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1.
BMJ Case Rep ; 14(2)2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33558386

RESUMEN

A 45-year-old man had recurrent presentations with pleuritic chest pain and shortness of breath. Four months prior, he had developed cauda equina syndrome from a spinal epidural abscess in the setting of intravenous drug use, complicated by lasting neurological deficits and a rectal prolapse. On his final presentation, blood cultures taken in the absence of antibiotics grew Enterococcus faecalis from multiple sets. A transoesophageal echocardiogram confirmed tricuspid valve endocarditis. He recovered well post-targeted long-term antibiotics. Endoscopy confirmed a chronic rectal prolapse with multiple ulcers and was hypothesised as the source of bacteraemia. He subsequently underwent perineal rectosigmoidectomy. This uncommon sequela of rectal prolapse highlights several issues, including the management of neurogenic bowel dysfunction following spinal cord injury and the importance of early prolapse recognition and management. Finally, appropriate collection of blood cultures and correct use of echocardiography are critical steps in investigating infective endocarditis.


Asunto(s)
Endocarditis Bacteriana/diagnóstico , Enterococcus faecalis , Absceso Epidural/complicaciones , Absceso Epidural/microbiología , Infecciones por Bacterias Grampositivas/diagnóstico , Prolapso Rectal/complicaciones , Prolapso Rectal/microbiología , Antibacterianos/uso terapéutico , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Síndrome de Cauda Equina/etiología , Enfermedad Crónica , Colonoscopía , Diagnóstico Diferencial , Ecocardiografía Transesofágica , Endocarditis Bacteriana/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Abuso de Sustancias por Vía Intravenosa/complicaciones
2.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33431448

RESUMEN

Embolised needles causing injury to the right heart and cardiac tamponade has been reported before in intravenous drug users, but to our knowledge, this is the first reported case of a needle migrating via the pulmonary arterial system to cause perforation of the left ventricle. Appropriate utilisation of imaging modalities such as plain X-ray and point-of-care focused cardiac ultrasound can be vital and life-saving in the emergency setting, and the value of gated multidetector CT as a powerful tool for imaging moving structures is highlighted.


Asunto(s)
Migración de Cuerpo Extraño/diagnóstico , Lesiones Cardíacas/diagnóstico , Ventrículos Cardíacos/lesiones , Agujas/efectos adversos , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Puente Cardiopulmonar , Ecocardiografía , Migración de Cuerpo Extraño/complicaciones , Migración de Cuerpo Extraño/cirugía , Lesiones Cardíacas/etiología , Lesiones Cardíacas/cirugía , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/cirugía , Humanos , Pulmón/irrigación sanguínea , Pulmón/diagnóstico por imagen , Pulmón/cirugía , Masculino , Pericardiocentesis , Arteria Pulmonar/diagnóstico por imagen , Cirugía Torácica Asistida por Video , Resultado del Tratamiento
4.
BMC Infect Dis ; 20(1): 806, 2020 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-33129259

RESUMEN

BACKGROUND: This study aimed at determining the prevalence of and risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran in 2015-16. METHODS: The required data was collected from a database provided by Iranian national bio-behavioral surveillance surveys (BBSSs) on 11,988 prisoners selected from among 55 prisons in 19 provinces in 2015-16. The data on demographics and behavioral variables were collected through interviews and the status of exposure to HBV and HCV were determined using ELISA blood test. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into the study. Data were analyzed using the survey package in Stata/SE software, Version 14.0. Univariate and multivariate logistic regression tests were used to investigate the relationships between risk factors and outcomes. RESULTS: The mean age of the incarcerated PWID was 36.83 ± 8.13 years. Of all the studied subjects, 98.46% were male and 50.97% were married. The prevalence of HCV and HBV among the subjects were 40.52 and 2.46%, respectively. The prevalence of HCV was associated with age ≥ 30 years, being single, illiteracy and low level of education, prison term> 5 years, history of piercing, and extramarital sex in lifetime (P < 0.05). CONCLUSIONS: The prevalence of HCV is alarmingly high. In general, it is recommended to adopt measures to screen and treat patients with HCV and vaccinat incarcerated PWID without a history of vaccination against HBV.


