Abstract Introduction: Due to their relative rarity, the natural history of iliac artery aneurysms and treatment outcomes are poorly understood. However, IAA treatment has evolved, and nowadays, there are a variety of open surgery, endovascular therapy, and hybrid options. This study aimed to compare the outcomes of endovascular treatment versus open surgery for patients with iliac artery aneurysms. Methods: A systematic review was performed according to the PRISMA statement. An online search was conducted using the Medline database from January 2014 to January 31st, 2023. Only original articles in English or Portuguese, reporting on a minimum of 5 cases, were considered. Studies were included if reporting at least one of the following outcomes: peri-operative complications, length of stay (LS), and 30-day mortality. The software Review Manager 5.4 was used for data analysis. Results: The database search identified 418 articles, of which 413 records were excluded by screening by title/abstract, and five were read in full and subsequently included. A total of 1837 patients were included. Open surgery was performed in 29.02% (442/1523) and endovascular in 70.58% (1075/1523). More than half of endovascular cases included internal iliac artery preservation techniques (iliac branch design grafts). Patients undergoing endovascular treatment were significantly older (mean difference [MD]: 5.49, 95% confidence interval [CI]: 2.34 to 8.65) and more likely to have congestive heart failure (odd ratio [OR]: 3.74, 95% CI: 1.24-11.27). On the other hand, patients undergoing open surgery were more often smokers (OR: 0.59, 95% CI: 0.42-0.82). The primary outcome - 30-day mortality - was significantly higher for open surgery (OR 0.34, 95% CI 0.19-0.61). Considering other peri-operative outcomes, patients undergoing open surgery presented with longer length of hospital stay (MD: -4.68, 95% CI: -6.43 to -2.92), higher risk of surgical wound infection (OR: 0.31, 95% CI: 0.10-0.94), renal failure (OR: 0.37, 95% CI: 0.18-0.75) and respiratory infection (OR: 0.19, 95% CI: 0.11-0.33). No significant differences regarding buttock claudication and leg and bowel ischemia were found. The 30-day reintervention rates weren´t significantly different for open and endovascular surgery (OR 0.83, 95% CI 0.33-2.1). Conclusion: Endovascular treatment of iliac artery aneurysms can reduce 30-day mortality, peri-operative complications and length of hospitalization. No differences were identified regarding 30-day reintervention rates. Consequently, endovascular treatment has gained preference over open surgery as the initial approach for patients with suitable anatomy. No other meta-analysis in the literature compares the results of open surgery and endovascular treatment, particularly the results of new endovascular techniques (iliac branch design grafts). Comparing long-term reintervention rates will be essential in the future.

Abstract Introduction: Carotid revascularization is a well-established technique for preventing stroke in patients with significant symptomatic or asymptomatic carotid artery stenosis. Carotid artery stenting (CAS) has become an alternative to carotid endarterectomy (CEA), especially in high-risk surgical patients. However, restenosis after CAS is a potentially severe complication that can impact the medium and long-term success of the procedure and increase the risk of cerebrovascular events. Methods: Relevant articles on restenosis after carotid stenting were searched in the PubMed database. The selected studies were evaluated for quality and relevance, and the information was summarized to provide an overview of the causes, risk factors, diagnosis, and treatment options for restenosis after CAS due to atherosclerotic carotid artery disease. Results: Restenosis after CAS can occur due to various factors, including thrombosis, intimal hyperplasia, and stent migration. Several risk factors have been identified, such as age, diabetes, hypertension, dyslipidemia, and smoking. Restenosis can be diagnosed with carotid Doppler ultrasound, contrast-enhanced computed tomography, or arteriography. Treatment options include angioplasty with or without rescue stent placement, CEA associated with stent explantation, or medical treatment. Conclusion: Restenosis after carotid stenting is a potentially serious complication. It is especially important to identify the risk factors for restenosis and maintain close follow-up with patients after the procedure. The treatment of restenosis should be individualized. Further studies are needed to define the best strategies for preventing and treating restenosis after carotid stenting.

Abstract The integration of emigrants into the labor market has effects on the person's migration trajectory and their interaction with the host society. It is often overcome by difficulties in adjusting human capital and professional skills to the needs of the labor market. Qualified migration illustrates with acuity the heterogeneity of these processes. The employability of qualified emigration is not uniform. Some emigrants, despite having a higher level of qualification, may find themselves working in unskilled professions - a situation of over-qualification. Based on two studies on Portuguese emigration, over-qualification rates were found in the order of 18.1% and 16.9%. Negative consequences of this over-qualification were identified: dissatisfaction with work and low wages. Factors associated with this over-qualification were also identified: young age, social and human sciences training, and residence in classic Portuguese emigration countries with a high proportion of low-skilled emigration. persons person s society processes uniform qualification overqualification. overqualification over qualification. 181 18 1 18.1 169 16 9 16.9% identified wages age training lowskilled skilled 18. 16.9 16.

