Letter to the Editor
Hydatid Cyst Case Imitating Thoracic Wall Malignancy
Caso de quiste hidatídico que imitaba una neoplasia de la pared torácica
Read
3649
Timeswas read the article
1563
Total PDF
2086
Total HTML
Share statistics
array:24 [ "pii" => "S1579212917303610" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.01.028" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1551" "copyright" => "SEPAR" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:692-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1090 "formatos" => array:3 [ "EPUB" => 133 "HTML" => 679 "PDF" => 278 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S0300289617300285" "issn" => "03002896" "doi" => "10.1016/j.arbres.2017.01.009" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1551" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:692-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1266 "formatos" => array:3 [ "EPUB" => 149 "HTML" => 698 "PDF" => 419 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Hydatid Cyst Case Imitating Thoracic Wall Malignancy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "692" "paginaFinal" => "693" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Caso de quiste hidatídico que imitaba una neoplasia de la pared torácica" ] ] "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" => 1004 "Ancho" => 1045 "Tamanyo" => 71007 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed tomography showing extrapleural localized mass destroying the anterior right sixth rib.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Miktat Arif Haberal, ÖzlemŞengören Dikiş, Gökhan Öztürk" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Miktat Arif" "apellidos" => "Haberal" ] 1 => array:2 [ "nombre" => "ÖzlemŞengören" "apellidos" => "Dikiş" ] 2 => array:2 [ "nombre" => "Gökhan" "apellidos" => "Öztürk" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212917303610" "doi" => "10.1016/j.arbr.2017.01.028" "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/S1579212917303610?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617300285?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000012/v1_201711290729/S0300289617300285/v1_201711290729/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S157921291730352X" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.10.013" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1597" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:693-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1295 "formatos" => array:3 [ "EPUB" => 128 "HTML" => 782 "PDF" => 385 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Incidental Finding of Right Pulmonary Artery Agenesis in an Adult" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "693" "paginaFinal" => "694" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hallazgo incidental de agenesia de la arteria pulmonar derecha en el adulto" ] ] "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" => 523 "Ancho" => 1800 "Tamanyo" => 77195 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest radiograph showing elevation of the right hemidiaphragm. (B) CT reconstruction showing absence of the right pulmonary artery. (C) Cardiac magnetic resonance imaging slice with right pulmonary artery agenesis and partial agenesis of the right lung.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eva Cabrera César, M. Carmen Fernández Aguirre, Lorena Piñel Jiménez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Eva Cabrera" "apellidos" => "César" ] 1 => array:2 [ "nombre" => "M. Carmen Fernández" "apellidos" => "Aguirre" ] 2 => array:2 [ "nombre" => "Lorena Piñel" "apellidos" => "Jiménez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289617300807" "doi" => "10.1016/j.arbres.2017.03.014" "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/S0300289617300807?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921291730352X?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000012/v1_201711290721/S157921291730352X/v1_201711290721/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212917303464" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.10.008" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1632" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:691" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1169 "formatos" => array:3 [ "EPUB" => 124 "HTML" => 668 "PDF" => 377 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Multiple Cavitary Pulmonary Nodules. Tuberculosis or Malignancy?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "691" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Múltiples nódulos pulmonares cavitados… ¿tuberculosis o neoplasia maligna?" ] ] "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" => 1252 "Ancho" => 1196 "Tamanyo" => 135382 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray: bilateral pulmonary nodules, mostly cavitated.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Jesús Blanco, Fernando Rezola, Arancha Dueñas" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María Jesús" "apellidos" => "Blanco" ] 1 => array:2 [ "nombre" => "Fernando" "apellidos" => "Rezola" ] 2 => array:2 [ "nombre" => "Arancha" "apellidos" => "Dueñas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289617301473" "doi" => "10.1016/j.arbres.2017.05.006" "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/S0300289617301473?