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Sodium Nitroprusside as a Nitric Oxide Donor in a Rat Intestinal Ischemia-Reperfusion Model
Ali Emre, Orhan Bayram, Bulent Salman, Sevim Ercan, Ziya Anadol, Okhan Akin
Zonguldak Karaelmas University, General Surgery – Turkey
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          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Histological appearance of the I&#47;R group&#46; Villous epithelial separation&#44; luminal epithelial seeding and naked subepithelial areas &#40;H&#38;E x100&#41;&#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">It is a well known phenomenon that reperfusion is as dangerous for the tissues as ischemia&#44; particularly in the heart and the intestines&#46;<a class="elsevierStyleCrossRef" href="#bib1">1</a> Intestinal ischemia is a result of systemic factors &#40;hypovolemia&#44; hypotension&#44; hypoxia&#44; sepsis&#41; or local factors &#40;mechanical obstruction of the intestine or the intestinal vessels&#41;&#46; The restored circulation results in the formation of free oxygen radicals and other acute phase reactants&#46; Resulting cellular death occurs via the lipid peroxydation of the cell wall&#46;<a class="elsevierStyleCrossRef" href="#bib2">2</a>&#44;<a class="elsevierStyleCrossRef" href="#bib3">3</a></p><p id="para20" class="elsevierStylePara elsevierViewall">The role of endogenous endothelin peptides in the intestinal ischemia-reperfusion &#40;I&#47;R&#41; model has been well studied&#46;<a class="elsevierStyleCrossRef" href="#bib4">4</a> Although the exact mechanism is still not fully understood&#44; investigations on nitric oxide &#40;NO&#41;&#44; an endothelial-derived relaxation factor&#44; revealed its importance in the management of I&#47;R injury&#46; <a class="elsevierStyleCrossRef" href="#bib5">5</a>&#44;<a class="elsevierStyleCrossRef" href="#bib6">6</a> NO inhibits lipid peroxidation via the lipophilic free radical effect&#46;<a class="elsevierStyleCrossRef" href="#bib7">7</a> There are many studies concerning NO agonists and antagonists&#44; but the main concern in recent years has been NO donors releasing exogenous NO&#46; 3-morpholinosydnonimine &#40;SIN-1&#41;&#44; spermine NO&#44; diethanolamine nitric oxide &#40;DEA&#47;NO&#41;&#44; S-nitroso-N-acetylpenicillamine &#40;SNAP&#41;&#44; FK409&#44; S-nitrosoglutatione &#40;GSNO&#41;&#44; NOC5&#44; NOC12&#44; CAS 754&#44; and Gliseryl trinitrate are the major products used&#46;<a class="elsevierStyleCrossRef" href="#bib1">1</a>&#44;<a class="elsevierStyleCrossRef" href="#bib7">7</a></p><p id="para30" class="elsevierStylePara elsevierViewall">Sodium Nitroprusside &#40;SNP&#41; is another nitric oxide donor investigated for its intravascular and intraluminal effects on ischemia reperfusion injury&#46; We investigated the effects of NO in I&#47;R injury with the commercially available and inexpensive product sodium nitroprusside &#40;SNP&#41; administered intraperitoneally in a rat intestinal model&#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">Ethics</span><p id="para40" class="elsevierStylePara elsevierViewall">This study was performed in the investigation laboratories of Gazi University with the permission of the Gazi University Ethical Committee&#46;</p></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">Study design</span><p id="para50" class="elsevierStylePara elsevierViewall">The study was conducted with 35 male Wistar albino rats weighing between 200&#8211;230 grams&#44; divided into 5 groups&#46; Rats were fed standard food until the last 12 hours of the study and were given water ad libitum&#46; A midline incision was performed and the superior mesenteric artery was clamped for 40 minutes to create ischemia&#46; Intestinal segments were taken into the abdominal cavity and a light source was used to avoid hypothermia&#46; All medications were administered intraperitoneally &#40;i&#46;p&#41; immediately before removal of the superior mesenteric artery clamp&#44; and the intestines were allowed to reperfuse for 30 minutes after the abdominal wall was closed&#46;</p><p id="para60" class="elsevierStylePara elsevierViewall">The groups are designed as&#58;<elsevierMultimedia ident="tbl1a"></elsevierMultimedia></p><p id="para70" class="elsevierStylePara elsevierViewall">In the SNP group&#44; Sodium Nitroprusside &#40;Nipruss&#44; ADEKA&#41; was given i&#46;p&#46; at 5 mg&#47;kg&#59; in the N<span class="elsevierStyleSup">G</span>-Nitro-<span class="elsevierStyleItalic">L</span>-Arginin Methyl Ester &#40;L-NAME&#41; group&#44; L-NAME was given i&#46;p&#46; at 10 mg&#47;kg &#40;Sigma Chemical Co&#41;&#46; In the SNP&#43;L-NAME group&#44; SNP and L-NAME were given i&#46;p&#46; at 5 mg&#47;kg and 10 mg&#47;kg&#44; respectively</p><p id="para80" class="elsevierStylePara elsevierViewall">Intestinal tissue samples taken from the jejunum 30 minutes after the reperfusion were preserved in 10&#37; formaline solution for histopathological examinations and snap frozen in liquid nitrogen and then stored at &#8211;80&#176;C for tissue MDA level determination&#46;</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">Pathological examination</span><p id="para90" class="elsevierStylePara elsevierViewall">Tissue samples were examined under the light microscope after haemotoxyleneosine &#40;H&#38;E&#41; staining using the criteria reported by Park and Chiu&#46;<a