Resumo A integração de emigrantes no mercado de trabalho tem efeitos na trajetória migratória da própria pessoa e na sua interação com a sociedade de acolhimento. É frequentemente trespassada por dificuldades de ajustamento do capital humano e das competências profissionais às necessidades do mercado de trabalho. A migração qualificada ilustra com particular acuidade a heterogeneidade destes processos. Com efeito, a empregabilidade da emigração qualificada não é uniforme. Alguns/mas emigrantes, embora com uma qualificação de nível superior, podem encontrar-se a desempenhar profissões não qualificadas - situação de sobre-qualificação. Com base em dois estudos sobre a emigração portuguesa, apuraram-se taxas de sobre-qualificação na ordem dos 18,1% e dos 16,9%. Identificaram-se consequências negativas desta sobre-qualificação: insatisfação com o trabalho e baixos salários. Identificaram-se também fatores associados a esta sobre-qualificação: a idade jovem, a formação em ciências sociais e humanas e a residência em países clássicos da emigração portuguesa com elevado peso de emigração pouco qualificada. acolhimento processos efeito uniforme Algunsmas Alguns mas superior encontrarse encontrar se sobrequalificação. sobrequalificação qualificação. apuraramse apuraram 181 18 1 18,1 169 16 9 16,9% Identificaramse Identificaram salários jovem 18, 16,9 16,

Abstract Introduction: Treatment decision in patients with asymptomatic carotid artery stenosis (ACS) is a matter of current debate with a recent shift towards isolated best medical treatment (BMT) as treatment of choice in most patients. However, poor medical compliance is one of the main constraints to the success of BMT. We hypothesized that more invasive treatment approaches can influence how patients perceive the severity of their illness and hence, treatment compliance. Methods: A cross-sectional study was performed including patients with asymptomatic >50% carotid artery stenosis (NASCET method) followed-up as outpatients in a Vascular Surgery department from January 2017 to December 2021. Optimal BMT was defined according to the European Society of Vascular Surgery Carotid Atherosclerotic Disease 2023 guidelines. Demographic and risk factor patient data was attained and subsequently a Portuguese translation of the Morisky medication-taking adherence scale (MMAS-4) questionnaire was given to all patients. Several additional questions developed by our group were also applied. Results: A total of 320 patients were identified (186 under BMT alone and 134 submitted to BMT and carotid endarterectomy - CEA). Most patients were male in both groups (75%) and the mean age was similar. Furthermore, patients undergoing CEA presented higher rates of current smoking (51.4% vs 15.9%; p<0.001) and lower rates of antiplatelet (80.0% vs. 92.8%; p=0.029) and statin (78.6% vs. 94.2%; p=0.007) prescription. Patients in the CEA group also presented with significantly lower medical compliance (40.3% vs. 24.5%, p<0.001) despite being more aware of their current medication´s name and therapeutic purpose. Conclusion: In conclusion, physicians seem to be more aggressive in controlling risk factors in BMT-only patients when compared to CEA-submitted patients. However, patients subjected to CEA may be more aware of ACS, despite having poorer medical adherence.

Abstract Background: Endovascular mechanical thrombectomy (MT) changed acute ischaemic stroke management and is considered the standard of care for patients with proximal anterior circulation occlusion. MT improves functional independence, without an increase in mortality. Despite its advantages, up to 20% of patients treated with MT do not have successful recanalization, leading to poor clinical outcome. We present a case of an acute ischaemic stroke of the anterior circulation due to occlusion of the common carotid artery successfully submitted to surgical thrombectomy after failed MT. Case report: A 43-year-old male, with prior history of diabetes, hypertension, dyslipidaemia and heart failure was admitted at the emergency unit with acute bilateral lower limb ischaemia, due to cardioembolic phenomena. He was submitted to bilateral femoral thrombectomy and started endovenous unfractionated heparin. On the fifth postoperative day he developed sudden depression of cognitive status and left side hemiplegia of brachial predominance. Computed tomography angiography revealed an occlusion of brachiocephalic trunk, right subclavian artery and common carotid artery, preserving its branches. MT, performed by interventional neuroradiology, was unsuccessful (no recanalization or clinical improvement). After multidisciplinary discussion, the patient underwent urgent surgical thrombectomy through carotid and transaxillary approaches. Postoperatively, the patient’s mental status and left sided motor function recovered progressively over time. Three months after, patient maintains anticoagulation with warfarin, without neurological sequalae. Conclusion: The low rate of recanalization and poor clinical outcome after MT failure underlines the need for alternative rescue approaches. Surgical thrombectomy could represent a lifeline. More studies are needed to corroborate its efficacy in patients with anterior circulation acute ischaemic stroke.

