Aim-A case-control study was initiated to determine the risk factors for the development of age related macular degeneration (AMD). Methods-Study 19).Conclusions-This large case-control study confirms some of the risk factors previously identified and may contribute to the determination of methods for prevention of AMD. (Br J Ophthalmol 1998;82:996-1002) Age related macular degeneration (AMD) is the most common cause of blindness in people over 55 years of age in developed countries. The pathogenesis of this condition is still putative 1 and, in absence of therapy, there is a need to identify risk factors associated with AMD in an eVort to preclude its development.Following the Framingham Eye Study, 2 a number of epidemiological studies have attempted to identify risk factors for AMD. 2-23These studies, which were case-control and population based, have provided informative but controversial data. The goals of the present study were to further explore the possible link between environmental factors and systemic and ocular conditions that may be risk factors for AMD in a European population.Based upon previously published reports, we studied the following risk factors in a casecontrol study: present and past smoking habits, coronary artery disease, systemic hypertension, ametropia, iris colour, and lens status.

Compared with nonelective total knee arthroplasties (TKAs), elective procedures have more time for preoperative planning, which allows for potentially improved patient optimization, risk factor modification, and patient education. The purpose of this study was to (1) determine nationwide trends in operative times and (2) evaluate associations between surgery type, elective or nonelective, with respect to (a) operative times, (b) length of stay (LOS), (c) discharge dispositions, (d) 30-day postoperative complications, (e) reoperations, and (f) readmissions. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all primary TKAs performed between 2011 and 2016. This yielded 209,178 cases which were stratified into elective and nonelective cases. Elective cases were those in which patients were brought from their normal living environment for scheduled procedures. One-way ANOVA (analysis of variance) was used to evaluate associations between operative times and year of surgery. Multivariate linear and logistic regression models adjusted for surgery year and patient factors (age, sex, BMI [body mass index], and ASA [American Society of Anesthesiologists] score) were used to evaluate associations of surgery type with peri- and postoperative outcomes. A significant inverse correlation between operative times and operative year was observed (p < 0.001). Mean operative times and LOS were significantly shorter in elective cases compared with nonelective cases (93 vs. 112 minutes, p < 0.005; 3 vs. 5 days, p < 0.001). Multivariate analysis showed these associations remained significant even after adjusting for potential confounders (p < 0.001). Compared with the nonelective cohort, patients in the elective cohort were more likely to be discharged home (74 vs. 69%, p < 0.001). Nonelective patients had higher rates of pneumonia (0.7 vs. 0.3%, p = 0.005), organ-space surgical site infections (SSI; 0.4 vs. 0.2%, p = 0.004), transfusions (10.9 vs. 6.5%, p < 0.001), sepsis (0.6 vs. 0.2%, p = 0.001), and septic shock (0.2 vs. 0.1%, p = 0.005) compared with elective patients. These associations remained significant with multivariate logistic regression. This study demonstrated that preoperative planning can help shorten operative times and LOS as well as reduce complication and reoperation rates. Alongside the direct advantages identified in this study, potential greater effects include superior patient outcomes and reduced health care costs.

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