RESUMO
Background: There remains a scarcity of published data on the clinical significance of paraneoplastic cutaneous manifestations in hepatocellular carcinoma (HCC). Method: A systematic search of MEDLINE was performed in December 2022. Inclusion criteria comprised studies reporting on patients with HCC, who had paraneoplastic cutaneous manifestations. Outcomes of interests comprise survival and response to cancer-directed and/or skin directed therapy. Results: A total of 48 studies comprising 60 HCC patients were included in the analysis. The most frequent reported skin abnormalities were dermatomyositis, pityriasis rotunda, and porphyria. Most patients presented with dermatomyositis had underlying viral hepatitis, while all reported porphyria and acanthosis cases were associated with metabolic causes of HCC, such as steatosis. Paraneoplastic skin changes were more common in patients with metastatic disease. Pityriasis Rotunda was associated with the lowest risk of death, (OR: 0.05, 95% CI: 0.003 to 0.89; p = 0.04), while dermatomyositis had a statistically significant higher risk of death (OR: 3.37, 95% CI: 1.01-12.1; p = 0.03). Most patients showed an improvement in their cutaneous abnormalities, following cancer-directed therapy. Conclusion: Paraneoplastic cutaneous manifestations are reported more frequently in patients with a higher burden of disease, especially presence of metastases. Certain cutaneous manifestations have prognostic implication.
RESUMO
OBJECTIVES: To review the epidemiology of acetabular fractures in Jordan and to provide a base to advance high-level clinical research in the future. METHODS: A total of 141 acetabular fractures admitted to King Hussein Medical City, Amman, Jordan, from July 2018 to December 2022 were reviewed retrospectively. Fractures were classified according to Judet and Letournel and were analyzed regarding age, gender, the cause of injury, fracture classification, mode of treatment, and associated nerve and other body part injuries. RESULTS: Males represented 84.4% of patients. The mean age was 42.52 (±17.655) years, and the age group from 20 to 39 represented 54.6% of patients. Road traffic accidents caused 56.7% of injuries, and 53.9% had other accompanying injuries. Posterior wall fractures were the most common (37.6%) patterns, and femoral head dislocation was reported in 28.4%. Posttraumatic and iatrogenic sciatic nerve injuries were reported in 7% of patients. The mean time from admission to surgery was 7.62 (±7.915) days; 66% of patients received surgical treatment, and 83.9% had a satisfactory reduction. CONCLUSION: Acetabular fractures are uncommon injuries, with road traffic accidents being the most common cause of injury. Posterior wall fracture was the most frequent pattern; most patients were males. Our results are comparable to the literature. However, we recommend future studies to measure the outcome of acetabular fracture management.
