Carta al Director
Ceguera y sordera como manifestación inicial de un cáncer de pulmón no microcítico
Blindness and Deafness as Initial Manifestation of Non-small Cell Lung Cancer
Luisa Maria Nascimento
, Ricardo Reis, Ana Fernandes
Corresponding author
Servicio de Neumología, Centro Hospitalario de Trás-os-Montes e Alto Douro, Vila Real, Portugal
Read
11507
Timeswas read the article
1927
Total PDF
9580
Total HTML
Share statistics
array:24 [ "pii" => "S0300289615002562" "issn" => "03002896" "doi" => "10.1016/j.arbres.2015.06.006" "estado" => "S300" "fechaPublicacion" => "2016-02-01" "aid" => "1216" "copyright" => "SEPAR" "copyrightAnyo" => "2015" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2016;52:115-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4178 "formatos" => array:3 [ "EPUB" => 111 "HTML" => 3488 "PDF" => 579 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S1579212915003092" "issn" => "15792129" "doi" => "10.1016/j.arbr.2015.09.018" "estado" => "S300" "fechaPublicacion" => "2016-02-01" "aid" => "1216" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2016;52:115-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1713 "formatos" => array:3 [ "EPUB" => 135 "HTML" => 1160 "PDF" => 418 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Blindness and Deafness as Initial Manifestation of Non-small Cell Lung Cancer" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "115" "paginaFinal" => "116" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ceguera y sordera como manifestación inicial de un cáncer de pulmón no microcítico" ] ] "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" => 829 "Ancho" => 1781 "Tamanyo" => 135976 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Brain CT with no intracranial lesions; (B) chest CT showing a 3<span class="elsevierStyleHsp" style=""></span>cm lobulated mass in the right lower lobe.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luisa Maria Nascimento, Ricardo Reis, Ana Fernandes" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Luisa Maria" "apellidos" => "Nascimento" ] 1 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Reis" ] 2 => array:2 [ "nombre" => "Ana" "apellidos" => "Fernandes" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289615002562" "doi" => "10.1016/j.arbres.2015.06.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615002562?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915003092?idApp=UINPBA00003Z" "url" => "/15792129/0000005200000002/v1_201601300120/S1579212915003092/v1_201601300120/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0300289615002586" "issn" => "03002896" "doi" => "10.1016/j.arbres.2015.06.008" "estado" => "S300" "fechaPublicacion" => "2016-02-01" "aid" => "1218" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2016;52:116-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3165 "formatos" => array:3 [ "EPUB" => 127 "HTML" => 2334 "PDF" => 704 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Un cuerpo extraño insólito" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "116" "paginaFinal" => "117" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "An unusual foreign body" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 823 "Ancho" => 1500 "Tamanyo" => 112284 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cuerpo extraño 2.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Minesh Kooblall" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Minesh" "apellidos" => "Kooblall" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212915003079" "doi" => "10.1016/j.arbr.2015.09.016" "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/S1579212915003079?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615002586?idApp=UINPBA00003Z" "url" => "/03002896/0000005200000002/v1_201601280037/S0300289615002586/v1_201601280037/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0300289615000526" "issn" => "03002896" "doi" => "10.1016/j.arbres.2014.12.011" "estado" => "S300" "fechaPublicacion" => "2016-02-01" "aid" => "1115" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2016;52:114-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2696 "formatos" => array:3 [ "EPUB" => 106 "HTML" => 2004 "PDF" => 586 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Reducción de volumen pulmonar mediante espirales: ¿está indicada la profilaxis con antibióticos?