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1.
Vasc Endovascular Surg ; 53(6): 458-463, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31185832

RESUMEN

BACKGROUND: Few long-time follow-up studies describe all complications, treatment outcome of complications, and mortality in relation to endovascular aneurysm repair (EVAR). The purpose of this study was to evaluate the incidence and treatment outcome including mortality of radiological visible complications related to the EVAR procedure at a single center with up to 10 years' surveillance. MATERIALS AND METHODS: Patients treated with EVAR from March 2006 to March 2016 at a Danish university hospital, 421 in total, were included. Patient and aneurysm characteristics, follow-up, and secondary intervention data were collected from a national database and medical records. Follow-up computed tomography angiography and plain abdominal X-ray reports were reviewed for complications. Scans and X-rays with suspected complications were evaluated by an interventional radiologist. RESULTS: A total of 172 complications in 147 patients, mainly in the beginning of the follow-up period, were found; 35% had a least one complication. The main part of complications (62%) was type II endoleaks, followed by stent graft stenosis (11%), type I endoleaks (9%), and stent graft occlusion (7%). A total of 66 (38%) complications, observed in 55 patients, were treated with reintervention, of which 77% were treated with endovascular procedures and 23% with surgical treatment, that is, 13% of all studied patients had a complication that required a reintervention. The remaining 2 of the 3 complications were treated conservatively. We found no increased all-cause mortality in connection with having a complication including those requiring reintervention. CONCLUSION: We presented a 10-year single-center study of EVAR. Many patients treated with EVAR had a radiological visible complication, mainly in the beginning of the follow-up period. Only a smaller fraction required reintervention and having a reintervention-requiring complication was not connected to increased mortality.


Asunto(s)
Aneurisma/cirugía , Implantación de Prótesis Vascular/efectos adversos , Procedimientos Endovasculares/efectos adversos , Complicaciones Posoperatorias/epidemiología , Anciano , Aneurisma/diagnóstico por imagen , Aneurisma/epidemiología , Aneurisma/mortalidad , Implantación de Prótesis Vascular/mortalidad , Dinamarca/epidemiología , Procedimientos Endovasculares/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/mortalidad , Complicaciones Posoperatorias/cirugía , Reoperación , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
2.
Vasc Endovascular Surg ; 52(7): 505-511, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29874970

RESUMEN

PURPOSE: The aim of this study was to evaluate the incidence, risk factors, and outcome of endoleaks related to endovascular aneurysm repair (EVAR) procedure at a single center with up to 10 years' surveillance. MATERIALS AND METHODS: All patients treated with EVAR for an abdominal aorta or iliac aneurysm in a 10-year period at a single cardiovascular center in Denmark were included. Data were collected from a national database and patient journals. Follow-up computed tomography angiography and plain abdominal X-ray reports were reviewed. RESULTS: A total of 421 patients were included. There were 125 endoleaks observed in 117 (27.8%) patients after a median 95 days (interquartile range: 90-106 days). There were 16 type I, 107 type II, 1 type III, and 1 type V endoleaks. A total of 33 (7.8%) patients had at least 1 reintervention. Patients with type II endoleaks had significantly fewer active smokers and lower plasma creatinine at baseline. They also more often had one, or both, internal iliac arteries embolized as well as an identified endoleak at the procedural completion angiogram. Non-type II endoleaks were associated with internal iliac artery embolization. There was no association between the occurrence of endoleaks and increased mortality. CONCLUSION: Type II endoleaks are common after EVAR, yet few lead to reintervention. Absence of smoking, low plasma creatinine, embolized iliac arteries, and endoleak on completion angiogram were associated with type II endoleaks, whereas only embolized iliac arteries were associated with non-type II endoleaks. Overall, endoleaks are not associated with increased mortality.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/efectos adversos , Endofuga/terapia , Procedimientos Endovasculares/efectos adversos , Aneurisma Ilíaco/cirugía , Anciano , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/epidemiología , Aortografía/métodos , Comorbilidad , Angiografía por Tomografía Computarizada , Dinamarca/epidemiología , Supervivencia sin Enfermedad , Endofuga/diagnóstico por imagen , Endofuga/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Aneurisma Ilíaco/diagnóstico por imagen , Aneurisma Ilíaco/epidemiología , Incidencia , Estimación de Kaplan-Meier , Masculino , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
4.
Ugeskr Laeger ; 177(18): 868-71, 2015 Apr 27.
Artículo en Danés | MEDLINE | ID: mdl-26539576

