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Comparison of the effectiveness and safety of polyethylene glycol with and without electrolytes in the treatment of chronic constipation
Comparación sobre la efectividad y seguridad del polietilenglicol con y sin electrolitos en el tratamiento del estreñimiento funcional
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PEG: polyethylene glycol without electrolytes. PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL: polyethylene glycol with electrolytes.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Functional constipation in children is a common problem worldwide. Many affected individuals do not seek medical care, so it is difficult to determine its prevalence, but it has been estimated at between 0.7% and 29.6%.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> In Spain, reported prevalences in adults are as high as 14–20%.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2,3</span></a> Constipation significantly impacts quality of life, causing physical as well as emotional distress.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">4</span></a> It is diagnosed by the Rome III criteria,<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a> which are very similar to those established by the PACCT group.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a> The management of functional constipation includes several steps such as education, lifestyle changes, disimpaction and maintenance treatment.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">7</span></a> Some of the laxatives recommended for its treatment are magnesium hydroxide, lactulose, paraffin and polyethylene glycol (PEG). Compared to its predecessors, now in use for several decades, PEG has become the preferred choice of many practitioners.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">8</span></a> While the FDA has approved its use only in adults, its use in paediatrics has increased in several countries.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">9,10</span></a> Several studies have demonstrated its effectiveness and safety in the short term, and two recent systematic reviews<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">11,12</span></a> concluded that PEG may be superior to lactulose and magnesium hydroxide. At present, two formulations of PEG are available in the market, one with and another without electrolytes, and despite their widespread use no studies have been conducted in children to compare their effectiveness and assess their long-term safety. Our study compared the effectiveness of PEG with electrolytes (PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL) and without electrolytes (PEG) and their safety in relation to renal function and electrolyte values as biological markers of absorption over a period of twelve weeks.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design</span><p id="par0010" class="elsevierStylePara elsevierViewall">We conducted an observational and prospective parallel study in two groups of patients that compared the safety and efficacy of a PEG laxative with electrolytes and another without for the treatment of chronic constipation.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The researchers obtained the consent of the patents before starting the period of observation.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Products under study</span><p id="par0020" class="elsevierStylePara elsevierViewall">PEG without electrolytes (Casenlax<span class="elsevierStyleSup">®</span> powder for oral solution, 4<span class="elsevierStyleHsp" style=""></span>g and 10<span class="elsevierStyleHsp" style=""></span>g packets).<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Faecal impaction</span>: 1.5–2<span class="elsevierStyleHsp" style=""></span>g/kg/day in two doses until resolution for a maximum of six days (fixed dose).</p></li><li class="elsevierStyleListItem" id="lsti0010"><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Constipation</span>: 0.4–1<span class="elsevierStyleHsp" style=""></span>g/kg/day in two doses to a maximum of 20<span class="elsevierStyleHsp" style=""></span>g/day. The duration of treatment was of at least 12 weeks.</p></li></ul></p><p id="par0035" class="elsevierStylePara elsevierViewall">PEG with electrolytes (Movicol<span class="elsevierStyleSup">®</span>, powder for oral solution, 6.9 and 13.9<span class="elsevierStyleHsp" style=""></span>g packets).<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0015"><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Faecal impaction</span>: 1.5–2<span class="elsevierStyleHsp" style=""></span>g/kg/day in two doses until resolution for a maximum of six days (fixed dose).</p></li><li class="elsevierStyleListItem" id="lsti0020"><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Constipation</span>: 0.4–1<span class="elsevierStyleHsp" style=""></span>g/kg/day in two doses to a maximum of 27.8<span class="elsevierStyleHsp" style=""></span>g/day. The duration of treatment was of at least 12 weeks.</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Patients</span><p id="par0050" class="elsevierStylePara elsevierViewall">We included the patients referred to the Department of Paediatric Gastroenterology of the Hospital Sant Joan de Déu, between November 2011 and March 2013. The inclusion criteria were: age between 1 and 17 years, failure of educational and dietary interventions implemented for a minimum of one month, having had faecal impaction as part of the ongoing process, and meeting the Rome III criteria for the diagnosis of chronic functional constipation (presence of at least two of the following prior to diagnosis, for at least one month in children aged less than 4 years<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">13</span></a> or two months in older children<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a>: 2 defecations or fewer per week, at least one episode of faecal incontinence per week, history of retentive posturing [age<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>4 years], History of painful or hard bowel movements, presence of faecal masses in the rectum, and history of large diameter stools that may obstruct the toilet).