Letter to the Editor
Massive deep venous thrombosis in a patient addicted to cocaine
Trombosis venosa profunda masiva en un paciente adicto a la cocaína
Ricardo A. Losno
, José C. Milisenda, Jesús Aibar
Corresponding author
Servicio de Medicina Interna, Hospital Clinic, Barcelona, Spain
Read
18
Timeswas read the article
2
Total PDF
16
Total HTML
Share statistics
array:24 [ "pii" => "S0025775319301411" "issn" => "00257753" "doi" => "10.1016/j.medcli.2019.02.009" "estado" => "S300" "fechaPublicacion" => "2020-02-14" "aid" => "4791" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2019" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2020;154:110-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5 "HTML" => 5 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S2387020619305571" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.02.038" "estado" => "S300" "fechaPublicacion" => "2020-02-14" "aid" => "4791" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2020;154:110-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Massive deep venous thrombosis in a patient addicted to cocaine" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "110" "paginaFinal" => "111" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Trombosis venosa profunda masiva en un paciente adicto a la cocaína" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1286 "Ancho" => 1750 "Tamanyo" => 216722 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT scan images. (A) Axial Image of the infrahepatic inferior vena cava (IVC) thrombosis (orange arrow). (B) Coronal Image of the infrahepatic IVC thrombosis (orange arrows). (C) Axial Image of both common iliacs thrombosis (orange arrows). (D) Axial Image of both femoral veins’ thrombosis (orange arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ricardo A. Losno, José C. Milisenda, Jesús Aibar" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ricardo A." "apellidos" => "Losno" ] 1 => array:2 [ "nombre" => "José C." "apellidos" => "Milisenda" ] 2 => array:2 [ "nombre" => "Jesús" "apellidos" => "Aibar" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0025775319301411" "doi" => "10.1016/j.medcli.2019.02.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775319301411?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619305571?idApp=UINPBA00004N" "url" => "/23870206/0000015400000003/v1_202002091807/S2387020619305571/v1_202002091807/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0025775319302970" "issn" => "00257753" "doi" => "10.1016/j.medcli.2019.03.033" "estado" => "S300" "fechaPublicacion" => "2020-02-14" "aid" => "4854" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2020;154:112" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4 "HTML" => 4 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen médica</span>" "titulo" => "Síndrome de Mondor" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "112" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Mondor's syndrome" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 743 "Ancho" => 500 "Tamanyo" => 39413 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Cabezudo Molleda, Angela Montero Moretón, Elena Laherrán Rodríguez, Silvia Franco Hidalgo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Cabezudo Molleda" ] 1 => array:2 [ "nombre" => "Angela" "apellidos" => "Montero Moretón" ] 2 => array:2 [ "nombre" => "Elena" "apellidos" => "Laherrán Rodríguez" ] 3 => array:2 [ "nombre" => "Silvia" "apellidos" => "Franco Hidalgo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020619305522" "doi" => "10.1016/j.medcle.2019.03.033" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619305522?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775319302970?idApp=UINPBA00004N" "url" => "/00257753/0000015400000003/v1_202001280635/S0025775319302970/v1_202001280635/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0025775318305980" "issn" => "00257753" "doi" => "10.1016/j.medcli.2018.10.005" "estado" => "S300" "fechaPublicacion" => "2020-02-14" "aid" => "4658" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2020;154:108-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 1 "PDF" => 3 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Diagnóstico prenatal de cardiopatías congénitas en un hospital terciario en 2 años" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "108" "paginaFinal" => "109" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prenatal diagnosis of congenital heart diseases in a tertiary hospital over two years" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Lidia Cardiel Valiente, Ariadna Ayerza Casas, Pilar Samper Villagrasa" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Lidia" "apellidos" => "Cardiel Valiente" ] 1 => array:2 [ "nombre" => "Ariadna" "apellidos" => "Ayerza Casas" ] 2 => array:2 [ "nombre" => "Pilar" "apellidos" => "Samper Villagrasa" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020619305492" "doi" => "10.1016/j.medcle.2018.10.038" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619305492?