class="elsevierStyleCrossRef" href="#bib8">8</a> Briefly&#44; &#91;0&#93; was described as normal mucosa&#44; &#91;1&#93; as subepithelial space at villus tips&#44; &#91;2&#93; as extension of subepithelial space with moderate lifting&#44; &#91;3&#93; as massive lifting down sides of villi&#44; with some denuded tips&#44; &#91;4&#93; as denuded villi&#44; dilated capillaries&#44; &#91;5&#93; as disintegration of lamina propria&#44; &#91;6&#93; as crypt layer injury&#44; &#91;7&#93; as transmucosal infarction and &#91;8&#93; as transmural infarction&#46;</p></span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle110">Tissue malonyldialdehyde &#40;MDA&#41; level</span><p id="para100" class="elsevierStylePara elsevierViewall">Tissue MDA levels were studied as reported by Uchiyama et al&#46;<a class="elsevierStyleCrossRef" href="#bib9">9</a> Tissue samples were homogenized with 1&#46;15&#37; cold KCL&#44; and then 1&#37; phosphoric acid and 0&#46;6&#37; thiobarbituric acid were added sequentially&#46; After boiling in a water bath for 45 minutes&#44; n-buthanol was added&#46; The material was centrifuged at 2500 rpm for 5 minutes and spectrophotometric determinations were performed at 535 and 520 nm&#46; The results are given as nmol&#47;gr of tissue&#46;</p></span><span id="cesec70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle120">Statistics</span><p id="para110" class="elsevierStylePara elsevierViewall">Tissue MDA levels and the results of the pathological examinations were subjected to the Kruskal-Wallis test&#46; Post-hoc multiple comparison test &#40;Bonferroni&#41; was also performed in order to find significant differences between groups&#46; Values of p&#60;0&#46;05 were accepted as significant&#46;</p></span></span><span id="cesec80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">RESULTS</span><p id="para120" class="elsevierStylePara elsevierViewall">There is a significant difference between groups according to Kruskal-Wallis variance analysis &#40;p&#60;0&#46;001&#41;&#46; The histopathological scores are displayed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a></p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><span id="cesec90" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">Control Group</span><p id="para130" class="elsevierStylePara elsevierViewall">The mean histopathological injury score in the control group is 0&#46; The histological appearance of the control group is shown in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia></span><span id="cesec100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle150">I&#47;R Group</span><p id="para140" class="elsevierStylePara elsevierViewall">In the samples of the I&#47;R group&#44; the mean score of injury is 3&#46;28 &#177; 0&#46;48&#46; Histopathological examination reveals significant villous epithelial separation&#44; luminal epithelial seeding and naked subepithelial areas &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig2"></elsevierMultimedia></span><span id="cesec110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle160">SNP Group</span><p id="para150" class="elsevierStylePara elsevierViewall">In the SNP group&#44; the mean injury score is 1&#46;43 &#177; 0&#46;53&#44; and a contact epithelial lining&#44; except with some subepithelial spacings&#44; is observed upon histopathological examination &#40;<a class="elsevierStyleCrossRef" href="#fig3">Figure 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig3"></elsevierMultimedia></span><span id="cesec120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle170">L-NAME Group</span><p id="para160" class="elsevierStylePara elsevierViewall">In the L-NAME group&#44; where endogenous NO synthesis is thought to be inhibited&#44; the mean score of injury is 3&#46;28 &#177; 0&#46;95&#44; as in the I&#47;R group&#46; Similar to the I&#47;R group&#44; free mucosal cell particles can be seen in the lumen and epithelial layer separations are obvious &#40;<a class="elsevierStyleCrossRef" href="#fig4">Figure 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig4"></elsevierMultimedia></span><span id="cesec130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle180">SNP&#43;L-NAME Group</span><p id="para170" class="elsevierStylePara elsevierViewall">In the SNP&#43;L-NAME group&#44; the mean score of injury is 2&#46;0 &#177; 0&#46;81&#46; Pathological examination revealed an increase in the amount of subepithelial spaces and epithelial separations in this group &#40;<a class="elsevierStyleCrossRef" href="#fig5">Figure 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig5"></elsevierMultimedia><p id="para180" class="elsevierStylePara elsevierViewall">Statistical analysis of the data with the Mann-Whitney U test shows that the I&#47;R group is statistically significantly different than the SNP and the SNP&#43;L-NAME groups &#40;p&#60; 0&#46;05&#41;&#46; The difference is not significant between either the I&#47;R group and the L-NAME group or the SNP and the SNP&#43;L-NAME group&#46; There is also a statistically significant difference between the L-NAME group and the SNP group&#44; and between the L-NAME group and the SNP&#43;L-NAME group &#40;p&#60;0&#46;05&#41;&#46;</p><p id="para190" class="elsevierStylePara elsevierViewall">Tissue MDA levels are displayed in <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a></p><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p