</p><p id="par0055" class="elsevierStylePara elsevierViewall">The exclusion criteria included patients that had used medications that can affect intestinal motility such as laxatives, probiotics or prebiotics in the four weeks preceding the first visit; patients with defecation problems of an organic aetiology, such as Hirschsprung disease, spina bifida (occult form), hypothyroidism, coeliac disease, metabolic or renal disorders, and patients with suspected gastrointestinal obstruction or stenosis.</p><p id="par0060" class="elsevierStylePara elsevierViewall">All patients included in the study were assigned to one treatment or another in an alternating fashion in order to obtain a similar number of patients in each group. The administered dose was determined based on whether the patient presented with or without faecal impaction (as specified above). The possibility of changing the dose was considered if the patient did not respond to treatment after three days or developed any adverse effects, such as diarrhoea or abdominal pain.</p><p id="par0065" class="elsevierStylePara elsevierViewall">To improve patient acceptance of both products, we allowed their suspension in fruit juice or milk.</p><p id="par0070" class="elsevierStylePara elsevierViewall">We requested that parents keep a diary during the followup, documenting the frequency of depositions per week, their shape and their consistency according to the Bristol scale, which rates the consistency of faeces on a scale from 1 to 7.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">14</span></a> Appointments were scheduled at weeks 1, 4 and 12 from initiation of treatment, and subsequently every 8 weeks until treatment could be discontinued. Each visit included a full history taking and physical examination, including a rectal exam. Potential adverse effects of the treatment were also documented: abdominal pain, diarrhoea, flatulence, nausea and product acceptance. The need to increase or decrease the dose of the laxative based on the patient's clinical condition and bowel movements recorded in the journal was evaluated during each visit.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The primary outcome measures were the number of bowel movements per week recorded at weeks 6 and 12 of treatment, and the presence of electrolyte imbalances at week 6. Secondary outcomes included the time required to achieve disimpaction, change in the consistency of the stools, use of laxatives and tolerance (episodes of nausea or abdominal pain).</p><p id="par0080" class="elsevierStylePara elsevierViewall">A blood sample was collected at the beginning of the study, six weeks of treatment and whenever the clinician deemed it appropriate during follow-up visits. All were fasting samples, and were collected in the laboratory of the hospital. The tests performed included complete blood count, electrolyte panel, serum osmolality, glucose, urea, creatinine, total serum protein and albumin. A first-void urine sample was also collected for electrolyte and osmolality testing. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents the laboratory result ranges.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">No changes were made to the usual diet of patients during the entire period under study.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0090" class="elsevierStylePara elsevierViewall">Based on previous studies,<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">15,16</span></a> we decided that a difference of more than 30% between the treatments would be considered clinically relevant. Assuming an average frequency of seven bowel movements per week with a standard deviation of 3.5, we calculated that a sample of 60 (30 in each group) would be needed to require a 30% difference between the two groups in the number of bowel movements per week with a power of 80% (<span class="elsevierStyleItalic">α</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0095" class="elsevierStylePara elsevierViewall">We performed an intention-to-treat analysis of efficacy and biological and clinical safety that included all the data of enrolled patients that had received at least one dose of the laxatives under study and provided follow-up data for one or more of the analysed variables.</p><p id="par0100" class="elsevierStylePara elsevierViewall">We performed comparisons between groups and within groups (before and after treatment) with the appropriate tests. We used the Kolmogorov–Smirnov test to ascertain the normality of the distributions. Quantitative parameters were compared by means of the Wilcoxon signed-rank test for paired samples and the Mann–Whitney <span class="elsevierStyleItalic">U</span> test for independent samples, and we described the data using the mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation (SD) and the median. We summarised qualitative variables as frequencies and percentages, and compared them by means of the <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span> test or Fisher's exact test. The statistical analysis was performed with the software SPSS version 21. The level of statistical significance was 5%, and <span class="elsevierStyleItalic">P</span>-values of less than .05 were considered significant.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0105" class="elsevierStylePara elsevierViewall">Between November 2011 and March 2013 we recruited a total of 77 patients with constipation. Four of them were excluded due to having secondary constipation (three with coeliac disease and one with Hirschsprung disease) and another four because they improved with hygiene measures that were part of the routine management of functional constipation. After recruitment, patients were assigned to the two treatment groups. We lost another seven patients during followup, and one patient discontinued treatment due to intolerance to the drug. A total of 62 patients completed the 12 weeks of treatment, 30 in the PEG group and 32 in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The average age was 5 years, and 53% of the patients were male. We found no relevant clinical or demographic differences between both treatment groups at the beginning of the study (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Efficacy</span><p id="par0110" class="elsevierStylePara elsevierViewall">The number of bowel movements per week was similar in both groups at weeks 6 and 12. The mean (SD) number of bowel movements per