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Biomedical subjects

M Budoff

Publications and source records attributed to M Budoff.

At least 19 recordsLinked to original sources
PubMed1998

Coronary calcium and standard risk factors in symptomatic patients referred for coronary angiography.

OBJECTIVES: The purpose of this study was to compare quantitative estimates of coronary calcification with traditional coronary risk factors to determine their independent predictive power for the diagnosis of obstructive angiographic coronary artery disease in symptomatic patients. METHODS: Three hundred sixty-eight symptomatic patients underwent coronary angiography and electron beam computed tomography at four different centers between April 1989 and December 1993. A blinded cardiologist interpreted the electron beam computed tomograms. Coronary risk factors were obtained in all 368 patients. Both bivariate and multivariate analyses were used to investigate the relation between risk factors and angiographic disease. RESULTS: One hundred fifty-eight patients (43%) had angiographically obstructive coronary artery disease (>50% luminal stenosis) and 297 (81%) had coronary calcification. At the bivariate level, only male sex and log-transformed coronary calcification were predictive of angiographic disease (p = 0.008, p = 0.001). By multivariate analysis, only male sex and coronary calcification were predictive (p = 0.001, p = 0.001). Sixty-four of the 71 patients without coronary calcification did not have disease, yielding a negative predictive value of 90%. Receiver operating characteristic curve analysis showed that the amount of coronary calcium was a significantly better discriminator of disease than were the other risk factors. CONCLUSIONS: Coronary calcification is a stronger predictor of angiographic coronary artery disease in symptomatic patients undergoing angiography than are standard risk factors.

Aged↗
PubMed1997

Relation of coronary calcium score by electron beam computed tomography to arteriographic findings in asymptomatic and symptomatic adults.

Coronary arteriography was performed on 18 asymptomatic, apparently healthy adults with elevated coronary calcium scores. To extend the range of observation to subjects with low calcium scores, arteriograms from 18 patients with exertional dyspnea and/or valvular heart disease and low calcium scores were also analyzed; these 18 patients were considered asymptomatic from the point of view of coronary artery disease (CAD). For the comparison of symptomatic and asymptomatic persons, 3 age and sex-matched symptomatic patients were also selected for each of the original 18 asymptomatic subjects. Arteriograms were analyzed by computer-assisted quantitative coronary arteriography at a remote site without knowledge of the calcium score or any other patient characteristics. In the 18 asymptomatic subjects with elevated calcium scores, the mean calcium score was 573 +/- 504 (Agatston method) and the mean worst stenosis was 45% +/- 16%. For all 36 patients without symptoms of CAD, worst stenosis was closely correlated with the square root of the calcium score (r = 0.85, p <0.0001). Patients with symptomatic coronary disease and calcium scores < 1,000 had stenoses more severe than asymptomatic persons with similar calcium scores. Most asymptomatic adults with elevated calcium scores have nontrivial, nonobstructive CAD or preclinical obstructive CAD, and the relation between coronary calcium score and severity of stenosis is highly significant. These data indicate that electron beam tomography can be used to estimate the severity of CAD in asymptomatic persons.

Adult↗
PubMed1996

Prognostic value of coronary calcification and angiographic stenoses in patients undergoing coronary angiography.

OBJECTIVES: This investigation sought to determine the relative prognostic value of coronary calcific deposits and coronary angiographic findings for predicting coronary heart disease-related events in patients referred for angiography. BACKGROUND: The relation among coronary calcification, coronary stenoses and coronary heart disease-related events is of interest on a clinical as well as a pathophysiologic basis. METHODS: Four hundred ninety-one symptomatic patients underwent coronary angiography and electron beam computed tomography at five different centers between April 1989 and December 1993. The electron beam computed tomograms were interpreted by a cardiologist with no knowledge of the coronary angiographic and clinical data. Receiver operating characteristic (ROC) curves were constructed to determine the relation between electron beam computed tomographic and coronary angiographic findings. A follow-up telephone survey was completed in 86% of patients. The records for all patients who died or were admitted to the hospital for chest pain or suspected myocardial infarction were reviewed by three other cardiologists with no knowledge of the coronary angiographic and electron beam computed tomographic study results. RESULTS: The mean (+/- SE) area under the ROC curve was 0.75 +/- 0.02 for the coronary calcium score, indicating moderate discriminatory power for this score for predicting angiographic findings. Thirteen coronary heart disease-related deaths and eight nonfatal acute infarctions occurred over 30 +/- 13 months. Scores were sorted in ascending order and divided into quartiles of equal size. One patient in the first quartile had a fatal myocardial infarction (coronary calcium score range 0 to 2.1); 2 in the second quartile (range 2.1 to 75.3), 8 in the third quartile (range 75.3 to 397.1) and 10 in the fourth quartile (> 397.1) had a coronary heart disease-related event. Application of bivariate logistic regression showed that log score but not number of angiographically diseased vessels significantly predicted the probability of a coronary heart disease-related event occurring during follow-up. CONCLUSIONS: Electron beam computed tomographic calcium scores correlate moderately well with angiographic findings. These scores predict coronary heart disease-related events in patients undergoing angiography as well as do the number of angiographically affected arteries.

Calcinosis↗
PubMed1984

Language intervention: a pragmatic approach.

The approach to language intervention described in this paper provides a means of teaching pragmatically appropriate and effective uses of language in conversational contexts while simultaneously teaching the production and comprehension of specific linguistic forms. The approach, developed in work with seriously language-disabled young children, consists of a series of communication games. These games, which focus and intensify certain characteristics of conversational situations, teach vocabulary, syntax, and articulation as devices for serving the same pragmatic functions these devices serve in ordinary conversation. The games integrate the advantages of the traditional language lessons and those of incidental teaching. Spontaneous speech data collected before and after a 4-month interval from trained and contrast-group children suggest the positive impact of the intervention on the language performance of children with no or moderate cognitive delays, but the results do not suggest a similar impact on children with severe cognitive delays. The results suggest that the intervention merits further application and evaluation, with particular attention to the control of cognitive level.

