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CLINICAL SCIENCE
Vitamin D deficiency is independently associated with mortality among critically ill patients
Rafael Barberena MoraesI,
Corresponding author
moraesrb@hotmail.com

Corresponding author: Rafael Barberena Moraes
, Gilberto FriedmanI, Iuri Christmann WawrzeniakI, Leonardo S. MarquesI, Fabiano Márcio NagelI, Thiago Costa LisboaI, Mauro Antonio CzepielewskiII
I Division of Critical Care Medicine, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Department of Internal Medicine
II Division of Endocrinology, Porto Alegre/RS, Brazil
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          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Receiver-operating characteristic curve for various cutoff levels of vitamin D &#91;25&#40;OH&#41;D&#93;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle60">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Vitamin D is a fat-soluble vitamin that is synthesized in the skin in response to sunlight exposure &#40;as provitamin D3 and previtamin D3&#41; and is also obtained&#44; to a limited extent&#44; from dietary intake &#40;vitamins D2 and D3&#41;&#46; Vitamin D is stored in adipose cells or is converted in the liver to its circulating form&#44; 25-hydroxyvitamin D3 &#91;25&#40;OH&#41;D3&#93;&#46; Mainly in the kidneys&#44; 25&#40;OH&#41;D is converted to its active metabolite&#44; 1&#44;25-dihydroxyvitamin D &#91;1&#44;25&#40;OH&#41;2D&#93;&#44; also known as calcitriol&#46; Calcitriol synthesis is enhanced by parathyroid hormone &#40;PTH&#41; and hypophosphatemia&#46; The endocrine action of calcitriol on bone mineral metabolism has been known for decades&#44; and vitamin D supplementation has been advocated in patients with chronic conditions&#44; such as osteoporosis&#46; For many years&#44; vitamin D deficiency was recognized as a chronic condition associated with bone pain&#44; weakness and fractures in the general population&#46; Serum vitamin D levels below 10 ng&#47;mL &#40;generally described as deficiency or severe deficiency&#41; are associated with osteomalacia and rickets&#44; whereas levels in the 20-30 ng&#47;mL range &#40;vitamin D insufficiency or subclinical deficiency&#41; are associated with osteoporosis and elevated PTH and have the potential to cause long-term harmful effects on bone metabolism&#46; Children with rickets are more susceptible to infections&#44; and vitamin D has been implicated in the pathogenesis of tuberculosis <a class="elsevierStyleCrossRefs" href="#bib1">1-4</a>&#46; The paracrine and autocrine effects of vitamin D have been increasingly reported in the literature&#46; In recent years&#44; it has become clear that several cell lines&#44; including macrophages and cardiac muscle cells&#44; express vitamin D receptors and the enzyme 25&#40;OH&#41;D3-1-alpha-hydroxylase&#44; which allows the cells to convert 25&#40;OH&#41;D to its active form&#44; 1&#44;25&#40;OH&#41;2D <a class="elsevierStyleCrossRef" href="#bib5">5</a>&#46;</p><p id="para20" class="elsevierStylePara elsevierViewall">Studies have shown correlations between low vitamin D levels and certain cancers&#44; immune system dysfunction&#44; diabetes&#44; cardiovascular disease&#44; hypertension and metabolic syndrome <a class="elsevierStyleCrossRefs" href="#bib6">6-8</a>&#46; Thus&#44; investigators in several fields&#44; including critical care medicine&#44; have turned their attention to the nonskeletal effects of vitamin D <a class="elsevierStyleCrossRefs" href="#bib9">9-15</a>&#46; Some observational studies have demonstrated a high prevalence of vitamin D deficiency in critically ill patients&#44; who are generally deprived of sunlight&#44; confined to bed and fed diets with low vitamin D content&#46;</p><p id="para30" class="elsevierStylePara elsevierViewall">Data regarding the association between vitamin D deficiency and poor ICU outcomes&#44; such as mortality&#44; increased length of stay&#44; increased length of mechanical ventilation&#44; and infections&#44; are conflicting&#46; After an initial report by Lee et al&#46; <a class="elsevierStyleCrossRef" href="#bib16">16</a> suggesting a high prevalence of vitamin D deficiency in critically ill patients&#44; a retrospective study involving 2&#44;399 patients <a class="elsevierStyleCrossRef" href="#bib14">14</a> showed an association between vitamin D deficiency&#44; mortality and positive blood cultures&#46; Subsequently&#44; smaller prospective studies did not find this association&#46; Differences in the definition of vitamin D deficiency&#44; the studied populations &#40;surgical ICUs <span class="elsevierStyleItalic">versus</span> medical ICUs&#41;&#44; the methodology of vitamin D measurement&#44; the interventions not measured &#40;such as the volume and type of solutions infused&#41; and the geographical location may account for the different findings in these studies <a class="elsevierStyleCrossRefs" href="#bib17">17&#44;18-24</a>&#46; The relevance of vitamin D measurement and kinetics at ICU admission is open to debate&#46; Furthermore&#44; the 25&#40;OH&#41;D levels required for proper maintenance of the pleiotropic effects of vitamin D remain unknown&#46;</p><p id="para40" class="elsevierStylePara elsevierViewall">The purpose of this study was to assess the relationship between serum vitamin D levels at admission&#44; vitamin D kinetics during ICU stay&#44; and morbidity and mortality in critically ill patients&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">MATERIALS AND METHODS</span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">Study design and setting</span><p id="para50" class="elsevierStylePara elsevierViewall">This is a prospective study of patients admitted to the medical-surgical ICU of a university hospital &#40;Hospital de Cl&#237;nicas de Porto Alegre&#44; state of Rio Grande do Sul&#44; Brazil&#41; between March and November 2012&#46; The city of Porto Alegre is located in the South of Brazil at 30&#176;05&#39;S&#46; The study protocol was approved by the institutional research ethics committee&#44; and written informed consent was provided by all patients or their surrogates&#46;</p></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">Methods</span><p id="para60" class="elsevierStylePara elsevierViewall">We included adult patients &#40;age 18 years and older&#41; with a predicted length of ICU stay greater than 3 days&#46; We excluded patients with a length of pre-ICU hospital stay &#62;3 days&#44; chronic renal failure requiring dialysis or pre admission creatinine &#62;2 mg&#47;dL&#44; a life expectancy of less than 24 hours&#44; pregnancy&#44; admission for cardiac or elective surgery&#44; hyper- or hypoparathyroidism&#44; and granulomatous diseases&#44; such as tuberculosis or sarcoidosis&#46;</p><p id="para70" class="elsevierStylePara elsevierViewall">Patient demographic and clinical data were recorded on ICU admission&#44; including age&#44; sex&#44; comorbidities&#44; current medications&#44; ethnicity&#44; reason for admission&#44; season&#44; APACHE II score&#44; and body mass index &#40;BMI&#41; &#40;Kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#46; The SOFA score was calculated at ICU admission and at ICU discharge or death&#46; Infections and cultures &#40;blood&#44; sputum&#44; urine&#44; ascites or pleural fluid&#41; were prospectively assessed throughout the ICU stay for each patient&#46; Patients were considered infected when the attending physicians&#44; who were not involved with the study and had no access to serum 25&#40;OH&#41;D levels&#44; diagnosed ICU-acquired infections and prescribed antimicrobials to their patients&#46; In addition to the total number of positive cultures and clinically overt infections&#44; the incidence rates of culture positivity and infection over time were also assessed&#46; Patients were also assessed for the duration of mechanical ventilation&#44; length of ICU stay&#44; length of hospital stay&#44; and 28-day mortality&#46;</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">Biochemical analysis</span><p id="para80" class="elsevierStylePara elsevierViewall">Blood samples were collected within 24 hours of ICU admission for the measurement of capillary blood glucose&#44; PTH&#44; ionized calcium&#44; albumin&#44; creatinine&#44; phosphorus&#44; magnesium&#44; C-reactive protein&#44; and lactate&#46; The estimated glomerular filtration rate was calculated using the MDRD equation <a class="elsevierStyleCrossRef" href="#bib10">10</a>&#46; All tests were performed by routine methods employed at the biochemistry laboratory of Hospital de Cl&#237;nicas de Porto Alegre&#46; 25&#40;OH&#41;D was measured once weekly for 4 weeks or until ICU discharge&#46; Samples were protected from sunlight exposure&#44; centrifuged and stored under refrigeration until processing&#44; which was performed once weekly on Fridays&#46; 25&#40;OH&#41;D levels were measured using the chemiluminescence method &#40;Liaison&#59; Diasorin&#44; Stillmater&#44; Minnesota&#59; inter- and intra-assay coefficients of variation&#44; 10&#37;&#41; and reported in ng&#47;mL <a class="elsevierStyleCrossRef" href="#bib11">11</a>&#46; &#40;To convert the 25&#40;OH&#41;D concentration from ng&#47;mL to nmol&#47;L&#44; multiply by 2&#46;5&#46;&#41; PTH levels were measured by a chemiluminescent immunoassay &#40;Advia Centaur XP&#59; Siemens Healthcare Diagnostics Inc&#46;&#41;&#46;</p></span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle110">Statistical analysis</span><p id="para90" class="elsevierStylePara elsevierViewall">Normally distributed quantitative variables are expressed as the mean &#177; standard deviation&#46; Asymmetrically distributed variables are expressed as the median &#91;interquartile range&#93;&#46; The chi-square test was used for the assessment of categorical variables&#44; and Student&#39;s <span class="elsevierStyleItalic">t</span>-test was used for continuous variables&#46; Normally distributed and asymmetric variables were compared using the Mann-Whitney <span class="elsevierStyleItalic">U</span> test&#46; Receiver-operating characteristic &#40;ROC&#41; curves were plotted to illustrate 25&#40;OH&#41;D cutoff values&#46; Relative risks &#40;along with 95&#37; confidence intervals&#41; were estimated using Poisson regression adjusted for 6 covariates&#58; lactate&#44; albumin&#44; SOFA and APACHE II scores&#44; sepsis as the reason for ICU admission and BMI&#46; Survival analysis was performed by means of Kaplan-Meier curves&#46; Log-rank statistics were used to determine significant differences over time&#46; For the comparative analysis of changes in the 25&#40;OH&#41;D levels over time during ICU admission between survivors and non-survivors&#44; we used a generalized estimating equation model for longitudinal data analysis <a class="elsevierStyleCrossRef" href="#bib12">12</a>&#46; Infection and culture positivity rates were compared by means of incidence density ratio analysis&#46; The significance level was set at <span class="elsevierStyleItalic">p</span>&#60;0&#46;05&#46;</p></span></span><span id="cesec70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle120">RESULTS</span><span id="cesec80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">Cohort profile</span><p id="para100" class="elsevierStylePara elsevierViewall">Overall&#44; 135 patients were included&#46; The 28-day mortality rate was 21&#46;5&#37;&#46; Slightly less than half of all patients &#40;47&#37;&#41; were women&#44; and 78&#37; were Caucasian&#46; The median vitamin D level at admission was 13&#46;3 &#91;8&#46;1-20&#93; ng&#47;mL&#46; Only 16 patients &#40;11&#46;8&#37;&#41; were vitamin D sufficient &#40;25&#40;OH&#41;D&#62;30 ng&#47;mL&#41;&#59; 101 &#40;74&#46;8&#37;&#41; were vitamin D insufficient &#40;25&#40;OH&#41;D&#60;20 ng&#47;mL&#41;&#46; Five patients were on bisphosphonate&#44; calcium&#44; and