id="para200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">In the Sham Group&#44; the</span> tissue MDA level is 3&#46;71 &#177; 1&#46;38 nmol&#47;gr of tissue&#46;</p><p id="para210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">In the I&#47;R Group&#44;</span> I&#47;R injury to the intestinal tissues results in a significant increase in MDA levels&#46; The mean MDA level in this group is 14&#46;42 &#177; 2&#46;50 nmol&#47;gr of tissue&#46;</p><p id="para220" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">In the SNP Group&#44;</span> the mean MDA level is significantly decreased to 8&#46;85&#177;1&#46;06 nmol&#47;gr of tissue&#46; There is no difference between the SNP and SNP&#43;L-NAME groups&#44; although the difference between the MDA levels of the SNP and L-NAME groups are again statistically significant &#40;p&#60;0&#46;05&#41;&#46;</p><p id="para230" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">In the L-NAME Group&#44;</span> the mean tissue MDA level is 12&#46;85 &#177; 3&#46;53 nmol&#47;gr of tissue&#46; There is no difference between the L-NAME and I&#47;R groups&#46;</p><p id="para240" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">In the SNP&#43;L-NAME Group&#44; t</span>he mean MDA level is 9&#46;42 &#177; 1&#46;27nmol&#47;gr of tissue and the difference compared with the L-NAME group is statistically significant &#40;p&#60;0&#46;05&#41;&#46;</p></span></span><span id="cesec140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle190">DISCUSSION</span><p id="para250" class="elsevierStylePara elsevierViewall">The deleterious effect of reperfusion on intestines and its exacerbation of the ischemic event is strongly suggested&#46;<a class="elsevierStyleCrossRef" href="#bib10">10</a> The mechanism responsible for the injury caused by reperfusion is the formation of free oxygen radicals and the oxidative stress generated by these reactive oxygen species&#46; In fact&#44; the mechanism of injury is not fully understood&#44; as there are other factors involved such as activation of phospholipase A2 and alterations of calcium flux&#46; Chan et al&#46; reported that third degree injury begins after only 15 mins of ischemia in the jejunum and after 60 mins in the ileum&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> Ischemia lasting more than 40 minutes can cause irreversible damage in the small intestine&#46; Kurose et al&#46; reported that ischemia lasting over 30 minutes does not cause a change in reperfusion&#46;<a class="elsevierStyleCrossRef" href="#bib12">12</a> In order to avoid such a scenario&#44; we used jejunal segments after 40 minutes of ischemia&#46; As 40 minutes of ischemia is sufficient for creating ischemic injury and is less than the time needed for irreversible transmural infaction&#44; the maximum grade of injury was found to be 4 in all groups&#46; In the I&#47;R group&#44; the mean level of injury was 3&#46;28 &#177; 0&#46;95&#44; which is similar to the results reported by Kazez et al&#46; with the same scoring system&#46;<a class="elsevierStyleCrossRef" href="#bib13">13</a> Schoenberg et al&#46; showed that ischemia itself causes less injury within the same time period&#46;<a class="elsevierStyleCrossRef" href="#bib3">3</a> Most of the systems used for grading the injury were qualitative or semi-quantitative&#46;<a class="elsevierStyleCrossRef" href="#bib8">8</a> Quadeckers et al&#46; studied the different grading methods and reported that the Park and Chiu method for grading injury has advantages over the others becasue it minimizes examiner-based differences in pathological examination and detailed structural aspects&#46;<a class="elsevierStyleCrossRef" href="#bib8">8</a> Park&#8217;s classification alone is not able to take the villous and crypt injury into account&#46;<a class="elsevierStyleCrossRef" href="#bib8">8</a> Apoptosis is also a valuable area of study for estimating tissue injury&#44; and has become more popular in recent years&#46;<a class="elsevierStyleCrossRef" href="#bib14">14</a></p><p id="para260" class="elsevierStylePara elsevierViewall">The histopathological results of the study are also supported by the increase in the tissue MDA levels&#46; The MDA levels of normal intestinal tissue in the sham group were found to be 3&#46;71 &#177; 1&#46;38 nmol&#47;gr of tissue&#44; which increased to 14&#46;42 &#177; 2&#44;50 nmol&#47;gr of tissue in the I&#47;R group&#46; These results demonstrate the correlation of histological and biochemical markers of the tissue injury&#46; Lipid peroxidation results from the reaction of reactive oxygen metabolites&#44; especially the hydroxyl and hydroperoxyl radicals with the membrane bound polyunsaturated fatty acids with a loss of a carbon radical and its rearrangement for formation of a conjugated diene&#46; This conjugated form reacts immediately with oxygen to form peroxide radicals&#46; Peroxide radicals initiate a chain reaction by removing a hydrogen atom from the other fatty acids&#46; The end product of this reaction is tissue MDA and hydroperoxide&#46;<a class="elsevierStyleCrossRef" href="#bib17">17</a></p><p id="para270" class="elsevierStylePara elsevierViewall">The spectrophotometric analysis of this tissue MDA is an important marker of <span class="elsevierStyleItalic">in vivo</span> lipid peroxidation&#46; The other lipid peroxidation products used for the same purpose are conjugated dienes&#44; endoperoxidases and