RESUMEN

Vaccination with aluminium-adsorbed vaccines can induce aluminium allergy with persistent itching subcutaneous nodules at the injection site ­ vaccination granulomas. In this article we give an overview of childhood aluminium-adsorbed vaccines available in Denmark. Through literature studies we examine the incidence, the symptoms and the prognosis for the vaccination granulomas and the allergy. Finally we discuss the status in Denmark.


Asunto(s)
Aluminio/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Vacunas/efectos adversos , Aluminio/administración & dosificación , Aluminio/inmunología , Niño , Dinamarca , Dermatitis Alérgica por Contacto/patología , Granuloma/inducido químicamente , Granuloma/patología , Humanos , Prurito/inducido químicamente , Prurito/inmunología , Prurito/patología , Vacunas/inmunología
5.
J Dermatolog Treat ; 26(6): 575-6, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25909367

RESUMEN

The small molecule vismodegib is a great treatment alternative to patients challenged, e.g. psychiatric disorders, suffering from severe basal cell carcinoma of the skin in which surgery or other treatment modalities is not possible because of patient's wish or condition. We present a case of a 73-year-old schizophrenic patient with a 15-year history of a neglected tumour located at the forehead and scalp, admitted to hospital in a state of inanition because of tumour expansion to the meninges and severe anaemia caused by bleeding, treated successfully with vismodegib.


Asunto(s)
Anilidas/uso terapéutico , Antineoplásicos/uso terapéutico , Carcinoma Basocelular/tratamiento farmacológico , Piridinas/uso terapéutico , Neoplasias Cutáneas/tratamiento farmacológico , Anciano , Carcinoma Basocelular/patología , Femenino , Humanos , Cuero Cabelludo/patología , Esquizofrenia/fisiopatología , Neoplasias Cutáneas/patología
6.
Ugeskr Laeger ; 176(12A)2014 Mar 17.
Artículo en Danés | MEDLINE | ID: mdl-25350883

RESUMEN

Vaccination with aluminium-adsorbed vaccines can induce aluminium allergy with persistent itching subcutaneous nodules at the injection site - vaccination granulomas. In this article we give an overview of childhood aluminium-adsorbed vaccines available in Denmark. Through literature studies we examine the incidence, the symptoms and the prognosis for the vaccination granulomas and the allergy. Finally we discuss the status in Denmark.


Asunto(s)
Aluminio/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Vacunas/efectos adversos , Aluminio/administración & dosificación , Aluminio/inmunología , Niño , Dinamarca , Dermatitis Alérgica por Contacto/patología , Granuloma/inducido químicamente , Granuloma/patología , Humanos , Prurito/inducido químicamente , Prurito/inmunología , Prurito/patología , Vacunas/inmunología
7.
Rev Environ Health ; 29(3): 169-74, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25205703

RESUMEN

Abstract Some natural sites, as a result of contaminants emitted into the air and subsequently deposited in soil or accidental industrial release, have high levels of organic and non-organic chemicals in soil. In occupational and recreation settings, these could be potential sources of percutaneous exposure to humans. When investigating percutaneous absorption from soil - in vitro or vivo - soil load, particle size, layering, soil "age" time, along with the methods of performing the experiment and analyzing the results must be taken into consideration. Skin absorption from soil is generally reduced compared with uptake from water/acetone. However, the absorption of some compounds, e.g., pentachlorophenol, chlorodane and PCB 1254, are similar. Lipophilic compounds like dichlorodiphenyltrichloroethane, benzo[A]pyrene, and metals have the tendency to form reservoirs in skin. Thus, one should take caution in interpreting results directly from in vitro studies for risk assessment; in vivo validations are often required for the most relevant risk assessment.


Asunto(s)
Absorción Cutánea , Contaminantes del Suelo/farmacocinética , Animales , Humanos , Contaminantes del Suelo/toxicidad
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