vitamin D therapy prior to admission&#46; These patients&#39; 25&#40;OH&#41;D levels ranged from 4&#46;7 ng&#47;mL to 18 ng&#47;mL&#46; No patient received supplemental vitamin D during his or her ICU stays&#46; The sample profile is shown in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#46; Non-survivors had higher APACHE II and SOFA scores and PTH and lactate levels on admission and had more difficult clinical courses with more organ dysfunction &#40;lower &#916;SOFA&#41;&#46; In addition&#44; fewer progressed to enteral feeding&#59; five patients were never fed due to death secondary to refractory shock within the first few days of ICU admission&#46; Electrolytes and renal function were assessed in 117 patients who were not on dialysis at the time of 25&#40;OH&#41;D measurement&#46; Non-survivors had lower ionized calcium levels and lower glomerular filtration rates &#40;<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p id="para110" class="elsevierStylePara elsevierViewall">The area under the ROC curve for 25&#40;OH&#41;D levels at admission in relation to mortality was 0&#46;61 &#40;95&#37;CI 0&#46;49-0&#46;73&#41;&#44; similar to those for APACHE II &#40;0&#46;7&#44; 95&#37; CI 0&#46;59-0&#46;8&#41; and SOFA scores &#40;0&#46;7&#44; 95&#37; CI 0&#46;6-0&#46;8&#41;&#46; The best cutoff was 11&#46;9 ng&#47;mL&#44; with a sensitivity of 65&#37;&#44; a specificity of 62&#37;&#44; a negative predictive value of 86&#46;8&#37;&#44; and a positive predictive value of 32&#46;2&#37; &#40;<a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><p id="para120" class="elsevierStylePara elsevierViewall">Compared with patients with 25&#40;OH&#41;D levels &#62;12 ng&#47;mL&#44; the 59 patients with 25&#40;OH&#41;D&#8804;12 ng&#47;mL &#40;43&#46;7&#37; of the sample&#41; had higher prevalence rates of prior corticosteroid therapy &#40;18&#37; <span class="elsevierStyleItalic">vs&#46;</span> 2&#46;6&#37;&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;005&#41; and of acute respiratory failure as a reason for ICU admission &#40;25&#37; <span class="elsevierStyleItalic">vs&#46;</span> 6&#46;6&#37;&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;013&#41;&#46; Although there is no difference between the median vitamin D levels among seasons&#44; a seasonal association was found for the prevalence of vitamin D deficiency &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;041&#41;&#44; which was more common in the winter &#40;37&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 21&#37;&#41; and less common in the summer &#40;10&#46;2&#37; <span class="elsevierStyleItalic">vs&#46;</span> 27&#46;6&#37;&#41;&#46; Vitamin D-deficient patients had higher BMIs &#40;27&#46;4 Kg&#47;m<span class="elsevierStyleSup">2</span> &#91;24&#46;2-35&#46;2&#93; <span class="elsevierStyleItalic">vs&#46;</span> 26 Kg&#47;m<span class="elsevierStyleSup">2</span> &#91;22&#46;7-29&#46;3&#93;&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;015&#41;&#46; There were no differences in APACHE II scores &#40;19&#46;8&#177;9 <span class="elsevierStyleItalic">vs&#46;</span> 18&#46;7&#177;8&#46;3&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;482&#41;&#44; SOFA scores at admission &#40;5 &#91;2-8&#93; <span class="elsevierStyleItalic">vs&#46;</span> 5 &#91;3-8&#93;&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;170&#41;&#44; albumin &#40;3&#46;08&#177;0&#46;78 g&#47;dL <span class="elsevierStyleItalic">vs&#46;</span> 3&#46;06&#177;0&#46;6 g&#47;dL&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;87&#41;&#44; ionized calcium &#40;4&#46;7 &#91;4&#46;4-5&#46;0&#93; mg&#47;dL <span class="elsevierStyleItalic">vs&#46;</span> 4&#46;7 &#91;4&#46;5-4&#46;8&#93; mg&#47;dL&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;770&#41;&#44; or PTH &#40;146 &#91;79-260&#93; pg&#47;mL <span class="elsevierStyleItalic">vs&#46;</span> 107 &#91;53-200&#93;&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;70&#41;&#44; which was elevated in both groups&#46; Patients with 25&#40;OH&#41;D levels &#8804;12 ng&#47;mL developed greater organ system dysfunction during their ICU stays &#40;&#916;SOFA&#58; 0&#46;9&#177;4&#46;7 <span class="elsevierStyleItalic">vs&#46;</span> 3&#46;4&#177;3&#46;9&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;001&#41;&#46;</p></span><span id="cesec90" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">Mortality</span><p id="para130" class="elsevierStylePara elsevierViewall">Over the course of the 28-day observation period&#44; 19 of the 59 patients with 25&#40;OH&#41;D levels &#8804;12 ng&#47;mL died &#40;32&#46;2&#37;&#41;&#44; compared with 10 of the 76 patients with 25&#40;OH&#41;D levels &#62;12 ng&#47;mL &#40;13&#46;2&#37;&#41;&#59; this difference was statistically significant &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;014&#41;&#46; The crude relative risk of death was 2&#46;11 &#40;95&#37; CI 1&#46;08-4&#46;11&#41;&#46; After multivariable adjustment&#44; the relative risk remained significantly higher&#44; at 2&#46;20 &#40;95&#37; CI 1&#46;07-4&#46;54&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia><p id="para140" class="elsevierStylePara elsevierViewall">There were no significant differences in mortality &#40;23&#46;5&#37; <span class="elsevierStyleItalic">vs&#46;</span> 15&#46;2&#37;&#59; <span class="elsevierStyleItalic">p</span>&#61;0&#46;275&#41; when the 25&#40;OH&#41;D cutoff was set at 20 ng&#47;mL&#46;</p></span><span id="cesec100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle150">Length of stay</span><p id="para150" class="elsevierStylePara elsevierViewall">25&#40;OH&#41;D levels &#8804;12 ng&#47;mL were not associated with any significant differences in the overall length of hospital stay &#40;20 &#91;9-28&#93; <span class="elsevierStyleItalic">vs&#46;</span> 23&#46;5 &#91;14-28&#93;&#44; <span class="elsevierStyleItalic">p</span>&#61;0&#46;869&#41; or length of ICU stay &#40;9 &#91;5-21&#93; <span class="elsevierStyleItalic">vs&#46;</span> 9 &#91;5-21&#93;&#44; <span class="elsevierStyleItalic">p</span>&#61;0&#46;092&#41;&#44; in days&#46;</p></span><span id="cesec110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle160">Mechanical ventilation</span><p id="para160" class="elsevierStylePara elsevierViewall">Invasive mechanical ventilation was used in 44 &#40;74&#46;6&#37;&#41; patients with 25&#40;OH&#41;D levels &#8804;12 ng&#47;mL and in 59 &#40;77&#46;7&#37;&#41; patients with 25&#40;OH&#41;D levels &#62;12 ng&#47;mL &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;834&#41;&#46;</p></span><span id="cesec120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle170">Infection and culture positivity</span><p id="para170" class="elsevierStylePara elsevierViewall">Overall&#44; 78 patients &#40;57&#46;8&#37;&#41; had positive cultures at some point during their ICU stays&#46; Among the 59 patients with 25&#40;OH&#41;D&#8804;12 ng&#47;mL&#44; a total of 73 infections and 101 positive cultures &#40;including 28 positive blood cultures&#41; were detected&#46; Among the 76 patients with 25&#40;OH&#41;D&#62;12 ng&#47;mL&#44; 88 infections and 121 positive cultures &#40;including 32 positive blood cultures&#41; were detected&#46; The rates of infection and culture positivity per 100 patient-days in the ICU are shown in <a class="elsevierStyleCrossRef" href="#tbl4">Table 4</a>&#46; There were no significant differences between groups for either indicator&#46;</p><elsevierMultimedia ident="tbl4"></elsevierMultimedia></span><span id="cesec130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle180">Vitamin D kinetics</span><p id="para180" class="elsevierStylePara elsevierViewall">A slight decrease in 25&#40;OH&#41;D concentrations occurred over time&#44; reaching statistical significance only on day 21 among all patients&#46; Among non-survivors&#44; a non-significant decline in 25&#40;OH&#41;D levels occurred at the 14<span class="elsevierStyleSup">th</span> day of ICU stay&#46; The decline in vitamin 25&#40;OH&#41;D levels through ICU stay were not related to mortality or other clinical outcomes&#46;</p></span></span><span id="cesec140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle190">DISCUSSION</span><p id="para190" class="elsevierStylePara elsevierViewall">Our findings show that severe vitamin D deficiency is an independent predictor of mortality in critically ill patients&#46; In this sample&#44; a 25&#40;OH&#41;D level of 12 ng&#47;mL was the best cutoff for the identification of critically ill patients at a higher risk of death&#46;</p><p id="para200" class="elsevierStylePara elsevierViewall">The relationship between mortality and serum vitamin D levels in critically ill patients is a topic of debate in the current literature <a class="elsevierStyleCrossRef" href="#bib13">13</a>&#46; While some studies have reported such an association <a class="elsevierStyleCrossRefs" href="#bib14">14-21</a>&#44; others have not <a class="elsevierStyleCrossRefs" href="#bib22">22-27</a>&#46; The higher mortality rate among severely vitamin D-deficient subjects found in this study is in agreement with the retrospective studies of Braun et al <a class="elsevierStyleCrossRefs" href="#bib14">14-15</a>&#46; Our study confirms these findings with a prospective design and also demonstrates that the increased mortality attributed to vitamin D deficiency persists even after adjusting the risk for variables associated with mortality&#46; Notably&#44; APACHE II and SOFA scores on admission were similar in 25&#40;OH&#41;D-deficient and non-deficient patients&#46; Nevertheless&#44; the mortality rate was higher in the 25&#40;OH&#41;D-deficient group&#46; In 2012&#44; Higgins et al&#46; <a class="elsevierStyleCrossRef" href="#bib24">24</a> conducted a prospective study and found no significant differences in mortality among critically ill vitamin D-deficient patients&#44; although deficient patients had longer ICU lengths of stay&#46; The authors note that their study was not powered to detect differences in mortality&#46; Heterogeneity between studies may explain the different results&#46; The Higgins et al sample was older&#44; and data collection occurred between 2002 and 2003 in Canada&#44; while our data collection occurred in 2012 in Southern Brazil&#46; In our study&#44; we excluded patients with a total length of hospital stay &#62;3 days before ICU transfer&#44; whereas Higgins et al had no such exclusion criterion&#46; We thus excluded patients with normal pre-admission vitamin D levels whose decrease in serum 25&#40;OH&#41;D levels was attributable to hospitalization&#46; Our sample had a higher prevalence of sepsis as the reason for ICU admission&#46; Some studies have suggested that this etiology may be associated with higher mortality related to vitamin D deficiency <a class="elsevierStyleCrossRef" href="#bib6">6</a>&#46;</p><p id="para210" class="elsevierStylePara elsevierViewall">Vitamin D may be no more than a marker of severity in critically ill patients&#46; However&#44; the literature reports several vitamin D-dependent physiological mechanisms&#44; suggesting that 25&#40;OH&#41;D deficiency may be implicated in the pathogenesis of organ dysfunction and mortality in critically ill patients&#44; perhaps mediated by its effects on immunity and on the cardiovascular system <a class="elsevierStyleCrossRefs" href="#bib6">6&#44;7&#44;27-29</a>&#46; As ours was an observational study&#44; we cannot ascertain whether the association between vitamin D deficiency and mortality is causal or attributable to chance&#46; However&#44; even after logistic regression&#44; 25&#40;OH&#41;D levels &#60;12 ng&#47;mL remained an independent predictor of mortality&#46;</p><p id="para220" class="elsevierStylePara elsevierViewall">The current literature provides no information on the 25&#40;OH&#41;D level that can adequately support the pleiotropic effects of vitamin D&#46; In our