Resumo A doença quística adventicial é uma patologia que afeta principalmente o leito arterial, porém, em raros casos pode envolver o sistema venoso. O objetivo desta revisão foi padronizar a marcha diagnóstica, tratamento e vigilância de doentes com suspeita de doença quística adventicial venosa. Para cumprir os objetivos supracitados, uma revisão narrativa sumarizando os principais achados da literatura usando as bases de dados PUBMED e EMBASE foi feita. Um total de 33 artigos foram selecionados traduzindo-se num total de 41 casos de vACD. Após analise dos dados, foi possível concluir que o vaso mais frequentemente atingido é a veia femoral comum, e a maior parte dos doentes refere edema unilateral de membro com tempo de evolução variável. Quando perante um doente com edema unilateral de membro, em que a TVP foi excluída, é necessário proceder a outros meios complementares de diagnóstico de forma a confirmar, ou excluir, a vACD.

Abstract Introduction: The development of a uretero-arterial fistula (UAF) is a rare and life-threatening condition. Owing to its low prevalence, diagnosis and management remains a challenge for both urologists and vascular surgeons and UAF’s high mortality rates may be at least partially attributed to delayed diagnosis. We present a case of UAF in a patient with previous pelvic surgery and indwelling ureter catheter. Case report: An 82-year-old male presented to the emergency department with haemodynamic instability and gross haematuria that started one hour prior to admission. The laboratory study performed showed an acute anaemia of 7.5g/dl and a contrast enhanced computed tomography revealed a ureteral fistula between the stented left ureter and the common iliac artery. The patient was taken to the angiography suit and a balloon-expandable stent-graft (GORE® VIABAHN® VBX - 11mm diameter and 59mm in length) was deployed. Following the procedure, the haematuria resolved, and the patient had an uneventful post-operative stay. He was discharged two weeks after admission, following a course of large spectrum antibiotic therapy. The patient remained asymptomatic at 3 month follow up. Conclusions: Uretero-arterial fistula is an uncommon condition but with an increasing prevalence, at least in part due to improved pelvic cancer treatment.

Resumo A doença quística adventicial é uma patologia que afeta principalmente o leito arterial, porém, em raros casos pode envolver o sistema venoso. O objetivo desta revisão foi padronizar a marcha diagnóstica, tratamento e vigilância de doentes com suspeita de doença quística adventicial venosa. Para cumprir os objetivos supracitados, uma revisão narrativa sumarizando os principais achados da literatura usando as bases de dados PUBMED e EMBASE foi feita. Um total de 33 artigos foram selecionados traduzindo-se num total de 41 casos de vACD. Após analise dos dados, foi possível concluir que o vaso mais frequentemente atingido é a veia femoral comum, e a maior parte dos doentes refere edema unilateral de membro com tempo de evolução variável. Quando perante um doente com edema unilateral de membro, em que a TVP foi excluída, é necessário proceder a outros meios complementares de diagnóstico de forma a confirmar, ou excluir, a vACD.

Abstract Introduction: The development of a uretero-arterial fistula (UAF) is a rare and life-threatening condition. Owing to its low prevalence, diagnosis and management remains a challenge for both urologists and vascular surgeons and UAF’s high mortality rates may be at least partially attributed to delayed diagnosis. We present a case of UAF in a patient with previous pelvic surgery and indwelling ureter catheter. Case report: An 82-year-old male presented to the emergency department with haemodynamic instability and gross haematuria that started one hour prior to admission. The laboratory study performed showed an acute anaemia of 7.5g/dl and a contrast enhanced computed tomography revealed a ureteral fistula between the stented left ureter and the common iliac artery. The patient was taken to the angiography suit and a balloon-expandable stent-graft (GORE® VIABAHN® VBX - 11mm diameter and 59mm in length) was deployed. Following the procedure, the haematuria resolved, and the patient had an uneventful post-operative stay. He was discharged two weeks after admission, following a course of large spectrum antibiotic therapy. The patient remained asymptomatic at 3 month follow up. Conclusions: Uretero-arterial fistula is an uncommon condition but with an increasing prevalence, at least in part due to improved pelvic cancer treatment.

