Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.947
Filtrar
1.
Pan Afr Med J ; 38: 114, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33912284

RESUMO

Sepsis results in intense disturbances in homoeostasis and is responsible for considerable morbidity and mortality in early infancy. Owing to insufficiency on part of infant to develop adequate inflammatory response to localize the infection, they usually progress to disseminated systemic infection, pneumonia and/or meningitis. We present the case of a 26 weeks preterm boy with acute digital ischemia in right index finger progressing to impending gangrene as a manifestation of septicemia. Use of topical nitroglycerin patch with meticulous monitoring successfully alleviated the impending peripheral gangrene without any adverse effects.


Assuntos
Isquemia/tratamento farmacológico , Sepse Neonatal/complicações , Nitroglicerina/administração & dosagem , Administração Cutânea , Dedos/irrigação sanguínea , Gangrena/etiologia , Gangrena/prevenção & controle , Humanos , Recém-Nascido , Isquemia/etiologia , Masculino , Nitroglicerina/efeitos adversos , Adesivo Transdérmico , Resultado do Tratamento , Vasodilatadores/administração & dosagem , Vasodilatadores/efeitos adversos
2.
BMJ Case Rep ; 14(1)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33500313

RESUMO

Novel COVID-19 continues to intrigue medical professionals with its varied presentations. Though it affects the respiratory tract primarily, thrombogenesis has been the Achilles' heel. A 44-year-old man diagnosed with COVID-19 presented with upper limb pain at a local hospital and was found to have thrombosis of the right axillary artery. Despite a successful embolectomy at the local hospital, there was re-occlusion of the axillary artery and the limb became ischaemic. He was referred to our institution by which time the limb became gangrenous above the elbow and had to be amputated. Extensive sloughing of the nerves was also seen in the local area. Hypercoagulability presenting with various manifestations is common in COVID-19 and needs early anticoagulation. We present this asymptomatic patient who lost a limb to this COVID-19 sequelae.


Assuntos
Amputação , Braço/cirurgia , Artéria Axilar , COVID-19/complicações , Gangrena/cirurgia , Isquemia/cirurgia , Trombose/complicações , Adulto , Braço/irrigação sanguínea , Braço/patologia , Artéria Axilar/cirurgia , Embolectomia , Gangrena/etiologia , Gangrena/patologia , Humanos , Isquemia/etiologia , Isquemia/patologia , Masculino , Recidiva , SARS-CoV-2 , Trombose/cirurgia
3.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462011

RESUMO

Neonates are at highest risk of thrombosis among paediatric patients. The relative prothrombotic state in a well neonate is compensated by other factors preventing spontaneous thrombosis; however, in a neonate with genetic predisposition, the balance is tilted predisposing them to a life-threatening thrombotic episode. We describe a rare case of methylenetetrahydrofolate reductase A1298C (homozygous) mutation along with plasminogen activator inhibitor (4G) mutation in a neonate who developed bilateral lower limb gangrene following thrombosis of the iliac vessels without any triggering factor. The neonate underwent thrombectomy as debulking measure along with thrombolytic therapy followed by unfractionated heparin and low-molecular-weight heparin which is still being continued along with oral aspirin. The neonate had to undergo amputation of both the involved lower limbs in view of dry gangrene. This case highlights that the dual mutations causing the prothrombotic state predispose the individual to the spontaneous life-threatening thrombotic episode as compared with the single mutation.


