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Purpose: The purpose of this work is to perform an application study on experimental animals (dogs) to investigate the efficiency of using weft knitted mesh fabric as cardiac support mesh to support left ventricular hypertrophy. Design/methodology/approach: In this work, weft-knitted mesh sample "Knitted Cardiac Support Mesh" manufactured using Nylon (6, 6) yarns, with count 20 Denier and medium mesh size, was placed around the two ventricles to prevent further dilatation, support and reduce left ventricular wall stress. Findings: Medical textile is a rapidly expanding field in technical textiles that are widely used in a variety of medical applications. One of these medical textile applications is "Knitted Cardiac Support Mesh", which is used in the treatment of Dilated Cardiomyopathy. Originality/value: After the implantation of the manufactured Knitted Cardiac Support Mesh around the myocardium, all dogs survived for three months before being euthanized, and some clinical examinations were performed to investigate and evaluate the sample performance. It was demonstrated from the experimental application, that the nylon mesh sample performed the best during the surgical operation due to its good ability to stretch and recover at a moderate rate, as well as the textile mesh lightweight. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Renal masses are becoming an increasingly common finding on cross-sectional images. Characterization of the nature of the lesion either neoplastic or not, benign or malignant as well as further subtype characterization is becoming an important factor in determining management plan. The purpose of our study with to assess the sensitivity and specificity of both ADC mean value and ADC ratio in such characterization along with the calculation of different cutoff values to differentiate between different varieties, using pathological data as the main gold standard for diagnosis. Results: Our study included 50 patients with a total of 72 masses. A final diagnosis was reached in 69 masses by pathological examination and three masses had clinical and laboratory signs of infection. We had a total of 49 malignant lesions (68%) and 23 benign lesions (32%). The ADC value of ccRCC (1.4 × 10−3 mm2/s) was significantly higher than all other renal masses. A cutoff ADC value of > 1.1 and a cutoff ADC ratio of > 0.56 can be used to differentiate between clear cell renal cell carcinoma and other lesions and an ADC value of < 0.8 and an ADC ratio of ≤ 0.56 to differentiate papillary renal cell carcinoma from other masses. There was no statistically significant ADC value to differentiate between benign and malignant lesions but a statistically significant ADC ratio (> 0.52) was reached. Conclusion: ADC value and ADC ratio can be used as an adjunct tool in the characterization of different renal masses, with ADC ratio having a higher sensitivity, which can affect the prognosis and management of the patient. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common malignancy in females around the world representing 25.1% of all cancers. The high prevalence and need for early treatment of breast malignancy highlight the importance of early and accurate diagnosis. In order to achieve this target, it is necessary to select the most appropriate modality for investigation. Early detection of breast cancer by conventional mammography tends to reduce mortality; however, it has a low sensitivity and specificity in young females with dense breasts owing to reduced contrast between a possible tumor and the surrounding breast tissue with superimposition of the glandular tissue obscuring underlying lesions. Our study included 25 patients with dense breasts presented with different breast symptoms, yet the breast lump was the most common complaint. The aim of our study is to evaluate the supplementary value of contrast-enhanced spectral mammography in the assessment of symptomatic patients with dense breasts. Results: In our study, the enrolled subjects underwent both contrast-enhanced spectral mammography (CESM) and conventional full-field digital mammography (FFDM). CESM was shown to be better than FFDM in terms of sensitivity, positive predictive value, negative predictive value, and accuracy, measuring 100%, 77.8%, 100%, and 84%, compared to 56%, 75%, 46%, and 60%, respectively, yet both modalities showed low specificity, measuring 63.6% and 66.6% for CESM and FFDM, respectively. The added value of CESM was assessed in terms of ability to detect and correctly characterize the lesions in correlation to histopathological results where CESM could detect 88% of the lesions included in our study and correctly characterized 84% of the lesions; on the other side, FFDM detected only 20% of the lesions and correctly characterized 60% of the lesions. CESM changed the treatment plan to a more extensive surgery +/− neoadjuvant chemotherapy in 57% out of fourteen cases diagnosed with breast cancer emphasizing the role of CESM in assessing the extent of the disease, multicentricity, and multifocality and consequently tailoring the most appropriate treatment plan suitable for each patient. Conclusion: Contrast-enhanced spectral mammography is superior to full-field digital mammography in patients with dense breasts with a significant supplementary value in detection, characterization of lesions, and tailoring the appropriate treatment plan. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The association between uric acid (UA) on one side and systemic hypertension (Htn), dyslipidemia, glucose intolerance, overweight, fatty liver, renal disease and cardiovascular disease (CVD) on the other side is well recognized. However, the causal relationship between UA and these different clinical problems is still debatable. The recent years have witnessed hundreds of experimental and clinical trials that favored the opinion that UA is a probable player in the pathogenesis of these disease entities. These studies disclosed the strong association between hyperuricemia and metabolic syndrome (MS), obesity, Htn, type 2 diabetes mellitus (DM), non-alcoholic fatty liver disease, hypertriglyceridemia, acute kidney injury, chronic kidney disease (CKD), coronary heart disease (CHD), heart failure and increased mortality among cardiac and CKD patients. The association between UA and nephrolithiasis or preeclampsia is a non-debatable association. Recent experimental trials have disclosed different changes in enzyme activities induced by UA. Nitric oxide (NO) synthase, adenosine monophosphate kinase (AMPK), adenosine monophosphate dehydrogenase (AMPD), and nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase are affected by UA. These changes in enzymatic activities can lead to the observed biochemical and pathological changes associated with UA. The recent experimental, clinical, interventional, and epidemiologic trials favor the concept of a causative role of UA in the pathogenesis of MS, renal, and CVDs. [ABSTRACT FROM AUTHOR]