week in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL and the PEG groups were 6.0 (2.7) and 6.1 (2.5) at 6 weeks, and 5.4 (1.8) and 4.6 (2.2) at 12 weeks, respectively. The mean number of days elapsed until patients first passed soft stools was similar in both groups: 2.7 (1–10) days in the PEG group and 2 (1–7) days in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group, a difference that was not statistically significant (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The proportion of patients with hard stools (Bristol ≤3) decreased considerably in the PEG group and to a lesser degree in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group, a difference that was not statistically significant. At 6 weeks, 21% (7 out of 32) had hard stools, compared to 6% (2 out of 30), respectively, but the differences between groups disappeared by 12 weeks, with hard stools found in 9% (9 out of 30) and 5% (5 out of 18) of patients, respectively (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Faecal impaction at the time of enrolment was present in 37% of the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group (12 out of 32) and 30% of the PEG group (9 out of 30). At 6 weeks of treatment, this symptom persisted in a higher percentage of patients in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group (21% [7/32]) compared to the PEG group (10% [3/30]), a difference that was not statistically significant. At 12 weeks, the difference had disappeared, with impaction found in only 6% (3 out of 31) and 9% (2 out of 30) of patients, respectively. The number of days after which patients first passed soft stools was very similar: it was 2 days on average in the PEG group, and 2.3 days in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The mean doses at 6 weeks were 0.61<span class="elsevierStyleHsp" style=""></span>g/kg/day (PEG) and 0.63<span class="elsevierStyleHsp" style=""></span>g/kg/day (PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL) (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.8), and at 12 weeks, they were 0.56<span class="elsevierStyleHsp" style=""></span>g/kg/day (PEG) and 0.61 (PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL) (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.49), with no statistically significant differences.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Biological tolerance</span><p id="par0130" class="elsevierStylePara elsevierViewall">After six weeks of treatment, 56% of patients in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group (18 out of 32) and 83% in the PEG group (25 out of 30) had at least one abnormal laboratory result, a difference that was statistically significant (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.02). This difference persisted when we analysed patients with more than two abnormal parameters, found in 28% of patients in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group (9 out of 32) and in 50% of the PEG group (15 out of 30), although the difference was not statistically significant (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>).</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">None of the patients had abnormal results in the complete blood count, total serum protein, albumin or transaminase levels.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Of the laboratory values that we analysed (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), serum sodium was the parameter that was most frequently disturbed with treatment, and we found hyponatraemia (sodium<span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>135<span class="elsevierStyleHsp" style=""></span>mEq/L) in up to 15% of the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group (5 out of 32) and 36% of the PEG group (11 out of 30), a difference that was statistically significant (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.05). The second abnormal result corresponded to urine potassium, found in 21% (5 out of 23) and 32% (9 out of 28), respectively. Finally, changes in urine osmolality were found in 17% of the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group (4 out of 23) and 28% of the PEG group (8 out of 28). We did not find statistically significant differences in the baseline parameters of both groups.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Clinical tolerance</span><p id="par0145" class="elsevierStylePara elsevierViewall">Only three patients reported adverse effects that did not improve upon reducing the usual dose. The reported adverse effects were diarrhoea (one patient in the PEG group) and abdominal pain and flatulence (two patients in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group), and treatment was discontinued and switched in all of them. Only one patient in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL reported that the product had a bad taste, leading to a change in treatment. None of the laboratory abnormalities were clinically relevant. All reported cases of hyponatraemia were mild, with a mean sodium level of 134<span class="elsevierStyleHsp" style=""></span>mEq/L (133–135<span class="elsevierStyleHsp" style=""></span>mEq/L).</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">This is the first study in the literature conducted in children that compares the effectiveness of PEG with and without electrolytes and the fluid and electrolyte imbalances that they may cause. We corroborated that PEG without electrolytes causes mild hyponatraemia in a greater number of patients compared to PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL. These results are similar to those reported by Seinela et al. in a study of institutionalised senile adults, in whom only serum sodium levels were abnormal, although they did not assess for additional abnormalities in urine. Although all the electrolyte imbalances were asymptomatic, we must keep in mind that we conducted the study on patients with no chronic, renal, pancreatic or heart comorbidities, diseases in which these imbalances could be more relevant.</p><p id="par0155" class="elsevierStylePara elsevierViewall">The studies that assess the safety of PEG without electrolytes in children, sometimes in comparison with other laxatives, report electrolyte imbalances in none or only a few isolated patients. However, all of these studies have particular characteristics that must be taken into account, most of them were not designed nor had a large enough sample to detect differences, such as two studies that assessed the safety of PEG at 3–4 days of treatment.