Assuntos
Artéria Ilíaca/patologia , Extremidade Inferior/patologia , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Mutação , Inativadores de Plasminogênio/genética , Trombose/diagnóstico , Trombose/genética , Gangrena/diagnóstico , Gangrena/etiologia , Marcadores Genéticos , Humanos , Recém-Nascido , Masculino , Trombose/complicações , Trombose/patologia
4.
BMJ Case Rep ; 14(1)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33419746

RESUMO

A 24+5-week preterm neonate with a severe scalp lesion was admitted to the neonatal intensive care unit (NICU) after caesarean section due to maternal chorioamnionitis (MC). An Arabin pessary had been inserted in addition to a previous cervical cerclage due to cervix insufficiency at 21+5 weeks of pregnancy (wp). At 23+5 wp, preterm rupture of membranes was evidenced. Both devices were kept to provide fetal viability. On 24+4 wp, she developed MC. Urgent caesarean section was performed. Transvaginal manual manipulation was required during the procedure. On NICU, she presented severe shock which required high-dose vasopressors and blood products. Following surgical repair, a bilateral grade IV intracranial haemorrhage was evidenced. Subsequently, it was agreed to withdraw life support. We hypothesise that MC and local infection could have acted as predisposing factors, with the presence of a pessary in the setting causing uterine contractions and its manipulation acting as a precipitating factor.


Assuntos
Gangrena/etiologia , Doenças do Prematuro/etiologia , Isquemia/etiologia , Couro Cabeludo/irrigação sanguínea , Evolução Fatal , Feminino , Gangrena/patologia , Gangrena/cirurgia , Humanos , Lactente Extremamente Prematuro , Recém-Nascido , Doenças do Prematuro/patologia , Doenças do Prematuro/cirurgia , Isquemia/patologia , Isquemia/cirurgia
5.
Am J Case Rep ; 21: e928342, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33323917

RESUMO

BACKGROUND Coronavirus disease 2019 (COVID-19) is a novel infectious disease with an evolving understanding of its clinical manifestations, complications, and therapeutic implications. Thromboembolic disease and coagulopathy are common and have been seen in COVID-19 patients. Phlegmasia cerulea dolens had been reported in previous cases associated with malignancy which is a known cause of a procoagulable state. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may also induce a procoagulable state and be associated with PCD. CASE REPORT A 61-year-old man presented with a painful, swollen limb and gangrene, findings consistent with a diagnosis of PCD due to venous thrombosis. The patient tested positive for SARS-CoV-2 infection after a nasopharyngeal swab sample using the XPRSARS-COV2-10 reverse transcription polymerase chain reaction kit. He had bilateral leg swelling with a gangrenous left fourth digit in the presence of a palpable peripheral pulse. His venous duplex showed bilateral acute deep venous thrombosis, whereas his arterial Doppler scan was normal and his skin biopsy was negative for vasculitis. One of our screening blood tests was suggestive of an antiphospholipid-like syndrome. These clinical and radiologic findings were consistent with PCD. This patient was promptly anticoagulated; other supportive treatments were also initiated. He had a significant resolution of his pedal swelling with the associated revitalization of his previously gangrenous toe. CONCLUSIONS This case report shows the importance of testing for SARS-CoV-2 infection in patients who present with unusual thrombotic symptoms and signs and highlights the potential severity of these thrombotic complications.


Assuntos
COVID-19/complicações , Edema/etiologia , Gangrena/etiologia , Trombose Venosa/complicações , Anticoagulantes/uso terapêutico , Humanos , Extremidade Inferior/patologia , Masculino , Pessoa de Meia-Idade
7.
Am J Case Rep ; 21: e926886, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32999267

RESUMO

BACKGROUND Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, China, in late 2019 and has led to an ongoing pandemic. COVID-19 typically affects the respiratory tract and mucous membranes, leading to pathological involvement of various organ systems. Although patients usually present with fever, cough, and fatigue, less common manifestations have been reported including symptoms arising from thrombosis and thromboembolism. A spectrum of dermatologic changes is becoming recognized in patients with COVID-19 who initially present with respiratory symptoms. The mechanism behind these manifestations remains unclear. This report presents the case of a 47-year-old Hispanic man who developed cutaneous vasculitic lesions and gangrene of the toes following admission to hospital with COVID-19 pneumonia. CASE REPORT COVID-19 has been associated with cardiovascular disease entities including stroke, acute coronary syndrome, venous thromboembolism, and peripheral vascular disease. We present a case in which a 47-year-old Hispanic man arrived at the Emergency Department with COVID-19 and was admitted for respiratory failure. Despite anticoagulation initiated on admission in the presence of an elevated D-dimer, the patient developed gangrene of all his toes, which required bilateral transmetatarsal amputation. CONCLUSIONS This case shows that dermatologic manifestations may develop in patients who initially present with COVID-19 pneumonia. These symptoms may be due to venous thrombosis following SARS-CoV-2 vasculitis, leading to challenging decisions regarding anticoagulation therapy. Randomized controlled trials are needed to evaluate the efficacy of anticoagulation, to choose appropriate anticoagulants and dosing, and to assess bleeding risk.


