Many of the previously suggested associations found with CVI are in reality due to this population's greater age. Patients with CVI are older, male, obese, have a history of phlebitis, and have a history of serious leg injury. These results suggest that a prior deep vein thrombosis, either clinical or subclinical, may be a predisposing factor for CVI.

Background: The standard of care for early-stage breast cancer includes surgical removal of the tumor and axillary lymph node dissection (ALND). Despite increased use of breast-conserving surgery, lymphedema rates are similar to those with more radical surgery.Hypothesis: Women who experience breast cancerrelated lymphedema have a measurable reduction in quality of life compared with women without lymphedema.Design: In a retrospective cohort study, we explored the association between lymphedema and quality of life, controlling for patient demographics, surgical factors, and treatment types.Settings: An urban academic medical center and a community hospital.Participants: A total of 151 women surgically treated for early-stage breast cancer (stages 0-II) were assessed at least 1 year after their ALND. The women had been treated with either conservative surgery and radiation or mastectomy without radiation. Main Outcome Measures:Arm volume was measured by water displacement. Grip strength and rangeof-motion measurements assessed arm function. The Functional Assessment of Cancer Therapy-Breast (FACT-B) quality-of-life instrument assessed breast, emotional, functional, physical, and social well-being.Results: Lymphedema (an arm volume difference Ն200 cm 3 ) was measured in 42 women (27.8%). Mastectomy or conservative surgery patients had similar lymphedema rates. Women with lymphedema in both surgical groups scored significantly lower on 4 of the 5 subsections than women without lymphedema, even after adjusting for other factors influencing quality of life.Conclusions: Lymphedema occurs at appreciable rates, and its impact on long-term quality of life in survivors of early-stage breast cancer should not be underestimated.

In patients with renal failure and a history of diabetes, both primary BCAVFs and TBAVFs demonstrate significantly greater maturation and increased primary cumulative patency rates compared with RCAVFs; therefore, these autogenous conduits are considered to be optimal in this group of patients. Whether the discrepancy in lower-arm vein maturation is a result of a lack of compensatory increase in radial arterial flow or an intrinsic defect in the lower-arm cephalic vein is currently under investigation.

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We assessed the oral health status of 216 refugee torture survivors seeking care at an urban torture treatment center in the United States. Results showed that patients' dental health ranged from poor to fair; 76% had untreated cavities, and approximately 90% required immediate or near-immediate dental care. Torture treatment centers, in addition to offering safe environments for educating and examining patients, are ideal settings to provide basic oral health services without the risk of retraumatization. (Am J

Hypertension, smoking, and male sex are risk factors for the development of femoral atherosclerosis and abdominal aortic aneurysm formation. However, abdominal aortic aneurysms occur predominantly in white men and do not appear to be associated with diabetes mellitus or income. In contrast, the higher rate of femoral artery bypass in black patients is probably the result of greater prevalence among black patients of hypertension, diabetes, smoking, and perhaps by other ill-defined factors associated with socioeconomic status.

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Despite the use of the optimal autogenous conduit, the combination of diabetes and end-stage renal disease can be expected to significantly decrease primary graft patency without affecting limb salvage. The greatest effect of these comorbid factors is on patient survival.