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Biomedical subjects

Miguel A Quiñones

Publications and source records attributed to Miguel A Quiñones.

17 recordsLinked to original sources
PubMed2007

Expectations of obese trainees: how stigmatized trainee characteristics influence training effectiveness.

This study identifies stigma as a potential precursor to self-fulfilling prophecies in training interactions. Expectations held by leaders often result in actions that elicit expectancy-confirming behaviors from their subordinates. The results of the present study suggest that trainee weight (manipulated with a photograph depicting the trainee as either obese or average weight for height) influenced female trainer expectations and evaluations of the training and trainee. Furthermore, the results suggest that negative expectations held by trainers were related to trainee evaluations of the training and the trainer and, for less flexible trainers, to decrements in trainee performance on the trained task. Overall, the results suggest that trainer expectations can be influenced by stereotypes held about trainee characteristics, thus undermining training effectiveness.

Adult↗
PubMed2005

Reversal of pulmonary hypertension and subsequent repair of atrial septal defect after treatment with continuous intravenous epoprostenol.

We report the first case in the world literature of a patient with an atrial septal defect, severe pulmonary hypertension, and equalization of pulmonary and systemic pressures, who underwent successful closure of an ASD following prolonged therapy with the intravenous vasodilator epoprostenol. Judicious use of continuous prostacyclin in apparently inoperable patients with congenital heart disease may be associated with significant reversal of pulmonary hypertension, and conversion to an operable state.

Adult↗
PubMed2004

Evolution of expression of cardiac phenotypes over a 4-year period in the beta-myosin heavy chain-Q403 transgenic rabbit model of human hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM), the most common cause of sudden cardiac death in the young, is characterized by a diverse array of cardiac phenotypes evolving over several decades. We have developed transgenic rabbits that fully recapitulate the phenotype of human HCM and provide for the opportunity to delineate the sequence of evolution of cardiac phenotypes, and thus, the pathogenesis of HCM. We determined evolution of biochemical, molecular, histological, structural and functional phenotypes at 4 age-periods in 47 beta-myosin heavy chain-glutamine (MyHC-Q)-403 transgenic rabbits. Ca(+2) sensitivity of myofibrillar ATPase activity was reduced very early and in the absence of other discernible phenotypes. Myocyte disarray also occurred early, prior to, and independent of hypertrophy and fibrosis. The latter phenotypes evolved predominantly during puberty in conjunction with activation of stress-related signaling kinases. Myocardial contraction and relaxation velocities were decreased early despite normal global cardiac function and in the absence of histological phenotype. Global cardiac function declined with aging, while left atrial size was increased along with Doppler indices of left ventricular filling pressure. Thus, Ca(+2) sensitivity of myofibrillar ATPase activity is a primary phenotype expressed early and independent of the ensuing phenotypes. Pathogenesis of myocyte disarray, which exhibits age-independent penetrance, differs from those of hypertrophy and fibrosis, which show age-dependent expression. Myocardial dysfunction is an early marker that predicts subsequent development of hypertrophy. These findings in an animal model that recapitulates the phenotype of human HCM, implicate involvement of multiple independent mechanisms in the pathogenesis of cardiac phenotypes in HCM.

Adenosine Triphosphatases↗
PubMed2003

Tissue Doppler imaging predicts the development of hypertrophic cardiomyopathy in subjects with subclinical disease.

BACKGROUND: Systolic (Sa) and diastolic (Ea) myocardial velocities measured by tissue Doppler (TD) imaging (TDI) recently were shown to be decreased in subjects who have mutations causing hypertrophic cardiomyopathy (HCM) but who do not have left ventricular (LV) hypertrophy. By studying these subjects at a later date, we sought to determine whether TDI predicts the subsequent evolution of the HCM phenotype. METHODS AND RESULTS: Serial 2D and Doppler echocardiography were performed in 12 subjects (age range, 17 to 51 years) with HCM-causing mutations on 2 occasions: before development of hypertrophy and 2 years later. Twelve age- and gender-matched family members without mutations were included as control subjects. In those with mutations, mean septal thickness and LV mass were 1.07+/-0.14 cm and 103.0+/-11 g at baseline, respectively, and increased to 1.30+/-0.36 cm and 193.0+/-78 g at follow-up (P<0.01), with 6 subjects satisfying HCM diagnostic criteria. Sa and Ea velocities in those with mutations were lower compared with control subjects at baseline and follow-up (lateral Sa, 15+/-1.2 versus 8.2+/-2.1 cm/s; lateral Ea, 16.5+/-2.8 versus 8.1+/-2.3 cm/s; P<0.01). At 2 years, left atrial volume and pulmonary venous flow indices of LV filling pressures increased, whereas TD early and late diastolic velocities decreased (all P<0.05) in those with the mutations. Control subjects had no significant interval changes of the above parameters. CONCLUSIONS: Subsequent development of HCM in subjects with initially reduced TD velocities establishes TDI as a reliable method for early identification of HCM mutation carriers.

