Objective

To determine the prevalence of age-related macular degeneration (AMD) and indentify its risk factors in an Oklahoma Indian population.

Design

Cross sectional study design

Participants

A total of 1019 Oklahoma Indians who participated in baseline and second examinations of the Oklahoma Strong Heart Study were enrolled in Vision Keepers.

Methods

Retinal photographs of at least one eye were taken and graded for AMD by the University of Wisconsin Ocular Epidemiology Reading Center using the Wisconsin Age-Related Maculopathy Grading System. Retinal photographs of 986 participants were considered gradable and included in the study.

Main Outcome Measures

Age-related macular degeneration (early & late).

Results

The overall prevalence of any AMD in the Vision Keepers study was 35.2% including a prevalence of 0.81% for late AMD. The prevalence of early AMD increased from 30.6% in those aged 48–59 years to 46.1% in age group 70–82 years. When potential risk factor was considered individually in the univariate analyses, men with hypertension had significantly higher prevalence of AMD (p=0.02) than those without hypertension. In women high density lipoprotein-cholesterol and sun exposure were positively associated with the prevalence of AMD (p=0.01) while a history of using multivitamins was associated with lower AMD prevalence (p= 0.005). When multiple risk factors were considered simultaneously in the logistic regression analyses, only age showed significant association with AMD in both men (p=0.02) and women (p <0.0001) and was the only significant risk factor in men. In women, multivitamin use and total cholesterol had significant inverse association with AMD while sun exposure and high density lipoprotein cholesterol had positive association. When men and women are combined, age and high density lipoproteincholesterol had significant positive association while total cholesterol and multivitamin use and current alcohol use showed a significant inverse association with AMD.

Conclusion

This study was the first to report detailed prevalence of AMD in Oklahoma Indians and its risk factors. The prevalence appeared to be relatively high as compared to other ethnic groups. Some of the modifiable risk factors identified confirmed previous findings and can be used to design preventive programs to reduce the burden of AMD, though longitudinal data are still needed.

Background

Dendritic cells (DCs) are the sentinels of the mammalian immune system, characterized by a complex maturation process driven by pathogen detection. Although multiple studies have described the analysis of activated DCs by transcriptional profiling, recent findings indicate that mRNAs are also regulated at the translational level. A systematic analysis of the mRNAs being translationally regulated at various stages of DC activation was performed using translational profiling, which combines sucrose gradient fractionation of polysomal-bound mRNAs with DNA microarray analysis.

Results

Total and polysomal-bound mRNA populations purified from immature, 4 h and 16 h LPS-stimulated human monocyte-derived DCs were analyzed on Affymetrix microarrays U133 2.0. A group of 375 transcripts was identified as translationally regulated during DC-activation. In addition to several biochemical pathways related to immunity, the most statistically relevant biological function identified among the translationally regulated mRNAs was protein biosynthesis itself. We singled-out a cluster of 11 large ribosome proteins mRNAs, which are disengaged from polysomes at late time of maturation, suggesting the existence of a negative feedback loop regulating translation in DCs and linking ribosomal proteins to immuno-modulatory function.

Conclusion

Our observations highlight the importance of translation regulation during the immune response, and may favor the identification of novel protein networks relevant for immunity. Our study also provides information on the potential absence of correlation between gene expression and protein production for specific mRNA molecules present in DCs.

Indicators of the performance of clinical preventive services (CPS) have been adopted in the ambulatory setting to improve quality of care. The impact of CPS was evaluated in a network of 49 primary care practices providing care to an estimated 245,000 adults in the Dallas–Fort Worth area through a sample chart review to determine delivery of recommended evidence-based CPS combined with medical literature estimates of the effectiveness of CPS. In this population in 2005, CPS were estimated to have prevented 36 deaths and 97 incident cases of cancer; 420 coronary heart disease events (including 66 sudden deaths) and 118 strokes; 816 cases of influenza and pneumonia (including 24 hospital admissions); and 87 osteoporosis-related fractures. Thus, CPS have substantial benefits in preventing deaths and illness episodes.