Assuntos
Infecções por Coronavirus/complicações , Gangrena/etiologia , Gangrena/cirurgia , Pneumonia Viral/complicações , Síndrome Respiratória Aguda Grave/complicações , Dedos do Pé/cirurgia , Vasculite/etiologia , Amputação/métodos , Infecções por Coronavirus/diagnóstico , Serviço Hospitalar de Emergência , Seguimentos , Gangrena/fisiopatologia , Hispano-Americanos , Humanos , Masculino , Ossos do Metatarso/cirurgia , Pessoa de Meia-Idade , Multimorbidade , Pandemias , Admissão do Paciente , Pneumonia Viral/diagnóstico , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/etnologia , Insuficiência Respiratória/etiologia , Medição de Risco , Síndrome Respiratória Aguda Grave/diagnóstico , Dedos do Pé/irrigação sanguínea , Dedos do Pé/fisiopatologia , Resultado do Tratamento , Vasculite/fisiopatologia
9.
World J Emerg Surg ; 15(1): 43, 2020 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32615987

RESUMO

BACKGROUND: Since its first documentation, a novel coronavirus (SARS-CoV-2) infection has emerged worldwide, with the consequent declaration of a pandemic disease (COVID-19). Severe forms of acute respiratory failure can develop. In addition, SARS-CoV-2 may affect organs other than the lung, such as the liver, with frequent onset of late cholestasis. We here report the histological findings of a COVID-19 patient, affected by a tardive complication of acute ischemic and gangrenous cholecystitis with a perforated and relaxed gallbladder needing urgent surgery. CASE PRESENTATION: A 59-year-old Caucasian male, affected by acute respiratory failure secondary to SARS-CoV-2 infection was admitted to our intensive care unit (ICU). Due to the severity of the disease, invasive mechanical ventilation was instituted and SARS-CoV-2 treatment (azithromycin 250 mg once-daily and hydroxychloroquine 200 mg trice-daily) started. Enoxaparin 8000 IU twice-daily was also administered subcutaneously. At day 8 of ICU admission, the clinical condition improved and patient was extubated. At day 32, patient revealed abdominal pain without signs of peritonism at examination, with increased inflammatory and cholestasis indexes at blood tests. At a first abdominal CT scan, perihepatic effusion and a relaxed gallbladder with dense content were detected. The surgeon decided to wait and see the evolution of clinical conditions. The day after, conditions further worsened and a laparotomic cholecystectomy was performed. A relaxed and perforated ischemic gangrenous gallbladder, with a local tissue inflammation and perihepatic fluid, was intraoperatively met. The gallbladder and a sample of omentum, adherent to the gallbladder, were also sent for histological examination. Hematoxylin-eosin-stained slides display inflammatory infiltration and endoluminal obliteration of vessels, with wall breakthrough, hemorrhagic infarction, and nerve hypertrophy of the gallbladder. The mucosa of the gallbladder appears also atrophic. Omentum vessels also appear largely thrombosed. Immunohistochemistry demonstrates an endothelial overexpression of medium-size vessels (anti-CD31), while not in micro-vessels, with a remarkable activity of macrophages (anti-CD68) and T helper lymphocytes (anti-CD4) against gallbladder vessels. All these findings define a histological diagnosis of vasculitis of the gallbladder. CONCLUSIONS: Ischemic gangrenous cholecystitis can be a tardive complication of COVID-19, and it is characterized by a dysregulated host inflammatory response and thrombosis of medium-size vessels.