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303464?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000012/v1_201711290721/S1579212917303464/v1_201711290721/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Hydatid Cyst Case Imitating Thoracic Wall Malignancy" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "692" "paginaFinal" => "693" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Miktat Arif Haberal, ÖzlemŞengören Dikiş, Gökhan Öztürk" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Miktat Arif" "apellidos" => "Haberal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "ÖzlemŞengören" "apellidos" => "Dikiş" "email" => array:1 [ 0 => "ozlemsengoren@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Gökhan" "apellidos" => "Öztürk" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Health Sciences University Bursa Yüksekİhtisas Education & Research Hospital, Thoracic Surgery Department, Bursa, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Health Sciences University Bursa Yüksekİhtisas Education & Research Hospital, Pulmonary Diseases Department, Bursa, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Caso de quiste hidatídico que imitaba una neoplasia de la pared torácica" ] ] "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" => 1004 "Ancho" => 1045 "Tamanyo" => 79262 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed tomography showing extrapleural localized mass destroying the anterior right sixth rib.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hydatid cyst disease (hydatidosis or echhinococcosis) is a parasitic disease found in farming communities, notably in South America, North Africa, the Middle East, the Mediterranean and Eastern and Central Anatolia.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It is most frequently seen in the liver (60%–70%) and lungs (20%–30%). Intrathoracic extrapulmonary involvement is rare.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> The rate of recurrence following surgical removal of lung or liver hydatid cystis has been to be between 1.4% and 11%.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> This report describes a case of a hydatid cyst imitating thoracic wall malignancy.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 67-year-old male, non-smoker, a native of Ağrı (Eastern Anatolia), was admitted to our clinic with a 3-month history of cough and loss of appetite. Physical examination showed diminished breath sounds. Laboratory findings were within normal limits. Chest X-ray revealed a homogenous density adjacent to the right chest wall. Chest computed tomography (CT) showed a 52<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>28<span class="elsevierStyleHsp" style=""></span>mm extrapleural mass in the thoracic wall destroying the anterior right sixth rib (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Suspecting thoracic wall malignancy, transthoracic fine needle aspiration biopsy (TTFNAB) was performed. The cytology report indicated “homogenous eosinophyllic lamellar material of a hydatid cyst closely surrounded by scolices”. The patient underwent surgery to remove the cyst. Postoperative 15–20<span class="elsevierStyleHsp" style=""></span>mg/kg/day albendazol treatment was initiated and finalized at 12 weeks. After 2 years of follow-up, the patient has not shown any sign of recurrence.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Hydatid cyst disease is usually asymptomatic, and is diagnosed after combined clinical, radiological, and specific laboratory tests.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> The metastasis of hydatid cyst in costa is generally slow, and laboratory tests are usually negative. In our case, specific laboratory studies for hydatid cyst were not performed, since thoracic wall tumor (osteosarcoma) was strongly suspected on the CT image of rib destruction, and TTFNAB was used to establish definitive diagnosis, even though guidelines recommend avoiding this technique in order to prevent tumor spread and minor or major allergic reactions.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In cases of recurrence of chest wall hydatid cyst, the fundamental principle in surgical therapy is the removal of the affected ribs or the chest wall.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> In our case the affected sixth rib was partially removed.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Treatment with mebendazole or albendazole is effective for pulmonary hydatid cysts in up to 70% of cases. Antihelmintics are known to cause degenerative changes in the cyst membrane and cyst rupture. Unlike the liver, the lung environment is not aseptic, so even if the parasite perishes, cyst membrane persisting in lung cavities can lead to secondary bacterial infection and other complications, including anaphylactic reaction, asphyxia, tension pneumothorax and massive hemoptysis. Preoperative albendazole may increase the risk of perforation in cases of pulmonary hydatid cysts, and we do not recommend this therapy. Medical treatment is recommended for patients who can not tolerate or who do not accept surgery.