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03). Analyzing the HD group, there was a significant positive correlation between the percentage of collagen fibers in the left ventricle and mast cell density immunolabeled by anti-chymase and anti-tryptase antibodies (p=0.04) and also mast cell density immunolabeled only with anti-tryptase antibodies (p=0.02). CONCLUSIONS Mast cells are involved in the development of hypertensive heart disease, contributing to the remodeling of collagen fibers in this disease. INTRODUCTION Coronary artery disease is becoming the leading cause of death in women in Western society. However, the available data shows that women are still underdiagnosed and undertreated with guideline-recommended secondary prevention therapy, leading to a significantly higher rate of in-hospital complications and in-hospital mortality. OBJECTIVE The main objective of this work is to assess the approach to acute coronary syndrome (ACS) in Portugal, including form of presentation, in-hospital treatment and in-hospital complications, according to gender and in three different periods. METHODS We performed an observational study with retrospective analysis of all patients included between 2002 and 2019 in the Portuguese Registry of Acute Coronary Syndromes (ProACS), a voluntary, observational, prospective, continuous registry of the Portuguese Society of Cardiology and the National Center for Data Collection in Cardiology. RESULTS A total of 49 113 patients (34 936 men and 14 177 women) were included. Obesignosis other than ACS. Both during hospitalization and at hospital discharge, women were less likely to receive guideline-recommended secondary prevention therapy. CONCLUSION In women admitted for ACS, revascularization strategies are still underused, as is guideline-recommended secondary prevention therapy, which may explain their higher incidence of in-hospital complications and higher unadjusted mortality. Vascular access is an important element in the overall care provided to kidney transplant recipients. The transplanted kidney is not indestructible, and chronic kidney disease after transplantation may result in needing another transplant or beginning dialysis. Commonly used vascular accesses, like peripheral and central lines, can preclude the creation of future, permanent dialysis access. Therefore, there is urgent need to preserve vessels for the future access needs for hemodialysis among kidney transplant recipients without functional vascular access for dialysis. Moreover, the proper care of functional vascular access among kidney transplant recipients is crucial. In this review article, we will address the common vascular access procedures and complications among kidney transplant recipients. INTRODUCTION Skeletal muscle is the primary site of glucose uptake and its reduction would increase insulin resistance, which is a determinant factor for diseases such as type 2 diabetes mellitus, hypertension, and metabolic syndrome. However, the role of low skeletal muscle mass as a risk factor for metabolic syndrome and its association with cardiometabolic risk is still uncertain. We aimed to investigate the association between muscle mass (determined by different skeletal mass indices) and metabolic syndrome in Brazilian adults. METHODOLOGY We conducted a cross-sectional population-based study with 689 adults of both sexes aged between 20 and 59 years. Data were collected through questionnaires and assessment of body composition through dual-energy X-ray absorptiometry and anthropometric, clinical, and biochemical measurements. RESULTS Older individuals, obese and those with metabolic syndrome predominated in the highest tertile of skeletal mass index adjusted by height (SMIheight), whereas using skeletal mass index adjusted by weight (SMIweight) and skeletal mass index adjusted by body mass index (SMIBMI) these individuals were the majority in the lowest tertile of these indices. In men and women, the adjusted logistic regression model revealed that the highest tertile of SMIweight (odds ratio [OR] 0.06; 95% confidence interval [CI] 0.02-0.21 and OR 0.27, 95% CI 0.10-0.74) and SMIBMI (OR 0.14, 95% CI 0.05-0.37 and OR 0.34, 95% CI 0.12-0.94) were negatively associated with metabolic syndrome. On the other hand, the highest tertile of SMIheight was positively associated with metabolic syndrome in both sexes (OR 4.17, 95% CI 1.80-9.66 and OR 6.15, 95% CI 2.31-16.37, respectively in men and women). CONCLUSION In adults, the muscle mass assessed from the skeletal mass index adjusted for body weight and body mass index is inversely associated with metabolic syndrome in both sexes. BACKGROUND This study aims to investigate how expectation fulfillment changes up to 10 years following total knee arthroplasty (TKA). METHODS Preoperative data were collected for 323 patients undergoing TKA (Hospital for Special Surgery Knee Replacement Expectations survey, Oxford Knee Score [OKS], and Short Form [SF]-12). Expectation fulfillment, OKS, SF-12, and patient satisfaction were assessed at 1 year and 9-10 years postoperatively. Relative risk (RR) of dissatisfaction at late follow-up was calculated for each specific expectation question. see more Linear regression analysis was used to identify factors independently associated with early (1 year) and late (mean 9 years) expectation fulfillment scores. RESULTS Mean expectation fulfillment scores declined from early to late follow-up (25.9-23.9, P = .025). Multivariate analysis identified younger age and better 1-year OKS as factors independently associated with long-term expectation fulfillment. Twelve percent of patients reported dissatisfaction at late follow-up. The risk of long-term dissatisfaction was greatest in patients with high preoperative expectations of kneeling (RR 2.2, 95% confidence interval [CI] 0.9-5.5), walking without aids (RR 2.4, 95% CI 0.7-7.6), and improved psychological well-being (RR 3.9, 95% CI 0.9-5.0). Night pain relief, kneeling ability, participating in outside activities, and sports were the most poorly fulfilled expectations at both early and late time points. Fulfillment improved the least from early to late for kneeling ability (17%) and ability to participate in outside activities (17%). CONCLUSION Expectation fulfillment following TKA changes with time. Expectations of kneeling ability and the ability to perform outside activities demonstrated persistently low levels of fulfillment. This information can be used to manage the longer term expectations of patients undergoing TKA.