Resumo Objetivo: Apresentar a atualização das recomendações do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, da Sociedade Brasileira de Mastologia e da Federação Brasileira das Associações de Ginecologia e Obstetrícia para o rastreamento do câncer de mama no Brasil. Materiais e Métodos: Foram feitas buscas das evidências científicas publicadas nas bases Medline (PubMed), Excerpta Medica (Embase), Cochrane Library, Ebsco, Cinahl e Lilacs, entre janeiro de 2012 e julho de 2022. As recomendações foram baseadas nessas evidências, mediante consenso da comissão de especialistas das três entidades. Recomendações: O rastreamento mamográfico anual é recomendado para as mulheres de risco habitual entre 40 e 74 anos. Acima de 75 anos deve ser reservado para as que tenham expectativa de vida maior que sete anos. Mulheres com risco maior que o habitual, entre elas as com mamas densas, com história pessoal de hiperplasia lobular atípica, carcinoma lobular in situ clássico, hiperplasia ductal atípica, tratamento de câncer de mama ou de irradiação no tórax antes dos 30 anos, ou ainda portadoras de mutação genética ou com forte história familiar, se beneficiam do rastreamento complementar, sendo consideradas de forma individualizada. A tomossíntese é uma evolução da mamografia e deve ser considerada no rastreamento, sempre que acessível e disponível. Objetivo Imagem Brasil Métodos PubMed, PubMed , (PubMed) Embase, Embase (Embase) Library Ebsco Lilacs 201 2022 entidades Recomendações 4 7 densas atípica clássico 3 familiar complementar individualizada disponível (PubMed (Embase 20 202 2

Abstract Objective: To present an update of the recommendations of the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology, and the Brazilian Federation of Gynecology and Obstetrics Associations for breast cancer screening in Brazil. Materials and Methods: Scientific evidence published between January 2012 and July 2022 was gathered from the following databases: Medline (PubMed); Excerpta Medica (Embase); Cochrane Library; Ebsco; Cumulative Index to Nursing and Allied Health Literature (Cinahl); and Latin-American and Caribbean Health Sciences Literature (Lilacs). Recommendations were based on that evidence and were arrived at by consensus of a joint committee of experts from the three entities. Recommendations: Annual mammographic screening is recommended for women between 40 and 74 years of age. For women at or above the age of 75, screening should be reserved for those with a life expectancy greater than seven years. Women at higher than average risk are considered by category: those with dense breasts; those with a personal history of atypical lobular hyperplasia, classical lobular carcinoma in situ, or atypical ductal hyperplasia; those previously treated for breast cancer; those having undergone thoracic radiotherapy before age 30; and those with a relevant genetic mutation or a strong family history. The benefits of complementary screening are also addressed according to the subcategories above. The use of tomosynthesis, which is an evolved form of mammography, should be considered in screening, whenever accessible and available. Objective Imaging Mastology Brazil Methods 201 202 databases PubMed (PubMed) Embase (Embase) Library Ebsco Cinahl (Cinahl) LatinAmerican Latin American Lilacs. Lilacs . (Lilacs) entities 4 7 75 category breasts hyperplasia situ 30 tomosynthesis mammography available 20 (PubMed (Embase (Cinahl (Lilacs 3 2

Resumo Objetivo Apresentar a atualização das recomendações do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem da Sociedade Brasileira de Mastologia e da Federação Brasileira das Associações de Ginecologia e Obstetrícia para o rastreamento do câncer de mama no Brasil. Métodos Foram pesquisadas evidências científicas publicadas nas bases de dados Medline EMBASE Biblioteca Cochrane EBSCO CINAHL e Lilacs entre janeiro de 2012 e julho de 2022. As recomendações foram baseadas nessas evidências por consenso do comitê de especialistas das três entidades. Recomendações A mamografia anual é recomendada para mulheres com risco habitual entre 40 e 74 anos. Acima de 75 anos deve ser reservado para aqueles com expectativa de vida superior a sete anos. Mulheres com risco maior do que o normal incluindo aquelas com mamas densas com história pessoal de hiperplasia lobular atípica carcinoma lobular in situ clássico hiperplasia ductal atípica tratamento para câncer de mama ou irradiação de tórax antes dos 30 anos ou ainda portadoras de doença genética mutação ou com forte histórico familiar beneficiam-se de triagem complementar e devem ser considerados individualmente. A tomossíntese é uma forma de mamografia e deve ser considerada na triagem sempre que acessível e disponível. Brasil 201 2022 entidades 4 7 3 beneficiamse beneficiam se individualmente disponível 20 202 2

