was read the article
array:19 [ "pii" => "X1665579614676005" "issn" => "16655796" "estado" => "S300" "fechaPublicacion" => "2014-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Medicina Universitaria. 2014;16:161-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1812 "formatos" => array:3 [ "EPUB" => 46 "HTML" => 1251 "PDF" => 515 ] ] "itemSiguiente" => array:15 [ "pii" => "X1665579614676013" "issn" => "16655796" "estado" => "S300" "fechaPublicacion" => "2014-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Medicina Universitaria. 2014;16:165-70" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4322 "formatos" => array:3 [ "EPUB" => 64 "HTML" => 3370 "PDF" => 888 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Nutritional screening and prevalence of hospital malnutrition risk. University Hospital of the UANL, Monterrey" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "165" "paginaFinal" => "170" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Patricia R. Áncer-Rodríguez, Carmen Porrata-Mauri, Manuel Hernández-Triana, Karla Salinas-Zamora, Verónica Bernal-García, Samantha Trejo-Guzmán, Blanca González-García, Mayra Herrera-López, Anel de la Torre-Salinas, Clemente Rojas-Ramírez, Dionicio A. Galarza-Delgado" "autores" => array:11 [ 0 => array:2 [ "nombre" => "Patricia R." "apellidos" => "Áncer-Rodríguez" ] 1 => array:2 [ "nombre" => "Carmen" "apellidos" => "Porrata-Mauri" ] 2 => array:2 [ "nombre" => "Manuel" "apellidos" => "Hernández-Triana" ] 3 => array:2 [ "nombre" => "Karla" "apellidos" => "Salinas-Zamora" ] 4 => array:2 [ "nombre" => "Verónica" "apellidos" => "Bernal-García" ] 5 => array:2 [ "nombre" => "Samantha" "apellidos" => "Trejo-Guzmán" ] 6 => array:2 [ "nombre" => "Blanca" "apellidos" => "González-García" ] 7 => array:2 [ "nombre" => "Mayra" "apellidos" => "Herrera-López" ] 8 => array:2 [ "nombre" => "Anel" "apellidos" => "de la Torre-Salinas" ] 9 => array:2 [ "nombre" => "Clemente" "apellidos" => "Rojas-Ramírez" ] 10 => array:2 [ "nombre" => "Dionicio A." "apellidos" => "Galarza-Delgado" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X1665579614676013?idApp=UINPBA00004N" "url" => "/16655796/0000001600000065/v0_201607061452/X1665579614676013/v0_201607061452/en/main.assets" ] "itemAnterior" => array:15 [ "pii" => "X1665579614675994" "issn" => "16655796" "estado" => "S300" "fechaPublicacion" => "2014-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Medicina Universitaria. 2014;16:156-60" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2610 "formatos" => array:3 [ "EPUB" => 52 "HTML" => 1921 "PDF" => 637 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Impact of a fall prevention program in the Internal Medicine wards of a tertiary care university hospital" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "156" "paginaFinal" => "160" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "304v16n65-90367599fig4.jpg" "Alto" => 845 "Ancho" => 1529 "Tamanyo" => 115013 ] ] "descripcion" => array:1 [ "en" => "Number of falls and days/ patients per year since 2007 up to 2013, as well as the 1000 days/patient rate." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Reynaldo Lara-Medrano, Carlos Alcázar-Quiñones, Dionicio Ángel Galarza-Delgado, Laura Baena-Trejo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Reynaldo" "apellidos" => "Lara-Medrano" ] 1 => array:2 [ "nombre" => "Carlos" "apellidos" => "Alcázar-Quiñones" ] 2 => array:2 [ "nombre" => "Dionicio Ángel" "apellidos" => "Galarza-Delgado" ] 3 => array:2 [ "nombre" => "Laura" "apellidos" => "Baena-Trejo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X1665579614675994?idApp=UINPBA00004N" "url" => "/16655796/0000001600000065/v0_201607061452/X1665579614675994/v0_201607061452/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "titulo" => "Ratio of hemocomponents in massive transfusion and mortality of trauma patients in a university hospital" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "161" "paginaFinal" => "164" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Felipe Mercado-del Angel, Rogelio Cazares-Tamez, Carlos G. Díaz-Olachea, Fernando Pérez-Chavez" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Felipe" "apellidos" => "Mercado-del Angel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Rogelio" "apellidos" => "Cazares-Tamez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "nombre" => "Carlos