hydrogen peroxidase&#46; Many investigators used tissue MDA as a marker of lipid peroxidation in ischemic tissue&#44;<a class="elsevierStyleCrossRef" href="#bib7">7</a>&#44;<a class="elsevierStyleCrossRef" href="#bib15">15</a>&#44;<a class="elsevierStyleCrossRef" href="#bib16">16</a> although there are some limitations of the procedure&#46; There are more specific assay methods including C11-BODIPY that may be studied where available&#46; Estimation of the tissue MDA reacting with amine groups on the phospholipids by photometric analysis of the fluorescent effect is the most frequently used method&#44; as performed here&#46; <a class="elsevierStyleCrossRef" href="#bib18">18</a>&#44;<a class="elsevierStyleCrossRef" href="#bib19">19</a></p><p id="para280" class="elsevierStylePara elsevierViewall">Increasing the level of NO production is thought to decrease the reperfusion injury of the post-ischemic intestine via the increase in the tissue perfusion or by protecting the mucosa from the high levels of the cytotoxic agent superoxide&#46;<a class="elsevierStyleCrossRef" href="#bib20">20</a> Increasing the perfusion is an important factor&#44; because dilution provides buffering of the acidic lamina propria of reperfused intestine and cleansing of the media from the toxins passing through the epithelium&#46; Investigations into the mechanism of the I&#47;R effect on NO production on the post-ischemic intestine revealed that reperfusion following 20 minutes of occlusion of the superior mesenteric artery causes a decrease in nitrite&#47;nitrate levels&#44; which is explained by the inhibition or inactivation of the NOS&#46;<a class="elsevierStyleCrossRef" href="#bib12">12</a> Increased production of superoxide in post-ischemic tissue is also responsible for minimizing the effect of endothelium-derived NO&#46; The half-life of NO is very short &#40;about 6 seconds&#41; and the basic mechanism of this short half-life is thought to be the reaction with superoxide&#44; as the half-life of NO increases in samples treated with superoxide dismutase&#46;<a class="elsevierStyleCrossRef" href="#bib21">21</a></p><p id="para290" class="elsevierStylePara elsevierViewall">As the endogenous production and the use of nitric oxide decreases after I&#47;R&#44; the importance of exogenous NO is better understood&#46; Mason et al&#46; reported the increase in free oxygen radicals after the decrease of tissue NO levels&#46;<a class="elsevierStyleCrossRef" href="#bib22">22</a> Endogenous NO can inhibit or delay the injury caused by the free oxygen radicals in the early periods of I&#47;R&#46; The results of the previous studies revealed that nitric oxide donors might cause vasodilatation and scavenge the free oxygen radicals&#44; the major cause of injury in reperfusion injury&#46; However&#44; the function of NO is still not fully understood as NO reacts with superoxide anion to form peroxynitrite anion &#40;ONOO2&#41;&#44; a highly reactive oxidizing agent capable of causing tissue damage&#46;</p><p id="para300" class="elsevierStylePara elsevierViewall">Payne and Kubes studied the permeability of intestines with I&#47;R injury treated with SIN 1&#44; CAS-754 and nitroprusside&#44; and reported a significant decrease in permeability even in the presence of the NOS inhibitor L-NAME&#46;<a class="elsevierStyleCrossRef" href="#bib20">20</a> NO released by the donor compounds not only inactivates the superoxide radicals&#44; the product of hypoxantine-xantine pathway&#44; but also has a direct inhibitory effect on inflammatory cells&#46; The inhibitory effect of NO on neutrophils and mast cells occurs via the inhibition of neutrophil adhesion&#44; migration and aggregation and blocking the histamine release from the mast cells&#46;</p><p id="para310" class="elsevierStylePara elsevierViewall">SNP is a cost effective and easily accessible compound&#46; In our study&#44; intraperitoneal use of the compound resulted in a significant decrease in the level of tissue injury&#44; as seen both histopathologically and by the changes in tissue MDA levels with respect to the control group&#46; This significant decrease in both SNP and SNP&#43;L-NAME groups convinced us that SNP administered intraperitoneally can supply enough NO concentration in the tissues&#46; SNP acts not only by inactivating the superoxide radicals and suppressing the inflammatory response&#44; but can also cause vasodilatation of the constricted vessels after ischemia&#46; On the other hand&#44; it should also be noted that SNP is a disodium salt of nitroprusside &#40;Na<span class="elsevierStyleInf">2</span>&#91;Fe&#40;CN&#41;<span class="elsevierStyleInf">5</span>NO&#93;&#183;2H<span class="elsevierStyleInf">2</span>O&#41; with a central iron molecule surrounded by one nitric oxide and five cyanide ligands&#46; Wang et al&#46; presented evidence that SNP donates iron to cells&#46; The increase in intracellular iron is another cause of oxidative injury&#46;</p><p id="para320" class="elsevierStylePara elsevierViewall">L-NAME is a NOS inhibitor&#46; It inhibits both Ca<span class="elsevierStyleSup">2&#43;</span> dependent neuronal nitric oxide synthase &#40;nNOS&#41; and Ca<span class="elsevierStyleSup">2&#43;</span> independent inducible nitric oxide synthase &#40;iNOS&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib23">23</a> Luo et al&#46; reported that L-NAME reduces the I&#47;R injury by inhibiting the