<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">17,18</span></a> Others did not report the normal ranges applied in their laboratories,<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a> or had a study design in which follow-up laboratory tests were optional, so that laboratory results were only available for seventeen patients at three months since initiation of treatment.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">20</span></a> A study by Dupont et al<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">21</span></a> reported not having found electrolyte imbalances in any of the patients, but this result could have been influenced by their broader sodium normal range (132–145).</p><p id="par0160" class="elsevierStylePara elsevierViewall">Several studies have demonstrated the safety of PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL in adults,<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a> while there are only two studies in the paediatric age group<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">22,23</span></a> that assess for laboratory abnormalities during treatment, neither of which found abnormalities, consisted with the findings of our study.</p><p id="par0165" class="elsevierStylePara elsevierViewall">As for the efficacy of either laxative, so far the only study in the literature that has compared their use in children is the one conducted by Savino et al.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a> They concluded that PEG without electrolytes was better tolerated and associated with a greater number of bowel movements per week than PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL. However, they only compared both medications over a period of 4 weeks. In our study, we also observed that PEG without electrolytes was associated to a greater number of patients with soft stools at six weeks, but these differences had disappeared by 12 weeks. We also found a small difference in the resolution of faecal impaction, which was resolved more frequently in the PEG group at 6 weeks, that had also disappeared by 12 weeks.</p><p id="par0170" class="elsevierStylePara elsevierViewall">One possible hypothesis is that it takes more time for PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL to act, but since both laxatives have the same active ingredient, this could only be explained by the ingestion of lower doses of PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL, probably due to its taste. Two studies in adults<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">16,25</span></a> and one in children<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a> showed that PEG without electrolytes was better tolerated or more palatable. In the study by Savino et al., 26% of participants treated with PEG + EL reported that they found the taste bad or very bad compared to only 2% of those treated with PEG. This was also the case in a study on 100 adult volunteers, of who 84 preferred PEG and only 7 PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">The study by Savino et al<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a> did not specify whether the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group was allowed to dissolve the drug in anything other than water. The patient information leaflet for Movicol<span class="elsevierStyleSup">®</span> advises that it should only be dissolved in water. This may be the reason why its patient acceptance and palatability are inferior to those of Casenlax<span class="elsevierStyleSup">®</span>.</p><p id="par0180" class="elsevierStylePara elsevierViewall">In our study, we allowed both products to be dissolved in different beverages to improve patient acceptance, and it is possible that doses of PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL are lower in the early weeks while patients find out which beverage improves its palatability, after which adherence to the prescribed dose would improve.</p><p id="par0185" class="elsevierStylePara elsevierViewall">Furthermore, two studies in adults have also demonstrated that both products have a similar efficacy, as they found no differences between PEG with and without electrolytes.<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">16,26</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">We observed few adverse effects in our study: they occurred in only 3 of the 62 analysed patients, which remarks the safety of polyethylene glycol compared to other medications, such as stimulant or saline laxatives and hyperosmolar agents such as lactulose or lactitol, which are associated with a higher incidence of transient diarrhoea (10%), flatulence (6%) and abdominal pain (2%).</p><p id="par0195" class="elsevierStylePara elsevierViewall">In conclusion, both PEG formulations (with or without electrolytes) have a similar effectiveness, safety and patient acceptance. The electrolyte imbalances found more frequently in the group treated with PEG without electrolytes were very mild and caused no symptoms. It is possible that, compared to other studies, patient acceptance of PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL in our study was greater because it could be dissolved in different beverages.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0200" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres677625" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec683608" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres677624" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec683607" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Patients and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study design" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Products under study" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Patients" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Efficacy" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Biological tolerance" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Clinical tolerance" ] ] ] 7 => array:2 [ "identificador" => "sec0055" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-04-21" "fechaAceptado" => "2015-08-19" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec683608" "palabras" => array:4 [ 0 => "Constipation" 1 => "Laxatives" 2 => "Polyethylene glycol" 3 => "Treatment of constipation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec683607" "palabras" => array:4 [ 0 => "Estreñimiento" 1 => "Laxantes" 2 => "Polietilenglicol" 3 => "Tratamiento del estreñimiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To compare the effectiveness and safety of polyethylene glycol with and without electrolytes (EL) over a 12 week period in treatment of chronic constipation in paediatrics.