Abstract Objective To present the update of the recommendations of the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Society of Mastology and the Brazilian Federation of Associations of Gynecology and Obstetrics for breast cancer screening in Brazil. Methods Scientific evidence published in Medline, EMBASE, Cochrane Library, EBSCO, CINAHL and Lilacs databases between January 2012 and July 2022 was searched. Recommendations were based on this evidence by consensus of the expert committee of the three entities. Recommendations Annual mammography screening is recommended for women at usual risk aged 40–74 years. Above 75 years, it should be reserved for those with a life expectancy greater than seven years. Women at higher than usual risk, including those with dense breasts, with a personal history of atypical lobular hyperplasia, classic lobular carcinoma in situ, atypical ductal hyperplasia, treatment for breast cancer or chest irradiation before age 30, or even, carriers of a genetic mutation or with a strong family history, benefit from complementary screening, and should be considered individually. Tomosynthesis is a form of mammography and should be considered in screening whenever accessible and available. Imaging Brazil Medline EMBASE Library EBSCO 201 202 searched entities 4074 40 74 40–7 years 7 breasts hyperplasia situ 30 even individually available 20 407 4 40– 3 2

Resumen La edición especial se propuso visibilizar especialmente los estudios sobre la diáspora de los pueblos lusohablantes, dada la escasez de investigaciones sobre migración que aborden de forma agregada los países lusohablantes, tanto en el área de Demografía como en otras áreas, especialmente la Administración, área para la cual fue pensada esta edición especial. Entendemos que la movilidad contemporánea adquiere contornos cada vez más complejos y desafiantes, lo que amplía aún más el análisis del fenómeno migratorio. Así, considerando el escenario contemporáneo, algunos puntos de reflexión guiaron esta convocatoria de trabajos, a saber: a) los movimientos del proyecto migratorio en los países de habla portuguesa; b) las estrategias para la inserción laboral de personas que migran hacia (o desde) países de habla portuguesa; c) las migraciones forzadas por guerras civiles, ataques armados y/o terroristas, y la consiguiente desestructuración de las economías; d) el cambio climático y su inducción a la migración en busca de trabajo; y e) las cuestiones de género y sus intersecciones con las cuestiones migratorias en esos países. lusohablantes áreas Administración desafiantes Así contemporáneo trabajos saber portuguesa b o desde c civiles yo terroristas economías d trabajo e

Resumo A edição especial objetivou especialmente visibilizar estudos sobre a diáspora de povos lusófonos, dada a escassez de pesquisas sobre migrações que tratam de modo agregado países lusófonos, tanto na área da Demografia quanto em outras áreas, em especial a área para a qual essa edição especial foi pensada: a Administração. Compreendemos que as mobilidades contemporâneas assumem contornos cada vez mais complexos e desafiadores, o que amplia ainda mais a análise do fenômeno migratório. Assim, considerando o cenário contemporâneo, alguns pontos para reflexão nortearam essa chamada de trabalhos, quais sejam: a) os movimentos do projeto migracional em países de língua portuguesa; b) as estratégias para a inserção laboral dos sujeitos que migram para (ou de) países lusófonos; c) as migrações forçadas por guerras civis, ataques armados e/ou terroristas, e a consequente desestruturação das economias; d) as alterações climáticas e sua indução de migrações em busca de trabalho; e) as questões de gênero e suas intersecções com as questões migracionais nesses países. lusófonos áreas pensada Administração desafiadores migratório Assim contemporâneo trabalhos sejam portuguesa b ou c civis eou terroristas economias d trabalho

Abstract This special issue was organized to highlight research on the diaspora of Lusophone people, addressing a gap in research on migration involving Lusophone countries comprehensively, encompassing aspects such as demography and, notably, administration, which is our primary focus. In the contemporary context, people’s mobility presents increasingly complex and challenging features, further expanding the scope of migratory analysis. Given the current scenario, some points guided the call for papers that led to this issue of Cadernos EBAPE.BR: a) the dynamics of migration in Portuguese-speaking countries; b) strategies for the labor insertion of individuals who migrate to (or from) Portuguese-speaking countries; c) migrations forced by civil wars, armed conflicts, and/or terrorist attacks, leading to economic disruptions; d) the impact of climate change, inducing migration in search of work; e) examining gender issues and their intersections with migration matters in these countries. people comprehensively notably administration focus context peoples s features analysis scenario EBAPE.BR EBAPEBR EBAPE BR Portuguesespeaking Portuguese speaking b or from c wars conflicts andor attacks disruptions d change work e