endogenous NO&#46;<a class="elsevierStyleCrossRef" href="#bib24">24</a> Kurose et al&#46; showed that L-NAME causes the formation of platelet-leukocyte aggregates&#44; and reported that decreased NO production caused an increase in aggregate formation&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> P-selectin specific monoclonal antibodies were thought to be the main factors of this aggregate formation&#46; NO donors hinder platelet-leukocyte aggregate formation by blocking P-selectin function on the I&#47;R activated platelet surface&#46;</p><p id="para330" class="elsevierStylePara elsevierViewall">We studied the L-NAME and L-NAME&#43;SNP groups separately to compare the effects of exogenous NO&#46; We did not find any difference neither between the I&#47;R and L-NAME groups nor between SNP and SNP&#43;L-NAME groups&#46; This can be explained by a significant decrease in NO levels due to NOS inactivation and superoxide related NO inactivation after 40 minutes of ischemia followed by reperfusion&#46;</p><p id="para340" class="elsevierStylePara elsevierViewall">In summary&#44; this experimental I&#47;R model showed us that intraperitoneal administration of SNP may be beneficial in reducing I&#47;R injury&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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        0 => array:2 [
          "identificador" => "xpalclavsec1585152"
          "titulo" => "KEYWORDS"
        ]
        1 => array:2 [
          "identificador" => "cesec10"
          "titulo" => "INTRODUCTION"
        ]
        2 => array:3 [
          "identificador" => "cesec20"
          "titulo" => "MATERIALS AND METHODS"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "cesec30"
              "titulo" => "Ethics"
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            1 => array:2 [
              "identificador" => "cesec40"
              "titulo" => "Study design"
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            2 => array:2 [
              "identificador" => "cesec50"
              "titulo" => "Pathological examination"
            ]
            3 => array:2 [
              "identificador" => "cesec60"
              "titulo" => "Tissue malonyldialdehyde &#40;MDA&#41; level"
            ]
            4 => array:2 [
              "identificador" => "cesec70"
              "titulo" => "Statistics"
            ]
          ]
        ]
        3 => array:3 [
          "identificador" => "cesec80"
          "titulo" => "RESULTS"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "cesec90"
              "titulo" => "Control Group"
            ]
            1 => array:2 [
              "identificador" => "cesec100"
              "titulo" => "I&#47;R Group"
            ]
            2 => array:2 [
              "identificador" => "cesec110"
              "titulo" => "SNP Group"
            ]
            3 => array:2 [
              "identificador" => "cesec120"
              "titulo" => "L-NAME Group"
            ]
            4 => array:2 [
              "identificador" => "cesec130"
              "titulo" => "SNP&#43;L-NAME Group"
            ]
          ]
        ]
        4 => array:2 [
          "identificador" => "cesec140"
          "titulo" => "DISCUSSION"
        ]
        5 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2007-10-03"
    "fechaAceptado" => "2007-10-25"
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          "clase" => "keyword"
          "titulo" => "KEYWORDS"
          "identificador" => "xpalclavsec1585152"
          "palabras" => array:5 [
            0 => "Ischemia"
            1 => "Reperfusion"
            2 => "Intestine"
            3 => "Sodium nitroprusside"
            4 => "Rat"
          ]
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      ]
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    "tieneResumen" => true
    "resumen" => array:1 [
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        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">AIM</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to investigate the efficacy of sodium nitroprusside in the reduction of the intestinal ischemia-reperfusion injury as a nitric oxide donor after intraperitoneal administration&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">METHODS</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">The histopathological examinations and tissue malonyldialdehyde levels of 35 Wistar albino rats that were subjected to ischemia-reperfusion&#44; were performed in 5 groups&#46; The groups include Control&#44; Ischemia-reperfusion&#44; Sodium nitroprusside&#44; NG-Nitro-L-Arginine Methyl Ester &#40;L-NAME&#41; and Sodium nitroprusside&#43;L-NAME&#46; Each rat was subjected to ischemia for 40 minutes and reperfusion for 30 minutes&#44; except the control group&#46; The medications were done intraperitoneally as saline 4 ml&#47;kg&#44; Sodium nitroprusside 5 mg&#47;kg&#44; L-NAME 10 mg&#47;kg just before reperfusions&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS</span><p id="spara100" class="elsevierStyleSimplePara elsevierViewall">Significant tissue injury in histological sections and an increase in tissue levels of Malonyldialdehyde was detected in the I&#47;R group&#46; The efficacy of intraperitoneal administration of Sodium nitroprusside in both Sodium nitroprusside alone and Sodium nitroprusside&#43;L-NAME groups was found statistically significant for the reducing of injury scores &#40;p&#60;0&#46;05&#41;&#46; The difference between the Ischemia&#47;reperfusion and Sodium nitroprusside groups was found statistically significant as in the Ischemia&#47;reperfusion and Sodium nitroprusside&#43;L-NAME groups due to the tissue Malonyldialdehyde levels &#40;p&#60;0&#46;05&#41;&#46; There was no statistical difference between Ischemia&#47;reperfusion and L-NAME groups&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">CONCLUSION</span><p id="spara110" class="elsevierStyleSimplePara elsevierViewall">Ischemia&#47;reperfusion induced injury might be reduced by the intraperitoneal administration of Sodium nitroprusside&#44; even in the presence of L-NAME&#44; in the rat intestinal model&#46;</p></span>"