population&#44; ROC curve analysis identified 12 ng&#47;mL as the best cutoff for mortality&#46; This finding is similar to that reported in a retrospective study <a class="elsevierStyleCrossRef" href="#bib18">18</a>&#46; Even if 25&#40;OH&#41;D is merely a marker of severity&#44; these studies suggest that vitamin D levels &#60;10-12 ng&#47;mL can be used to identify patients at a higher risk of mortality and can prompt more intensive monitoring of these patients&#46; In non-critically ill patients&#44; 25&#40;OH&#41;D levels this low are incapable of maintaining serum concentrations of 1&#44;25&#40;OH&#41;2D&#44; leading to clinical repercussions such as rickets and osteomalacia&#46; This study suggests that&#44; similarly to outpatients&#44; critically ill patients with severe vitamin D deficiency suffer the most clinical consequences from the lack of vitamin D&#59; from this finding&#44; we infer that these patients are most likely to benefit from vitamin D replacement during the ICU stay&#46; This hypothesis must still be confirmed by clinical trials&#46; Dietary vitamin D intake is reduced in critically ill patients&#46; Enteral formulas provide 200 to 300 IU&#47;1000 mL&#44; as do multivitamins&#46; The current recommended daily intake of 200 IU&#47;day is not enough to restore vitamin D to a sufficient level <a class="elsevierStyleCrossRef" href="#bib30">30</a>&#46; Two recent studies showed that higher &#40;yet safe&#41; doses are required for vitamin D replacement in critically ill patients <a class="elsevierStyleCrossRefs" href="#bib31">31&#44;32</a>&#46; Our results also align with those of a recently published clinical trial <a class="elsevierStyleCrossRef" href="#bib33">33</a>&#46; In this trial&#44; patients randomized to the intervention group received a loading dose of 540&#44;000 IU of vitamin D followed by 90&#44;000 IU monthly for 5 months&#46; The analysis of the subgroup of patients with baseline levels of vitamin D &#60;10 ng&#47;mL showed a decrease in mortality&#46; This result requires confirmation in future multicenter randomized clinical trials before a therapeutic recommendation can be generated&#46;</p><p id="para230" class="elsevierStylePara elsevierViewall">As in other prospective studies <a class="elsevierStyleCrossRefs" href="#bib24">24&#44;34</a>&#44; we found no significant differences in infection and culture positivity rates between vitamin D-deficient and non-deficient patients&#46; Previous studies have shown a trend toward a greater incidence of infections but have lacked the statistical power to conclusively establish this association&#46; Higher rates of infection and culture positivity have been observed among vitamin D-deficient patients in retrospective studies <a class="elsevierStyleCrossRef" href="#bib14">14</a>&#44; which&#44; despite design bias&#44; are able to include larger samples&#46;</p><p id="para240" class="elsevierStylePara elsevierViewall">Although the literature suggests an association between 25&#40;OH&#41;D deficiency and morbidity in critically ill patients&#44; our study did not find a longer duration of mechanical ventilation among patients with severe vitamin D deficiency&#46; These results are consistent with other recently published prospective studies conducted in critically ill adult <a class="elsevierStyleCrossRefs" href="#bib17">17&#44;18&#44;21</a> and pediatric <a class="elsevierStyleCrossRef" href="#bib26">26</a> populations&#46;</p><p id="para250" class="elsevierStylePara elsevierViewall">In this study&#44; we observed a modest decrease in 25&#40;OH&#41;D levels in critically ill patients&#44; with a tendency toward lower levels among non-survivors&#46; Only two other studies have prospectively measured vitamin D levels during the course of an ICU stay <a class="elsevierStyleCrossRefs" href="#bib24">24&#44;28</a>&#46; In both studies&#44; data collection was restricted to 7 and 10 days of hospitalization&#46; In our study&#44; we measured 25&#40;OH&#41;D levels once weekly until the 28<span class="elsevierStyleSup">th</span> day in the ICU and found that non-survivors may have experienced a greater decrease in 25&#40;OH&#41;D concentrations after the second week in the ICU&#46; As the half-life of 25&#40;OH&#41;D is approximately 15 days&#44; these findings partly reflect the lack of vitamin D intake during the ICU stay due to a lack of sunlight exposure and low vitamin D concentrations in the diet provided to critically ill patients&#46; Prior studies have shown a decrease in vitamin D-binding protein &#40;VDBP&#41; concentrations during an ICU stay <a class="elsevierStyleCrossRef" href="#bib29">29</a>&#44; corroborating the decline in 25&#40;OH&#41;D levels during admission&#44; particularly in non-survivors&#46; This behavior is analogous to that observed with other constitutional proteins&#44; the synthesis of which is inhibited as metabolic pathways shift to the production of acute phase proteins in the setting of systemic inflammatory response syndrome &#40;SIRS&#41;&#46; Therefore&#44; the criticality of the illness may also be reflected by serum vitamin D levels&#46;</p><p id="para260" class="elsevierStylePara elsevierViewall">The high prevalence of vitamin D deficiency and insufficiency observed in our sample is consistent with other studies carried out at other centers&#44; as well as with the high prevalence found in the non-critically ill population in our center <a class="elsevierStyleCrossRef" href="#bib35">35</a>&#46; We are unaware of other reports of the prevalence and incidence of vitamin D deficiency in critically ill patients in South and Central America&#46;</p><p id="para270" class="elsevierStylePara elsevierViewall">This study has some limitations&#46; It was conducted at a tertiary care center with a largely Caucasian population and a relatively small sample size&#46; The infection rate was solely calculated based on clinical diagnoses made by the assisting physicians&#46; We cannot completely rule out the potential influence of unassessed variables&#8212;such as the volume infused in the first hours after admission or the cause of death&#8212;on mortality <a class="elsevierStyleCrossRef" href="#bib36">36</a>&#46; Vitamin D measurements were not performed in duplicate&#46; VDBP and biologically active 25&#40;OH&#41;D metabolites were not measured&#46; Notably&#44; albumin levels did not differ according to the vitamin D status&#46; Importantly&#44; the pleiotropic effects of vitamin D are dependent on local vitamin D concentrations&#59; it is biologically plausible that these effects would be independent of serum 25&#40;OH&#41;D levels&#46; Furthermore&#44; the association between mortality and severe vitamin D deficiency found in this observational study is not enough to recommend the measurement of vitamin D levels in critically ill patients or supplementation in those with vitamin D deficiency&#59; such changes in practice would depend on the results of clinical trials&#44; which are ongoing&#46;</p><p id="para280" class="elsevierStylePara elsevierViewall">The strengths of this study include its assessment of a hard endpoint &#40;mortality&#41; that is not prone to measurement bias&#46; In addition to 25&#40;OH&#41;D levels&#44; we measured other components that affect the vitamin D axis such as PTH&#44; ionized calcium&#44; magnesium&#44; and phosphorus&#46; The method employed for 25&#40;OH&#41;D measurement was the DiaSorin radioimmunoassay&#44; which is currently considered the standard for this purpose in view of its excellent agreement with isotope dilution liquid chromatography-tandem mass spectroscopy &#40;LC-MS&#41; <a class="elsevierStyleCrossRefs" href="#bib13">13&#44;37</a>&#46;</p><p id="para290" class="elsevierStylePara elsevierViewall">In our study&#44; PTH levels were higher among non-survivors&#46; The elevation of PTH among critically ill patients is due to factors such as peripheral resistance to the action of PTH&#44; especially in the acute phase&#44; in hypovitaminosis D and in hypocalcemia&#44; and may be related to morbidity in critically ill patients <a class="elsevierStyleCrossRef" href="#bib38">38</a>&#46; Thus&#44; PTH itself appears to be a marker of severity&#44; as observed with TSH or cortisol&#59; however&#44; PTH does not appear to be a potential therapeutic target&#44; unlike vitamin D&#46;</p><p id="para300" class="elsevierStylePara elsevierViewall">This study found that low vitamin D levels on admission are an independent risk factor for mortality in critically ill patients&#46; The best cutoff of 25&#40;OH&#41;D levels on admission for stratifying the risk of death among critically ill patients was 12 ng&#47;mL&#46; As well as being markers of disease severity&#44; low vitamin D levels and vitamin D kinetics during ICU admission may be causally associated with mortality and may serve as indicators for vitamin D supplementation in this patient population&#46; Nevertheless&#44; randomized trials are required to confirm this hypothesis&#46;</p></span><span id="cesec150" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle200">AUTHOR CONTRIBUTIONS</span><p id="para310" class="elsevierStylePara elsevierViewall">Moraes RB performed the study conception and design&#44; sample collection&#44; data analysis and manuscript preparation&#46; Czepielewski MA participated in the study conception&#44; design and supervision and manuscript preparation and revision&#46; Lisboa TC participated in the sample collection and performed the statistical analysis&#46; Wawrzeniak IC&#44; Marques LS and Nagel FM were involved in the study design and sample collection and storage&#46; Friedman G participated in the study design&#44; data analysis and manuscript preparation and revision&#46; All authors read and approved the final manuscript&#46;</p></span></span>"
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        1 => array:2 [
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          "titulo" => "INTRODUCTION"
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          "titulo" => "MATERIALS AND METHODS"
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              "titulo" => "Study design and setting"
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              "titulo" => "Biochemical analysis"
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              "identificador" => "cesec60"
              "titulo" => "Statistical analysis"
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        3 => array:3 [
          "identificador" => "cesec70"
          "titulo" => "RESULTS"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "cesec80"
              "titulo" => "Cohort profile"
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            1 => array:2 [
              "identificador" => "cesec90"
              "titulo" => "Mortality"
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            2 => array:2 [
              "identificador" => "cesec100"
              "titulo" => "Length of stay"
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            3 => array:2 [
              "identificador" => "cesec110"
              "titulo" => "Mechanical ventilation"
            ]
            4 => array:2 [
              "identificador" => "cesec120"
              "titulo" => "Infection and culture positivity"
            ]
            5 => array:2 [
              "identificador" => "cesec130"
              "titulo" => "Vitamin D kinetics"
            ]
          ]
        ]
        4 => array:2 [
          "identificador" => "cesec140"
          "titulo" => "DISCUSSION"
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        5 => array:2 [
          "identificador" => "cesec150"
          "titulo" => "AUTHOR CONTRIBUTIONS"
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        6 => array:2 [
          "identificador" => "xack639264"
          "titulo" => "Acknowledgments"
        ]