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "114" "paginaFinal" => "115" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Lung Volume Reduction Coil Treatment: Is There an Indication for Antibiotic Prophylaxis?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alessio Casutt, Angela Koutsokera, Alban Lovis" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Alessio" "apellidos" => "Casutt" ] 1 => array:2 [ "nombre" => "Angela" "apellidos" => "Koutsokera" ] 2 => array:2 [ "nombre" => "Alban" "apellidos" => "Lovis" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212915004255" "doi" => "10.1016/j.arbr.2015.12.003" "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/S1579212915004255?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615000526?idApp=UINPBA00003Z" "url" => "/03002896/0000005200000002/v1_201601280037/S0300289615000526/v1_201601280037/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Ceguera y sordera como manifestación inicial de un cáncer de pulmón no microcítico" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Sr. Director:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "115" "paginaFinal" => "116" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luisa Maria Nascimento, Ricardo Reis, Ana Fernandes" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Luisa Maria" "apellidos" => "Nascimento" "email" => array:1 [ 0 => "lu_maria_nascimento@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Reis" ] 2 => array:2 [ "nombre" => "Ana" "apellidos" => "Fernandes" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología, Centro Hospitalario de Trás-os-Montes e Alto Douro, Vila Real, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Blindness and Deafness as Initial Manifestation of Non-small Cell Lung Cancer" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 829 "Ancho" => 1780 "Tamanyo" => 133552 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) TAC cerebral que no muestra lesiones intracraneales. B) TAC torácica que muestra una masa lobulada de 3<span class="elsevierStyleHsp" style=""></span>cm en el lóbulo inferior derecho.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">La carcinomatosis meníngea (CM) es una entidad devastadora infrecuente que se caracteriza por una infiltración maligna de las leptomeninges y el espacio subaracnoideo. Aunque habitualmente se trata de un hallazgo tardío en pacientes con enfermedad diseminada conocida, también puede ser una manifestación inicial.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Presentamos el caso de una mujer no fumadora de 71 años de edad, con <span class="elsevierStyleItalic">situs inversus totalis</span>, que fue hospitalizada en el servicio de neurología por pérdida visual y auditiva progresiva de 2 meses de evolución. La exploración física mostró amaurosis e hipoacusia bilateral. La tomografía axial computarizada (TAC) cerebral no reveló lesiones intracraneales (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A) y la resonancia magnética (RM) con gadolinio no mostró potenciación leptomeníngea focal o difusa ni lesiones tumorales. Se efectuó una punción lumbar. El análisis anatomopatológico del líquido cefalorraquídeo (LCR) reveló la presencia de células adenocarcinomatosas, y las pruebas inmunohistoquímicas mostraron positividad al TTF-1 y a la citoqueratina 7, ambos indicativos de un origen pulmonar. La TAC torácica reveló una masa lobulada de 3<span class="elsevierStyleHsp" style=""></span>cm en el lóbulo inferior derecho (LID) (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>B). Se realizó una biopsia percutánea guiada mediante TAC, con la intención de obtener tejido tumor adicional para la secuenciación de la mutación <span class="elsevierStyleItalic">EGFR</span>. El análisis histológico mostró la ocupación del parénquima pulmonar por estructuras neoplásicas con características de adenocarcinoma y tinción difusa para TTF-1 y citoqueeratina 7. Durante el ingreso hospitalario, la paciente presentó una neumonía por aspiración y falleció. Una semana más tarde, la biopsia de la masa del LID indicó que el tumor albergaba una mutación <span class="elsevierStyleItalic">EGFR</span> G719C en el exón 18.