Adolescent↗
PubMed2003

Prognostic value of exercise echocardiography: validation of a new risk index combining echocardiographic, treadmill, and exercise electrocardiographic parameters.

Exercise (Ex) echocardiography has been shown to have significant prognostic power, independent of other known predictors of risk from an Ex stress test. The purpose of this study was to evaluate a risk index, incorporating echocardiographic and conventional Ex variables, for a more comprehensive risk stratification and identification of a very low-risk group. Two consecutive, mutually exclusive populations referred for treadmill Ex echocardiography with the Bruce protocol were investigated: hypothesis-generating (388 patients; 268 males; age 55 +/- 13 years) and hypothesis-testing (105 patients; 61 males age: 54 +/- 14 years).Cardiac events included cardiac death, myocardial infarction, late revascularization (>90 days), hospital admission for unstable angina, and admission for heart failure. Mean follow-up in the hypothesis-generating population was 3.1 years. There were 38 cardiac events. Independent predictors of events by multivariate analysis were: Ex wall motion score index (odds ratio [OR] = 2.77/Unit; P <.001); ischemic S-T depression > or = 1 mm (OR = 2.84; P =.002); and treadmill time (OR = 0.87/min; P =.037). A risk index was generated on the basis of the multivariate Cox regression model as: risk index = 1.02 (Ex wall motion score index) + 1.04 (S-T change) - 0.14 (treadmill time). The validity of this index was tested in the hypothesis-testing population. Event rates at 3 years were lowest (0%) in the lower quartile of risk index (-1.22 to -0.47), highest (29.6%) in the upper quartile (+0.66 to +2.02), and intermediate (19.2% to 15.3%) in the intermediate quartiles. The OR of the risk index for predicting cardiac events was 2.94/Unit ([95% confidence interval: 1.4 to 6.2]; P =.0043). Echocardiographic and Ex parameters are independent powerful predictors of cardiac events after treadmill stress testing. A risk index can be derived with these parameters for a more comprehensive risk stratification with Ex echocardiography.

Adult↗
PubMed2003

Practice variability and transfer of training: the role of self-efficacy generality.

Practice variability has been shown to enhance transfer of training. The purpose of the present study was to examine the role of self-efficacy generality as a motivational mechanism in explaining the relationship between practice variability and transfer. Undergraduate students (N = 82) were randomly assigned to 1 of 2 training conditions (constant or variable) for a computer decision-making task. Measures of self-efficacy (intensity and generality) and transfer (near and far) were assessed. The results provided support for some of the hypothesized relationships. Specifically, practice variability led to increased self-efficacy generality. Both self-efficacy intensity and generality influenced far transfer performance, although only self-efficacy generality served as a mediator between practice variability and far transfer.

Adult↗
PubMed2002

Acute effect of nonsurgical septal reduction therapy on regional left ventricular asynchrony in patients with hypertrophic obstructive cardiomyopathy.

BACKGROUND: Patients with hypertrophic obstructive cardiomyopathy have left ventricular (LV) diastolic dysfunction due, in part, to temporal heterogeneity in regional function. The acute effect of the relief of LV outflow tract obstruction is unknown. Therefore, we investigated the effects of nonsurgical septal reduction therapy (NSRT) on regional function. METHODS AND RESULTS: Twenty-two patients (aged 56+/-17 years) underwent echocardiographic examination, including tissue Doppler imaging, simultaneously with left heart catheterization before and after NSRT. LV regional function was assessed in 12 segments from which myocardial strain was obtained. Asynchrony was calculated as the coefficient of variation of the time interval from the QRS complex to the onset of expansion and to early diastolic strain. After NSRT, a significant reduction in LV outflow tract obstruction (from 57+/-5 to 12+/-3 mm Hg) occurred with shortening of the time constant of LV relaxation (71+/-4 to 61+/-3 ms; both P<0.05). The coefficient of variation of the time interval to onset of regional expansion decreased significantly and related well to the changes in the time constant of LV relaxation (r=0.81, P<0.01). CONCLUSIONS: NSRT has a favorable effect on LV regional asynchrony, which accounts for the acute changes in LV relaxation.

Cardiomyopathy, Hypertrophic↗
PubMed2002

Peak early diastolic velocity rather than pressure half-time is the best index of mechanical prosthetic mitral valve function.

