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Introduction: Silicone tube implantation in lymphoedema reduces symptoms by improving fluid drainage. Although there are descriptions of implant host reaction that can be misdiagnosed as graft infections these are scarce. Report: A 34 year old female with lymphoedema of the lower limb, underwent silicone tube implantation. Ten months after surgery, the patient presented with fever and dermatolymphangioadenitis of the limb. Ultrasound suggested an abscess surrounding the tubes. Clinical improvement was achieved after a 6-day cycle of meropenem. She was discharged under oral cefuroxime and clindamycin for one week. After 1 month, CT-angiography was performed showing only residual inflammation surrounding the tubes, the patient was asymptomatic and limb diameter was normal. Conclusion: Sudden onset and improvement of the patient’s condition after a short cycle of antibiotics without the need of tube removal supports a host-like reaction rather than an actual infection. Doctors should be aware of such complications avoiding unnecessary procedures., Portuguese Journal of Cardiac Thoracic and Vascular Surgery, Vol. 30 No. 2 (2023): Apr-Jun

Osteosarcoma is the most common primary bone malignancy. The prognosis of patients after local recurrence is generally poor and management of the locally recurrent disease is not well defined, especially in patients who have undergone limb-sparing surgery. A 20-year-old male presented a local recurrence of conventional osteosarcoma at the popliteal fossa with encasement of popliteal vascular bundle after previous tumor-wide resection and reconstruction with proximal tibia endoprosthesis. A wide resection “en bloc” of the lesion included part of the popliteal vessel. A bypass of both popliteal vessels, the vein with polytetrafluoroethylene (PTFE) prosthesis, and the artery with contralateral saphenous vein were performed to allow a limb salvage surgery. Local management of recurrent osteosarcoma in a previously reconstructed limb is highly individualized. This case confirms that preservation of lower limb function is possible using reconstruction techniques of bone and vessels in the sarcoma of the musculoskeletal system., Portuguese Journal of Cardiac Thoracic and Vascular Surgery, Vol. 30 No. 2 (2023): Apr-Jun

This paper aims to analyze the degree of compliance with the IFRS 16 disclosure requirements, in the first year of mandatory adoption of IFRS 16, and to identify its determinant factors. As methodology, we performed a content analysis of the reports and accounts of a sample of companies listed on Euronext Lisbon. A multiple linear regression model was also developed, which assumes the compliance disclosure index as a dependent variable as some companies’ characteristics as potential explanatory factors. Results of descriptive statistics indicate that, in the first year of adoption of IFRS 16, the average level of compliance with disclosure requirements is approximately 0.66. The multivariate analyses reveals that the type of auditor significantly positively influences the compliance disclosure index and therefore we conclude that entities with accounts audited by one of the Big Four exhibit a higher level of disclosure than those that are audited by other audit firms.

BACKGROUND: Individualized risk assessment using comorbidity adjustment is an important component in modern clinical practice and can be performed considering individual comorbidities or through the use of summary measures. The Charlson Comorbidity Index adjusted to age (CCIa) is the most widely validated and used comorbidity assessment tool. Studies have proved CCIa as a strong predictor of mortality for a variety of medical and surgical conditions; however, its utility in patients submitted to elective endovascular abdominal aortic aneurysm repair (EVAR) has not been studied. METHODS: Patients submitted to EVAR between January 1, 2017 and December 31, 2021 in our tertiary, academic Vascular Surgery Department were retrospectively evaluated and 123 patients fulfilled the inclusion criteria. Patient characteristics and peri-operative variables were collected and CCIa was calculated. Surgical complications were classified according to Clavien-Dindo. The area under the curve of the receiver operating characteristic curves was calculated to validate and determine the discriminating ability of CCIa in predicting complications and mortality and the Youden index used to determine the critical value. RESULTS: Mean age was 73.49±7.95 years and mean follow-up was 30.55±16.49 months. 30-day complication rate was 16%, 30-day mortality 1.63% and overall mortality 16%. Patients with higher CCIa had higher overall mortality (p=.002) but CCIa had no impact on 30-day complication rate and on 30-day mortality. Logistic regression showed that even after adjusting for patient ́s comorbidities individually, CCIa was the only independent mortality predictor (p=.003). The optimal cutoff associated with higher overall mortality was found to be ≥6. CONCLUSION: CCIa does not seem to predict complications and early mortality after EVAR but it seems to be a useful predictor of mid-term survival after EVAR. These results show the limited role of this score in predicting outcomes after surgery but may help identify a sub-population whose shorter life-expectancy should be considered towards the benefits of EVAR., Angiologia e Cirurgia Vascular, Vol. 18 No. 4 (2022): December