Temporal Bone Fractures and Related Complications in Pediatric and Adult Cranio-Facial Trauma: A Comparison of MDCT Findings in the Acute Emergency Setting.

PURPOSE: The purpose of this study was to analyze the prevalence of and complications resulting from temporal bone fractures in adult and pediatric patients evaluated for cranio-facial trauma in an emergency setting. METHODS: A retrospective blinded analysis of CT scans of a series of 294 consecutive adult and pediatric patients with cranio-facial trauma investigated in the emergency setting was conducted. Findings were compared between the two populations. Preliminary reports made by on-call residents were compared with the retrospective analysis, which was performed in consensus by two experienced readers and served as reference standard. RESULTS: CT revealed 126 fractures in 116/294 (39.5%) patients, although fractures were clinically suspected only in 70/294 (23.8%); p < 0.05. Fractures were longitudinal, transverse and mixed in 69.5%, 10.3% and 19.8% of cases, respectively. Most fractures were otic-sparing fractures (95.2%). Involvement of the external auditory canal, ossicular chain and the osseous structures surrounding the facial nerve was present in 72.2%, 8.7% and 6.3% of cases, respectively. Temporal bone fractures extended into the venous sinuses/jugular foramen and carotid canal in 18.3% and 17.5% of cases, respectively. Vascular injuries (carotid dissection and venous thrombosis) were more common in children than in adults (13.6% versus 5.3%); however, the observed difference did not reach statistical significance. 79.5% of patients with temporal bone fractures had both brain injuries and fractures of the facial bones and cranial vault. Brain injuries were more common in adults (90.4%) than in children (63.6%), p = 0.001. Although on-call residents reliably detected temporal bone fractures (sensitivity = 92.8%), they often missed trauma-associated ossicular dislocation (sensitivity = 27.3%). CONCLUSIONS: Temporal bone fractures and related complications are common in patients with cranio-facial trauma and need to be thoroughly looked for; the pattern of associated injuries is slightly different in children and in adults.

Perfil Clínico-Epidemiológico do Câncer Colorretal na Região Oeste do Paraná, Brasil, 2016-2018 / Clinical and Epidemiological Profile of Colorectal Cancer in Paraná's Western Region, Brazil, 2016-2018 / Perfil Clínico-Epidemiológico de lo Cáncer Colorrectal en la Región Oeste de Paraná, Brasil, 2016-2018

Introdução: O câncer colorretal é a neoplasia mais frequente do trato gastrointestinal, sendo a segunda principal causa de morte por câncer no mundo. Objetivo: Traçar um perfil clínico-epidemiológico do câncer colorretal na Região Oeste do Paraná (Brasil), entre 2016 e 2018. Método: Estudo observacional analítico do tipo transversal, construído a partir da análise de resultados de exames anatomopatológicos, realizados entre 2016 a 2018. Realizaram-se análises por estatística descritiva, teste de associação qui-quadrado e U de Mann-Whitney. Adotou-se nível de significância de 5%. Resultados: A análise de 509 laudos positivos para câncer colorretal permitiu identificar o predomínio de pacientes do sexo masculino e a idade média de diagnóstico de 62 anos. A malignidade mostrou-se mais incidente na faixa etária de 61 a 70 anos (29,9%), e considerável número de casos ocorreu em pacientes abaixo de 50 anos (19,6%). Houve predomínio em cólon esquerdo e do tipo histológico adenocarcinoma infiltrativo moderadamente diferenciado. Verificou-se associação entre topografia da doença e sexo, com maior predominância do sexo feminino para tumores do cólon direito e do sexo masculino para tumores do cólon esquerdo (p=0,0081). Conclusão: A partir deste estudo, delineia-se um perfil clínico-epidemiológico do câncer colorretal na Região Oeste do Paraná, com maior incidência da doença em homens, sexagenários, além de predomínio de tumores em cólon esquerdo e do tipo adenocarcinoma infiltrativo moderadamente diferenciado. Tais achados são relevantes considerando a possibilidade de aplicação assertiva de protocolos internacionais de rastreio do câncer nessa população

