Publications
We work hard to attract, retain, and support the most outstanding faculty.
2013
2013
BACKGROUND
Few studies have examined the relationship of human immunodeficiency virus (HIV) monoinfection and its associated perturbations with liver fibrosis.
METHODS
USING multivariable linear regression, we examined the demographic, behavioral, metabolic and viral factors associated with transient elastography-measured liver stiffness in 314 participants (165 HIV positive/hepatitis C virus [HCV] negative, 78 HIV positive/HCV positive, 14 HIV negative/HCV positive, 57 HIV negative/HCV negative) in the Women's Interagency HIV Study.
RESULTS
Compared with HIV negative/HCV negative women, HIV positive/HCV positive women had higher median liver stiffness values (7.1 vs 4.4 kPa; P < .001); HIV positive/HCV negative and HIV negative/HCV negative women had similar liver stiffness values (both 4.4 kPa; P = .94). HIV/HCV coinfection remained associated with higher liver stiffness values (74% higher; 95% confidence interval [CI], 49-104) even after multivariable adjustment. Among HCV positive women, waist circumference (per 10-cm increase) was associated with 18% (95% CI, 7.5%-30%) higher liver stiffness values after multivariable adjustment; waist circumference showed little association among HIV positive/HCV negative or HIV negative/HCV negative women. Among HIV positive/HCV negative women, history of AIDS (13%; 95% CI, 4% -27%) and HIV RNA (7.3%; 95% CI, 1.59%-13.3%, per 10-fold increase) were associated with greater liver stiffness.
CONCLUSIONS
HCV infection but not HIV infection is associated with greater liver stiffness when infected women are compared with those with neither infection. Our finding that waist circumference, a marker of central obesity, is associated with greater liver stiffness in HIV/HCV-coinfected but not HIV-monoinfected or women with neither infection suggests that in the absence of HCV-associated liver injury the adverse effects of obesity are lessened.
View on PubMed2013
2013
2013
2013
2013
BACKGROUND
Patellar fractures are debilitating injuries that compromise the knee extensor mechanism and are frequently associated with poor outcomes. The purpose of this study was to quantify the functional outcomes of operative treatment of patellar fractures.
METHODS
Functional outcome data on thirty patients with an isolated unilateral patellar fracture were prospectively obtained at three, six, and twelve months postoperatively.
RESULTS
All fractures healed. There were two complications (7%) related to the surgery (wound dehiscence and refracture), and eleven patients (37%) underwent removal of symptomatic implants. The tibial plateau-patella angle demonstrated patella baja in seventeen (57%) of the patients. Anterior knee pain during activities of daily living was experienced by twenty-four (80%) of the patients. Clinical improvement occurred over the first six months. However, functional impairment persisted at twelve months, with objective testing demonstrating that the knee extensor mechanism on the injured side had deficits in strength (-41%), power (-47%), and endurance (-34%) as compared with the uninjured side.
CONCLUSIONS
Despite advances in surgical protocols and acceptable radiographic outcomes, functional impairment remains common after treatment of patellar fractures. Rehabilitation strategies following surgical stabilization of these injuries will be a fruitful area for future clinical research.
View on PubMed