiac area. Extent of LV damage correlated with the level of significance of the Q-QS code, and when the code was present in only 1 cardiac location damage was greatest if the anteroseptal area was involved. Q-QS codes present in 2 rather than 1 cardiac area were associated with an even greater degree of LV damage. A previous study has shown a strong correlation between LV function and the Minnesota codes when the latter were recorded 0.5 to 5 years (mean 2.2) earlier at the time of the acute MI. The present data show that the relation between LV function and the Minnesota codes after an acute MI persists over time and is even stronger when both are determined in the healed state at a time remote from the acute event.

Adult↗

PubMed1985

Quantitative assessment of left ventricular function after myocardial infarction using the minnesota Q-QS codes for resting electrocardiograms.

The electrocardiogram as a quantitative predictor of left ventricular systolic function was investigated in subjects with one myocardial infarction. The first 509 consecutive subjects to enter the Program of Surgical Control of Hyperlipidemia were studied by selective left ventriculography. Electrocardiograms taken during a prior hospitalization of the subjects for acute myocardial infarction were classified according to the Minnesota Q-QS codes. This study showed that the lower (ie, the more significant) Q-QS codes were highly correlated with reduced left ventricular function as measured both by a lower ejection fraction and by a greater number of left ventricular segments showing abnormal systolic motion. In addition, the location of segmental wall motion abnormalities correlated with the electrocardiographic site of the Q-QS code.

Adult↗

PubMed1985

Development and evolution of electrocardiographic Minnesota Q-QS codes in patients with acute myocardial infarction.

The development of ECG Minnesota Q-QS codes and their subsequent evolution were studied in the first 692 subjects to enter the POSCH program who had had one MI. The mean interval from MI to entry into the study was 2.2 years. Sixty-three percent of the subjects developed the most significant code with the infarction. By the time the subjects entered the study, the codes had commonly regressed to a lower level, disappearing altogether in 34%. The likelihood of complete regression varied inversely with the significance of the code. There was no significant difference between the groups with disappearance and with retention of a Q-QS code as to time since MI, the extent of coronary arterial disease, or the age or sex of the subject. In about half of the subjects the original code did not change with time and in 21% to 44% the code increased to one of a higher level of significance.

Adult↗

PubMed1983

Directional ST-segment deviation in graded exercise tests correlated with motion of the individual segments of the left ventricular wall.

An exercise test may be characterized as positive because of the production of either electrocardiographic ST-segment depression or elevation. The relationship of exercise-induced ST-segment deviation to the specific motion abnormalities of the individual segments of the left ventricular wall was investigated. The first 280 subjects to enter the Program of Surgical Control of Hyperlipidemia were studied by treadmill exercise testing and left ventriculography. The results showed that exercise-induced ST-segment elevation could occur without evidence in the resting subject of either dyskinesia or aneurysm of the left ventricle, that the area of left ventricular damage was much greater in subjects with exercise-induced ST-segment elevation than in those with ST-segment depression, and that wall motion abnormalities were concentrated in the inferoposterior area in the group with ST-segment elevation, but were generally scattered throughout the left ventricular wall in the group with ST-segment depression.

Adult↗

PubMed1983

Post-stratification in the randomized clinical trial.

A topic of current biometric discussion is whether stratification should be used in randomized clinical trials and, if so, which kind. An approach based upon randomization theory is used to evaluate pre- versus post-stratification. The results obtained relate specifically to the effect of the size of the clinical trial on the bias and precision of estimated treatment contrasts.

Biometry↗