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The purpose of this study was to evaluate the efficacy and safety of implantation of a new continuous corneal ring in keratoconic corneas of an Iranian population.

This study was conducted on 95 contact lens-intolerant keratoconic eyes with clear central corneas. A continuous corneal ring, annular intrastromal corneal inlay (AICI), was inserted using femtosecond laser in all cases. Patients were followed up for 1, 3, and 12 months postsurgery. Visual and subjective refractive outcomes were evaluated in each examination. Besides, keratometry and aberrometric values were recorded before and 12 months after surgery. Finally, vector analysis of refractive astigmatism was performed using the Alpins method.

The uncorrected and corrected distance visual acuities improved significantly 12 months after surgery from 0.91 ± 0.39 to 0.38 ± 0.22 (P < 0 0.001) and 0.33 ± 0.21 to 0.13 ± 0.11 logMAR (P < 0.001), respectively. Moreover, spherical and cylindrical refractive components reduced from -2.52 ± 2.62 to -0.76 ± 1.78 D (P < 0.001) and -4.14 ± 1.64 to -1.91 ± 1.18 D (P < 0.001), respectively. The mean anterior keratometry had a significant reduction 12 months after AICI insertion (P< 0.001). Primary coma and spherical aberration values showed a significant increase (both, P < 0.05). Our results showed 100% safety (safety index 1.8) and 45% efficacy (efficacy index 1).

AICI implantation seemed to be a safe and effective procedure for improving visual acuity and refractive outcomes in subjects with keratoconus.

AICI implantation seemed to be a safe and effective procedure for improving visual acuity and refractive outcomes in subjects with keratoconus.

Hirayama disease is a rare neuromuscular disease which classically presents as lower motor neuron weakness and atrophy in the upper extremities and specifically the C7-T1 myotomes. Proposed pathogenesis relates to microcirculatory dysfunction in the territory of the anterior spinal artery caused by epidural venous plexus engorgement with forward displacement of the posterior dura and spinal cord during neck flexion, leading to chronic ischemic changes in the lower cervical anterior horn cells. Diagnosis hinges upon clinical and radiographic findings and treatment is generally conservative given the self-limited nature of the disease. Here, we present a case with classic radiologic findings of Hirayama disease with lower limb myelopathic findings alone. This case raises the question of whether the pathophysiology leading to focal anterior cervical myelopathy in forward flexion could present along a broader clinical spectrum than previously recognized, from complete asymptomaticity, to classic Hirayama diseasognized, from complete asymptomaticity, to classic Hirayama disease with C7-T1 atrophy, to cervical myelopathy with long tract signs.

HIV and HBV co-infection can accelerate morbidity and mortality, especially in sub-Saharan Africa where both infections are common. While inflammation contributes to disease progression, more information is needed to better understand the pathology. This study compared markers of cirrhosis and inflammation in HIV/HBV coinfected individuals compared to monoinfected and uninfected patients.

The HIV/HBV coinfected participants from the Ugandan arm of the prospective African Cohort Study (AFRICOS) were selected for evaluation and matched by age and sex with HIV-monoinfected, HBV-monoinfected, and uninfected controls.

Plasma samples were used to quantify markers of immune activation and inflammation. The FIB-4 score was used to estimate liver fibrosis. Demographic and laboratory characteristics were compared across the groups.

Together, 31 HIV/HBV-coinfected participants were identified and compared to 62 HIV-monoinfected, 7 HBV-monoinfected, and 62 uninfected controls. The HIV/HBV-coinfected group had genlect the mechanism of liver fibrosis and increased risk for disease progression. Finally, there may be an underappreciated amount of undiagnosed advanced liver disease in sub-Saharan Africa.

Antiretroviral therapy (ART) is an important hallmark of HIV-1 treatment, enabling viral load suppression to undetectable levels and CD4+ T cells recovery. However, some individuals do not recover the CD4+ T cell count to normal levels, despite viral suppression. We hypothesize that variation in genes involved in extrinsic apoptosis pathways may influence interindividual immune recovery during ART.

We assessed clinic-epidemiological variables, and the allelic/genotypic distribution of functional single nucleotide polymorphisms in genes involved in extrinsic apoptosis pathways (TNFRSF1A rs1800692, rs767455; TNFAIP3 rs2270926; NFKBIA rs8904; TNF-α rs1800629) and their relationship with immune recovery in ART treated (one year) HIV-1-infected individuals. We enrolled 155 HIV-1 infected individuals, 102 showing immunological success and 53 with immunological failure.

Through univariate analysis, we observed that the male sex (60.4%, p=0.002) showed higher median of age at treatment onset (34.8 years, p=0.034) and higher time until virological suppression (6 months, p=0.035), both risk factors for immune failure. Survival analysis revealed that individuals who started ART treatment with T CD4+ cells count <200 cells/mm3 took a longer time to immunological recovery (median time = 27 months, p=0.029). ART containing zidovudine (AZT) also was associated with immune recovery in univariate e multivariate analysis. Variants in TNFRSF1A (rs767455 T, TT; rs1800692-rs767455 T-T combination) and NFKBIA (rs8904 A) genes associated with immune failure, while NFKBIA (rs8904 GA) and TNF-α (rs1800629 GA), with CD4+ T cells recovery.

Clinic-epidemiological and variants in genes involved in extrinsic apoptosis pathways might influence the CD4+ T cells immune recovery.

Clinic-epidemiological and variants in genes involved in extrinsic apoptosis pathways might influence the CD4+ T cells immune recovery.

The recent global pandemic of coronavirus disease-19, also known as COVID-19, has posed significant challenges to Emergency Department (ED) HIV and HCV screening programs as well as linkage to care efforts in those identified with HIV or HCV infections. The goal of this educational report was to describe challenges in the face of the COVID-19 pandemic and solutions, focusing on our HIV and HCV opt-out universal ED screening program at the University of California San Diego (UCSD) Medical Center, San Diego, CA, USA. Our automated, routine HIV and HCV ED screening program continued high-level screening during the peak of the COVID-19 pandemic, although absolute numbers were reduced by about one-third, in line with a reduced ED census. Although linkage to care procedures continued during the pandemic, COVID-19 played a significant role in slowing the process, particularly in relinkage of known HIV-positive patients and in linkage of HCV-positive patients. Isuzinaxib mouse Further efforts are needed to improve linkage to care processes in the era of COVID-19, especially as cases are rising in the United States.