The recent discoveries in the fields of pathogenesis and management of diabetic nephropathy have revolutionized the knowledge about this disease. Little was added to the management of diabetic nephropathy after the introduction of renin angiotensin system blockers. The ineffective role of the renin- angiotensin system blockers in primary prevention of diabetic nephropathy in type 1 diabetes mellitus necessitated the search for other early therapeutic interventions that target alternative pathogenic mechanisms. Among the different classes of oral hypoglycemic agents, recent studies highlighted the distinguished mechanisms of sodium glucose transporter 2 blockers and dipeptidyl peptidase-4 inhibitors that settle their renoprotective actions beyond the hypoglycemic effects. The introduction of antioxidant and anti-inflammatory agents to this field had also added wealth of knowledge. However, many of these agents are still waiting well-designed clinical studies in order to prove their beneficial therapeutic role. The aim of this review of literature is to highlight the recent advances in understanding the pathogenesis, diagnosis, the established and the potential renoprotective therapeutic agents that would prevent the development or the progression of diabetic nephropathy. [ABSTRACT FROM AUTHOR]

The death rate among chronic kidney disease patients is the highest compared to other chronic diseases. 60% of these fatalities are cardiovascular. Cardiovascular calcifications and chronic inflammation affect almost all chronic kidney disease patients and are associated with cardiovascular mortality. Fibroblast growth factor 23 is associated with vascular calcification. Systemic inflammation in chronic kidney disease patients is multifactorial. The role of systemic inflammation in the pathogenesis of vascular calcification was recently reappraised. Fibroblast growth factor 23 was accused as a direct stimulus of left ventricular hypertrophy, uremic inflammation, and impaired neutrophil function. This review will discuss the underlying mechanisms that underlie the link between Fibroblast growth factor 23 and increased mortality encountered among chronic kidney disease patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: Most patients with chronic renal failure suffer from complications that make brachial plexus block a good choice for providing anesthesia. The use of ultrasonography increases the success rate and decreases complications. We compared the efficacy of ultrasound-guided supraclavicular and infraclavicular brachial plexus block in providing anesthesia for creation of arteriovenous fistula. Patients and methods: Sixty adult patients with chronic renal failure, scheduled for creation of arteriovenous fistula of the distal upper extremity were randomly divided into two equal groups: Supra G (n =30): ultrasonic guided supraclavicular brachial plexus block was given and Infra G (n =30): ultrasonic guided infraclavicular brachial plexus block was given. For both groups we used 20–25cm 1:1 volumes of 0.5% bupivacaine and 2% lidocaine. The measured parameters were block performance time and related pain, the degree and duration of sensory and motor block, patient discomfort, first call for analgesics, complications and the patient’s satisfaction. Results: There was no statistically significant difference between both groups as regard the block performance time, the block related pain, the degree of sensory and motor block in the areas supplied by the median, radial and musculocutaneous nerves at 10, 20 and 30min. There was no statistically significant difference as regard the sensory block grade in the area supplied by the ulnar nerve at 10min, but it was significantly higher in the Supra G than Infra G at 20 and 30min. No statistically significant difference as regard the motor block grade in the area supplied by the ulnar nerve, the block duration, first call for analgesia, complications and patients’ satisfaction. Conclusion: Both approaches can provide satisfactory sensory and motor block, very good analgesia that extends for a long time postoperatively in patients with chronic renal failure undergoing creation of arteriovenous fistula. [Copyright &y& Elsevier]

Abstract: Introduction: Hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease. An estimated 180million people are infected worldwide. The prevalence of hepatitis C virus (HCV) infection is relatively low in children, with an anti-HCV prevalence rate of 0.2–0.4% in the Western world. Egypt has the highest prevalence of adult HCV infection in the world, averaging 15–25% in rural communities. The main (90%) HCV genotype is type 4. The magnitude of HCV infection in children is not well studied. Asymptomatic HCV infection is detectable in 2.02% of Egyptian children. Aim: To study the clinical presentation and histopathological features of the liver in children with chronic hepatitis C infection. Methods: The study population included 40 children from 2 to 16years who had been diagnosed with chronic hepatitis C (HCV-RNA positive for 6months or more by Real-time PCR) in the liver clinic at El-Shatby Children Hospital. Results: Among the 40 patients’ biopsies, 26 (65%) were stage 0, 10 (25%) were stage 1, 4 (10%) were stage 2–3 (HAI). The grades of all 40 children ranged between 0 and 1 (HAI). Developing fibrosis was significantly associated with age (P =0.015). Conclusion: Children with chronic HCV infection are generally asymptomatic. Significant hepatic fibrosis was present in 10% of children with HCV infection. Fibrosis stage was significantly higher in older age children. There was no significant association between fibrosis stage and any biochemical parameter. [Copyright &y& Elsevier]

Abstract: Introduction: Chronic allograft nephropathy (CAN) is a poorly understood clinico-pathological entity associated with chronic allograft loss due to immunologic and non-immunologic causes. It remains the leading cause of late allograft loss. Bone marrow derived stem cells are undifferentiated cells typically characterized by their capacity for self renewal, ability to give rise to multiple differentiated cellular population, including hematopoietic (HSCs) and mesenchymal stem cells (MSCs). Characterization of HSCs includes their multipotency, expression of typical surface markers such as CD34 and CD45, while characterization of MSC includes their multipotency, expression of typical surface markers such as CD90 and CD105, and the absence of hemopoietic lineage markers. Aim & methods: The aim of the present work was to study the role of bone marrow-derived HSCs and MSCs, renal progenitor cells and SCF in chronic renal allograft nephropathy in relation to renal hemodynamics and histopathological changes. We studied 30 patients with kidney transplantation for more than 6months, divided into 15 patients with stable serum creatinine and 15 patients who developed CAN. Detection of HSCs and MSCs in the peripheral blood using flow cytometry via detection of CD34, CD45, CD117 and CD106, as well as immunohistochemical detection of CD34, CD133, VEGF and αSMA in transplanted kidney biopsies of patients with CAN were done. Results: There was a significant increase in the levels of SCF, number of peripheral blood HSCs and MSCs in both transplanted patient groups than the controls and they were higher in patients of group Ia than patients of group Ib, (F =39.73, P <0.001), (F =13.28, P <0.001), (F =11.94, P <0.001), respectively and this was accompanied by evident expression of markers of renal repair. Conclusion: Stem cells might have a role in renal regeneration in CAN and this may pave the way toward the use of stem cells in correction of CAN. [Copyright &y& Elsevier]

Abstract: Background: There are so many factors contributing to the pathophysiology of type II DM, some of these factors are trace elements and Malondialdehyde (MDA). Their increase or decrease may affect control of diabetes and delay the complications. Aim: Zinc (Zn), copper (Cu), magnesium (Mg), chromium (Cr), selenium (Se) and MDA were studied in this work to clarify their role in the pathogenesis and complications of type II DM aiming at preventing or delaying its complications. Materials and methods: The present study was conducted on 50 patients with type II DM divided into 2 groups: group I (controlled diabetic patients), n =20 and group II which comprised 30 uncontrolled diabetic patients complicated with diabetic nephropathy, neuropathy and retinopathy. Their results were compared to 15 age and sex matched healthy group. Patients and controls were subjected to full history taking, complete clinical examination and laboratory investigations which included measuring fasting serum glucose, cholesterol, triglycerides, HDL-c and LDL-c. HbA1c was measured by column chromatography. MDA was assayed using colorimetric technique. The trace elements were measured in blood by means of atomic absorption spectrometer. Results: The mean levels of Zn, Mg, Se were significantly lower in the diabetic groups than the control group (P <0.001), while MDA was significantly higher in the diabetic groups (P <0.001). MDA showed significant positive correlation with HbA1c (r =0.301), cholesterol (r =0.394), triglycerides (0.315) and LDL-c (r =0.354) and negative correlation with HDL-c (r =−0.315). Significant negative correlation was found between each of Zn, Mg and Se and each of HbA1c and cholesterol. Copper positively correlated with HbA1c, cholesterol and LDL-c. MDA positively correlated with copper (r =0.307) and negatively correlated with Zn, Mg and Se (r =−0.356, −0.282, −0.513, respectively). Conclusion: Trace elements and MDA could have a role as cofactors in the pathogenesis of type II DM. They could be used as markers to evaluate the glycemic control as well as showing the lipid status of diabetic patients. Trace elements supplementations as zinc, magnesium and selenium might have utility in the treatment of the complex disorder in type II DM and may help in control of blood glucose and lipid levels, thus preventing or delaying serious clinical events in these patients. [Copyright &y& Elsevier]