        7 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2014-09-16"
    "fechaAceptado" => "2015-02-06"
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            0 => "Vitamin D"
            1 => "Septic shock"
            2 => "Critical care"
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        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">OBJECTIVE&#58;</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">Studies suggest an association between vitamin D deficiency and morbidity&#47;mortality in critically ill patients&#46; Several issues remain unexplained&#44; including which vitamin D levels are related to morbidity and mortality and the relevance of vitamin D kinetics to clinical outcomes&#46; We conducted this study to address the association of baseline vitamin D levels and vitamin D kinetics with morbidity and mortality in critically ill patients&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">METHOD&#58;</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">In 135 intensive care unit &#40;ICU&#41; patients&#44; vitamin D was prospectively measured on admission and weekly until discharge from the ICU&#46; The following outcomes of interest were analyzed&#58; 28-day mortality&#44; mechanical ventilation&#44; length of stay&#44; infection rate&#44; and culture positivity&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS&#58;</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">Mortality rates were higher among patients with vitamin D levels &#60;12 ng&#47;mL &#40;versus vitamin D levels &#62;12 ng&#47;mL&#41; &#40;32&#46;2&#37; <span class="elsevierStyleItalic">vs&#46;</span> 13&#46;2&#37;&#41;&#44; with an adjusted relative risk of 2&#46;2 &#40;95&#37; CI 1&#46;07-4&#46;54&#59; <span class="elsevierStyleItalic">p</span>&#60; 0&#46;05&#41;&#46; There were no differences in the length of stay&#44; ventilation requirements&#44; infection rate&#44; or culture positivity&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">CONCLUSIONS&#58;</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">This study suggests that low vitamin D levels on ICU admission are an independent risk factor for mortality in critically ill patients&#46; Low vitamin D levels at ICU admission may have a causal relationship with mortality and may serve as an indicator for vitamin D replacement among critically ill patients&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "ceabs10"
            "titulo" => "OBJECTIVE&#58;"
          ]
          1 => array:2 [
            "identificador" => "ceabs20"
            "titulo" => "METHOD&#58;"
          ]
          2 => array:2 [
            "identificador" => "ceabs30"
            "titulo" => "RESULTS&#58;"
          ]
          3 => array:2 [
            "identificador" => "ceabs40"
            "titulo" => "CONCLUSIONS&#58;"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:1 [
        "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">No potential conflict of interest was reported&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Receiver-operating characteristic curve for various cutoff levels of vitamin D &#91;25&#40;OH&#41;D&#93;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl1"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="tfn1" class="elsevierStyleSimplePara elsevierViewall">COPD&#44; chronic obstructive pulmonary disease&#59; Ca&#47;VITD&#58; calcium&#47;vitamin D ratio&#59; &#916;SOFA&#44; SOFA on admission - final SOFA &#40;at ICU discharge or death&#41;&#59; BMI&#44; body mass index &#40;Kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#59; CRP&#44; C-reactive protein&#59; PTH&#44; parathyroid hormone&#46; &#42; denotes a statistically significant change&#46; Summer&#58; December 21 to March 21&#46; Autumn&#58; March 21 to June 21&#46; Winter&#58; June 21 to September 23&#46; Spring&#58; September 23 to December 21&#46;</p>"
          "tablatextoimagen" => array:1 [
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">Survivors &#40;n&#61;106&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">Non-survivors &#40;n&#61;29&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p-</span><span class="elsevierStyleBold">value</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Age&#44; years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#46;4&#177;16&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#46;4&#177;16&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Gender&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;462&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;45&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Comorbidities&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coronary artery disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;11&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;882&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;51&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;964&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heart failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;774&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hypothyroidism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">COPD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;18&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Asthma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AIDS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;7&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;201&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrhosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;8&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;720&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stroke&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;6&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;249&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;7&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;201&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neoplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;557&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">7 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;714&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Chronic medications&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diuretic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">28 &#40;26&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">11 &#40;38&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;326&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Corticosteroid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">8 &#40;7&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ca&#47;VITD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;292&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bisphosphonate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;385&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antiepileptic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;169&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Proton pump inhibitor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;9&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;456&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Ethnicity&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#46;660&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83 &#40;78&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;75&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">African&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;13&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;8&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;13&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Reason for ICU admission&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;48&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acute respiratory failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Post-surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;4&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Post-cardiac arrest&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#37;&#41;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-septic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acute renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;3&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;32&#37;&#41;&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Provenance&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;839&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emergency department&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;69&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ward&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Operating theater&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;30&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;20&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Admission service&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;924&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Medical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80 &#40;75&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Surgical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Season of admission&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;577&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Summer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;22&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Autumn&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;34&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;27&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Winter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;26&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;34&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">Spring&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">19 &#40;18&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">7 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">APACHE II score</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">17 &#91;12 to 23&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">23 &#91;18 to 29&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">SOFA score</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">4&#46;5 &#91;2 to 8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">7 &#91;4&#46;5 to 12&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">3&#46;0 &#91;1 to 6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2 &#91;&#8722;5&#46;5 to 1&#46;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">BMI &#40;Kg&#47;m<span class="elsevierStyleSup">2</span>&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">26&#46;7 &#91;23&#46;3 to 30&#46;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;5 &#91;23&#46;5 to 31&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#46;823&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Capillary blood glucose &#40;mg&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">146 &#91;113 to 193&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">141 &#91;99 to 189&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">3&#46;1&#177;0&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">2&#46;7&#177;0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#46;004&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">CRP &#40;mg&#47;L&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83 &#91;28 to 231&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">168 &#91;23 to 264&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#46;316&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Lactate &#40;mmol&#47;L&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">1&#46;4 &#91;1 to 2&#46;1&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;1 &#91;1&#46;4 to 5&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">PTH &#40;pg&#47;mL&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#46;9 &#91;56&#46;8 to 198&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#46;8 &#91;92&#46;6 to 331&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="tfn2" class="elsevierStyleSimplePara elsevierViewall">GFR&#58; glomerular filtration rate calculated by the Modification of Diet in Renal Disease Study Group &#40;MDRD&#41;&#46; Values are expressed as the total mean &#177; 95&#37; confidence interval OR the median &#91;interquartile range&#93;&#46;</p>"