Introduction: The colorectal cancer is the most frequent neoplasm of the gastrointestinal tract and the second cause of cancer related death. Objective: To design a clinical and epidemiological profile of the colorectal cancer at the Western Region of the Paraná State from 2016 to 2018. Method: Analytical cross-sectional observational study based on the evaluation of the results of anatomopathological exams, between 2016 and 2018, at a regional specialized center. Analyses were performed using descriptive statistics, chi-square test for association and Mann-Whitney U test. A significance level of 5% was adopted. Results: The analysis of 509 positive anatomopathological reports of colorectal cancer allowed to identify the predominance of male patients and mean age at diagnosis of 62 years. The malignancy was more incident in patients between 61 and 70 years of age (29.9%). A considerable number of cases was found in patients younger than 50 years (19.6%). The disease was predominant at the left colon, of the type moderately differentiated infiltrating adenocarcinoma according to the histological classification. Association between the tumor topography and sex was found, with predominance of females for the right colon and males for the left colon (p=0.0081). Conclusion: This study designed the colorectal cancer clinical and epidemiological profile at Paraná's Western Region. The disease affects more males, older than 60 years of age, mostly with moderately differentiated infiltrative adenocarcinoma at the left colon. These findings are relevant considering the possibility of applying international cancer screening protocols in this population.

Introducción: El cáncer colorrectal es la neoplasia más frecuente del tracto gastrointestinal y la segunda causa de muerte por cáncer a nivel mundial. Objetivo: Trazar un perfil clínico-epidemiológico del cáncer colorrectal en el Oeste de Paraná (Brasil), entre 2016 y 2018. Método: Estudio observacional analítico transversal realizado con los análisis de resultados de exámenes anatomopatológicos entre 2016 a 2018. Se realizaron análisis mediante estadísticas descriptivas, prueba de asociación chi-cuadrado y U de MannWhitney. Se adoptó nivel de significación del 5%. Resultados: Entre los 509 informes positivos para cáncer colorrectal, el 52,8% de los pacientes eran del sexo masculino y tenían promedio de edad de diagnóstico de 62 años. El cáncer fue más frecuente en el grupo de 61 a 70 años (29,9%) y un número significativo de casos se presentó en pacientes menores de 50 años (19,6%). Predominó la enfermedad de colon izquierdo y del tipo histológico de adenocarcinoma infiltrante moderadamente diferenciado. Fue encontrado asociación entre la topografía y el sexo, con mayor predominio del sexo femenino para los tumores de colon derecho y del sexo masculino para los tumores de colon izquierdo (p=0,0081). Conclusión: Se elabora un perfil clínico-epidemiológico del cáncer colorrectal en la región Oeste de Paraná, con mayor incidencia en el sexo masculino, edad de 60 años, predominio de tumores en el colon izquierdo y del tipo adenocarcinoma infiltrante moderadamente diferenciado. Estos puntos son relevantes considerando la posibilidad de aplicación asertiva de protocolos internacionales de rastreo del cáncer en esta población.

Réplica à Carta às Editoras de Autoria de Pablo Salomón Montes-Arcón / Reply to the Letter to the Editors by Pablo Salomón Montes-Arcón / Respuesta a la Carta a las Editoras por Autoria de Pablo Salomón Montes-Arcón

Réplica à Carta às Editoras de Autoria de Pablo Salomón Montes-Arcón.

[Corrigendum] VEGF in nuclear medicine: Clinical application in cancer and future perspectives (Review).

Following the publication of this article, after having re-examined our manuscript, we noted an error in the acknowledgements section, as regards the funding of our study. The correct version of acknowledgements section is shown below: Acknowledgements This study was supported by the Ministry of Health and Fondazione Roma and by NOBILE S.p.A. Thanks are also due to REGIONE LAZIO Prot. FILAS-RU-2014 - 1020 (E.A.). [the original article was published in the International Journal of Oncology 49: 437-447, 2016; DOI: 10.3892/ijo.2016.3553].

VEGF in nuclear medicine: Clinical application in cancer and future perspectives (Review).

Clinical trials using antiangiogenic drugs revealed their potential against cancer. Unfortunately, a large percentage of patients does not yet benefit from this therapeutic approach highlighting the need of diagnostic tools to non-invasively evaluate and monitor response to therapy. It would also allow to predict which kind of patient will likely benefit of antiangiogenic therapy. Reasons for treatment failure might be due to a low expression of the drug targets or prevalence of other pathways. Molecular imaging has been therefore explored as a diagnostic technique of choice. Since the vascular endothelial growth factor (VEGF/VEGFR) pathway is the main responsible of tumor angiogenesis, several new drugs targeting either the soluble ligand or its receptor to inhibit signaling leading to tumor regression could be involved. Up today, it is difficult to determine VEGF or VEGFR local levels and their non-invasive measurement in tumors might give insight into the available target for VEGF/VEGFR-dependent antiangiogenic therapies, allowing therapy decision making and monitoring of response.