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          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Histological appearance of the control group &#40;H&#38;E x 40&#41;&#46;</p>"
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          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Histological appearance of the I&#47;R group&#46; Villous epithelial separation&#44; luminal epithelial seeding and naked subepithelial areas &#40;H&#38;E x100&#41;&#46;</p>"
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          "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Histological appearance of the SNP group&#46; A contact epithelial lining except for some subepithelial spacings &#40;H&#38;E x 40&#41;&#46;</p>"
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          "en" => "<p id="spara40" class="elsevierStyleSimplePara elsevierViewall">Histological appearance of the L-NAME group&#46; Epithelial separations and luminal epithelial seeding is obvious &#40;H&#38;E x 40&#41;&#46;</p>"
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          "en" => "<p id="spara50" class="elsevierStyleSimplePara elsevierViewall">Histological appearance of the SNP&#43;L-NAME group&#46; An increase in the amount of subepithelial spaces and epithelial separations &#40;H&#38;E x100&#41;&#46;</p>"
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;Rat&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;Rat&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="center" 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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;Rat&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="center" 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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;Rat&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="center" 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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;Rat&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="center" 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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;Rat&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="center" 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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total Score&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="center" 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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Mean &#177; SD&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">0&#177;0&#46;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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">3&#46;28&#177;0&#46;48&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">1&#46;42&#177;0&#46;53&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">3&#46;28&#177;0&#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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">2&#46;0&#177;0&#46;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara60" class="elsevierStyleSimplePara elsevierViewall">The histological injury scores according to the criteria of Park and Chiu&#46;</p>"
        ]
      ]
      6 => array:7 [
        "identificador" => "tbl2"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "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" scope="col">Mean&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col">SD&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col">Minimum&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col">Maximum&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">Control group&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;71&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;38&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="center" valign="\n
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                  \t\t\t\t">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="center" valign="\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">I&#47;R group&#42;&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">7&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="center" valign="\n