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                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">Survivors &#40;n&#61;95&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t">Ca<span class="elsevierStyleSup">&#43;&#43;</span> &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;7 &#91;4&#46;6-4&#46;9&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;4 &#91;3&#46;8-4&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">GFR &#40;mL&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#91;48-60&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">59 &#91;26-60&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Phosphorus &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;9 &#91;2&#46;3-4&#46;2&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;2 &#91;2&#46;7-4&#46;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">0&#46;334&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Magnesium &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">2&#46;0&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">1&#46;9&#177;0&#46;36&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;345&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p id="tfn3" class="elsevierStyleSimplePara elsevierViewall">APACHE II&#58; Acute Physiology and Chronic Health Disease Classification System II&#59; SOFA&#58; Sequential Organ Failure Assessment&#59; BMI&#58; body mass index &#40;Kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#59; CI&#58; confidence interval&#46;</p>"
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                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">Crude relative risk</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">95&#37; CI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">Adjusted relative risk</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">95&#37; CI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitamin D &#40;25&#91;OH&#93;D3 &#8804; 12 ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;08-4&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;07-4&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APACHE II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;03-1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;99-1&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SOFA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;06-1&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;97-1&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lactate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;07-1&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;99-1&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Albumin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;38-0&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;47-1&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;96-1&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;95-1&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;63-1&#46;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;54-2&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "en" => "<p id="spara40" class="elsevierStyleSimplePara elsevierViewall">Crude and adjusted mortality by Poisson regression&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl4"
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        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "tabla" => array:2 [
          "leyenda" => "<p id="tfn4" class="elsevierStyleSimplePara elsevierViewall">ICU&#58; Intensive Care Unit</p><p id="tfn5" class="elsevierStyleSimplePara elsevierViewall">&#42;Rate of infections per 100 patient-days in ICU</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">25&#91;OH&#93;D3 &#8804; 12 ng&#47;mL</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleBold">25&#91;OH&#93;D3 &#62; 12 ng&#47;mL</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28-day mortality&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mechanical ventilation&#44;&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;834&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infections<a class="elsevierStyleCrossRef" href="#tfn5">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;468&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Positive cultures<a class="elsevierStyleCrossRef" href="#tfn5">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;369&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Positive blood cultures<a class="elsevierStyleCrossRef" href="#tfn5">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;516&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara50" class="elsevierStyleSimplePara elsevierViewall">Mortality&#44; mechanical ventilation and culture positivity according to vitamin D &#40;25&#91;OH&#93;D3&#41; status&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "cebibsec10"
          "bibliografiaReferencia" => array:38 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D supplementation&#58; guidelines and evidence for subclinical deficiency"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              P Pramyothin \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MF Holick \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1097/MOG.0b013e32835004dc"
                      "Revista" => array:7 [
                        "tituloSerie" => "Curr Opin Gastroenterol"
                        "fecha" => "2009"
                        "volumen" => "28"
                        "numero" => "2"
                        "paginaInicial" => "139"
                        "paginaFinal" => "150"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22274617"
                            "web" => "Medline"
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                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1097/MOG.0b013e32835004dc"
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                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1097&#47;MOG&#46;0b013e32835004dc"
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                  ]
                ]
              ]
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              "identificador" => "bib2"
              "etiqueta" => "2"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Evaluation&#44; treatment&#44; and prevention of vitamin D deficiency&#58; an Endocrine Society clinical practice guideline"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              MF Holick \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              NC Binkley \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              HA Bischoff-Ferrari \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              CM Gordon \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              DA Hanley \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              RP Heaney \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2011-0385"
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                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2011"
                        "volumen" => "96"
                        "numero" => "7"
                        "paginaInicial" => "1911"
                        "paginaFinal" => "1930"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21646368"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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                      "doi" => "10.1210/jc.2011-0385"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1210&#47;jc&#46;2011-0385"
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                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D recommendations&#58; beyond deficiency"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              HK Biesalski \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1159/000332066"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Nutr Metab"
                        "fecha" => "2011"
                        "volumen" => "59"
                        "numero" => "1"
                        "paginaInicial" => "10"
                        "paginaFinal" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22123631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1159/000332066"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1159&#47;000332066"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D Deficiency in Medical Patients at a Central Hospital in Malawi&#58; A Comparison with TB Patients from a Previous Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              Y Mastala \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              P Nyangulu \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              RV Banda \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              B Mhemedi \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              SA White \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              TJ Allain \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "PLoS One"
                        "fecha" => "2013"
                        "volumen" => "8"
                        "numero" => "3"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1371&#47;journal&#46;pone&#46;0059017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonclassic actions of vitamin D"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              D Bikle \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2008-1454"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2009"
                        "volumen" => "94"
                        "numero" => "1"
                        "paginaInicial" => "26"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18854395"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              L Jeng \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              AV Yamshchikov \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              SE Judd \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              HM Blumberg \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              GS Martin \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              TR Ziegler \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1186/1479-5876-7-28"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Transl Med"
                        "fecha" => "2009"
                        "volumen" => "7"
                        "paginaInicial" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19389235"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1186/1479-5876-7-28"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1186&#47;1479-5876-7-28"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "1&#44;25-Dihydroxyvitamin D3 and rat vascular smooth muscle cell growth"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              EP Carthy \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              W Yamashita \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              A Hsu \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              BS Ooi \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1161/01.hyp.13.6.954"
                      "Revista" => array:7 [
                        "tituloSerie" => "Hypertension"
                        "fecha" => "1989"
                        "volumen" => "13"
                        "numero" => "6"
                        "paginaInicial" => "954"