Resumo Fundamento O treinamento intervalado de alta intensidade (HIIT) tem sido sugerido como alternativa ao treinamento contínuo (TC) em indivíduos com diabetes mellitus (DM) devido à sua curta duração e potencial para melhorar a adesão ao exercício. No entanto, dados sobre seu impacto sobre a variabilidade da frequência cardíaca (VFC) são escassos. Objetivos Avaliar e comparar os efeitos do HIIT e TC sobre a capacidade no exercício, VFC e corações isolados em ratos diabéticos. Métodos Animais diabéticos (estreptozotocina intravenosa, 45 mg.kg -1 ) e controles (C) realizaram 20 sessões de TC (5 dias/semana, 50 min, por quatro semanas) em esteira (70% da capacidade máxima de exercício) ou HIIT (ciclos de 1:1min a 50% e 90% da capacidade máxima de exercício). A VFC foi avaliada por eletrocardiograma contínuo, e a função cardíaca foi avaliada em corações isolados perfundidos. Para a análise dos dados, utilizamos a matriz do modelo linear generalizado de covariância multivariada ou o teste one-way ANOVA seguido pelo teste de Tukey, considerando um valor de p<0,05 como significativo. Resultados A capacidade de exercício (m/min) foi maior no grupo submetido ao HIIT [DM-HIIT: 36,5 (IIQ 30,0-41,3); C-HIIT: 41,5 (37,8-44,5), ambos n=10) em comparação ao grupo submetido ao TC [DM-TC: 29,0 (23,8-33,0); C-TC: 32,0 (29,5-37,0), ambos n=10) (p<0,001). A frequência cardíaca (bpm) foi mais baixa no grupo DM em comparação aos controles (p<0,001) tanto in vivo (DM-HIIT: 348±51, C-HIIT:441±66, DM-TC:361±70, C-TC:437±38) como nos corações isolados. Não houve diferenças na VFC entre os grupos. Os valores máximos e mínimos de dP/dt foram reduzidos no DM, com exceção da +dP/dt no grupo DM-HIIT vs. C-HIIT (diferença média: 595,5±250,3, p=0,190). Conclusão O HIIT de curto prazo promoveu melhora superior no desempenho no exercício em comparação ao TC, sem causar mudanças significativas na variabilidade da frequência cardíaca. (HIIT (TC (DM entanto (VFC escassos estreptozotocina intravenosa 4 mgkg mg kg 1 - C (C 2 5 ( diassemana dias semana dias/semana min semanas 70% 70 (70 ciclos 11min 1min 90 . perfundidos oneway one way Tukey p005 p 0 05 p<0,0 significativo m/min mmin m (m/min DMHIIT [DM-HIIT 365 36 36, IIQ 30,041,3 300413 30,0 41,3 30 41 3 30,0-41,3) CHIIT 415 41, 37,844,5, 378445 37,8 44,5 , 37 8 44 (37,8-44,5) n=10 n10 n 10 DMTC [DM-TC 290 29 29, 23,833,0 238330 23,8 33,0 23 33 (23,8-33,0) CTC C-TC 320 32 32, 29,537,0, 295370 29,5 37,0 (29,5-37,0) p<0,001. p0001 p<0,001 001 bpm (bpm (p<0,001 (DM-HIIT 34851 348 51 348±51 CHIIT441±66, CHIIT44166 441±66, 441 66 C-HIIT:441±66 DMTC361±70, DMTC36170 361±70, 361 DM-TC:361±70 CTC437±38 CTC43738 437±38 437 38 C-TC:437±38 grupos dPdt dP dt vs diferença média 59552503 595 250 595,5±250,3 p=0,190. p0190 p=0,190 190 p=0,190) 7 (7 9 p00 p<0, 041 30,041, 30041 300 30, 413 30,0-41,3 844 37,844,5 37844 378 37, 445 44, (37,8-44,5 n=1 n1 833 23,833, 23833 238 23, 330 33, (23,8-33,0 537 29,537,0 29537 295 370 (29,5-37,0 p000 p<0,00 00 (p<0,00 3485 34 348±5 CHIIT441 CHIIT441±66 CHIIT4416 44166 441±66 6 C-HIIT:441±6 DMTC361 DMTC361±70 DMTC3617 36170 361±70 DM-TC:361±7 CTC437 CTC437±3 CTC4373 43738 437±3 43 C-TC:437±3 5955250 59 25 595,5±250, p019 p=0,19 19 p0 p<0 04 30,041 3004 30,0-41, 84 37,844, 3784 (37,8-44, n= 83 23,833 2383 (23,8-33, 53 29,537, 2953 (29,5-37, (p<0,0 348± CHIIT44 CHIIT441±6 4416 441±6 C-HIIT:441± DMTC36 DMTC361±7 3617 361±7 DM-TC:361± CTC43 CTC437± 4373 437± C-TC:437± 595525 595,5±250 p01 p=0,1 p< 30,04 30,0-41 37,844 (37,8-44 23,83 (23,8-33 29,537 (29,5-37 (p<0, CHIIT4 CHIIT441± 441± C-HIIT:441 DMTC3 DMTC361± 361± DM-TC:361 CTC4 C-TC:437 59552 595,5±25 p=0, 30,0-4 37,84 (37,8-4 (23,8-3 29,53 (29,5-3 (p<0 C-HIIT:44 DM-TC:36 C-TC:43 5955 595,5±2 p=0 30,0- (37,8- (23,8- (29,5- (p< C-HIIT:4 DM-TC:3 C-TC:4 595,5± p= (37,8 (23,8 (29,5 (p DM-TC: 595,5 (37, (23, (29, DM-TC 595, (37 (23 (29 (3 (2

