Lipoatrophy of the footpad in HIV-treated patients is associated with increased PAI-1

Purpose: To describe lipoatrophy of the plantar pedis fat pads in HIV patients with or without long-term antiretroviral therapy (ART); to compare the characteristics of ART patients with and without plantar pedis lipoatrophy; and to examine the effects of HIV and metabolic/cardiovascular risk parameters and treatment history on plantar pedis lipoatrophy. Design: One hundred and thirty four patients who started PI-ART in 1996 and 49 treatment naïve patients, recruited 2004, were examined and graded for lipoatrophy of five body compartments including the plantar fat pads eight years after start of ART. Baseline HIV- and ART-related factors were documented together with follow up metabolic/cardiovascular risk parameters. Results: Plantar pedis lipoatrophy occurred more often among ART patients (60%) than among treatment naïve patients (12%; p <0.001). ART patients with plantar lipoatrophy were older, had higher PAI-1 values, a higher prevalence of lipoatrophy in other body compartments, and longer stavudine and didanosine treatment history as compared to patients without plantar lipoatrophy. In multiple logistic regression, the best predictive model for plantar lipoatrophy was increased PAI-1 when HIV and metabolic/cardiovascular risk parameters were studied and treatment with didanosine when treatment history was studied. Increased PAI-1 was not associated to lioatrophy in any other location. Conclusions: Plantar lipoatrophy is common among patients on long-term ART and, although often overlooked, may cause significant discomfort. The association to PAI-1, a well known marker of increased cardiovascular risk, is intriguing and further focuses on the need of an active approach to evaluating and lowering cardiovascular risk factors in long-term HIV treatment

Case Wall Pressures in a Multistage Axial Compressor with Tip Clearance Variation

The article of record as published may be found at http://dx.doi.org/10.2514/3.24129Presented as Paper 93-2389 at the AIAA/SAE/ASME/ASEE 29th Joint Propulsion Conference, Monterey, CA, June 28-30, 1993Large cyclical pressure excursions from stator-averaged values are observed on the suction side of a rotor blade at the case wall in a multistage compressor as the rotor moves relative to the stator. The pressure changes correlate well with stator relative position, occur in the passage away from the blade, and are only slightly modified by tip clearance changes. Close to the entry and exit of the tip gap, however, the pressures remain stable. The pressures near the gap are only slightly affected by stator proximity and primarily vary with tip gap height.Naval Air Systems CommandAir Breathing Propulsion Research Progra

Stator Averaged, Rotor Blade-to-Blade near Wall Flow in a Multistage Axial Compressor with Tip Clearance Variation

Presented at the International Gas Turbine and Aeroengine Congress and Exposition Orlando, FL June 3-6, 1991This paper describes the effect of tip clearance changes on the pressure at the case wall of a second stage rotor. Wall shear distributions under the rotor tip are also presented. The results show low pressure areas extending along the rotor suction side but lying away from the blade. Pressure contours indicate the tangential loading at the tip is lower than predicted by two dimensional calculations, however, the predicted loading is observed between the lowest pressure’s path in the passage and the blade pressure side. The results suggest a viscous or shearing layer, due to blade-to-wall relative motion, is generated on the blade side of the tip gap which modifies the inviscid relative flow field and produces an unloading on the blade tip.Naval Air Systems Comman