                        "paginaFinal" => "959"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2786849"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1161/01.hyp.13.6.954"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1161&#47;01&#46;HYP&#46;13&#46;6&#46;954"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "1&#44;25-Dihydroxyvitamin D3 modulates expression of chemokines and cytokines in pancreatic islets&#58; Implications for prevention of diabetes in nonobese diabetic mice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              CA Gysemans \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              AK Cardozo \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              H Callewaert \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Giulietti \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              L Hulshagen \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              R Bouillon \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1210/en.2004-1322"
                      "Revista" => array:7 [
                        "tituloSerie" => "Endocrinology"
                        "fecha" => "2005"
                        "volumen" => "146"
                        "numero" => "4"
                        "paginaInicial" => "1956"
                        "paginaFinal" => "1964"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15637289"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                      "doi" => "10.1210/en.2004-1322"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1210&#47;en&#46;2004-1322"
                      ]
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                ]
              ]
            ]
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              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D deficiency in the intensive care unit&#58; an invisible accomplice to morbidity and mortality&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              P Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              P Nair \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              JA Eisman \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              JR Center \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-009-1642-x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2009"
                        "volumen" => "35"
                        "numero" => "12"
                        "paginaInicial" => "2028"
                        "paginaFinal" => "2032"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19756497"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1007/s00134-009-1642-x"
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                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1007&#47;s00134-009-1642-x"
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                  ]
                ]
              ]
            ]
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              "identificador" => "bib10"
              "etiqueta" => "10"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              AS Levey \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              J Coresh \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              T Greene \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              LA Stevens \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              YL Zhang \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              S Hendriksen \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.7326/0003-4819-145-4-200608150-00004"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2006"
                        "volumen" => "145"
                        "numero" => "4"
                        "paginaInicial" => "247"
                        "paginaFinal" => "254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16908915"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.7326/0003-4819-145-4-200608150-00004"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;7326&#47;0003-4819-145-4-200608150-00004"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analytical and clinical validation of the 25 OH vitamin D assay for the liaison automated analyzer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              DL Ersfeld \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              DS Rao \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              JJ Body \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              JL Sackrison Jr \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              AB Miller \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              N Parikh \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clinbiochem.2004.06.006"
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Biochem"
                        "fecha" => "2004"
                        "volumen" => "37"
                        "numero" => "10"
                        "paginaInicial" => "867"
                        "paginaFinal" => "874"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15369717"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.clinbiochem.2004.06.006"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1016&#47;j&#46;clinbiochem&#46;2004&#46;06&#46;006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Longitudinal data analysis using generalized linear models"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              K-Y Liang \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              SL Zeger \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Biometrika"
                        "fecha" => "1986"
                        "volumen" => "73"
                        "paginaInicial" => "13"
                        "paginaFinal" => "22"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1093&#47;biomet&#47;73&#46;1&#46;13"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D and the Ctitically ill Patient&#58; An Update for the Intensivist"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              A Krishnan \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              P Nair \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              B Venkatesh \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "editores" => "JLVincent"
                        "titulo" => "Annual Update in Intensive Care and Emergency Medicine"
                        "paginaInicial" => "183"
                        "paginaFinal" => "195"
                        "serieFecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              A Braun \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              D Chang \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              K Mahadevappa \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              FK Gibbons \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              Y Liu \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              E Giovannucci \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e318206ccdf"
                      "Revista" => array:7 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2011"
                        "volumen" => "39"
                        "numero" => "4"
                        "paginaInicial" => "671"
                        "paginaFinal" => "677"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21242800"
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                      "doi" => "10.1097/CCM.0b013e318206ccdf"
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              ]
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              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low serum 25-hydroxyvitamin D at critical care initiation is associated with increased mortality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              AB Braun \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              FK Gibbons \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              AA Litonjua \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              E Giovannucci \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              KB Christopher \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e31822d74f3"
                      "Revista" => array:7 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2012"
                        "volumen" => "40"
                        "numero" => "1"
                        "paginaInicial" => "63"
                        "paginaFinal" => "72"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21926604"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1097/CCM.0b013e31822d74f3"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1097&#47;CCM&#46;0b013e31822d74f3"
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                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D deficiency in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              P Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              JA Eisman \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              JR Center \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMc0809996"
                      "Revista" => array:7 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2009"
                        "volumen" => "360"
                        "numero" => "19"
                        "paginaInicial" => "1912"
                        "paginaFinal" => "1914"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19403914"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1056/NEJMc0809996"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1056&#47;NEJMc0809996"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship between vitamin D status and ICU outcomes in veterans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              JD McKinney \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              BA Bailey \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              LH Garrett \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              P Peiris \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              T Manning \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              NA Peiris \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Med Directors Assoc"
                        "fecha" => "2011"
                        "volumen" => "12"
                        "numero" => "3"
                        "paginaInicial" => "208"
                        "paginaFinal" => "211"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1016&#47;j&#46;jamda&#46;2010&#46;04&#46;004"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D deficiency is associated with mortality in the medical intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              S Venkatram \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              S Chilimuri \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              M Adrish \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Salako \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              M Patel \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              G Diaz-Fuentes \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1186/cc10585"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2011"
                        "volumen" => "15"
                        "numero" => "6"
                        "paginaInicial" => "R292"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22152332"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1186/cc10585"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1186&#47;cc10585"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Worsening severity of vitamin D deficiency is associated with increased length of stay&#44; surgical intensive care unit cost&#44; and mortality rate in surgical intensive care unit patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              LR Matthews \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              Y Ahmed \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              KL Wilson \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              DD Griggs \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              OK Danner \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjsurg.2011.07.021"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Surg"