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                  \t\t\t\t">14&#46;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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;50&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;00&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SNP group&#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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;85&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="center" 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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;00&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">L-NAME group&#42;&#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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;85&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;53&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;00&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SNP&#43;L-NAME group&#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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;27&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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#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="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara70" class="elsevierStyleSimplePara elsevierViewall">Tissue Malonyl dialdehyde levels of the groups &#40;nmol&#47;gr tissue&#41;&#46;</p>"
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      7 => array:5 [
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">Group 1 &#40;Control&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Laparatomy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Ischemia40 min&#46;&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="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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      "titulo" => "REFERENCES"
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        0 => array:2 [
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              "etiqueta" => "1"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schemes against ischemia&#59; solutions for reperfusion &#40;injury&#41;&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              PS Barie \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1097/00003246-199904000-00009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "1999"
                        "volumen" => "27"
                        "paginaInicial" => "684"
                        "paginaFinal" => "685"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10321649"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib2"
              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Oxygen radicals&#44; lipid peroxidation&#44; and permeability changes after intestinal ischemia and reperfusion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              JW Horton \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              PB Walker \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1993.74.4.1515"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1993"
                        "volumen" => "74"
                        "paginaInicial" => "1515"
                        "paginaFinal" => "1520"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8514664"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reperfusion injury after intestinal ischemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              MH Schoenberg \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              HG Beger \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1097/00003246-199309000-00023"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "1993"
                        "volumen" => "21"
                        "paginaInicial" => "1376"
                        "paginaFinal" => "1386"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8370303"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "titulo" => "Role of endogenous endothelin peptides in intestinal ischemia-reperfusion injury in rats"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              AZ Anadol \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              O Bayram \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              A Dursun \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              S Ercan \n
                              \t\t\t\t\t\t\t\t
                              """
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                      "Revista" => array:5 [
                        "tituloSerie" => "Prostaglandins Leucot Essent Fatty Acids"
                        "fecha" => "1998"
                        "volumen" => "59"
                        "paginaInicial" => "279"
                        "paginaFinal" => "283"
                      ]
                    ]
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              "etiqueta" => "5"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nitric oxide&#58; initiator and modulator"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              FP Nijkamp \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              G Folkerts \n
                              \t\t\t\t\t\t\t\t
                              """
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Allergy"
                        "fecha" => "1997"
                        "volumen" => "27"
                        "paginaInicial" => "347"
                        "paginaFinal" => "350"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9146924"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            5 => array:3 [
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              "etiqueta" => "6"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endothelial nitric oxide in humans in health and disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              P Vallance \n