Child↗
PubMed1982

Judgments of EMR students toward their peers: effects of label and academic competence.

To test the relative potency of a clinical label and behavioral competence on the judgments of EMR students, we asked special-class students to evaluate a target child (labeled "mentally retarded" or "regular" student) who performed competently or incompetently on an academic task, controlling sex of target. The EMR students rated the target child in a manner similar to that of nonretarded raters. They responded most negatively to the incompetent retarded target child, while expressing positive affect toward the other three target children, in ascending order: the incompetent nonlabeled, competent retarded, and competent nonlabeled child. For these subjects competence was valued highly and more potently determined their expressed attitude than did the assigned label.

Adolescent↗
PubMed1980

Effects of the labels "mentally retarded" and "retard" on the social acceptability of mentally retarded children.

Effects of the labels "mentally retarded" and "retard" on fifth- and sixth-grade children's attitudes toward peers were studied. Results indicated that children's attitudes (feelings and behavioral intentions) were more positive toward the target child labeled "mentally retarded" than labeled "retard." The data also showed that children's reactions to the two labels were, in part, a function of the physical appearance and academic competence of the peer being rated. Children had the most negative attitudes toward a child labeled "retard" who appeared to be "normal." In contrast, children reacted favorably to the target child labeled "mentally retarded," even when he or she was academically incompetent. Finally, boys were more negative than were girls toward the target child, especially when the child was labeled "retard." Implications for the movement to abandon the use of labels were discussed.

Attitude↗
PubMed1978

Low-income children's attitudes toward mentally retarded children: effects of labeling and academic behavior.

Effects of the label "mentally retarded" and academic competence on low-income sixth-grade children's attitudes toward peers were examined. Attitude was defined in terms of children's affective feelings and behavioral inclinations. The results showed that low-income children expressed more favorable attitudes toward a competent than an incompetent child and, paradoxically, toward a labeled than a nonlabeled child. The data also revealed that an academically incompetent child who was not labeled as retarded evoked negative attitudes, especially from boys, whereas an incompetent child who was labeled as retarded evoked positive attitudes. The findings were discussed in terms of the pros and cons of the current trend toward delabeling.

Achievement↗
PubMed1976

Special-class EMR children mainstreamed: a study of an aptitude (learning potential) X treatment interaction.

Academic, personal, and social growth were compared for special-class EMR children who were assigned randomly to regular grades or retained in special classes at three time intervals: prior to the assignment, 2 month after assignment, and at the conclusion of the school year. There were no significant differences between the two groups prior to or 2 months after reintegration. After one school year, the reintegrated children were more internally controlled, had more positive attitudes toward school, and were more reflective in their behavior. The hypothesis that the more able students by the learning potential criterion would benefit more from regular than special-class placement was supported. These students expressed more positive feelings toward themselves as students, felt others perceived them as more competent, and behaved more reflectively when they were integrated than when assigned to special class. The high-able (learning potential) students performed more competently academically than the low-able (learning potential) students, regardless of placement.

Achievement↗
PubMed1976

Optimizing test performance of moderately and severely mentally retarded adolescents and adults.

This study provided further evidence for the validity of a learning potential assessment procedure with institutionalized moderately and severely retarded adolescents and adults. Significant positive correlations were obtained between psychometric and learning scores, attendants' and teachers' ratings of ability, and the posttraining scores on the modified Kohs Extended Learning Potential procedure. In addition, performance on this test-train-test procedure was compared with a train-within-test format for two different tasks: training embedded within the administration of the Leiter International Performance Scale and a formboard version of Raven's Coloured Progressive Matrices. The students responded equally to the two formats. Stanford-Binet IQs were least predictive of performance on the three learning potential measures and were unrelated to teachers' and attendants' ratings of ability. The implications of these data were discussed with particular attention to the potential advantages of the train-within-test model.

Adolescent↗
PubMed1976

Effectiveness of a learning potential procedure in improving problem-solving skills of retarded and nonretarded children.

In this study we sought to determine the effectiveness of learning potential training on improving children's probelm-solving skills on Raven's Coloured Progressive Matrices. A sample of 553 retarded and nonretarded students were pretested, randomly assigned to trained or nontrained groups, and posttested. Analyses of variance on factor scores derived from a varimax rotation of item responses revealed that learning potential training was effective in increasing the ability to reason by analogy of both retarded and nonretarded children. The learning potential procedure provided learning experiences related to reasoning skills that may not have been previously acquired in school.

Adolescent↗
PubMed1975

Differences between EMR and nonretarded children in fluency and quality of verbal associations.

An association task, in which a subject was asked to give up to 25 associations to each of 10 verbal stimuli, was administered to 32 EMR and 32 nonretarded subjects, along with the Peabody Picture Vocabulary Test. The associations were scored for quantity and speed of response; they were also categorized by a modification of Flavell's system for response quality. As expected, the two groups differed in vocabularly size. When vocabularly size was controlled, relatively few differences between EMR and nonretarded subjects remained: EMR subjects were slower than nonretarded subjects in their first and continuing responses to the association stimuli, used fewer logical associations, and used fewer responses with vocational connotations. In light of the fact that after adjustment for vocabulary differences, the two groups differed on only 6 of the 24 measures examined, the associative networks of the two groups were surprisingly comparable. The remaining differences demonstrated a specific deficit in logical connections and in speed of access to the associative net.

Adolescent↗