G." "apellidos" => "Díaz-Olachea" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] 3 => array:3 [ "nombre" => "Fernando" "apellidos" => "Pérez-Chavez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Clinical Pathology, Dr. José Eleuterio González University Hospital, UANL, Monterrey, Nuevo León, México" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Department of Clinical Pathology, Hospital San José, Monterrey, Nuevo León, México " "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "304v16n65-90367600fig4.jpg" "Alto" => 854 "Ancho" => 1529 "Tamanyo" => 78226 ] ] "descripcion" => array:1 [ "en" => "Kaplan-Meier survival curve. FFP: fresh frozen plasma." ] ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Introduction </span></p><p class="elsevierStylePara"> The need for massive transfusion in an acute hemorrhage is catalogued as one of the most important risk factors for death among multiple trauma patients.<span class="elsevierStyleSup">1</span> Massive transfusion is defined as the reposition of the blood volume in 24 h or 7% of the ideal weight in adults or 9% in children; however, there are different definitions like a replacement higher than 50% of the blood volume in 3 h, or more practical definitions like the transfusion of over 4 PRBC in 1 h, or over 10 units of PRBC in a period of 24 h.<span class="elsevierStyleSup">2</span></p><p class="elsevierStylePara"> In the first studies in which massive transfusion was linked to mortality the numbers were close to 90%,<span class="elsevierStyleSup">3</span> even nowadays rates between 30% and 70% continue to be reported.<span class="elsevierStyleSup">4,5</span> Therefore, massive hemorrhage morbi-mortality remains unacceptably high, and thus new therapeutic schemes have been suggested in the last decade with the purpose of increasing survival.<span class="elsevierStyleSup">6</span> The institution of these massive transfusion protocols has brought benefits and they have been attributed mainly to keeping a close or equivalent ratio to fresh frozen plasma (FFP) in relation to red blood cells (RBC) transfused.<span class="elsevierStyleSup">7</span></p><p class="elsevierStylePara"> Even though each hemoderivate has precise indications, the circumstances of the bleeding (with or without tissue damage) determine the different transfusion thresholds.<span class="elsevierStyleSup">8</span> One of the main challenges in the timely reinstitution with hemocomponents is also the identification of the patient who will have massive transfusion and the prediction of transfusion requirements.<span class="elsevierStyleSup">9</span></p><p class="elsevierStylePara"> Nowadays the frequency of massive hemorrhages in our country varies greatly and there are few studies in our field, which confirms the need to institute these protocols. Few institutions have standardized massive transfusion protocols. The objective of the present study is to describe mortality and the use of RBC:FFP ratio in trauma patients subject to massive transfusion, as well as to detect factors associated with morbidity and mortality.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Materials and methods </span></p><p class="elsevierStylePara"> A retrospective analysis of acute hemorrhage patients within the shock-trauma area was performed. Patients who had transfusions of 10 or more PRBC in a period of less than 24 h from october 1st 2010 to october 30th 2012 were evaluated. Acute hemorrhage and massive transfusion patients were recruited through the blood bank’s CiBank V1.0<span class="elsevierStyleSup">®</span> (TDI) operative system, excluding patients who were under 15 years old, patients with neoplastic diseases, and patients with previous chronic diseases. RBC:FFP ratio was obtained for each case (i.e. 10 RBC + 5 FFP = 10 / 5 = 2 ratio) and the population was divided into three different groups, those with an RBC:FFP rate ≤2, another group where the RBC:FFP ratio was >2 and a third group which did not receive FFP during massive transfusion. Patients’ characteristics were described according to age, gender and diagnosis (admission and injury), both diagnoses were evaluated in percentage and divided according the type of injury: vital organ injury grades 3 to 5 according to the American Association for the Surgery of Trauma Organ Injury Scale,<span class="elsevierStyleSup">10</span> severe head injury (SHI), larger-caliber vessel and other injuries. This last group was formed