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                              """
                            1 => """
                              A Hingorani \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1365-2613.1999.00137.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Exp Pathol"
                        "fecha" => "1999"
                        "volumen" => "80"
                        "paginaInicial" => "291"
                        "paginaFinal" => "303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10632779"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            6 => array:3 [
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              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Inhibition of intestinal lipid peroxidation does not minimize morphologic damage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              TM Van Ye \n
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                              """
                            1 => """
                              AM Roza \n
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                              """
                            2 => """
                              GM Pieper \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              J Henderson Jr \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              CP Johnson \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              MB Adams \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1006/jsre.1993.1183"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Surg Res"
                        "fecha" => "1993"
                        "volumen" => "55"
                        "paginaInicial" => "553"
                        "paginaFinal" => "558"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8231175"
                            "web" => "Medline"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "8"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "An evaluation of methods for grading histologic injury following ischemia&#47; reperfusion of the small bowel"
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                          "etal" => true
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                            0 => """
                              JS Quaedackers \n
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                              """
                            1 => """
                              RJ Beuk \n
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                              """
                            2 => """
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                              """
                            3 => """
                              A Charlton \n
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                              """
                            4 => """
                              MG oude Egbrink \n
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                              """
                            5 => """
                              AJ Gunn \n
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                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0041-1345(00)01238-0"
                      "Revista" => array:6 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10995960"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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                ]
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            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
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                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              M Uchiyama \n
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                              """
                            1 => """
                              M Mihara \n
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                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0003-2697(78)90342-1"
                      "Revista" => array:6 [
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                            "web" => "Medline"
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            9 => array:3 [
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              "etiqueta" => "10"
              "referencia" => array:1 [
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                  "contribucion" => array:1 [
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                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              H Sies \n
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                              """
                            1 => """
                              H de Groot \n
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                              """
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Toxicol Lett"
                        "fecha" => "1992"
                        "volumen" => "64&#8211;65"
                        "paginaInicial" => "547"
                        "paginaFinal" => "551"
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                  ]
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

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