Tailored Perioperative Medicine For Frail Patients Undergoing Vascular Surgery: A Narrative Review.

Frailty is a concept that is emerging as an important tool in the preoperative assessment of patients. The incidence of frailty in vascular surgery patients is high and is expected to increase concomitantly with the aging of the population. The identification of these patients and their optimization in the perioperative period can lead to an improvement in their outcomes with a reduction in morbidity and mortality.

Extracorporeal mechanical support and aspiration thrombectomy in treatment of massive pulmonary embolism: a case report.

Acute massive pulmonary embolism is the most serious presentation of venous thromboembolism that can ultimately cause obstructive shock, leading to cardiac arrest and death. In this case report, the authors present a case of a 49-year-old female who successfully recovered from a massive pulmonary embolism with the combined use of venoarterial extracorporeal membrane oxygenation and pulmonary aspiration thrombectomy, with no complications from these procedures. Although evidence of benefit from mechanical support has not been established for patients with massive pulmonary embolism, the implementation of extracorporeal cardiocirculatory support during resuscitation may allow improvement of systemic organ perfusion and better chance of survival.

[Satisfação com o Internato Médico em Portugal].

Introduction: In the last years, the global context of medical education and Medical Residency programs in Portugal suffered substantial changes. The primary objective of this study was to evaluate and characterize medical residents ́ satisfaction with medical residency programs in Portugal and to identify features that could be improved.

Material And Methods: We utilized as model the survey Postgraduate Hospital Educational Environment Measure that has been developed in the United Kingdom and is speci cally targeted to medical residents.