by patients with multiple fractures and limb amputations. Mortality and/or survival rates after 30 days and the amount of in-patient days after the event were evaluated. Factors associated with the hemorrhagic event, like systolic blood pressure (SBP) during transfusion and the presence of metabolic acidosis, as well as the number of PRBC and fresh frozen plasmas transfused, were analyzed. A chart representing survival rates up to 30 days after the event was created using the Kaplan-Meier curve, and an evaluation of the difference between groups using the log-rank test was performed, using mean and median as central tendency measurements and standard deviation and inter-quartile ranges as dispersion measurements. The x<span class="elsevierStyleSup">2</span> test was used for qualitative variables, and one-way ANOVA was used for differences between groups in the case of three groups. The Mann-Whitney U test was used as well in the case of two groups with a non-parametric distribution. The SPSS v.20 statistical program was used.</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results </span></p><p class="elsevierStylePara"> A total of 83 registries of patients with massive transfusions were obtained, excluding 9 patients with neoplastic diseases, 4 with previous chronic disease, and 1 younger than 15 years old. A total of 69 patients were included in the study with admission diagnoses distributed as follows: 37 trauma patients, 28 gunshot wounds and 4 with lacerated wounds. The average age was 33 years old, the majority of whom were male (84%). The groups were divided as follows: groups’ ratios ≤2 with 30 patients, ratios >2 with 30 patients and the no-plasma group with 9 patients (table 1). Diagnoses according to the type of injury and their comparison between groups are shown in tables 2 and 3. Mortality at 30 days resulted in 56.6% for the ratio ≤2 group just as in the ratio >2 group with 56.6% and 88% for the group without FFP (figure 1); obtaining an overall mortality of 60.8%. A distinctly lower survival rate of 12% was observed during the first 24 h in the group of patients who did not receive FFP (<span class="elsevierStyleItalic">P</span>=.015) showing a significant difference with respect to the other groups. The other two groups (>2 and ≤2) showed no differences (figure 1). Systolic blood pressure during transfusion within the no-plasma group had a mean of 67.7 mmHg proving a difference from the other two groups (<span class="elsevierStyleItalic">P</span>=.012) which presented means of 90 and 92 mmHg (table 1). 85.5% of the patients presented metabolic acidosis during the transfusion. The mean for the amount of in-hospital days was 24.5, without a significant difference among the groups, keeping in mind that in the no-plasma group only 1 patient survived longer than 24 h thus he was not included in the Days of hospital Stay (DOHS) analysis.</p><p class="elsevierStylePara"><img alt="Table 1 Characteristics and associated variables" src="304v16n65-90367600fig1.jpg"></img></p><p class="elsevierStylePara"><img alt="Table 2 Injuries of deceased patients" src="304v16n65-90367600fig2.jpg"></img></p><p class="elsevierStylePara"><img alt="Table 3 Injuries of living patients" src="304v16n65-90367600fig3.jpg"></img></p><p class="elsevierStylePara"><img alt="Figure 1 Kaplan-Meier survival curve. FFP: fresh frozen plasma." src="304v16n65-90367600fig4.jpg"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Figure </span>1 Kaplan-Meier survival curve. FFP: fresh frozen plasma.</p><p class="elsevierStylePara"> Regarding transfusions, 136 units were transfused for the >2 group and 249 units for the ≤2 group (<span class="elsevierStyleItalic">P</span><.01) with means of 4.5 and 8.3, and medians of 4 and 7.5 respectively (<span class="elsevierStyleItalic">P</span><.01). RBC transfusion did not show significant difference between the groups (<span class="elsevierStyleItalic">P</span>=.748) (table 1).</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Discussion </span></p><p class="elsevierStylePara"> Nowadays high mortality rates related to massive transfusions are still reported in our field. Therefore, we suggest through this study the use of FFP in massive transfusions, the above as a consequence of obtained results of different RBC:FFP ratios which suggest that FFP transfusion in similar amounts to RBC transfused could improve survival rates at 24 h and at 30 days after the hemorrhagic event. In our survival chart at the end of follow-up there wasn’t a statistically significant difference between the >2 group and the ≤2 group, we can see a slight tendency favoring survival rates in the ≤2 RBC:FFP ratio, but this could be a result of 5 of the patients in the ratio >2 group having a severe head injury diagnosis (table 2) which may cause a bias in this tendency.