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">La CM se diagnostica principalmente en pacientes con tumores hematológicos y, en segundo lugar, en pacientes que padecen cáncer de mama o de pulmón<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a>. Entre estos últimos, los pacientes con cáncer de pulmón microcítico son los que muestran un porcentaje más alto de diseminación meníngea<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a>. La presentación con CM y sin metástasis en el parénquima cerebral es extremadamente rara en el cáncer de pulmón no microcítico (CPNM). Asimismo, las notificaciones de ceguera y sordera simultáneas son excepcionales en la literatura<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a>.</p><p id="par0020" class="elsevierStylePara elsevierViewall">El pronóstico es extremadamente malo y la modalidad de tratamiento óptima es difícil de determinar, debido a que la mayor parte de estudios que se han realizado han sido pequeños y retrospectivos y, en muchas ocasiones, incluían diversas pautas concomitantes. En nuestro caso, el empleo de inhibidores de la tirosincinasa (ITC) EGFR podría haber tenido un efecto relevante sobre la evolución de la paciente, pues estos fármacos parecen ser particularmente eficaces, y mejoran el estado funcional y la supervivencia de los pacientes con CPNM positivo al EGFR<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a>.</p><p id="par0025" class="elsevierStylePara elsevierViewall">El informe ilustra un caso extremadamente raro de CPNM con CM y una manifestación clínica también excepcional, ceguera y sordera simultáneas en ausencia de metástasis en el parénquima cerebral y de cambios en la RM cerebral.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 829 "Ancho" => 1780 "Tamanyo" => 133552 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) TAC cerebral que no muestra lesiones intracraneales. B) TAC torácica que muestra una masa lobulada de 3<span class="elsevierStyleHsp" style=""></span>cm en el lóbulo inferior derecho.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Carcinomatous meningitis: Leptomeningeal metastasis in solid tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Le Rhun" 1 => "S. Taillibert" 2 => "M.C. Chamberlain" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/2152-7806.111304" "Revista" => array:7 [ "tituloSerie" => "Surg Neurol Int" "fecha" => "2013" "volumen" => "4" "numero" => "Suppl 4" "paginaInicial" => "S265" "paginaFinal" => "S288" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23717798" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neoplastic meningitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.C. Chamberlain" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1634/theoncologist.2008-0138" "Revista" => array:6 [ "tituloSerie" => "Oncologist" "fecha" => "2008" "volumen" => "13" "paginaInicial" => "967" "paginaFinal" => "977" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18776058" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deafness and blindness as a presentation of colorectal meningeal carcinomatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.B. Bruce" 1 => "M. Tehrani" 2 => "N.J. Newman" 3 => "V. Biousse" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Adv Hematol Oncol" "fecha" => "2010" "volumen" => "8" "paginaInicial" => "564" "paginaFinal" => "566" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20966893" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are effective for leptomeningeal metastasis from non-small cell lung cancer patients with sensitive EGFR mutation or other predictive factors of good response for EGFR TKI" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.G. Yi" 1 => "H.J. Kim" 2 => "Y.J. Kim" 3 => "S.W. Han" 4 => "D.Y. Oh" 5 => "S.H. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.lungcan.2008.10.016" "Revista" => array:6 [ "tituloSerie" => "Lung Cancer" "fecha" => "2009" "volumen" => "65" "paginaInicial" => "80" "paginaFinal" => "84" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19059670" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005200000002/v1_201601280037/S0300289615002562/v1_201601280037/es/main.assets" "Apartado" => array:4 [ "identificador" => "9222" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the Director / Cartas al Director" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005200000002/v1_201601280037/S0300289615002562/v1_201601280037/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615002562?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 12 | 1 | 13 |
| 2024 October | 119 | 20 | 139 |
| 2024 September | 98 | 17 | 115 |
| 2024 August | 121 | 38 | 159 |
| 2024 July | 88 | 15 | 103 |
| 2024 June | 124 | 26 | 150 |
| 2024 May | 100 | 24 | 124 |
| 2024 April | 102 | 24 | 126 |
| 2024 March | 94 | 22 | 116 |
| 2024 February | 60 | 33 | 93 |
| 2023 March | 26 | 0 | 26 |
| 2023 February | 147 | 23 | 170 |
| 2023 January | 127 | 21 | 148 |
| 2022 December | 122 | 31 | 153 |
| 2022 November | 166 | 25 | 191 |
| 2022 October | 135 | 29 | 164 |
| 2022 September | 183 | 22 | 205 |
| 2022 August | 144 | 42 | 186 |
| 2022 July | 124 | 46 | 170 |
| 2022 June | 159 | 30 | 189 |
| 2022 May | 162 | 40 | 202 |
| 2022 April | 148 | 33 | 181 |
| 2022 March | 194 | 43 | 237 |
| 2022 February | 154 | 25 | 179 |
| 2022 January | 170 | 36 | 206 |
| 2021 December | 120 | 41 | 161 |
| 2021 November | 148 | 40 | 188 |
| 2021 October | 116 | 45 | 161 |
| 2021 September | 123 | 43 | 166 |
| 2021 August | 125 | 29 | 154 |
| 2021 July | 114 | 32 | 146 |
| 2021 June | 148 | 32 | 180 |
| 2021 May | 130 | 38 | 168 |
| 2021 April | 264 | 94 | 358 |
| 2021 March | 190 | 22 | 212 |
| 2021 February | 125 | 20 | 145 |
| 2021 January | 110 | 29 | 139 |
| 2020 December | 121 | 21 | 142 |
| 2020 November | 117 | 26 | 143 |
| 2020 October | 137 | 15 | 152 |
| 2020 September | 131 | 26 | 157 |
| 2020 August | 117 | 19 | 136 |
| 2020 July | 125 | 26 | 151 |
| 2020 June | 116 | 13 | 129 |
| 2020 May | 152 | 18 | 170 |
| 2020 April | 134 | 19 | 153 |
| 2020 March | 98 | 23 | 121 |
| 2020 February | 126 | 21 | 147 |
| 2020 January | 149 | 19 | 168 |
| 2019 December | 178 | 33 | 211 |
| 2019 November | 111 | 19 | 130 |
| 2019 October | 113 | 16 | 129 |
| 2019 September | 145 | 13 | 158 |
| 2019 August | 97 | 31 | 128 |
| 2019 July | 112 | 17 | 129 |
| 2019 June | 155 | 35 | 190 |
| 2019 May | 152 | 36 | 188 |
| 2019 April | 214 | 34 | 248 |
| 2019 March | 125 | 15 | 140 |
| 2019 February | 115 | 15 | 130 |
| 2019 January | 96 | 15 | 111 |
| 2018 December | 94 | 13 | 107 |
| 2018 November | 118 | 20 | 138 |
| 2018 October | 129 | 19 | 148 |
| 2018 September | 106 | 10 | 116 |
| 2018 August | 1 | 0 | 1 |
| 2018 June | 3 | 0 | 3 |
| 2018 May | 38 | 0 | 38 |
| 2018 April | 76 | 1 | 77 |
| 2018 March | 43 | 4 | 47 |
| 2018 February | 45 | 8 | 53 |
| 2018 January | 39 | 5 | 44 |
| 2017 December | 62 | 11 | 73 |
| 2017 November | 45 | 6 | 51 |
| 2017 October | 48 | 10 | 58 |
| 2017 September | 39 | 7 | 46 |
| 2017 August | 45 | 4 | 49 |
| 2017 July | 25 | 2 | 27 |
| 2017 June | 53 | 12 | 65 |
| 2017 May | 38 | 9 | 47 |
| 2017 April | 45 | 8 | 53 |
| 2017 March | 27 | 1 | 28 |
| 2017 February | 23 | 0 | 23 |
| 2017 January | 14 | 4 | 18 |
| 2016 December | 29 | 17 | 46 |
| 2016 November | 58 | 17 | 75 |
| 2016 October | 54 | 20 | 74 |
| 2016 September | 55 | 6 | 61 |
| 2016 August | 49 | 7 | 56 |
| 2016 July | 51 | 5 | 56 |
| 2016 June | 59 | 12 | 71 |
| 2016 May | 49 | 11 | 60 |
| 2016 April | 24 | 1 | 25 |
| 2016 March | 4 | 2 | 6 |
| 2016 February | 38 | 12 | 50 |
| 2016 January | 10 | 5 | 15 |
| 2015 December | 1 | 1 | 2 |
| 2015 November | 12 | 1 | 13 |
| 2015 October | 3 | 0 | 3 |
Show all