Abstract Background High-intensity interval training (HIIT) has been suggested as an alternative for continuous training (CT) in people with diabetes mellitus (DM) due to its short duration and potential to improve adherence to exercise. However, data on its impact on heart rate variability (HRV) are scarce. Objectives To assess and compare the effects of HIIT and CT on exercise capacity, HRV and isolated hearts in diabetic rats. Methods DM (intravenous streptozotocin, 45 mg.kg -1 ) and control (C) animals performed 20 sessions (5 days/week, 50 min, for 4 weeks) of CT on a treadmill (70% of maximal exercise capacity) or HIIT (cycles of 1:1min at 50% and 90% of maximal exercise capacity). HRV was assessed by continuous electrocardiogram, and cardiac function assessed in isolated perfused hearts. For data analysis, we used the framework of the multivariate covariance generalized linear model or one-way ANOVA followed by Tukey’s test, considering p<0.05 as significant. Results Higher exercise capacity (m/min) was achieved in HIIT (DM-HIIT: 36.5 [IQR 30.0-41.3]; C-HIIT: 41.5 [37.8-44.5], both n=10) compared to CT (DM-CT: 29.0 [23.8-33.0]; C-CT: 32.0 [29.5-37.0], both n=10) (p<0.001). Heart rate (bpm) was lower in DM compared to controls (p<0.001) both in vivo (DM-HIIT:348±51, C-HIIT:441±66, DM-CT:361±70, C-CT:437±38) and in isolated hearts. There were no differences in HRV between the groups. Maximum and minimal dP/dt were reduced in DM, except +dP/dt in DM-HIIT vs. C-HIIT (mean difference: 595.5±250.3, p=0.190). Conclusion Short-term HIIT promotes greater improvement in exercise performance compared to CT, including in DM, without causing significant changes in HRV. Highintensity High intensity (HIIT (CT (DM However (HRV scarce rats intravenous streptozotocin mgkg mg kg 1 - C (C 2 5 ( daysweek days week days/week min weeks 70% 70 (70 cycles 11min 1min 90 capacity. . electrocardiogram analysis oneway one way Tukeys Tukey s test p005 p 0 05 p<0.0 m/min mmin m (m/min DMHIIT (DM-HIIT 365 36 36. IQR 30.041.3 300413 30.0 41.3 30 41 3 30.0-41.3] CHIIT 415 41. 37.844.5, 378445 37.8 44.5 , 37 8 44 [37.8-44.5] n=10 n10 n 10 DMCT (DM-CT 290 29 29. 23.833.0 238330 23.8 33.0 23 33 [23.8-33.0] CCT C-CT 320 32 32. 29.537.0, 295370 29.5 37.0 [29.5-37.0] p<0.001. p0001 p<0.001 001 bpm (bpm (p<0.001 DMHIIT348±51, DMHIIT34851 348±51, 348 51 (DM-HIIT:348±51 CHIIT441±66, CHIIT44166 441±66, 441 66 C-HIIT:441±66 DMCT361±70, DMCT36170 361±70, 361 DM-CT:361±70 CCT437±38 CCT43738 437±38 437 38 C-CT:437±38 groups dPdt dP dt vs mean difference 59552503 595 250 595.5±250.3 p=0.190. p0190 p=0.190 190 p=0.190) Shortterm Short term 7 (7 9 p00 p<0. 041 30.041. 30041 300 30. 413 30.0-41.3 844 37.844.5 37844 378 37. 445 44. [37.8-44.5 n=1 n1 833 23.833. 23833 238 23. 330 33. [23.8-33.0 537 29.537.0 29537 295 370 [29.5-37.0 p000 p<0.00 00 (p<0.00 DMHIIT348 DMHIIT348±51 DMHIIT3485 34851 348±51 34 (DM-HIIT:348±5 CHIIT441 CHIIT441±66 CHIIT4416 44166 441±66 6 C-HIIT:441±6 DMCT361 DMCT361±70 DMCT3617 36170 361±70 DM-CT:361±7 CCT437 CCT437±3 CCT4373 43738 437±3 43 C-CT:437±3 5955250 59 25 595.5±250. p019 p=0.19 19 p0 p<0 04 30.041 3004 30.0-41. 84 37.844. 3784 [37.8-44. n= 83 23.833 2383 [23.8-33. 53 29.537. 2953 [29.5-37. (p<0.0 DMHIIT34 DMHIIT348±5 3485 348±5 (DM-HIIT:348± CHIIT44 CHIIT441±6 4416 441±6 C-HIIT:441± DMCT36 DMCT361±7 3617 361±7 DM-CT:361± CCT43 CCT437± 4373 437± C-CT:437± 595525 595.5±250 p01 p=0.1 p< 30.04 30.0-41 37.844 [37.8-44 23.83 [23.8-33 29.537 [29.5-37 (p<0. DMHIIT3 DMHIIT348± 348± (DM-HIIT:348 CHIIT4 CHIIT441± 441± C-HIIT:441 DMCT3 DMCT361± 361± DM-CT:361 CCT4 C-CT:437 59552 595.5±25 p=0. 30.0-4 37.84 [37.8-4 [23.8-3 29.53 [29.5-3 (p<0 (DM-HIIT:34 C-HIIT:44 DM-CT:36 C-CT:43 5955 595.5±2 p=0 30.0- [37.8- [23.8- [29.5- (p< (DM-HIIT:3 C-HIIT:4 DM-CT:3 C-CT:4 595.5± p= [37.8 [23.8 [29.5 (p DM-CT: 595.5 [37. [23. [29. DM-CT 595. [37 [23 [29 [3 [2 [