</p><p class="elsevierStylePara"> It is difficult to affirm the participation of FFP in the hemodynamic state of these types of patients, however looking at our results and the differences regarding SBP between the no-plasma group and the other two groups, and knowing the role FFP plays in reducing endothelial vascular permeability in patients with hemorrhagic shock,<span class="elsevierStyleSup">11</span> suggests its implication as a helper in hemodynamic stabilization of massive hemorrhage patients.</p><p class="elsevierStylePara"> Additionally we stress the importance of the identification of metabolic deterioration, such as acidosis, present in most patients who undergo massive transfusion, knowing that patients at the beginning of crystalloid reanimation are administered large volumes of isotonic saline solution (Na<span class="elsevierStyleSup">+</span>Cl<span class="elsevierStyleSup">–</span> 0.9%) with the purpose of expanding intravascular volume in massive bleeding, conditioning us to a hyperchloremic metabolic acidosis.<span class="elsevierStyleSup">12</span></p><p class="elsevierStylePara"> Currently in Mexico the guidelines for massive transfusions suggest the administration of the blood components in deficit according to the patient’s clinical evolution and the results of the coagulation tests,<span class="elsevierStyleSup">13</span> thus through this study we promote an update of the guidelines with a reference to massive transfusions. On the other hand, international studies suggest sticking as closely as possible to a 1:1 ratio (RBC:FFP) in order to reduce mortality at least in the first 24 h.<span class="elsevierStyleSup">14</span></p><p class="elsevierStylePara"> Therefore, after having identified in this document the main risks of the patients undergoing massive transfusions in our hospital, we also suggest the institution of standardized protocols which closely stick to international transfusion guidelines. It is important to note that the use of FFP is relevant for the attention of these patients and acknowledging the challenge that the prediction of the use of timely restitution with hemoderivatives implies, we recommend the use of prediction scores like the TASH as part of the algorithm for massive hemorrhage diagnosis,<span class="elsevierStyleSup">15</span> as well as the use of thawed plasma with the purpose of shortening the availability times of said component,<span class="elsevierStyleSup">16</span> moreover it is necessary to insist on the need of prospective studies with variable adjustment like the severity of the injury in trauma patients. Massive transfusion is in many cases inevitable; recognizing the risk that comes along with this practice allows us to establish a treatment preventive protocol in which fresh plasma seems to play a very important role.</p><hr></hr><p class="elsevierStylePara"> Received: January 2014; <br></br> Accepted: July 2014</p><p class="elsevierStylePara"> *Corresponding author: <br></br> Departamento de Patología Clínica, <br></br> Hospital Universitario “Dr. José Eleuterio González” de la UANL. <br></br> Ave. Francisco I. Madero s/n y Ave. Gonzalitos, <br></br> Col. Mitras Centro, Monterrey, <br></br> Nuevo León, México C. P. 64460. <br></br><span class="elsevierStyleItalic">E-mail addresses: </span><a href="mailto:felipe_1411@msn.com" class="elsevierStyleCrossRefs">felipe_1411@msn.com</a>; <a href="mailto:felipe.mercadodelangel@gmail.com" class="elsevierStyleCrossRefs">felipe.mercadodelangel@gmail.com</a> (F. Mercado del Angel).</p>" "pdfFichero" => "304v16n65a90367600pdf001.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec686838" "palabras" => array:3 [ 0 => "Massive transfusion" 1 => "Mortality" 2 => "Fresh frozen plasma" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:1 [ "resumen" => "<p class="elsevierStylePara"> <span class="elsevierStyleItalic">Background:</span> Nowadays, there are very few studies about massive transfusion in our country. This situation generates the necessity to the elevation of possible new strategies to diminish mortality and its adverse effects.