Scientific Letter
Use of antipyretics in paediatric emergencies
Uso de antipiréticos en urgencias pediátricas
A. Velasco Aznara, M.E. Rendón-Macíasa,b,
, J. Iglesias-Leboreiroa,c, I. Bernárdez-Zapataa,c
Corresponding author
a Universidad La Salle, Facultad Mexicana de Medicina, División de Postgrado, México Distrito Federal, Mexico
b Unidad de Investigación en Epidemiología Clínica UMAE, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México Distrito Federal, Mexico
c Hospital Español de México, División de Pediatría, México Distrito Federal, Mexico
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Se consideró: adición si, al esquema inicial, se agregó otro antipirético; reducción, cuando inicialmente fueron más de 2 y al final hubo menos de los antipiréticos indicados al inicio; cambio, cuando el esquema final fue diferente en al menos uno o todos los antipiréticos; retiro, cuando se suspendió (suspendieron) el (los) antipirético(s); preingreso y al egreso igual cuando solo durante la hospitalización se cambió el esquema de antipiréticos. Diferencia entre grupos sin antipiresis previa χ<span class="elsevierStyleSup">2</span> 3,9<span class="elsevierStyleInf">8gl</span> p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,90; con antipiresis previa χ<span class="elsevierStyleSup">2</span> 31,5<span class="elsevierStyleInf">10gl</span> p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,0005.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Velasco Aznar, M.E. 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Velasco Aznar, M.E. Rendón-Macías, J. Iglesias-Leboreiro, I. Bernárdez-Zapata" "autores" => array:4 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Velasco Aznar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "M.E." "apellidos" => "Rendón-Macías" "email" => array:1 [ 0 => "drmariorendon@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "J." 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"apellidos" => "Bernárdez-Zapata" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Universidad La Salle, Facultad Mexicana de Medicina, División de Postgrado, México Distrito Federal, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Investigación en Epidemiología Clínica UMAE, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México Distrito Federal, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Español de México, División de Pediatría, México Distrito Federal, Mexico" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Uso de antipiréticos en urgencias pediátricas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2450 "Ancho" => 2917 "Tamanyo" => 342393 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Distribution of the modifications in antipyretic management by age group and depending on whether the patient had received prehospital antipyresis (first three bars) or not (last three bars). The modifications considered were: addition, if other agent(s) were added to the original prescription; reduction, if the original treatment consisted of two or more agents and the discharge prescription included fewer of them; change, if the final prescription differed in at least one to all the antipyretic agents; withdrawal, if antipyretic treatment was discontinued completely; same prehospital and discharge when the antipyresis scheme was only modified during the hospital stay. The difference between groups without prehospital antipyresis was <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.9; df<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.90; and the difference between groups with prehospital antipyresis was <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>31.5; df<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>10; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.0005.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Although fever has beneficial effects, its control is recommended due to the general malaise associated with it.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Its presentation leads parents to seek emergency services due to fear of seizures, brain damage or severe disease.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Good clinical practise guidelines (GCPGs) recommend controlling fever by physical methods and the administration of antipyretics to improve the wellbeing of the child.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a> However, surveys of doctors reveal indications for their use that are not recommended.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4,5</span></a> To evaluate this behaviour prospectively, we analysed the prescription of antipyretic drugs in a paediatric emergency room.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The study protocol was approved by the local committee for research and ethics. We recruited 181 patients younger than 16 years, previously healthy, that had acute fever (<72<span class="elsevierStyleHsp" style=""></span>h) in their first visit to the emergency department and discharged in less than 24<span class="elsevierStyleHsp" style=""></span>h without fever. The paediatrician in charge made the treatment decisions. Risky indications were reported, and it was ensured that the doses administered were given at the correct dosage.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We analysed age, sex, administration of prehospital medication, history of febrile seizures and reason for seeking care, medication(s) administered at the hospital, and medication(s) prescribed at discharge. We analysed changes by age group. The changes considered were: (1) no changes; (2) addition: to antipyretic agent(s) given prehospital or at the hospital; (3) substitution: the prescription at discharge differed in at least one antipyretic agent from previous prescription; (4) reduction: the number of antipyretics prescribed at discharge was lower; (5) withdrawal of antipyretics at discharge; and (6) same treatment before admission and at discharge, with changes in antipyretic prescription only at the emergency room.