Abstract Introduction: Aortoiliac occlusive disease (AIOD) can be treated using either open surgical revascularization (OSR) or endovascular revascularization (ER). Methods: A Medline search was performed in order to identify articles focused on the treatment of aortoiliac occlusive disease. Additional articles of scientific interest for the purpose of this non-systematic review were included by cross-referencing. Results: There are a few articles reporting direct results between both techniques based on retrospective or prospective single center or multicenter studies. In the majority of studies, primary patency is generally better for surgery in comparison to ER, but at a cost of more postoperative complications, with higher rates of respiratory failure and wound infection in the open group. On the other hand, endovascular recanalization is related to higher rates of limb ischemia/thrombosis, renal dysfunction and reinterventions. In the presence of femoral artery calcified disease, the hybrid approach should be considered. Conclusions: Endovascular treatment is a suitable alternative for extensive AIOD and can be accomplished in a less invasive manner, with most midterm outcomes comparable with open reconstruction. Surgery should be reserved for multilevel calcified disease and after endovascular failure.

Abstract Objective: Venous stenting of iliocaval obstructions has become a more frequent procedure over the last two decades. In-stent stenosis and thrombosis are potential complications, causing one of the main causes of symptoms recurrence and impacting quality of life. The aim of this review is to report on the impact of venous stent patency loss, as well on risk factors and management. Methods: A systematic review was conducted according to the recommendations of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement. Results: After a literature search, 12 studies (two prospective and 10 retrospective studies) were included in the analysis. A total of 1981 patients (34.1% male) and 2388 limbs (63.6% left side) were assessed. Mean age was 43.5 years (range 16-99). Indication for stenting included deep venous thrombosis (DVT) (4%), post-thrombotic syndrome (PTS) (18.8%) and non-thrombotic iliac vein lesions (NIVLs) (77.2%). Regarding treatment, most patients were submitted to angioplasty and stenting only (87%). Associated catheter directed thrombolysis or mechanical thrombectomy was performed when indicated (8.4%), and in the remaining an AVF/endophlebetomy was performed (4.6%). Primary, primary assisted and secondary patency rates at one year ranged from 68-100%, 79-90% and 85.8-100%, respectively. Reported anticoagulation duration after stenting ranged from 1-12 months. In one study involving only patients treated for NIVLs, no anticoagulation was prescribed, and antithrombotic therapy was continued for three months. Follow-up strategies included clinical and imagiological control with a mean follow-up of 19.7 months. Post-procedural stent re-stenosis was reported in 121 limbs (5.1%) and stent occlusion in 81 limbs (3.4%); the latter was distributed as follows: 11.1% after DVT, 77.8% PTS and 11.1% NIVLs. A total of 186 re-interventions were performed in symptomatic patients. The prognostic factor most consistently associated with stent failure was thrombotic inflow veins. Other reported factors were incomplete thrombolysis and age younger than 40 years. Stent placement below the inguinal ligament, type of stent and anticoagulation regimen do not seem to affect stent patency. Conclusion: Regarding venous lesions of the lower limbs, a selective approach and planning should focus on identification of risk factors for stent failure. It is noteworthy that most stent occlusions occur in post-thrombotic limbs. Stent failure continued after 6 months, emphasizing the importance of an extended surveillance especially on these patients.