Asunto(s)
Hepatitis B/epidemiología , Hepatitis C/epidemiología , Prisioneros , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Estudios Transversales , Femenino , Hepacivirus , Hepatitis B/complicaciones , Hepatitis B/prevención & control , Virus de la Hepatitis B , Hepatitis C/complicaciones , Hepatitis C/prevención & control , Humanos , Irán/epidemiología , Modelos Logísticos , Masculino , Prevalencia , Prisioneros/estadística & datos numéricos , Prisiones , Factores de Riesgo , Vacunas contra Hepatitis Viral/administración & dosificación
5.
Zhonghua Gan Zang Bing Za Zhi ; 28(10): 893-896, 2020 Oct 20.
Artículo en Chino | MEDLINE | ID: mdl-33105938

RESUMEN

HCV prevalence among people who inject drugs (PWID) is up to 67%. PWID is a population that needs priority attention to achieve the World Health Organization's goal of eliminating viral hepatitis as a public health threat by 2030. Although the SVR of HCV patients treated with direct-acting antiviral drugs (DAAs) can reach over 95%, especially in medical practice, there are still major obstacles to PWID treatment, because PWID is usually accompanied with concurrent infection, multiple-genotype infections, low compliance, substance abuse, methadone maintenance therapy, and risky behavior and re-infection conditions. Therefore, physicians often concern that these factors will affect the treatment efficacy, and refuse to provide hepatitis C treatment in PWID. This article reviews the relevant studies status and effects of hepatitis C treatment in PWID with different infection states and special behavior characteristics, and further highlights that the multidisciplinary cooperation for hepatitis C treatment in PWID is safe and effective, and can ensure treatment compliance.


Asunto(s)
Antivirales , Consumidores de Drogas , Hepatitis C , Abuso de Sustancias por Vía Intravenosa , Antivirales/uso terapéutico , Hepatitis C/tratamiento farmacológico , Humanos , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/tratamiento farmacológico
7.
BMC Infect Dis ; 20(1): 655, 2020 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-32894072

RESUMEN

BACKGROUND: People who use drugs including people who inject drugs (PWUD/ID), sex workers (SWs) and men who have sex with men (MSM) are at increased risk of HIV and viral hepatitis infection. Limited epidemiological data on the infections exists in key populations (KPs) in South Africa. We investigated the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV and selected risk factors among these KPs to inform effective responses. METHODS: We used convenience sampling to recruit a targeted 3500 KPs accessing HIV-related health services across Cape Town (SWs, MSM, PWUD/ID), Durban (SWs, PWUD/ID), Pietermaritzburg (SWs), Mthatha (SWs), Port Elizabeth (SWs), Johannesburg (MSM) and Pretoria (MSM and PWUD/ID) into a cross-sectional survey. An interviewer questionnaire to assess socio-demographic characteristics, drug use and sexual risk practices, was administered. HBV surface antigen (HBsAg); HCV antibody, viral load and genotype, and HIV antibody, was tested. RESULTS: Among the 3439 people included in the study (1528 SWs, 746 MSM, 1165 PWUD/ID) the median age was 29 years, most participants were black African (60%), and 24% reported homelessness. 82% reported substance use in the last month, including alcohol (46%) and heroin (33%). 75% were sexually active in the previous month, with condom use at last sex at 74%. HIV prevalence was 37% (highest among SWs at 47%), HBsAg prevalence 4% (similar across KPs) and HCV prevalence was 16% (highest among PWUD/ID at 46%). CONCLUSIONS: HBV, HCV and HIV pose a health burden for KPs in South Africa. While HIV is key for all included KPs, HCV is of particular importance to PWUD/ID. For KPs, HBV vaccination and behavioural change interventions that support consistent condom and lubricant access and use are needed. Coverage of opioid substitution therapy and needle and syringe services, and access to HCV treatment for PWUD/ID need to be expanded.


Asunto(s)
Infecciones por VIH/epidemiología , VIH/inmunología , Hepacivirus/genética , Hepacivirus/inmunología , Virus de la Hepatitis B/inmunología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Adulto , Estudios Transversales , Femenino , Genotipo , Anticuerpos Anti-VIH/sangre , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/etiología , Infecciones por VIH/prevención & control , Hepatitis B/etiología , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis C/etiología , Anticuerpos contra la Hepatitis C/sangre , Homosexualidad Masculina , Humanos , Masculino , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Trabajadores Sexuales , Minorías Sexuales y de Género , Sudáfrica/epidemiología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Carga Viral , Adulto Joven
10.
Dermatol Online J ; 26(6)2020 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-32815692

RESUMEN

Red puffy hand syndrome is an uncommon clinical manifestation of intravenous drug abuse, which presents with bilateral, painless and non-pitting erythema and edema of the dorsal hands. The pathophysiology is believed to primarily be the result of lymphatic blockage from either direct toxicity of the injected drug, drainage of impurities, or infection complications. A woman in her 40's with remote intravenous drug use presented with over a decade of fixed, painless erythema and swelling of bilateral dorsal hands. Owing to an elevated rheumatoid factor, which would later be attributed to patient's untreated hepatitis C, these findings were mistaken for rheumatoid arthritis and unnecessarily treated with methotrexate and prednisone. Upon proper recognition of her underlying Red puffy hand syndrome, systemic medications were discontinued and appropriate care was initiated with lymphedema decongestion and occupational therapy. Red puffy hand syndrome, albeit rare, is an important manifestation of intravenous drug abuse; its recognition will spare patients from unnecessary systemic treatments.