                        "fecha" => "2012"
                        "volumen" => "204"
                        "numero" => "1"
                        "paginaInicial" => "37"
                        "paginaFinal" => "43"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22325335"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.amjsurg.2011.07.021"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1016&#47;j&#46;amjsurg&#46;2011&#46;07&#46;021"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              Y Arnson \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              I Gringauz \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              D Itzhaky \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              H Amital \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1093/qjmed/hcs014"
                      "Revista" => array:7 [
                        "tituloSerie" => "QJM"
                        "fecha" => "2012"
                        "volumen" => "105"
                        "numero" => "7"
                        "paginaInicial" => "633"
                        "paginaFinal" => "639"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22331959"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1093/qjmed/hcs014"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1093&#47;qjmed&#47;hcs014"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of vitamin D deficiency in critically ill surgical patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              L Flynn \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              LH Zimmerman \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              K McNorton \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Dolman \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              J Tyburski \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              A Baylor \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjsurg.2011.09.012"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Surg"
                        "fecha" => "2012"
                        "volumen" => "203"
                        "numero" => "3"
                        "paginaInicial" => "379"
                        "paginaFinal" => "382"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22206852"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.amjsurg.2011.09.012"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1016&#47;j&#46;amjsurg&#46;2011&#46;09&#46;012"
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                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and risk factors of vitamin D deficiency in critically ill patients&#58; results from a prospective observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              O Lucidarme \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              E Messai \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              T Mazzoni \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Arcade \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              D du Cheyron \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-010-1875-8"
                      "Revista" => array:7 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2010"
                        "volumen" => "36"
                        "numero" => "9"
                        "paginaInicial" => "1609"
                        "paginaFinal" => "1611"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20373095"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1007/s00134-010-1875-8"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1007&#47;s00134-010-1875-8"
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                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D deficiency in septic patients at ICU admission is not a mortality predictor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              A Cecchi \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              M Bonizzoli \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              S Douar \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Mangini \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              S Paladini \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              B Gazzini \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Minerva Anestesiol"
                        "fecha" => "2011"
                        "volumen" => "77"
                        "numero" => "12"
                        "paginaInicial" => "1184"
                        "paginaFinal" => "1189"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21720281"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship of vitamin D deficiency to clinical outcomes in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              DM Higgins \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              PE Wischmeyer \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              KM Queensland \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              SH Sillau \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              AJ Sufit \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              DK Heyland \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1177/0148607112444449"
                      "Revista" => array:7 [
                        "tituloSerie" => "JPEN J Parenter Enteral Nutr"
                        "fecha" => "2012"
                        "volumen" => "36"
                        "numero" => "6"
                        "paginaInicial" => "713"
                        "paginaFinal" => "720"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22523178"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1177/0148607112444449"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1177&#47;0148607112444449"
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                ]
              ]
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            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The association of vitamin D status with pediatric critical illness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              JD McNally \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              K Menon \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              P Chakraborty \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              L Fisher \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              KA Williams \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              Al-Dirbashi \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2011-3059"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2012"
                        "volumen" => "130"
                        "numero" => "3"
                        "paginaInicial" => "429"
                        "paginaFinal" => "436"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22869837"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1542/peds.2011-3059"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1542&#47;peds&#46;2011-3059"
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                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D status in critically ill children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              C Rippel \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              M South \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              WW Butt \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              LS Shekerdemian \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-012-2718-6"
                      "Revista" => array:7 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2012"
                        "volumen" => "38"
                        "numero" => "12"
                        "paginaInicial" => "2055"
                        "paginaFinal" => "2062"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23052958"
                            "web" => "Medline"
                          ]
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                      ]
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                    1 => array:2 [
                      "doi" => "10.1007/s00134-012-2718-6"
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                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1007&#47;s00134-012-2718-6"
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              "identificador" => "bib27"
              "etiqueta" => "27"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              S Pilz \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              W Marz \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              B Wellnitz \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              U Seelhorst \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              A Fahrleitner-Pammer \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              HP Dimai \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2008-0784"
                      "Revista" => array:8 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2008"
                        "volumen" => "93"
                        "numero" => "10"
                        "paginaInicial" => "3927"
                        "paginaFinal" => "35&#46;0"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18682515"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S109037981930443X"
                          "estado" => "S300"
                          "issn" => "10903798"
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1210/jc.2008-0784"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1210&#47;jc&#46;2008-0784"
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                ]
              ]
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            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Significant perturbation of vitamin D-parathyroid-calcium axis and adverse clinical outcomes in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              P Nair \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              P Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              C Reynolds \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              ND Nguyen \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              J Myburgh \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              JA Eisman \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-012-2713-y"
                      "Revista" => array:7 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2013"
                        "volumen" => "39"
                        "numero" => "2"
                        "paginaInicial" => "267"
                        "paginaFinal" => "274"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23064465"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1007/s00134-012-2713-y"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1007&#47;s00134-012-2713-y"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Admission level of Gc-globulin predicts outcome after multiple trauma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              B Dahl \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              FV Schiodt \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              M Nielsen \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              T Kiaer \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              JG Williams \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              P Ott \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/s0020-1383(99)00080-7"
