Lower stages (0 and I) were more frequent among the oldest patients while nearly 50% of patients aged ≤40 had tumor stage III. We also observed a significant decreasing trend in the mean LN count (p<0.05) and blood vessel invasion (p=0.023) from younger to older age groups. Conclusions: More aggressive disease for younger age groups, earlier peak incidence age and high rate of advanced BC at the time of diagnosis among Iranian women, were the main findings of this study.

BackgroundIn candidate patients for permanent hemodialysis or dialysis on a regular basis, an appropriate vascular access has great importance. The best permanent access is AVF (arterio venous fistula). Use of a technique to create AVF with better patency seems to be logical.ObjectivesThe present study aimed to compare the efficacy rate of AVFs using two different anastomosis methods; Side to Side (STS) versus End to Side (ETS) and to determine whether the different approaches render any preferences or complications.Patients and MethodsSixty end stage renal disease (ESRD) patients were included in this clinical trial in two assigned groups of 30 patients. In one group end to side method to create AVF was used while in the other group Side to Side technique was applied for access in surgery. Both groups were followed for duration of 6 months to assess patency. For evaluating the quantitive variables, t-test was used while qualitative variables were measured using the chi-square and Fisher`s exact tests.ResultsIn the 6 months duration, 6 patients (20%) in the STS (side to side) group and 5 patients (16.6%) in the ETS (end to side) group experienced a non-functional AVF. In the ETS group the failure was generally a result of thrombosed access while in the STS group, 4 out of 6 patients with complications, experienced thrombosis while the other 2 patients had venous hypertension. The total failure rate was 18.3% and during the 6 months of follow up no significant difference was detected in the efficacy rate. Nevertheless, in case of longer follow ups, different outcomes could be seen.ConclusionsThis study demonstrated that there was no significant statistical difference between the functional patency rates of fistulae placed by STS or ETS methods.

Percutaneous vertebroplasty (PVP) with polymethylmethacrylate (PMMA) is a minimally invasive procedure that provides significant pain relief in a high percentage of patients with osteoporotic fractures. The complication rate of PVP is reported to be below 6%. This case illustrates, for the first time, an arterial PMMA embolus to the aorta and its branches as a complication of PVP.

Large-vessel aneurysm is an extremely rare complication of Wegener granulomatosis. We report a case of Wegener granulomatosis in a 49-year-old woman with large synchronous aneurysms of the celiac trunk (54 mm) and superior mesenteric artery (42 mm) who presented with abdominal pain. Because of the large diameter of the aneurysms and their proximity to each other, a combination of endovascular and hybrid repair was used for management. After surgical debranching and endovascular repair, the patient was discharged in good general condition. We concluded that abdominal pain in Wegener granulomatosis can be a rare manifestation of a large visceral aneurysm.

Introduction: The autonomic nervous system, a derivative of neural crest cells, may undergo the neoplastic transformation and give rise to paragangliomas, which can arise either at intra-adrenal or extra-adrenal sites, commonly referred to as pheochromocytomas and paragangliomas, respectively. Although indistinguishable at the cellular level and usually identical in clinical manifestation, these two tumors differ in means of malignancy risk, genetic testing, and the probability of detecting an associated neoplasm, highlighting the importance of making a correct diagnosis to prevent additional complications. Case Presentation: We report a 17-year-old female patient presented with sudden blurred vision and palpitation lasting for 1 week. The physical examination revealed tachycardia, hypertension, and a mildly tender mass on the left side of the umbilicus. A spiral abdominal and pelvic computed tomography (CT) scan was performed, which depicted a hypervascular retroperitoneal mass in the left infrarenal region. Mildly-elevated urine metanephrine and normetanephrine levels were suggestive of a paraganglioma (PGL). Iodine-131 metaiodobenzylguanidine (MIBG) scan was also in favor of PGL of the organ of Zuckerkandl. The mass was completely resected and the immunohistochemistry (IHC) study of the specimen confirmed the diagnosis. Conclusions: The diversity of manifestations and rarity of PGL can delay the diagnosis, which may lead to potential complications. This makes it compelling to include PGLs in differential diagnoses in a clinical setting compatible with catecholamine hypersecretion.