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> In our case, the treatment was finalized with postoperative oral albendazol.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Thoracic wall involvement in hydatid cyst disease is rare. For this reason, we believe this description of a definitive diagnosis of this phenomenon to be of interest, particularly in areas where hydatid disease is more frequently encountered.</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" => 1004 "Ancho" => 1045 "Tamanyo" => 79262 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed tomography showing extrapleural localized mass destroying the anterior right sixth rib.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Türk toraks derneği paraziter akciğer hastalıkları tanı ve tedavi uzlaşı raporu" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Umut" 1 => "B.S. Saryal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Türk Toraks Dergisi" "fecha" => "2009" "volumen" => "10" "numero" => "Suppl." "paginaInicial" => "8" "paginaFinal" => "9" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hydatid cyst of mediastinum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Seghal" 1 => "B. Mishra" 2 => "A. Thakur" 3 => "V. Dogra" 4 => "P.S. Loomba" 5 => "A. Banerjee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Indian J Med Microbiol" "fecha" => "2008" "volumen" => "26" "paginaInicial" => "80" "paginaFinal" => "81" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18227607" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intrathoracic extraparenchymal recurrent giant hydatid cyst" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.G. Ergönül" 1 => "T.İ. Akçam" 2 => "A. Çakan" 3 => "U. Çağırıcı" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ege Tıp Dergisi/Ege J Med" "fecha" => "2013" "volumen" => "52" "paginaInicial" => "121" "paginaFinal" => "123" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hydatid disease of rib" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N. Karaoğlanoğlu" 1 => "M. Gorguner" 2 => "A. Eroğlu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2001" "volumen" => "71" "paginaInicial" => "372" "paginaFinal" => "373" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11216791" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1525861013001126" "estado" => "S300" "issn" => "15258610" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Therapeutic strategies for complications secondary to hydatid cyst rupture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "U. Cobanoglu" 1 => "F. Sayır" 2 => "A. Şehitoglu" 3 => "S. Bilici" 4 => "M. Melek" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Clin Exp Med" "fecha" => "2011" "volumen" => "4" "paginaInicial" => "220" "paginaFinal" => "226" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21977236" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000012/v1_201711290721/S1579212917303610/v1_201711290721/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000012/v1_201711290721/S1579212917303610/v1_201711290721/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917303610?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 3 | 7 |
| 2024 October | 50 | 17 | 67 |
| 2024 September | 33 | 17 | 50 |
| 2024 August | 50 | 35 | 85 |
| 2024 July | 27 | 25 | 52 |
| 2024 June | 48 | 18 | 66 |
| 2024 May | 56 | 24 | 80 |
| 2024 April | 25 | 26 | 51 |
| 2024 March | 33 | 15 | 48 |
| 2024 February | 24 | 17 | 41 |
| 2023 September | 1 | 1 | 2 |
| 2023 March | 9 | 4 | 13 |
| 2023 February | 21 | 21 | 42 |
| 2023 January | 25 | 34 | 59 |
| 2022 December | 34 | 52 | 86 |
| 2022 November | 36 | 22 | 58 |
| 2022 October | 39 | 29 | 68 |
| 2022 September | 40 | 35 | 75 |
| 2022 August | 38 | 41 | 79 |
| 2022 July | 35 | 35 | 70 |
| 2022 June | 24 | 33 | 57 |
| 2022 May | 24 | 29 | 53 |
| 2022 April | 26 | 31 | 57 |
| 2022 March | 34 | 39 | 73 |
| 2022 February | 24 | 24 | 48 |
| 2022 January | 39 | 33 | 72 |
| 2021 December | 37 | 51 | 88 |
| 2021 November | 31 | 47 | 78 |
| 2021 October | 42 | 47 | 89 |
| 2021 September | 22 | 49 | 71 |
| 2021 August | 23 | 29 | 52 |
| 2021 July | 28 | 27 | 55 |
| 2021 June | 38 | 36 | 74 |
| 2021 May | 32 | 37 | 69 |
| 2021 April | 59 | 103 | 162 |
| 2021 March | 49 | 28 | 77 |
| 2021 February | 27 | 26 | 53 |
| 2021 January | 13 | 10 | 23 |
| 2020 December | 21 | 16 | 37 |
| 2020 November | 25 | 8 | 33 |
| 2020 October | 19 | 11 | 30 |
| 2020 September | 26 | 10 | 36 |
| 2020 August | 19 | 10 | 29 |
| 2020 July | 22 | 21 | 43 |
| 2020 June | 11 | 10 | 21 |
| 2020 May | 15 | 10 | 25 |
| 2020 April | 27 | 21 | 48 |
| 2020 March | 16 | 8 | 24 |
| 2020 February | 31 | 16 | 47 |
| 2020 January | 24 | 21 | 45 |
| 2019 December | 23 | 19 | 42 |
| 2019 November | 26 | 18 | 44 |
| 2019 October | 24 | 14 | 38 |
| 2019 September | 24 | 11 | 35 |
| 2019 August | 25 | 19 | 44 |
| 2019 July | 18 | 19 | 37 |
| 2019 June | 25 | 5 | 30 |
| 2019 May | 32 | 8 | 40 |
| 2019 April | 72 | 15 | 87 |
| 2019 March | 32 | 12 | 44 |
| 2019 February | 36 | 20 | 56 |
| 2019 January | 18 | 16 | 34 |
| 2018 December | 35 | 16 | 51 |
| 2018 November | 68 | 19 | 87 |
| 2018 October | 67 | 17 | 84 |
| 2018 September | 20 | 8 | 28 |
| 2018 April | 51 | 9 | 60 |
| 2018 March | 33 | 6 | 39 |
| 2018 January | 1 | 0 | 1 |
Show all