Assuntos
Colecistectomia/métodos , Colecistite , Infecções por Coronavirus , Vesícula Biliar , Gangrena , Omento , Pandemias , Pneumonia Viral , Perfuração Espontânea , Betacoronavirus/isolamento & purificação , Colecistite/etiologia , Colecistite/patologia , Colecistite/fisiopatologia , Colecistite/cirurgia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Cuidados Críticos/métodos , Vesícula Biliar/irrigação sanguínea , Vesícula Biliar/diagnóstico por imagem , Vesícula Biliar/patologia , Gangrena/etiologia , Gangrena/patologia , Humanos , Imuno-Histoquímica , Infarto/etiologia , Infarto/patologia , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Omento/irrigação sanguínea , Omento/patologia , Pneumonia Viral/complicações , Pneumonia Viral/imunologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Perfuração Espontânea/diagnóstico , Perfuração Espontânea/etiologia , Perfuração Espontânea/fisiopatologia , Perfuração Espontânea/cirurgia , Trombose/etiologia , Trombose/patologia , Resultado do Tratamento
10.
Trop Doct ; 50(3): 251-253, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32437296

RESUMO

We present a patient with severe Plasmodium falciparum malaria of seven days' duration who developed an altered sensorium of one day. During hospital admission, peripheral symmetrical gangrene of hands and feet followed, despite normal limb vasculature.


Assuntos
Gangrena/etiologia , Malária Falciparum/complicações , Idoso de 80 Anos ou mais , Feminino , Pé/patologia , Gangrena/parasitologia , Mãos/patologia , Humanos , Malária Falciparum/diagnóstico , Plasmodium falciparum/isolamento & purificação
13.
West Afr J Med ; 37(2): 189-196, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150639

RESUMO

Extremity gangrene is a fairly common pathology, which complicates systemic vascular and endocrine diseases. Most often, it is encountered in diseases like uncontrolled Diabetes Mellitus, presenting as diabetic foot gangrene, severe peripheral arteriosclerosis with gangrene of the extremity complicating severe uncontrolled systemic hypertension and meningococcal septicaemia with peripheral gangrene. It also occurs in some cases of snake bite as well as frost bite (in regions with extreme cold weather conditions). Some of them present as monolateral extremity gangrene. However, others present as bilateral symmetrical peripheral gangrene (SPG) characterized by bilateral extremity ischaemia resulting in gangrene in which there is no major vascular occlusive disease. There is disseminated intravascular coagulation with the gangrene being considered as a cutaneous marker and some of the patients that survive ultimately require amputation of the affected limb(s) in the severe cases. The mild cases end up losing some of the digits or just exfoliation of the dead cutaneous layer. The effects are generally more severe in the lower limbs than in upper limbs. Notable among these are some of those complicating meningococcal sepsis resulting from peripheral intravascular coagulation. We present here, five patients who presented with varying degrees of peripheral gangrene during an epidemic of meningitis and the treatments that were carried out depending on the severity of their cases.


Assuntos
Amputação , Coagulação Intravascular Disseminada/cirurgia , Gangrena/etiologia , Meningite Meningocócica/complicações , Infecções Meningocócicas/cirurgia , Sepse/microbiologia , Coagulação Intravascular Disseminada/complicações , Coagulação Intravascular Disseminada/diagnóstico , , Gangrena/cirurgia , Humanos , Perna (Membro) , Infecções Meningocócicas/complicações , Sepse/complicações
15.
J Foot Ankle Surg ; 59(1): 27-30, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31882144

RESUMO

Ray resection is frequently performed in cases of infection or ischemia, but the literature is scarce concerning its outcome as a definitive treatment. In this retrospective cohort study, we reviewed our cohort with transmetatarsal ray resection with a mean follow-up of 36.3 months. Reulcerations, transfer ulcers, and reamputations were determined. Risk factor analysis for revision surgery was conducted. Among 185 patients, 71 (38.4%) had revision surgery within a mean of 1.4 ± 2.6 years (range 2 days to 12.9 years), 22 (11.9%) had major amputations, 49 (26.5%) had minor amputations, 11 (5.9%) had same-ray reulceration, 40 (21.6%) had transfer ulceration, and 2 (1.1%) had both reulceration and transfer ulceration. Occurrence of a postoperative ulcer was statistically significantly associated with revision surgery (p < .01). In conclusion, metatarsal ray resection is a reasonable treatment option in cases of forefoot ischemia or infection to prevent major amputation but fails in 11.9%, and reulceration is associated with further revisions, making ulcer prevention paramount.


Assuntos
Amputação , Úlcera do Pé/cirurgia , Ossos do Metatarso/cirurgia , Osteomielite/cirurgia , Adulto , Idoso , Estudos de Coortes , Feminino , Úlcera do Pé/etiologia , Úlcera do Pé/patologia , Gangrena/etiologia , Gangrena/cirurgia , Humanos , Isquemia/etiologia , Isquemia/cirurgia , Masculino , Pessoa de Meia-Idade , Osteomielite/etiologia , Osteomielite/patologia , Reoperação , Resultado do Tratamento
16.
Ann Ital Chir ; 90: 427-431, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31814597

RESUMO

AIM: Acute appendicitis is one of the most common pathology requiring emergency operations, and if perforated, can cause morbidity and mortality. The serum bilirubin levels were studied to see whether an elevation predicted perforation. MATERIAL AND METHODS: In a retrospective cohort study the medical files of 221 patients who were operated for acute appendicitis were reviewed. RESULTS: Total and indirect bilirubin levels were significantly higher in patients with a perforated appendicitis compared with patients with simple appendicitis. Elevated serum bilirubin had a sensitivity of 50.00 (95% CI 29.93 to 70.07) and a specificity of 80.73 (95% CI 74.43 to 86.05) when predicting a perforated appendicitis. CONCLUSIONS: Appendiceal perforation may be accompanied with elevated serum bilirubin level. Assessment of bilirubin levels must be a part of the initial evaluation of a suspected appendicitis in the emergency room. KEY WORDS: Acute appendicitis, Gangrenous appendicitis, Perforated appendicitis, Serum bilirubin, Total Hyperbilirubinemia.


Assuntos
Apendicite/sangue , Bilirrubina/sangue , Hiperbilirrubinemia/etiologia , Perfuração Intestinal/sangue , Adolescente , Adulto , Idoso , Alanina Transaminase/sangue , Apendicectomia , Apendicite/complicações , Apendicite/cirurgia , Aspartato Aminotransferases/sangue , Biomarcadores , Emergências , Endotoxemia/sangue , Endotoxemia/etiologia , Feminino , Gangrena/etiologia , Humanos , Perfuração Intestinal/complicações , Perfuração Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Cuidados Pré-Operatórios , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
17.
BMJ Case Rep ; 12(12)2019 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-31818886

RESUMO

Digital dry gangrene is commonly seen in cases of connective tissue disease such as systemic sclerosis. In systemic lupus erythematosus (SLE) digital gangrene is rare. As initial manifestation, it is again a rare phenomenon because it occurs late in the course of disease. Here we are reporting the case of a woman who was having extensive cutaneous gangrene of her fingers and toes, as a first and foremost presentation without any other typical signs and symptoms of SLE. Her serology was positive for SLE. The patient was treated conservatively and responded well.