Asunto(s)
Artritis Reumatoide/diagnóstico , Errores Diagnósticos , Edema/diagnóstico , Mano/patología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Edema/etiología , Femenino , Humanos
11.
BMC Infect Dis ; 20(1): 634, 2020 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-32847528

RESUMEN

BACKGROUND: People who inject drugs (PWID) have increased risk of acquiring blood-transmitted chronic viral infections such as Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) as well as increased risk of acquiring bacterial infections. We aimed to identify and describe bacteraemic episodes, their recurrence rates, predictive and prognostic factors amongst hospitalised PWID. METHODS: In this retrospective cohort study, we included 257 hospitalised PWID during 2000-2006 with follow up at the Department of Infectious Diseases, Hvidovre Hospital, Denmark. Data collection included comorbidity (HBV-, HCV-, HIV-, and psychiatric comorbidities), social information (contact to an addiction treatment centre, homelessness), opioid substitution treatment (OST), treatment completion and microbiology findings. There was a 10-years follow-up regarding mortality. RESULTS: The study identified 257 patients classified as PWID. Of these, 58 (22.6%) had at least one episode of bacteraemia during their first hospital admission. Recurrence was found in 29 (50.0%) of the bacteraemia cases. Staphylococcus aureus was the dominant microorganism of both first and recurrent episodes with 24 (41.4%) and nine (31.4%) of cases, respectively. A psychiatric diagnose was significantly associated with a lower risk of bacteraemia in the multivariate analysis (OR: 0.29, [95%CI: 0.11-0.77], P = 0.01). Mortality was significantly higher in patients with bacteraemia (17.2% vs. 3.0%, P < 0.01, OR: 6.67 [95%CI: 2.33-20], P < 0.01). CONCLUSIONS: In hospitalised PWID, bacteraemia was found in 22.6% and was associated with at higher mortality. The most common microorganism of bacteraemia was S. aureus. Psychiatric comorbidity was significantly associated with a lower risk of bacteraemia.


Asunto(s)
Bacteriemia/epidemiología , Infecciones por VIH/epidemiología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Trastornos Mentales/epidemiología , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Comorbilidad , Dinamarca/epidemiología , Femenino , Estudios de Seguimiento , VIH/inmunología , Hepacivirus/inmunología , Virus de la Hepatitis B/inmunología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Recurrencia , Estudios Retrospectivos , Abuso de Sustancias por Vía Intravenosa/mortalidad
12.
PLoS One ; 15(7): e0235350, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32663203

RESUMEN

BACKGROUND: Skin and soft tissue infections (SSTI) are a common but preventable cause of morbidity and mortality among people who inject drugs (PWID). They can be severe, and hospitalisations of PWID with SSTI are rising. The most common SSTI presentations are abscesses and cellulitis. METHODS: We used data from Care & Prevent, a cross-sectional community survey of PWID in London. We reported the lifetime prevalence of SSTI, severity of infections, key risk factors, and associated sequelae. Pictorial questions were used to assess SSTI severity. RESULTS: We recruited 455 PWID. SSTI lifetime prevalence was high: 64% reported an abscess and/or cellulitis. Over one-third (37%) reported a severe infection, 137 (47%) reported hospitalisation. SSTIrisk factors were: aged 35+ years, injecting once or more times a day, subcutaneous or intra-muscular injections, and making four or more attempts to achieve an injection. Those who reported having other health conditions were at higher odds of having an abscess or cellulitis, with risk tending to increase with number of reported conditions. Half (46%) employed self-care for their worst SSTI, and 43% waited for ten or more days before seeking medical care or not seeking medical care at all. CONCLUSIONS: Abscess and cellulitis are very common among PWID in London. We corroborate findings indicating SSTIs are associated with risks, e.g. venous access problems, as well as other co-morbid conditions: septicaemia, endocarditis, DVT, and kidney disease. These co-morbidities may impact SSTIs severity and outcomes. Delayed healthcare seeking potentially exacerbates infection severity, which in turn increases poorer health outcomes and complications.