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We performed the statistical analysis using absolute frequencies and percentages, comparing variables with the <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span> test, analysis of variance and the nonparametric Kruskal–Wallis test as applicable. We set the level of statistical significance at <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The main reasons for seeking care were respiratory and gastrointestinal infections. The former predominated in infants and preschoolers, and the latter in schoolchildren and adolescents (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The number of patients that received prehospital antipyretic treatment was 130 (71.8%); this proportion was higher in infants (78.1%) and preschoolers (76.7%) than in schoolchildren and adolescents (57.4%) (<span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>6.9; df<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.03). The most common pattern was prescription of a single antipyretic agent (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>93), but two alternating agents were prescribed in 25.3% (33/180) of patients, and more than two in four patients. The most frequently prescribed agents were paracetamol and ibuprofen (in monotherapy or alternating). In infants it was paracetamol (43.8%), as opposed to ibuprofen in preschoolers (54%) and schoolchildren and adolescents (64.7%).</p><p id="par0035" class="elsevierStylePara elsevierViewall">All patients were treated with physical methods in the emergency room, and 92.2% (167/181) with at least one antipyretic in monotherapy (159/167; 94%), with no differences between groups (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The most frequently prescribed antipyretic agent, in monotherapy or in combination, was metamizole (97/167; 58%), followed by paracetamol (51/169; 30.2%) and ibuprofen (19/169; 11.2%). Eight patients received a combination (paracetamol and naproxen). The route used most frequently in infants was the rectal route (73.5%); in preschoolers they were the rectal (43.9%) and oral (29.8%) routes; and in schoolchildren and adolescents, the oral route (52.4%). The mean time elapsed until the body temperature normalised was 1<span class="elsevierStyleHsp" style=""></span>h.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Of the children that did not receive prehospital antipyretic agents, 22% (11/50) were discharged with a prescription for physical antipyresis alone, and there were no changes in treatment in 31%. In the rest, the most frequent changes were the addition of an antipyretic agent other than the one used in the emergency room, or switching to another (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The predominating prescription pattern at discharge in children that had received prehospital antipyretic treatment was: for infants, continuation of the agent prescribed at hospital and addition of one or more others; for preschoolers, addition or switching of antipyretic agents; and for schoolchildren and adolescents, switching to another agent. At discharge, 86.7% (157/181) of the patients were prescribed one or more antipyretics; 55.4% were prescribed a combination of two agents, 40.7% a single agent; and 3.8% (6/157) three agents. The antipyretic most frequently prescribed as monotherapy was paracetamol (52.6%), prescribed in 72.4% of infants, followed by ibuprofen (34.6%). The antipyretic most frequently prescribed in combination was ibuprofen (48.4%) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><p id="par0050" class="elsevierStylePara elsevierViewall">We found that antipyretics were used very frequently prior to visiting the emergency department. Although the use of paracetamol or ibuprofen (alone or in combination) was most prevalent,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> we also found combinations of up to three agents for which the efficiency and safety have not been demonstrated. The use of physical methods, as recommended in different GCPGs, predominated in the emergency room;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a> however, prescription of antipyretics not previously used and of agents like metamizole (banned in developed countries) to schoolchildren and adolescents was also common. The current recommendations are the use of monotherapy by the oral route and educating parents on the benefits of fever and its adequate control.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2</span></a> The major finding in our study was the change in the prescription of antipyretics at discharge to the home. Contrary to what we expected, at discharge most patients were prescribed an additional antipyretic or an antipyretic other than the one that had been used to control the fever. This may be interpreted as anxiety on the part of both parents and doctors, so better communication and education on warning signs, and not only on the control of body temperature, would be advisable. Our results need to be confirmed by studies performed in other locations and under different conditions.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as: Velasco Aznar A, Rendón-Macías ME, Iglesias-Leboreiro J, Bernárdez-Zapata I. Uso de antipiréticos en urgencias pediátricas. An Pediatr (Barc). 2015;82:268–271.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2450 "Ancho" => 2917 "Tamanyo" => 342393 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Distribution of the modifications in antipyretic management by age group and depending on whether the patient had received prehospital antipyresis (first three bars) or not (last three bars). The modifications considered were: addition, if other agent(s) were added to the original prescription; reduction, if the original treatment consisted of two or more agents and the discharge prescription included fewer of them; change, if the final prescription differed in at least one to all the antipyretic agents; withdrawal, if antipyretic treatment was discontinued completely; same prehospital and discharge when the antipyresis scheme was only modified during the hospital stay. The difference between groups without prehospital antipyresis was <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.9; df<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.90; and the difference between groups with prehospital antipyresis was <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>31.5; df<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>10; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.0005.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">LRTI: lower respiratory tract infection (bronchiolitis, acute bronchitis); Other: mesenteric adenitis (1) and dentition (1) in infants, hand-foot-mouth disease (1) in a preschooler; febrile syndrome: fever without a source; PIGE: probably infectious gastroenteritis with or without dehydration; URTI: upper respiratory tract infection (rhinopharyngitis, pharyngitis, pharyngoamygdalitis, laryngitis, laryngotracheitis and otitis media); UTI: urinary tract infection.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "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="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Infants \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Preschoolers \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">Schoolchildren and adolescents \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span>-value \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>73 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>60 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>47 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Sex, N (%)</span></td><td class="td" title="table-entry " align="char" valign="top">.26<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 (61.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (48.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 (51.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (38.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 (51.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 (48.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Infection site, N (%)</span></td><td class="td" title="table-entry " align="char" valign="top">.052<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>URTI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 (64.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 (65.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (42.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PIGE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (16.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (26.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (46.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Febrile syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (8.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (6.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>UTI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (5.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LRTI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">History of febrile seizure, N (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (8.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.01<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Antipyresis before admission, N (%)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Monotherapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 (60.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (46.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (44.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.09<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Combination (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (15.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (26.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (12.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Combination (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Combination (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No antipyresis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (21.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (23.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (42.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Antipyresis in emergency room, N (%)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Monotherapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 (89) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 (88) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 (87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.65<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Combination (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Only physical methods \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Antipyresis prescribed at discharge, N (%)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Monotherapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.70<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Combination (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 (45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 (57.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Combination (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Only physical methods \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Temperature at admission, °C</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1 SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.55<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Minutes elapsed to temperature control, median (min-max)</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No antipyresis before admission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 (19–80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 (30–105) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68.5 (40–162) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.12<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Antipyresis before admission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 (10–190) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 (19–130) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78 (30–182) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.004<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab802083.png" ] ] ] "notaPie" => array:4 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span> test.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">One-way analysis of variance.</p>" ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Kruskal–Wallis test: infants <span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>16, preschoolers <span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>12, schoolchildren and adolescents <span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20.</p>" ] 3 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "d" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Kruskal–Wallis test: infants <span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>57, preschoolers <span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>45, schoolchildren and adolescents <span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>24.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Body temperature control in the emergency room by age group, <span class="elsevierStyleItalic">N</span> (%).