Assuntos
Dedos/patologia , Gangrena/etiologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/patologia , Dedos do Pé/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Resultado do Tratamento
19.
Dermatol Ther ; 32(6): e13125, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31631451

RESUMO

The nontropical diabetic hand syndrome merits recognition as a serious hand infection and diabetic complication. Initially recognized in the tropics and called tropical diabetic hand syndrome, this entity has not been previously delineated in temperate regions. Due in part to its unremarkable initial presentation, nontropical diabetic hand syndrome is neglected in temperate zones of the world yet it can result in severe morbidity and mortality among diabetic patients. It is poorly understood, needs recognition, and mandates expedited treatment since its clinical presentation is often overlooked until serious consequences occur. Inner city diabetic patients with poor glycemic control appear to be particularly susceptible to developing nontropical diabetic hand syndrome. We review this new entity and differentiate it into three clinical presentations: (Stage I) superficial erosion and ulceration; (Stage II) cellulitis and necrosis; and (Stage III) gangrene. The treatment of this new diabetic syndrome involves aggressive glycemic control and possible surgical intervention. We stress the importance of recognizing the diabetic hand syndrome as a potentially disabling and life-threatening disorder in diabetics worldwide.


Assuntos
Complicações do Diabetes/patologia , Mãos/patologia , Dermatopatias/etiologia , Complicações do Diabetes/diagnóstico , Feminino , Gangrena/etiologia , Gangrena/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Necrose/etiologia , Necrose/patologia , Dermatopatias/patologia , Úlcera Cutânea/etiologia , Úlcera Cutânea/patologia , Síndrome
20.
Eur J Vasc Endovasc Surg ; 58(6): 854-863, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31653609

RESUMO

OBJECTIVE: The present study investigated the impact of endovascular pedal artery revascularisation (PAR) on the clinical outcomes of patients with critical limb ischaemia (CLI). METHODS: This retrospective analysis of a single centre cohort included 239 patients who underwent endovascular revascularisation of infrapopliteal arteries for a chronic ischaemic wound. PAR was attempted in 141 patients during the procedure. After propensity score matching, there were 87 pairs of patients with and without PAR. RESULTS: After the matching, the two groups showed balanced baseline clinical and lesion characteristics. PAR was achieved in 60.9% of the PAR group. Direct angiosome flow was more frequently obtained in the PAR group than in the non-PAR group (81.6% vs. 34.5%; p < .001). Subintimal angioplasty (47.1% vs. 29.9%; p = .019) and pedal-plantar loop technique (18.4% vs. 0%; p < .001) were more frequent in the PAR group. At the one year follow up, the PAR group showed greater freedom from major amputation (96.3% vs. 84.2%; p = .009). The wound healing rate, overall survival, major adverse limb event, and freedom from re-intervention did not differ significantly between the two groups. However, the patient subgroup with successful PAR showed a higher wound healing rate than the non-PAR group (76.0% vs. 67.0%; p = .031). In a multivariable Cox proportional hazards regression model, successful PAR (hazard ratio [HR] 1.564, 95% confidence interval [CI] 1.068-2.290; p = .022) was identified as an independent factor associated with improved wound healing, whereas gangrene (HR 0.659, 95% confidence interval [CI] 0.471-0.923; p = .015), C reactive protein >3 mg/dL (HR 0.591, 95% CI 0.386-0.904; p = .015), and pre-procedural absence of pedal arch (HR 0.628, 95% CI 0.431-0.916; p = .016) were associated with impaired wound healing. CONCLUSION: Successful PAR significantly improved wound healing in patients with CLI. Thus, efforts should be made to revascularise the pedal arteries, especially when the pedal arch is completely absent.


Assuntos
Procedimentos Endovasculares/métodos , Pé/irrigação sanguínea , Isquemia/cirurgia , Salvamento de Membro/métodos , Cicatrização , Idoso , Amputação/estatística & dados numéricos , Feminino , Seguimentos , Pé/cirurgia , Gangrena/epidemiologia , Gangrena/etiologia , Gangrena/prevenção & controle , Humanos , Isquemia/complicações , Isquemia/mortalidade , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Artéria Poplítea/cirurgia , Pontuação de Propensão , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...