Asunto(s)
Absceso/epidemiología , Celulitis (Flemón)/epidemiología , Enfermedades Cutáneas Infecciosas/epidemiología , Abuso de Sustancias por Vía Intravenosa/epidemiología , Absceso/complicaciones , Absceso/fisiopatología , Adulto , Celulitis (Flemón)/complicaciones , Celulitis (Flemón)/fisiopatología , Femenino , Humanos , Londres/epidemiología , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Aceptación de la Atención de Salud , Prevalencia , Factores de Riesgo , Sepsis/complicaciones , Sepsis/epidemiología , Sepsis/fisiopatología , Enfermedades Cutáneas Infecciosas/complicaciones , Enfermedades Cutáneas Infecciosas/fisiopatología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/fisiopatología , Reino Unido/epidemiología
14.
PLoS One ; 15(6): e0235445, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32603349

RESUMEN

BACKGROUND: Hepatitis C elimination will require widespread access to treatment and responses at the health-service level to increase testing among populations at risk. We explored changes in hepatitis C testing and the cascade of care before and after the introduction of direct-acting antiviral treatments in Victoria, Australia. METHODS: De-identified clinical data were retrospectively extracted from eighteen primary care clinics providing services targeted towards people who inject drugs. We explored hepatitis C testing within three-year periods immediately prior to (pre-DAA period) and following (post-DAA period) universal access to DAA treatments on 1st March 2016. Among ever RNA-positive individuals, we constructed two care cascades at the end of the pre-DAA and post-DAA periods. RESULTS: The number of individuals HCV-tested was 13,784 (12.2% of those with a consultation) in the pre-DAA period and 14,507 (10.4% of those with a consultation) in the post-DAA period. The pre-DAA care cascade included 2,515 RNA-positive individuals; 1,977 (78.6%) were HCV viral load/genotype tested; 19 (0.8%) were prescribed treatment; and 12 had evidence of cure (0.5% of those RNA-positive and 63.6% of those eligible for cure). The post-DAA care cascade included 3,713 RNA-positive individuals; 3,276 (88.2%) were HCV viral load/genotype tested; 1,674 (45.1%) were prescribed treatment; and 863 had evidence of cure (23.2% of those RNA-positive and 94.9% of those eligible for cure). CONCLUSION: Marked improvements in the cascade of hepatitis C care among patients attending primary care clinics were observed following the universal access of DAA treatments in Australia, although improvements in testing were less pronounced.


Asunto(s)
Antivirales/uso terapéutico , Hepatitis C , Adolescente , Adulto , Servicios de Salud Comunitaria , Femenino , Hepatitis C/diagnóstico , Hepatitis C/tratamiento farmacológico , Hepatitis C/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud , Estudios Retrospectivos , Abuso de Sustancias por Vía Intravenosa/complicaciones , Victoria/epidemiología , Adulto Joven
16.
J Int AIDS Soc ; 23(7): e25583, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32697423

RESUMEN

INTRODUCTION: In light of the COVID-19 pandemic, considerable effort is going into identifying and protecting those at risk. Criminalization, stigmatization and the psychological, physical, behavioural and economic consequences of substance use make people who inject drugs (PWID) extremely vulnerable to many infectious diseases. While relationships between drug use and blood-borne and sexually transmitted infections are well studied, less attention has been paid to other infectious disease outbreaks among PWID. DISCUSSION: COVID-19 is likely to disproportionally affect PWID due to a high prevalence of comorbidities that make the disease more severe, unsanitary and overcrowded living conditions, stigmatization, common incarceration, homelessness and difficulties in adhering to quarantine, social distancing or self-isolation mandates. The COVID-19 pandemic also jeopardizes essential for PWID services, such as needle exchange or substitution therapy programmes, which can be affected both in a short- and a long-term perspective. Importantly, there is substantial evidence of other infectious disease outbreaks in PWID that were associated with factors that enable COVID-19 transmission, such as poor hygiene, overcrowded living conditions and communal ways of using drugs. CONCLUSIONS: The COVID-19 crisis might increase risks of homelessnes, overdoses and unsafe injecting and sexual practices for PWID. In order to address existing inequalities, consultations with PWID advocacy groups are vital when designing inclusive health response to the COVID-19 pandemic.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Brotes de Enfermedades , Sobredosis de Droga/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Personas sin Hogar/estadística & datos numéricos , Humanos , Inyecciones/efectos adversos , Masculino , Pandemias , Factores de Riesgo , Sexo Inseguro/estadística & datos numéricos
19.
APMIS ; 128(8): 506-510, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32564430

RESUMEN

This case report discusses a patient with nephrotic syndrome, pulmonary hypertension, and repeated episodes of infections. He had a history of intravenous drug abuse. Kidney biopsy revealed the rare finding of numerous foam cells, mainly in glomeruli. The solvent used for the drugs is thought to be responsible for the foam cells. In line with previous reports, we suspect that the pulmonary hypertension is consistent with foam cells in pulmonary capillaries or fat embolism syndrome due to the intravenous administered drugs. Our case demonstrates that the use of intravenous drugs can lead to widely varying symptoms. Globally, the prevalence of substance abuse is increasing. Knowledge about their damaging effects is crucial in both clinical practice and anatomic pathology.


