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"documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2019;152:166" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "The «De Winter» pattern on the electrocardiogram: It is time to run" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "166" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Patrón de «De Winter» en el electrocardiograma: hay que correr" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1897 "Ancho" => 1333 "Tamanyo" => 277480 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Aleix Fort, Pablo Loma-Osorio, Óscar Alcalde, Ramon Brugada" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Aleix" "apellidos" => "Fort" ] 1 => array:2 [ "nombre" => "Pablo" "apellidos" => "Loma-Osorio" ] 2 => array:2 [ "nombre" => "Óscar" "apellidos" => "Alcalde" ] 3 => array:2 [ "nombre" => "Ramon" "apellidos" => "Brugada" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775318302987" "doi" => "10.1016/j.medcli.2018.05.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775318302987?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618305813?idApp=UINPBA00004N" "url" => "/23870206/0000015200000004/v1_201902100719/S2387020618305813/v1_201902100719/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Phalangeal metastasis in colon adenocarcinoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e23" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Javier Molina-Cerrillo, Arantzazu Barquin-García, Teresa Alonso-Gordoa" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Javier" "apellidos" => "Molina-Cerrillo" "email" => array:1 [ 0 => "javier.molinace@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Arantzazu" "apellidos" => "Barquin-García" ] 2 => array:2 [ "nombre" => "Teresa" "apellidos" => "Alonso-Gordoa" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis falángica en adenocarcinoma de colon" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 884 "Ancho" => 500 "Tamanyo" => 46057 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 81-year-old woman diagnosed of a metastatic colorectal cancer with pulmonary and hepatic involvement, that had just progressed to second line chemotherapy with 5-fluorouracil plus irinotecan. Admitted to our hospital due to uncontrolled lumbar pain and a new lesion of recent appearance in 4th finger of her right hand (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">On physical examination presented increased perimeter on the fourth finger, with swelling and stony consistency. Histopathological examination confirmed the clinical suspicion of colon cancer metastasis.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient received radiation therapy to the lesion with a reduction in the volume of the mass and improving pain control, decreasing the need of opioids.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We present this image of phalangeal metastatic involvement in colon cancer as an extremely rare location of metastases in this disease.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">This clinical image did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest and contributions</span><p id="par0030" class="elsevierStylePara elsevierViewall">All authors declare none conflict of interest. All authors have approved the final image.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest and contributions" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 884 "Ancho" => 500 "Tamanyo" => 46057 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015200000004/v1_201902100719/S2387020619300026/v1_201902100719/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015200000004/v1_201902100719/S2387020619300026/v1_201902100719/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619300026?idApp=UINPBA00004N" ]