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775318305980?idApp=UINPBA00004N" "url" => "/00257753/0000015400000003/v1_202001280635/S0025775318305980/v1_202001280635/es/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Massive deep venous thrombosis in a patient addicted to cocaine" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "110" "paginaFinal" => "111" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ricardo A. Losno, José C. Milisenda, Jesús Aibar" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Ricardo A." "apellidos" => "Losno" "email" => array:2 [ 0 => "ralosno@clinic.cat" 1 => "losnoric@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "José C." "apellidos" => "Milisenda" ] 2 => array:2 [ "nombre" => "Jesús" "apellidos" => "Aibar" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Interna, Hospital Clinic, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Trombosis venosa profunda masiva en un paciente adicto a la cocaína" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1102 "Ancho" => 1500 "Tamanyo" => 174599 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT scan images. (A) Axial Image of the infrahepatic inferior vena cava (IVC) thrombosis (orange arrow). (B) Coronal Image of the infrahepatic IVC thrombosis (orange arrows). (C) Axial Image of both common iliacs thrombosis (orange arrows). (D) Axial Image of both femoral veins’ thrombosis (orange arrows).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cocaine has become one of the most widely used illicit drugs among the Spanish population, leading to an increase in visits to the emergency department. The release of catecholamines in the context of cocaine can lead to deep hypertension, intense vasoconstriction and platelet activation which promotes thrombotic events such as myocardial infarction and stroke.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> In addition, cases of peripheral arterial thrombosis with involvement of the iliac, popliteal and distal arteries have been identified,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> while the practice of injecting drugs through the femoral vein is associated with iliofemoral deep venous thrombosis (DVT).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present a case of a 42-year-old man without allergies, active smoker, regular inhaled cocaine user and a past medical history of Hepatitis C Virus (HCV) infection without treatment. The patient was admitted to the Internal Medicine ward due to the presence of purpuric lesions and edemas in the lower extremities. On this admission, he admitted to taking cocaine the days prior to the onset of the complains. He was afebrile and haemodynamically stable. In the physical exploration the presence of edemas was corroborated in both lower extremities up to the groin with pitting edema and collateral circulation, without signs of necrosis and with present peripheral pulses.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The blood test showed a leukocytosis of 24<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>/L with 83% neutrophils, C-reactive protein 1.5<span class="elsevierStyleHsp" style=""></span>mg/dl, alanine transaminase (ALT) 4 UI/L, aspartate transaminase (AST) 15 UI/L, gamma-glutamyl transferase (GGT) 28 UI/L, lactate dehydrogenase (LDH) 587 UI/L. Human immunodeficiency virus (HIV) negative. RNA HCV<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>IU/mL. Cryoglobulins negative. An ultrasound showed bilateral iliac thrombosis affecting up to popliteal vessels. In view of these findings, a CT scan was performed which showed complete thrombosis of both common femoral veins, external iliacs, internal iliacs, common iliacs and the infrahepatic inferior vena cava (IVC) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), with extension to both segmental renal veins and cavernomatous transformation of the hepatic IVC without signs of pulmonary thromboembolism. Finally, it has been performed a PET-CT that showed no alterations in the pattern of FDG uptake discarding malignancy.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">As triggering causes of DVT, the patient had not made long trips, recent surgery, nor was on any medication; a vasculitis HCV-associated was considered, but the viral load was less of 15<span class="elsevierStyleHsp" style=""></span>IU/mL and cryoglobulins were negative. Subcutaneous enoxaparin 1<span class="elsevierStyleHsp" style=""></span>mg/kg/12<span class="elsevierStyleHsp" style=""></span>h was initiated. Thrombectomy was rejected due to the risk of complications and the impossibility of catheter passage due to the extension of the thrombosis. Six months after discharge, a blood study of thrombophilia was performed, which turned out to be negative. The patient showed a favorable evolution with great improvement of the signs of DVT and mobility.