Asunto(s)
Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/patología , Infecciones/etiología , Infecciones/patología , Síndrome Nefrótico/etiología , Síndrome Nefrótico/patología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Biopsia , Células Espumosas/patología , Humanos , Hipertensión Pulmonar/complicaciones , Infecciones/complicaciones , Riñón/patología , Masculino , Síndrome Nefrótico/complicaciones
20.
Ann Vasc Surg ; 69: 133-140, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32561239

RESUMEN

BACKGROUND: The objective of this study is to report an 18-year single-center experience in the surgical and endovascular treatment of arterial complications due to self-injection in drug abuser patients. METHODS: This retrospective single-center study was conducted analyzing a prospectively collected database including all endovascular or surgical procedures performed from January 2007 to December 2019 for any arterial complication due to self-injection in drug abuser patient. Collected data were patient demographic and comorbidity, site and type of arterial lesion (pseudoaneurysm [PA], arteriovenous fistula [AVF]), signs of systemic or local infection, and procedural data (endovascular/surgical treatment). End points were rate of postoperative complications, reintervention rate, limb salvage, and patients' early and long-term survival. RESULTS: In 11 patients (median age 36 years, range 27-47; male 73%), 13 arterial lesions were treated: 10 (77%) PA, 2 (15%) PA associated with AVF, and 1 (8%) isolated AVF. Arterial lesion involved common femoral artery in 5 (38%), superficial femoral artery in 4 (31%), profunda femoral artery in 1 (8%), brachial artery in 2 (15%), and subclavian artery in 1 (8%). Signs of infections were present in 9 of the 13 cases (69%). The treatment was surgical in 11 (85%) cases: 7 interposition graft (6 great saphenous vein, 1 arterial cryopreserved homograft), 2 direct reconstruction, 1 patch plasty with pericardium bovine patch, and 1 arterial ligation. Endovascular treatment was performed in 2 cases: 1 noninfected PA of the superficial femoral artery, and 1 55-mm PA of the postvertebral segment of the right subclavian artery with clinical sign of hemodynamic instability. At 1 month, postoperative complication rate was 8% (one lower limb claudication after superficial femoral artery ligation). Reintervention rate was 8% (interposition graft rupture for repeated self-injections). Limb salvage and patient survival were both 100%. Median follow-up was 5 years (range 1 month to 11.3 years); surgical group: median 8.2 years (range 2 months to 11.3 years); endovascular group: median 3.5 months (range 1-6). During follow-up, neither complications nor reinterventions occurred, and limb salvage was 100% for both groups. At 2, 4, and 6 years, overall estimated patient survival was 91%, 81%, and 81%, respectively, with no procedure-related death. CONCLUSIONS: After surgical or endovascular management of arterial lesions due to self-injection in drug abuser patients, complications occur mainly in the postoperative period. During follow-up, the surgical procedures have low rate of complications, reinterventions, and procedure-related mortality, whereas for the endovascular treatment the mid-term outcomes remain unknown.


Asunto(s)
Aneurisma Falso/terapia , Fístula Arteriovenosa/terapia , Implantación de Prótesis Vascular , Consumidores de Drogas , Procedimientos Endovasculares , Abuso de Sustancias por Vía Intravenosa/complicaciones , Lesiones del Sistema Vascular/terapia , Adulto , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/etiología , Aneurisma Falso/mortalidad , Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/etiología , Fístula Arteriovenosa/mortalidad , Implantación de Prótesis Vascular/efectos adversos , Implantación de Prótesis Vascular/mortalidad , Bases de Datos Factuales , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Femenino , Humanos , Italia , Ligadura , Recuperación del Miembro , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidad , Complicaciones Posoperatorias/terapia , Retratamiento , Estudios Retrospectivos , Factores de Riesgo , Abuso de Sustancias por Vía Intravenosa/mortalidad , Factores de Tiempo , Resultado del Tratamiento , Lesiones del Sistema Vascular/diagnóstico por imagen , Lesiones del Sistema Vascular/etiología , Lesiones del Sistema Vascular/mortalidad
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