RESUMO
Flare gun injuries are rare, and patients often present with complex trauma that may require multiple operative interventions. Our objective is to explore a case of a 15-year-old male, who presented with second-degree flame burns to the face, left upper extremity and bilateral hands, as well as third-degree burns to the oropharynx and a tongue laceration after a flare gun was discharged into his mouth. The patient underwent multiple debridements of the oral cavity and oropharynx, and his hospital course was complicated by an intra-oral abscess. He eventually made a full recovery and was discharged. This case not only illustrates the need for early operative intervention, but it also underscores the need for awareness campaigns that highlight the dangers of flare guns and similar devices.
Les blessures par pistolet lance-fusée sont rares. Les patients souffrent fréquemment de blessures complexes nécessitant de multiples interventions. Nous présentons le cas d'un adolescent de 15 ans se présentant avec des brûlures par flamme de la face, du membre supérieur gauche et des 2 mains (2ème degré) ainsi qu'une atteinte au 3ème de degré de l'oropharynx et une lacération de langue, consécutivement à la mise à feu intrabuccale d'un pistolet lance-fusée. Il a nécessité de multiples débridements des atteintes buccale et pharyngée, l'évolution ayant été compliquée par plusieurs abcès. Il est finalement sorti guéri. Cette observation illustre d'une part la nécessité d'une prise en chirurgicale précoce. Elle souligne la nécessité de campagnes d'information sur la dangerosité des pistolets lance-fusée et matériels similaires.
RESUMO
PURPOSE: The aim of this analysis was to compare the biochemical no evidence of disease (bNED) rates in low-risk prostate cancer patients treated at two centers of excellence using different approaches: seed brachytherapy (BT) and external beam radiotherapy (EBRT). MATERIALS AND METHODS: A total of 919 low-risk prostate cancer patients, treated from 1998-2008, were identified in the two databases. In Utrecht, 667 patients received I-125 BT applying a dose of 144 Gy. In Vienna, 252 patients were treated with EBRT, applying a local dose of 70 Gy in 82 patients and 74 Gy in 170 patients. bNED rates (Phoenix definition) were assessed. RESULTS: The median follow-up was 46 months (range 1-148 months). The 5-year actuarial bNED rates were 94% for BT patients and 88% for EBRT patients (p = 0.002)-84% for patients receiving 70 Gy and 91% for patients receiving 74 Gy, respectively. In the univariate analysis, patients receiving 70 Gy showed significantly worse outcome compared to BT (p = 0.001) and a difference close to significance compared to 74 Gy (p = 0.06). In the multivariate analysis including tumor stage, Gleason score, initial PSA, hormonal therapy, and dose, patients receiving 70 Gy EBRT showed significantly worse bNED rates compared to BT patients. CONCLUSION: Low-risk prostate cancer patients receiving 74 Gy by EBRT show comparable biochemical control rates to patients receiving seed brachytherapy, whereas patients receiving 70 Gy show significantly worse outcome.