</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">Material and methods:</span> All massive transfusions were evaluated in a retrospective way from October 2010 to October 2012. All diagnosis groups were recorded and the patients were divided into three groups depending on the ratio between packed red blood cells (PRBC) and fresh frozen plasma (FFP) units (ratios ≤2, >2, and without FFP). Their mortality and/or survival were evaluated 30 days after as well as all the factors associated with the event.</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">Results:</span> A total of 69 patients were included (37 trauma patients, 28 gunshot wounds and 4 with lacerated wounds); the groups (ratios ≤2, >2, and no plasma at all) were distributed as follows: 30, 30 and 9 patients each, with an overall mortality rate of 60.8% within 30 days. A lower survival rate (12%) in the no plasma group (<span class="elsevierStyleItalic">P</span>=.015) was found and systolic blood pressure during transfusion had a mean of 67.7 mmHg (<span class="elsevierStyleItalic">P</span>=.012) in this group. Fresh frozen plasma units were 136 and 249 for >2 and ≤2 ratios respectively (<span class="elsevierStyleItalic">P</span><.01); 85.5% of all patients developed metabolic acidosis during the transfusion, and the number of days in the hospital after the event had a mean of 24.5 days in all patients.</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">Conclusions:</span> High rates of massive transfusion mortality are still being reported in our field. The use of transfusion strategies contribute to elevate the survival rate in patients with massive transfusion treatment.</p>" ] ] "multimedia" => array:8 [ 0 => array:8 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "304v16n65-90367600fig1.jpg" "imagenAlto" => 887 "imagenAncho" => 2104 "imagenTamanyo" => 204126 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Characteristics and associated variables" ] ] 1 => array:8 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "304v16n65-90367600fig2.jpg" "imagenAlto" => 566 "imagenAncho" => 2104 "imagenTamanyo" => 95970 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Injuries of deceased patients" ] ] 2 => array:8 [ "identificador" => "tbl3" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "304v16n65-90367600fig3.jpg" "imagenAlto" => 575 "imagenAncho" => 2100 "imagenTamanyo" => 88926 ] ] ] ] ] "descripcion" => array:1 [ "en" => "Injuries of living patients" ] ] 3 => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "304v16n65-90367600fig4.jpg" "Alto" => 854 "Ancho" => 1529 "Tamanyo" => 78226 ] ] "descripcion" => array:1 [ "en" => "Kaplan-Meier survival curve. FFP: fresh frozen plasma." ] ] 4 => array:7 [ "identificador" => "tbl4" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "descripcion" => array:1 [ "en" => "Characteristics and associated variables" ] ] 5 => array:7 [ "identificador" => "tbl5" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "descripcion" => array:1 [ "en" => "Injuries of deceased patients" ] ] 6 => array:7 [ "identificador" => "tbl6" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "descripcion" => array:1 [ "en" => "Injuries of living patients" ] ] 7 => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "descripcion" => array:1 [ "en" => "Kaplan-Meier survival curve. FFP: fresh frozen plasma." ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Epidemiology of urban trauma deaths: a comprehensive reassessment 10 years later. World J Surg. 2007;31:1507-11. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Epidemiology of urban trauma deaths: a comprehensive reassessment 10 years later." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Cothren CC" 1 => "Moore EE" 2 => "Hedegaard HB" 3 => "Meng K." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00268-007-9087-2" "Revista" => array:6 [ "tituloSerie" => "World J Surg. " "fecha" => "2007" "volumen" => "31" "paginaInicial" => "1507" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17505854" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Massive transfusion practices around the globe and a sug-gestion for a common massive transfusion protocol. J Trauma. 2006;60:S91-6. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Massive transfusion practices around the globe and a sug-gestion for a common massive transfusion protocol." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Malone DL" 1 => "Hess JR" 2 => "Fingerhut A." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.ta.0000199549.80731.e6" "Revista" => array:6 [ "tituloSerie" => "J Trauma. " "fecha" => "2006" "volumen" => "60" "paginaInicial" => "S91" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16763487" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Eight years of experience with massive blood transfusions. J Trauma. 1971;11:275-85. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Eight years of experience with massive blood transfusions." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Wilson RF" 1 => "Mammen E" 2 => "Walt AJ." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Trauma. " "fecha" => "1971" "volumen" => "11" "paginaInicial" => "275" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5313649" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Improved survival following massive transfusion in patients who have undergone trauma. Arch Surg. 1999;134:964-8. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Improved survival following massive transfusion in patients who have undergone trauma." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Cinat ME" 1 => "WallaceWC" 2 => "Nastanski F" 3 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Surg. " "fecha" => "1999" "volumen" => "134" "paginaInicial" => "964" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10487591" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The independent association of massive blood loss with mortality in cardiac surgery. Transfusion. 2004;44:1453-62. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The independent association of massive blood loss with mortality in cardiac surgery." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Karkouti K" 1 => "Wijeysundera DN" 2 => "Yau TM" 3 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1537-2995.2004.04144.x" "Revista" => array:6 [ "tituloSerie" => "Transfusion. " "fecha" => "2004" "volumen" => "44" "paginaInicial" => "1453" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15383018" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Alternativas terapéuticas de la hemorragia masiva. Med Intensiva. 2012;36:496-503. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Alternativas terapéuticas de la hemorragia masiva." "idioma" => "pt" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Fernández-Hinojosa E" 1 => "Murillo-Cabezas F" 2 => "Puppo-Moreno A" 3 => "Leal-Noval SR." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2011.11.010" "Revista" => array:6 [ "tituloSerie" => "Med Intensiva. " "fecha" => "2012" "volumen" => "36" "paginaInicial" => "496" "paginaFinal" => "503" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22321860" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Blood product use in trauma resuscitation: plasma deficit versus plasma ratio as predictors of mortality in trauma. Transfusion. 2011;51:1925-32. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Blood product use in trauma resuscitation: plasma deficit versus plasma ratio as predictors of mortality in trauma." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "De Biasi AR" 1 => "Stansbury LG" 2 => "Dutton RP" 3 => "Stein DM" 4 => "Scalea TM" 5 => "Hess JR." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1537-2995.2010.03050.x" "Revista" => array:6 [ "tituloSerie" => "Transfusion. " "fecha" => "2011" "volumen" => "51" "paginaInicial" => "1925" "paginaFinal" => "32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21332727" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "El paciente crítico víctima de trauma. Med Urg México. 2012;4:26-41. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "El paciente crítico víctima de trauma." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Velázquez Alcántara JI" 1 => "Russi Hernández M" 2 => "Loría Castellanos J." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Urg México. " "fecha" => "2012" "volumen" => "4" "paginaInicial" => "26" "paginaFinal" => "41" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The effect of FFP: RBC ratio on morbility and mortality in trauma patients based on transfusion prediction score. Vox Sanguinis. 2011;101:44-54. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The effect of FFP: RBC ratio on morbility and mortality in trauma patients based on transfusion prediction score." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Borgman MA" 1 => "Spinella PC" 2 => "Holcomb JB" 3 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1423-0410.2011.01466.x" "Revista" => array:6 [ "tituloSerie" => "Vox Sanguinis. " "fecha" => "2011" "volumen" => "101" "paginaInicial" => "44" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21438884" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Scaling system for organ specific injuries. Curr Opin Crit Care. 1996;2:450-62. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Scaling system for organ specific injuries." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Moore EE" 1 => "Cogbill TH" 2 => "Malangoni M" 3 => "Jurkovich GJ" 4 => "Champion HR." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Curr Opin Crit Care. " "fecha" => "1996" "volumen" => "2" "paginaInicial" => "450" "paginaFinal" => "62" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Protective effects of fresh frozen plasma on vascular endothelial permeability, coagulation, and resuscitation after hemorrhagic shock are time dependent and diminish between days 0 and 5 after thaw. J Trauma. 2010;69 Suppl 1:S55-63. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Protective effects of fresh frozen plasma on vascular endothelial permeability, coagulation, and resuscitation after hemorrhagic shock are time dependent and diminish between days 0 and 5 after thaw." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Pati S" 1 => "Matijevic N." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/TA.0b013e3181e453d4" "Revista" => array:6 [ "tituloSerie" => "J Trauma. " "fecha" => "2010" "volumen" => "69 Suppl 1" "paginaInicial" => "S55" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20622621" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Transfusión masiva y manejo del paciente traumatizado: enfoque fisiopatológico del tratamiento. Cir Cir. 2011;79:473-80. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Transfusión masiva y manejo del paciente traumatizado: enfoque fisiopatológico del tratamiento." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Zunini-Fernández G" 1 => "Rando-Huluk K" 2 => "Martínez-Pelayo FJ" 3 => "Castillo-Trevizo AL." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cir Cir. " "fecha" => "2011" "volumen" => "79" "paginaInicial" => "473" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22385770" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Secretaria de Salud. 3.a ed. México: Secretaria de Salud, Asociación Mexicana de Medicina Transfusional, A.C., Agrupación Mexicana para el Estudio de la Hematología, A.C.; 2007. p.135-64. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Secretaria de Salud. 3.a ed. México: Secretaria de Salud, Asociación Mexicana de Medicina Transfusional, A.C., Agrupación Mexicana para el Estudio de la Hematología, A." "idioma" => "es" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Guía para el uso clínico de la sangre." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "C. " "volumen" => "2007. p.135-64" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study. JAMA Surg. 2013;148:127-36. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Holcomb JB" 1 => "Del Junco JD" 2 => "Fox EE" 3 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/2013.jamasurg.387" "Revista" => array:6 [ "tituloSerie" => "JAMA Surg. " "fecha" => "2013" "volumen" => "148" "paginaInicial" => "127" "paginaFinal" => "36" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23560283" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Predictive models and algorithms for the need of transfusion including massive transfusion in severely injured patients. Transfus Med Hemother. 2012;39:85-97. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Predictive models and algorithms for the need of transfusion including massive transfusion in severely injured patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Maegele M" 1 => "Brockamp T" 2 => "Nienaberc U" 3 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "000337243" "Revista" => array:6 [ "tituloSerie" => "Transfus Med Hemother. " "fecha" => "2012" "volumen" => "39" "paginaInicial" => "85" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22670126" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "An emergency department thawed plasma protocol for severely injured patients. JAMA Surg. 2013;148:170-5. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "An emergency department thawed plasma protocol for severely injured patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Radwan ZA" 1 => "Bai Y" 2 => "Matijevic N" 3 => "Del Junco DJ" 4 => "McCarthy JJ" 5 => "Wade CE" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamasurgery.2013.414" "Revista" => array:6 [ "tituloSerie" => "JAMA Surg. " "fecha" => "2013" "volumen" => "148" "paginaInicial" => "170" "paginaFinal" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23426594" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/16655796/0000001600000065/v0_201607061452/X1665579614676005/v0_201607061452/en/main.assets" "Apartado" => array:4 [ "identificador" => "55396" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/16655796/0000001600000065/v0_201607061452/X1665579614676005/v0_201607061452/en/304v16n65a90367600pdf001.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X1665579614676005?idApp=UINPBA00004N" ]
Original language: English
Year/Month | Html | Total | |
---|---|---|---|
2024 November | 3 | 1 | 4 |
2024 October | 19 | 5 | 24 |
2024 September | 40 | 8 | 48 |
2024 August | 22 | 12 | 34 |
2024 July | 20 | 5 | 25 |
2024 June | 19 | 6 | 25 |
2024 May | 7 | 3 | 10 |
2024 April | 15 | 8 | 23 |
2024 March | 23 | 5 | 28 |
2024 February | 27 | 8 | 35 |
2024 January | 17 | 5 | 22 |
2023 December | 20 | 8 | 28 |
2023 November | 29 | 5 | 34 |
2023 October | 22 | 6 | 28 |
2023 September | 16 | 5 | 21 |
2023 August | 16 | 8 | 24 |
2023 July | 6 | 7 | 13 |
2023 June | 13 | 3 | 16 |
2023 May | 23 | 6 | 29 |
2023 April | 7 | 2 | 9 |
2023 March | 9 | 8 | 17 |
2023 February | 12 | 2 | 14 |
2023 January | 8 | 2 | 10 |
2022 December | 15 | 5 | 20 |
2022 November | 16 | 19 | 35 |
2022 October | 15 | 10 | 25 |
2022 September | 11 | 7 | 18 |
2022 August | 21 | 10 | 31 |
2022 July | 12 | 7 | 19 |
2022 June | 9 | 16 | 25 |
2022 May | 21 | 8 | 29 |
2022 April | 28 | 10 | 38 |
2022 March | 33 | 16 | 49 |
2022 February | 20 | 6 | 26 |
2022 January | 41 | 6 | 47 |
2021 December | 26 | 12 | 38 |
2021 November | 55 | 9 | 64 |
2021 October | 52 | 10 | 62 |
2021 September | 40 | 11 | 51 |
2021 August | 57 | 10 | 67 |
2021 July | 85 | 7 | 92 |
2021 June | 27 | 15 | 42 |
2021 May | 31 | 12 | 43 |
2021 April | 83 | 38 | 121 |
2021 March | 65 | 15 | 80 |
2021 February | 43 | 13 | 56 |
2021 January | 35 | 15 | 50 |
2020 December | 45 | 9 | 54 |
2020 November | 39 | 11 | 50 |
2020 October | 21 | 20 | 41 |
2020 September | 13 | 10 | 23 |
2020 August | 20 | 9 | 29 |
2020 July | 19 | 7 | 26 |
2020 June | 23 | 6 | 29 |
2020 May | 28 | 12 | 40 |
2020 April | 22 | 4 | 26 |
2020 March | 31 | 6 | 37 |
2020 February | 22 | 5 | 27 |
2020 January | 16 | 15 | 31 |
2019 December | 26 | 14 | 40 |
2019 November | 21 | 7 | 28 |
2019 October | 26 | 4 | 30 |
2019 September | 18 | 4 | 22 |
2019 August | 27 | 5 | 32 |
2019 July | 22 | 13 | 35 |
2019 June | 49 | 9 | 58 |
2019 May | 63 | 41 | 104 |
2019 April | 33 | 6 | 39 |
2019 March | 8 | 1 | 9 |
2019 February | 10 | 5 | 15 |
2019 January | 8 | 3 | 11 |
2018 December | 4 | 3 | 7 |
2018 November | 8 | 4 | 12 |
2018 October | 9 | 7 | 16 |
2018 September | 5 | 5 | 10 |
2018 August | 5 | 0 | 5 |
2018 July | 8 | 2 | 10 |
2018 June | 3 | 0 | 3 |
2018 May | 8 | 1 | 9 |
2018 April | 2 | 0 | 2 |
2018 March | 5 | 0 | 5 |
2018 February | 2 | 0 | 2 |
2018 January | 9 | 0 | 9 |
2017 December | 5 | 0 | 5 |
2017 November | 7 | 0 | 7 |
2017 October | 6 | 1 | 7 |
2017 September | 5 | 2 | 7 |
2017 August | 7 | 0 | 7 |
2017 July | 8 | 1 | 9 |
2017 June | 13 | 8 | 21 |
2017 May | 15 | 5 | 20 |
2017 April | 10 | 4 | 14 |
2017 March | 16 | 19 | 35 |
2017 February | 14 | 0 | 14 |
2017 January | 5 | 4 | 9 |
2016 December | 9 | 0 | 9 |
2016 November | 15 | 1 | 16 |
2016 October | 17 | 0 | 17 |
2016 September | 7 | 1 | 8 |
2016 August | 18 | 1 | 19 |
2016 July | 10 | 1 | 11 |
2016 June | 31 | 6 | 37 |
2016 May | 28 | 15 | 43 |
2016 April | 27 | 12 | 39 |
2016 March | 33 | 15 | 48 |
2016 February | 38 | 19 | 57 |
2016 January | 24 | 17 | 41 |
2015 December | 26 | 16 | 42 |
2015 November | 25 | 15 | 40 |
2015 October | 27 | 15 | 42 |
2015 September | 31 | 13 | 44 |
2015 August | 39 | 12 | 51 |
2015 July | 29 | 12 | 41 |
2015 June | 21 | 13 | 34 |
2015 May | 85 | 42 | 127 |
2015 April | 42 | 21 | 63 |
2015 March | 25 | 18 | 43 |
2015 February | 44 | 19 | 63 |
2015 January | 44 | 18 | 62 |
2014 December | 41 | 15 | 56 |