Reliable screening of mechanical prosthetic mitral valve (PMV) dysfunction by transthoracic echocardiography (TTE) is mandatory because transesophageal echocardiography (TEE) cannot be routinely used. However, acoustic shadowing seriously hampers detection of PMV dysfunction with TTE, particularly regurgitation. To identify TTE indexes that can detect PMV dysfunction (regurgitation or obstruction), 134 patients (age 60 +/- 12 years, 64 men) with PMV who underwent TTE and TEE within 3 +/- 5 days were assessed. There were 73 normal and 61 dysfunctional valves (40 regurgitant, 21 obstructive). By multivariate analysis, peak E velocity was the best predictor of a dysfunctional valve. Both peak E velocity (E > or =1.9 m/s; sensitivity 92%, specificity 78%) and the ratio of velocity-time integrals of flow through the prosthesis to that of the left ventricular outflow (VTI(pmv/)VTI(lvo) > or =2.2; sensitivity 91%, specificity 74%) were successful in detecting PMV dysfunction. Although pressure half-time (PHT) readily identified PMV obstruction, it did not detect regurgitation. Logistic models including peak E velocity and VTI(pmv)/VTI(lvo) or PHT were equally successful in detecting PMV dysfunction. However, all 3 variables were needed to best distinguish among normal, obstructed, and regurgitant valves. A peak E velocity > or =1.9 m/s and VTI(pmv)/VTI(lvo) ratio > or =2.2 predicted valve regurgitation in 83% of valves when PHT was < 130 ms, and valve stenosis in 95% when PHT was >130 ms. Importantly, a peak E velocity < 1.9 m/s, VTI(pmv)/VTI(lvo) ratio < 2.2, and a PHT < 130 ms had a predictive accuracy for a normal valve of 98%. Thus, TTE Doppler indexes can be used as screening parameters of PMV dysfunction and help select patients for further diagnostic evaluation with TEE.

Adult↗
PubMed2002

Disentangling the effects of voice: the incremental roles of opportunity, behavior, and instrumentality in predicting procedural fairness.

Many voice studies have failed to distinguish among voice opportunity, perceived voice opportunity, voice behavior, and voice instrumentality. Thus, the authors sought to clarify the roles of each in determining procedural fairness perceptions. Controlling for the effect of voice opportunity, each of the 3 remaining constructs was hypothesized to predict fairness. Furthermore, voice instrumentality was hypothesized to moderate the effect of voice behavior on fairness. Undergraduates (N = 102; 81 for some analyses) participated in an orientation-week design simulation in which voice opportunity was manipulated. The results indicated significant incremental effects of perceived voice opportunity and the predicted Voice Instrumentality x Voice Behavior interaction. Fairness was lowest for individuals who were denied voice opportunity, perceived less voice opportunity, and provided high levels of noninstrumental voice behavior.

Adolescent↗
PubMed2002

Computer-adaptive testing: the impact of test characteristics on perceived performance and test takers' reactions.

This study examined how specific features of adaptive tests are related to test takers' reactions. Participants took a computer-adaptive test in which 2 features, difficulty of the initial item and difficulty of subsequent items, were manipulated, then responded to questionnaires assessing their reactions to the test. The data show that the relationship between a test's objective difficulty, which was determined by the 2 manipulated test characteristics, and reactions was fully mediated by perceived performance. Additional analyses evaluated the impact of feedback on reactions to the adaptive test. In general, feedback that was consistent with perceptions of performance was positively related to reactions. The results suggest that minor changes to the design of an adaptive test may potentially enhance examinees' reactions.

Adult↗
PubMed2002

Independent induction of two blue light-dependent monovalent anion transport systems in the plasma membrane of Monoraphidium braunii.

In the plasma membrane of the green alga Monoraphidium braunii there are at least two monovalent anion transport systems. One of them is specific for bicarbonate. This transport system is activated by blue light and its induction is triggered by a decrease in the external CO2 concentration. The second transport system is responsible for nitrate uptake at least. This transport system is also activated by blue light and its induction occurs when there is no ammonium in the external medium. Both transport systems are synthesized independently. Hence, when M. braunii cells grow with nitrate as the only nitrogen source under high CO2, they have a nitrate transport system but lack a bicarbonate transporter. Conversely, cells grown with ammonium under low CO2, have a bicarbonate transport system but lack a nitrate transporter. Both transport systems are induced in cells irradiated with white light in the absence of a carbon source, suggesting that there may be precursors in the plasma membrane that only need the synthesis and assembly of some component(s) to become fully active. The induction of nitrate and nitrite reductases, however, only takes place when a carbon source is supplied to the cells.

Anion Transport Proteins↗
PubMedDate not supplied

Chronic heart failure: a report from the Dartmouth Diastole Discourses.

On February 28, 2004, a group of investigators and clinician scientists with expertise in the field of heart failure met for 2 days in Woodstock, VT, to discuss the status of the current heart failure nomenclature and to seek a consensus on whether and how this nomenclature might be changed. Despite a wide diversity of expressed opinions, several areas of discussion ultimately led to the consensus expressed in this document.

Blood Pressure↗