                      "Revista" => array:7 [
                        "tituloSerie" => "Injury"
                        "fecha" => "1999"
                        "volumen" => "30"
                        "numero" => "4"
                        "paginaInicial" => "275"
                        "paginaFinal" => "281"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10476297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/s0020-1383(99)00080-7"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1016&#47;S0020-1383&#40;99&#41;00080-7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              ASPEN Board of Directors and the Clinical Guidelines Task Force \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "JPEN J Parenter Enteral Nutr"
                        "fecha" => "2002"
                        "volumen" => "26"
                        "numero" => "1suppl"
                        "paginaInicial" => "1SA"
                        "paginaFinal" => "138SA"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11841046"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of vitamin D endocrine system &#40;VDES&#41; status and response to treatment of patients in intensive care units &#40;ICUs&#41; using an on-line SPE-LC-MS&#47;MS method"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              JM Mata-Granados \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              J Vargas-Vasserot \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              C Ferreiro-Vera \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              MD Luque de Castro \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              RG Pavon \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              JM Quesada Gomez \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jsbmb.2010.03.078"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Steroid Biochem Mol Biol"
                        "fecha" => "2010"
                        "volumen" => "121"
                        "numero" => "1-2"
                        "paginaInicial" => "452"
                        "paginaFinal" => "455"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20399267"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.jsbmb.2010.03.078"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1016&#47;j&#46;jsbmb&#46;2010&#46;03&#46;078"
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                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short-term effects of high-dose oral vitamin D3 in critically ill vitamin D deficient patients&#58; a randomized&#44; double-blind&#44; placebo-controlled pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              K Amrein \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              H Sourij \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              G Wagner \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Holl \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              TR Pieber \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              KH Smolle \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1186/cc10120"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2011"
                        "volumen" => "15"
                        "numero" => "2"
                        "paginaInicial" => "R104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21443793"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1186/cc10120"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1186&#47;cc10120"
                      ]
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                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correction of vitamin D deficiency in critically ill patients - VITdAL&#64;ICU study protocol of a double-blind&#44; placebo-controlled randomized clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              K Amrein \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              C Schnedl \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              A Berghold \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              TR Pieber \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              H Dobnig \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1186/1472-6823-12-27"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Endocr Disord"
                        "fecha" => "2012"
                        "volumen" => "12"
                        "paginaInicial" => "27"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23134762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1186/1472-6823-12-27"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1186&#47;1472-6823-12-27"
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                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D deficiency in critically ill children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              K Madden \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              HA Feldman \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              EM Smith \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              CM Gordon \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              SM Keisling \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              RM Sullivan \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.2011-3328"
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2012"
                        "volumen" => "130"
                        "numero" => "3"
                        "paginaInicial" => "421"
                        "paginaFinal" => "428"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22869836"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1542&#47;peds&#46;2011-3328"
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              ]
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            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High prevalence of hypovitaminosis D and secondary hyperparathyroidism in elders living in nonprofit homes in South Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              R Scalco \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              MO Premaor \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              PE Froehlich \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              TW Furlanetto \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocr"
                        "fecha" => "2008"
                        "volumen" => "33"
                        "numero" => "1"
                        "paginaInicial" => "95"
                        "paginaFinal" => "100"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1007&#47;s12020-008-9061-2"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute fluid shifts influence the assessment of serum vitamin D status in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              A Krishnan \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              J Ochola \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              J Mundy \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              M Jones \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              P Kruger \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              E Duncan \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1186/cc9341"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2010"
                        "volumen" => "14"
                        "numero" => "6"
                        "paginaInicial" => "R216"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21110839"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1186/cc9341"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1186&#47;cc9341"
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              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "State-of-the-art vitamin D assays&#58; a comparison of automated immunoassays with liquid chromatography-tandem mass spectrometry methods"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              CJ Farrell \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              S Martin \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              B McWhinney \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              I Straub \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              P Williams \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              M Herrmann \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1373/clinchem.2011.172155"
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Chem"
                        "fecha" => "2012"
                        "volumen" => "58"
                        "numero" => "3"
                        "paginaInicial" => "531"
                        "paginaFinal" => "542"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22230812"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1373/clinchem.2011.172155"
                      "WWW" => array:1 [
                        "link" => "http&#58;&#47;&#47;dx&#46;doi&#46;org&#47;10&#46;1373&#47;clinchem&#46;2011&#46;172155"
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                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Significant perturbation of vitamin D-parathyroid-calcium axis and adverse clinical outcomes in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              P Nair \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              P Lee \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              C Reynolds \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              ND Nguyen \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              J Myburgh \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              JA Eisman \n
                              \t\t\t\t\t\t\t\t
                              """
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                        "tituloSerie" => "Intensive Care Med"
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                        "volumen" => "39"
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    "agradecimientos" => array:1 [
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        "identificador" => "xack639264"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="para320" class="elsevierStylePara elsevierViewall">This work was supported by grants from Brazilian public agencies of research&#58; Fundo de Incentivo &#232; Pesquisa e Eventos do Hospital de Cl&#237;nicas de Porto Alegre &#40;FIPE-HCPA&#41; and Grupo de Pesquisa e P&#243;s Gradua&#231;&#227;o - Endocrinologia da Universidade Federal do Rio Grande do Sul &#40;GPPG-Endocrinologia-HCPA&#41;&#46;</p><p id="para330" class="elsevierStylePara elsevierViewall">The authors would like to thank Martha Bergman Senger&#44; Maria Clara Medina Correa&#44; and Luiz Werres Junior at the Hospital de Cl&#237;nicas de Porto Alegre Biochemistry and Radioimmunoassay Unit for their invaluable assistance with sample processing&#44; Dr&#46; Laisa Bonzanini and undergraduate research fellows Manuela M&#46; Marimon&#44; Luiza Burin&#44; Helena T&#46; Schroeder&#44; and Mauricio Vieira Rodrigues for their assistance with data collection and entry&#46;</p>"
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Article information
ISSN: 18075932
Original language: English
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es en pt

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Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos