Access for dialysis of patients with end-stage chronic renal failure

Peritoneal catheters [PCs] were implanted in 40 patients as access for peritoneal dialysis and direct [autogenous] arteriovenous fistulas [DAVFs] were constructed in 40 patients as accesses for hemodialysis. All patients were followed for two years to study the complications and long term of the access for dialysis. In PCs infection [peritonitis] occurred in 10 patients, four of them were treated conservatively and their catheters were preserved and six cases required catheter removal, catheter malfunction occurred in four patients and required catheter removal. Early leakage of the dialysate occurred in two cases and stopped with conservative measures. Two patients developed hernia. Overall catheter removal was required in 10 patients. Infection was responsible for six cases and malfunction was responsible for four cases. AVFs, narrow veins causing difficulty during fistula construction were encountered in 65% of all patients and narrow arteries causing difficulty were encountered in 40% of all patients. Thrombosis occurred in six fistulas and they were all lost. Edema occurred in 14 patients and six of them showed venous congestion. Edema and venous congestion responded to conservative measures. Two patients developed aneurysm which did not require specific treatment. Infection, heart failure or ischemic manifestation did not occur. At two years, 85% of all fistula worked well. Thrombosis was responsible for all cases of fistulas failure

pathological involvement of axillary lymph nodes in cancer breast

This study has been completed on 23 patients with breast carcinoma. Their age ranged from 33 to 70 years with mean age of 48.6 years. The number of affected nodes increases in those patients with level two and three. The impact of the level of the affected nodes on their number was statistically highly significant. The impact of the stage on the number of the affected lymph nodes was statistically significant. The study showed that there was an increase in the number of the affected lymph nodes in the postmenopausal period. Modified radical mastectomy is the required treatment for breast cancer in order to provide enough specimen for the judgment of lymph node status of the patient which determines the further management whether radio or chemotherapy