Purpose: To evaluate the relationships among age-related macular degeneration (AMD), mortality, and biomarkers of systemic inflammation in patients with the acquired immunodeficiency syndrome (AIDS).
Design: Case control study. Participants: Participants with intermediate-stage AMD at enrollment in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) and 2:1 controls matched for age and gender.Methods: Cryopreserved baseline plasma specimens were assayed for biomarkers of inflammation, including high-sensitivity C-reactive protein (CRP), interleukin (IL)-6, interferon-γ inducible protein (IP)-10, soluble CD14 (sCD14), soluble CD163 (sCD163), kynurenine/ tryptophan (KT) ratio, and intestinal fatty acid binding protein (I-FABP).
Objective: To evaluate the relationship between plasma biomarkers of systemic inflammation and incident age-related macular degeneration (AMD) in persons with the AIDS.Design: Case-control study.Methods: Participants with incident intermediate-stage AMD (N ¼ 26) in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) and controls (N ¼ 60) without AMD. Cryopreserved baseline plasma specimens were assayed for biomarkers of inflammation, including high-sensitivity C-reactive protein (CRP), interleukin (IL)-6, interferon-g inducible protein (IP)-10, soluble CD14 (sCD14), soluble CD163 (sCD163), and intestinal fatty acid-binding protein (I-FABP).Results: After adjustment for age, sex, and race/ethnicity, baseline mean AE standard deviation (SD) log 10 (mg/ml) plasma levels of CRP (0.52 AE 0.60 vs. 0.20 AE 0.43; P ¼ 0.01) and mean AE SD log 10 (pg/ml) plasma levels of sCD14 (6.31 AE 0.11 vs. 6.23 AE 0.14; P ¼ 0.008) were significantly higher among cases (incident AMD) than among controls (no AMD). There was a suggestion that mean AE SD baseline log 10 (pg/ml) plasma IL-6 levels (0.24 AE 0.33 vs. 0.11 AE 0.29; P ¼ 0.10) might be higher among cases than controls. In a separate analysis of 548 participants in LSOCA, elevated baseline levels of plasma inflammatory biomarkers were associated with a greater risk of mortality but not with an increased risk of incident cataract.
Conclusion:These data suggest that systemic inflammatory biomarkers are associated with incident AMD but not incident cataract in persons with AIDS, and that systemic inflammation may play a role in the pathogenesis of AMD.
PURPOSE. To evaluate relationships among retinal vascular caliber and biomarkers of systemic inflammation in patients with AIDS. METHODS. A total of 454 participants with AIDS had retinal vascular caliber (central retinal artery equivalent and central retinal vein equivalent) determined from enrollment retinal photographs by reading center graders masked to clinical and biomarker information. Cryopreserved plasma specimens were assayed for inflammatory biomarkers, including Creactive protein (CRP), IL-6, interferon-c inducible protein (IP)-10, kynurenine/tryptophan (KT) ratio, and intestinal fatty acid binding protein (I-FABP). RESULTS. In the simple linear regression of retinal vascular caliber on plasma biomarkers, elevated CRP, IL-6, and IP-10 were associated with retinal venular dilation, and elevated KT ratio with retinal arteriolar narrowing. In the multiple linear regression, including baseline characteristics and plasma biomarkers, AMD was associated with dilation of retinal arterioles
Achilles repair has evolved over the past 30 years, from large open procedures with high complication rates to shorter, less-invasive procedures with better outcomes. Percutaneous repair has comparable failure rates with open repairs, fewer complications, and faster recovery. However, percutaneous Achilles repairs risk sural nerve injury. A miniopen repair fuses the gap between percutaneous and open procedures, and this approach has the potential to mitigate nerve injury while maintaining the increased efficiency in procedure time and patient recovery. The purpose of this Technical Note and accompanying video is to outline the repair of the Achilles tendon using a mini open repair using a low-profile flat braided suture.
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