</p><p id="par0025" class="elsevierStylePara elsevierViewall">There are no previous cases of massive thrombosis due to inhaled cocaine, so a casual association cannot be ruled out, however the Naranjo causality algorithm was applied with a total score of 5 points (2 points for temporality, 2 points for no other causes, 1 point for drug been detected in urine). It was oriented as a probable adverse reaction to the use of inhaled cocaine. Acute arterial thrombosis is described as a complication of inhaled cocaine intake, while the practice of injecting drugs through the femoral vein is associated with iliofemoral DVT.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> However, cases of massive DVT secondary to inhaled cocaine are not reported. The mechanism by which cocaine can induce thrombosis is unknown. Heesch et al. demonstrated that exposure to cocaine causes platelet activation, release of granules and formation of platelet microaggregates.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">We describe the case of a man with a history of sporadic use of inhaled cocaine who presented a massive DVT. Having reasonably ruled out other causes of DVT, we believe that the triggering cause could be the use of inhaled cocaine. As a provoked DVT, it was agreed to initiate and maintain anticoagulation for 6 months, with good clinical response afterwards.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1102 "Ancho" => 1500 "Tamanyo" => 174599 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT scan images. (A) Axial Image of the infrahepatic inferior vena cava (IVC) thrombosis (orange arrow). (B) Coronal Image of the infrahepatic IVC thrombosis (orange arrows). (C) Axial Image of both common iliacs thrombosis (orange arrows). (D) Axial Image of both femoral veins’ thrombosis (orange arrows).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trastornos por cocaína e infarto agudo de miocardio, prolongación de estancias y exceso de costes hospitalarios" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Gili" 1 => "G. Ramírez" 2 => "L. Béjar" 3 => "J. López" 4 => "D. Franco" 5 => "J. Sala" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rec.2013.11.010" "Revista" => array:7 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2014" "volumen" => "67" "paginaInicial" => "545" "paginaFinal" => "551" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24952394" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109709019524" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vascular disease in cocaine addiction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Bachi" 1 => "V. Mani" 2 => "D. Jeyachandran" 3 => "Z.A. Fayad" 4 => "R.Z. Goldstein" 5 => "N. Alia-Klein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.atherosclerosis.2017.03.019" "Revista" => array:6 [ "tituloSerie" => "Atherosclerosis" "fecha" => "2017" "volumen" => "262" "paginaInicial" => "154" "paginaFinal" => "162" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28363516" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Associations between injecting illicit drugs into the femoral vein and deep vein thrombosis: A case control study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N.M.J. Wright" 1 => "V. Allgar" 2 => "C.N.E. Tompkins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dar.12359" "Revista" => array:6 [ "tituloSerie" => "Drug Alcohol Rev" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "605" "paginaFinal" => "610" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26644314" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endothelium-dependent vasorelaxation is impaired in cocaine arteriopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.P. Havranek" 1 => "K. Nademanee" 2 => "P.A. Grayburn" 3 => "E.J. Eichhorn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0735-1097(96)00299-9" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "1996" "volumen" => "28" "paginaInicial" => "1168" "paginaFinal" => "1174" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8890811" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cocaine activates platelets and increases the formation of circulating platelet containing microaggregates in humans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Heesch" 1 => "C. Wilhelm" 2 => "J. Ristich" 3 => "J. Adnane" 4 => "F. Bontempo" 5 => "W. Wagner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/heart.83.6.688" "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "2000" "volumen" => "83" "paginaInicial" => "688" "paginaFinal" => "695" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10814631" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000015400000003/v1_202001280635/S0025775319301411/v1_202001280635/en/main.assets" "Apartado" => array:4 [ "identificador" => "80480" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Carta al Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000015400000003/v1_202001280635/S0025775319301411/v1_202001280635/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775319301411?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 1 | 0 | 1 |
| 2020 August | 2 | 0 | 2 |
| 2020 June | 2 | 0 | 2 |
| 2020 April | 2 | 0 | 2 |
| 2020 March | 1 | 2 | 3 |
| 2020 February | 8 | 0 | 8 |
