9 research outputs found

    Visfatin versus Flow-Mediated Dilatation as a Marker of Endothelial Dysfunction in Pediatric Renal Transplant Recipients

    Get PDF
    BACKGROUND: Renal transplantation (RTx) is the treatment of choice for paediatric end-stage renal disease (ESRD). A major cause of morbidity and mortality after RTx is cardiovascular disease. Independent predictors of cardiovascular events were shown to constitute an endothelial dysfunction (ED). This study aims to evaluate Visfatin serum level in comparison to brachial artery flow-mediated dilatation (FMD) as a marker of endothelial dysfunction in paediatric RTx recipients.METHODS: Visfatin serum level has been evaluated in 30 patients on regular hemodialysis (HD), 36 patients post-RTx and 30 controls as a measure for ED, and has been compared to brachial artery FMD.RESULTS: Visfatin level in transplant recipients was significantly lower than the hemodialysis group as well as FMD was better in transplant recipients. In spite of marked improvement of FMD and marked reduction of visfatin in post-RTx no direct statistical correlation was found between serum Visfatin level and flow-mediated dilatation.CONCLUSION: Pediatric RTx recipients show lower serum Visfatin level and better FMD than those on regular hemodialysis, reflecting less endothelial dysfunction (ED) and less cardiovascular risk. FMD in kidney transplant recipients tends to be less than normal subjects while visfatin level of the same group is similar to controls. Pediatric RTx appears to have a positive impact on the growth development of children with ESRD

    A Study of the Performance of Ship Diesel-Electric Propulsion Systems From an Environmental, Energy Efficiency, and Economic Perspective

    No full text
    Climate change and air pollution that are enormously impacted by ship emissions have become an intriguing issue, drawing consideration from the shipping industry. The ship’s propulsion system is the main contributor to energy efficiency and ship emissions. This research paper presents a solution to this issue through propelling the ship by using a diesel-electric propulsion system instead of the conventional one. As a case study, a passenger ship is investigated. The results showed that the proposed electric propulsion system has lower emission rates than the conventional one by 10%, 21%, and 88% for Carbon dioxide, Nitrogen oxides and Sulfur dioxide emissions, respectively. From an energy efficiency point of view, the diesel-electric propulsion system enhances the energy efficiency and complies with the required International Maritime Organization (IMO) values, as actual energy efficiency is about 66%, 70%, 83%, and 95% of the required IMO values at baseline, Phase 1, Phase 2, and Phase 3, respectively. From the economic point of view, the annual costs are 2.5and2.5 and 3.05 million for both diesel-electric and conventional propulsion systems, respectively. This shows that the annual cost of the diesel-electric option is less than that of the conventional by 22%

    Uses of Smartphone Thermal Imaging in Perforator Flaps as a Versatile Intraoperative Tool: The Microsurgeon's Third Eye

    No full text
    Introduction: In this study, we evaluate the versatility of smartphone thermal imaging technology as a valuable intraoperative modality in different stages of perforator flap surgery aiming to minimize the complications and achieve the best postoperative outcome. Patients and methods: Thermography was performed in 20 perforator flaps in 20 patients at different surgical stages in three different ways to identify the most dominant perforator: first, by measuring the surface temperature of the skin; second, by using the dynamic infrared thermography technique; and third, by assessing the perfusion pattern when the flap was supplied by each perforator separately. Thermography was used to help in discarding the least perfused area of the flap. After microvascular anastomosis, the flap reheating pattern was evaluated. Results: Seventeen free and three pedicled perforator flaps were included. Intraoperatively, each of the selected perforators had a corresponding hotspot. The perforator with the hottest hotpot, best rewarming, and provision of best flap perfusion on thermography was found clinically dominant. After microvascular anastomosis in free flaps, rapid rewarming was recorded in 15 cases. In two deep inferior epigastric perforator flaps, no rapid rewarming was observed. The pedicle was kinked in one case and there was a venous insufficiency in another case that required a cephalic turndown. All flaps showed good perfusion on thermography after inset. Conclusion: Smartphone thermography has proven to be a valuable, cheap, rapidly employed, and objective tool not only for the design of perforator flaps, but also for the decision making intraoperatively to achieve the best surgical outcome
    corecore