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fever and antipyretic use in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.J. Sullivan" 1 => "C.H. Farrar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2010-3852" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2011" "volumen" => "127" "paginaInicial" => "580" "paginaFinal" => "587" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21357332" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of fever in children: summary of the Italian pediatric society guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Chiappini" 1 => "N. Principi" 2 => "R. Longhi" 3 => "P.-A. Tovo" 4 => "P. Becherucci" 5 => "F. Bonsignori" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clinthera.2009.08.006" "Revista" => array:6 [ "tituloSerie" => "Clin Ther" "fecha" => "2009" "volumen" => "31" "paginaInicial" => "1826" "paginaFinal" => "1843" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19808142" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Understanding NICE guidance. Feverish illness in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "National Institute of Health and Clinical Excellence" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2013" "editorial" => "NICE" "editorialLocalizacion" => "London" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Knowledge attitudes and misconceptions of primary regarding fever in children: a cross sectional study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Demir" 1 => "O. Sekreter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1824-7288-38-40" "Revista" => array:5 [ "tituloSerie" => "Ital J Pediatr" "fecha" => "2012" "volumen" => "38" "paginaInicial" => "40" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22950655" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Symptomatic management of fever by Swiss board-certified pediatricians: results from a cross-sectional, web-based survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.A.G. Lava" 1 => "G.D. Simonetti" 2 => "G.P. Ramelli" 3 => "S. Tschumi" 4 => "M.G. Bianchetti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clinthera.2011.12.002" "Revista" => array:6 [ "tituloSerie" => "Clin Ther" "fecha" => "2012" "volumen" => "34" "paginaInicial" => "250" "paginaFinal" => "256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22218087" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systematic review of studies comparing combined treatment with paracetamol and ibuprofen, with either drug alone" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Purssell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/archdischild-2011-300424" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "2011" "volumen" => "96" "paginaInicial" => "1175" "paginaFinal" => "1179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21868405" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000008200000004/v2_201505130138/S2341287915000496/v2_201505130138/en/main.assets" "Apartado" => array:4 [ "identificador" => "38181" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008200000004/v2_201505130138/S2341287915000496/v2_201505130138/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915000496?idApp=UINPBA00005H" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 8 | 18 |
| 2024 October | 100 | 29 | 129 |
| 2024 September | 116 | 22 | 138 |
| 2024 August | 135 | 66 | 201 |
| 2024 July | 172 | 31 | 203 |
| 2024 June | 177 | 35 | 212 |
| 2024 May | 99 | 35 | 134 |
| 2024 April | 90 | 38 | 128 |
| 2024 March | 91 | 23 | 114 |
| 2024 February | 80 | 29 | 109 |
| 2024 January | 110 | 22 | 132 |
| 2023 December | 123 | 26 | 149 |
| 2023 November | 113 | 20 | 133 |
| 2023 October | 124 | 30 | 154 |
| 2023 September | 65 | 19 | 84 |
| 2023 August | 64 | 27 | 91 |
| 2023 July | 64 | 26 | 90 |
| 2023 June | 80 | 23 | 103 |
| 2023 May | 108 | 22 | 130 |
| 2023 April | 61 | 25 | 86 |
| 2023 March | 127 | 23 | 150 |
| 2023 February | 90 | 16 | 106 |
| 2023 January | 79 | 26 | 105 |
| 2022 December | 111 | 26 | 137 |
| 2022 November | 111 | 35 | 146 |
| 2022 October | 130 | 40 | 170 |
| 2022 September | 75 | 38 | 113 |
| 2022 August | 107 | 49 | 156 |
| 2022 July | 82 | 27 | 109 |
| 2022 June | 58 | 31 | 89 |
| 2022 May | 74 | 39 | 113 |
| 2022 April | 69 | 30 | 99 |
| 2022 March | 99 | 45 | 144 |
| 2022 February | 72 | 28 | 100 |
| 2022 January | 73 | 32 | 105 |
| 2021 December | 76 | 32 | 108 |
| 2021 November | 63 | 40 | 103 |
| 2021 October | 77 | 52 | 129 |
| 2021 September | 46 | 37 | 83 |
| 2021 August | 39 | 38 | 77 |
| 2021 July | 33 | 31 | 64 |
| 2021 June | 62 | 49 | 111 |
| 2021 May | 36 | 29 | 65 |
| 2021 April | 165 | 46 | 211 |
| 2021 March | 68 | 18 | 86 |
| 2021 February | 49 | 17 | 66 |
| 2021 January | 55 | 19 | 74 |
| 2020 December | 50 | 19 | 69 |
| 2020 November | 51 | 15 | 66 |
| 2020 October | 59 | 21 | 80 |
| 2020 September | 39 | 16 | 55 |
| 2020 August | 39 | 11 | 50 |
| 2020 July | 38 | 15 | 53 |
| 2020 June | 39 | 9 | 48 |
| 2020 May | 39 | 19 | 58 |
| 2020 April | 53 | 19 | 72 |
| 2020 March | 35 | 19 | 54 |
| 2020 February | 20 | 20 | 40 |
| 2020 January | 35 | 17 | 52 |
| 2019 December | 44 | 18 | 62 |
| 2019 November | 18 | 24 | 42 |
| 2019 October | 22 | 8 | 30 |
| 2019 September | 41 | 13 | 54 |
| 2019 August | 47 | 20 | 67 |
| 2019 July | 35 | 34 | 69 |
| 2019 June | 23 | 18 | 41 |
| 2019 May | 79 | 13 | 92 |
| 2019 April | 71 | 33 | 104 |
| 2019 March | 37 | 28 | 65 |
| 2019 February | 53 | 20 | 73 |
| 2019 January | 35 | 12 | 47 |
| 2018 December | 41 | 23 | 64 |
| 2018 November | 73 | 25 | 98 |
| 2018 October | 117 | 21 | 138 |
| 2018 September | 49 | 15 | 64 |
| 2018 August | 2 | 0 | 2 |
| 2018 July | 1 | 0 | 1 |
| 2018 June | 1 | 0 | 1 |
| 2018 May | 2 | 0 | 2 |
| 2018 April | 10 | 0 | 10 |
| 2018 March | 18 | 0 | 18 |
| 2018 February | 12 | 0 | 12 |
| 2018 January | 18 | 0 | 18 |
| 2017 December | 19 | 0 | 19 |
| 2017 November | 8 | 0 | 8 |
| 2017 October | 9 | 0 | 9 |
| 2017 September | 11 | 0 | 11 |
| 2017 August | 18 | 0 | 18 |
| 2017 July | 13 | 0 | 13 |
| 2017 June | 22 | 8 | 30 |
| 2017 May | 25 | 6 | 31 |
| 2017 April | 22 | 4 | 26 |
| 2017 March | 12 | 4 | 16 |
| 2017 February | 17 | 7 | 24 |
| 2017 January | 18 | 1 | 19 |
| 2016 December | 24 | 8 | 32 |
| 2016 November | 28 | 3 | 31 |
| 2016 October | 35 | 4 | 39 |
| 2016 September | 32 | 4 | 36 |
| 2016 August | 30 | 0 | 30 |
| 2016 July | 11 | 0 | 11 |
| 2016 April | 2 | 0 | 2 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 7 | 9 | 16 |
| 2015 November | 1 | 5 | 6 |
| 2015 October | 11 | 10 | 21 |
| 2015 September | 1 | 8 | 9 |
| 2015 August | 2 | 12 | 14 |
Show all