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was an observational, prospective, longitudinal, parallel group study, including 62 children with chronic constipation according to ROME III criteria and a history of faecal impaction. The children were divided into groups, one group of 30 received polyethylene glycol without EL (PEG) and 32 PEG with EL (PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL) for at least 12 weeks. The main outcomes were the number of bowel movements at 6 and 12 weeks, and the presence of electrolyte disturbances at 6 weeks.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean weekly stool frequencies were similar in both groups at 6 and 12 weeks, with 5.4 and 4.6 stools per week in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL and PEG groups, respectively at 12 weeks. After 6 weeks of treatment, 83% (25 of 30) of the PEG group had at least one electrolyte disturbance compared with 56% (18 of 32) in the PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL group (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.02). Hyponatraemia was found in 15% (5 of 32) vs. 36% (11 of 30) of PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL and PEG groups, respectively (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.05). None of the laboratory abnormalities were clinically relevant.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">PEG formulations with or without EL have a quite similar effectiveness, safety and acceptability. PEG without EL produced more electrolyte abnormalities, but none of them were symptomatic.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo del estudio fue comparar la efectividad y seguridad del polietilenglicol con y sin electrolitos (EL) en el estreñimiento funcional pediátrico a lo largo de 12 semanas.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional, prospectivo, longitudinal, de grupos paralelos, que incluye a 62 niños diagnosticados de estreñimiento funcional según los criterios de ROMA III con antecedente de impactación fecal. De ellos, 30 niños recibieron polietilenglicol sin EL (PEG) y 32 PEG con EL (PEG + EL) durante al menos 12 semanas. Los resultados principales fueron determinar el número de deposiciones por semana a las 6 y 12 semanas de tratamiento y la presencia de alteraciones hidroelectrolíticas a las 6 semanas.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La media de deposiciones por semana fue similar en ambos grupos a las 6 y a las 12 semanas, siendo en la semana 12 de 5,4 y 4,6 deposiciones por semana en los grupos PEG + EL y PEG respectivamente. Después de 6 semanas de tratamiento, el 83% (25 de 30) del grupo PEG tuvo al menos un parámetro alterado en la analítica, comparado con el 56% (18 de 32) en el grupo PEG + EL (p = 0,02). Se reportó una hiponatremia hasta en un 15% (5 de 32) y un 36% (11 de 30) del grupo PEG + EL y el grupo PEG (p = 0,05). Ninguna de las alteraciones analíticas fue clínicamente relevante.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Las formulaciones PEG con o sin EL tienen una efectividad, seguridad y aceptabilidad similar. PEG sin EL presentó un mayor número de alteraciones electrolíticas, pero ninguna fue sintomática.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Llerena E, Varea Calderón V, Pujol Muncunill G, Hernandez Hernandez K, Sosa Giraldo FJ, Suarez Fuentes T, et al. Comparación sobre la efectividad y seguridad del polietilenglicol con y sin electrolitos. An Pediatr (Barc). 2016;85:34–40.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1147 "Ancho" => 1613 "Tamanyo" => 136174 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patient selection. PEG: polyethylene glycol without electrolytes. PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL: polyethylene glycol with electrolytes.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">BNR, below normal range; ANR, above the normal range; NR, normal range.</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-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Range \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PEG</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> \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">% \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> \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">% \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="5" align="left" valign="top"><span class="elsevierStyleItalic">Sodium, mmol/L (136–145)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \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">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></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">84.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.4 \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">Potassium, mmol/L (3.8–5.2)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \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><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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \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">Chlorine, mmol/L (97–110)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \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><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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \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><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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 \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">Calcium, mmol/L (2.27–2.66)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \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><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \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><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80 \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">Glucose (mg/dL) 70–109</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \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><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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 \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">Urea (mg/dL) 18–45</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \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><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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \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><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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 \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">Creatinine (mg/dL)</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic"><</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0.64</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \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><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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 \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">Serum osmolality (278–298)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \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><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96 \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">Urine osmolality (513–1110)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71 \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">Urine sodium, mmol/L (34–214)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">89 \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">Urine potassium, mmol/L (27–93)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \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">Chlorine, mmol/L (4–218)</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>ANR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1112120.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Biological parameters.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables \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">PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>32) \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">PEG (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>30) \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">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age in years, mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.3 (50.63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57.2 (41.34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.75 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1–3 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3–5 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>5 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (56) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.62 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Height in cm, mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">106 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">102 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight in kg, mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.39 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duration of constipation in months (mean) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.77 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of bowel movements/week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.69 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stool consistency (Bristol stool scale) mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.53 (0.50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.57 (0.56) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.87 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Painful defecation, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28(93) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.69 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Volitional stool retention, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17(56) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Faecal incontinence, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Rectal bleeding, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.24 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Faecal impaction, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.53 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1112118.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Demographic characteristics of the patients.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Follow-up week \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">PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL \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">PEG \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">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6 (mean, median) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.09 (7.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.17 (7.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.927 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12 (mean, median) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.45 (7.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.67 (4.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.28 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1112117.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Number of bowel movements per week.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Follow-up week \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">PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL \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">PEG \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">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6 (mean, median) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.75 (4.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.93 (4.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12 (mean, median) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.73 (4.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.50 (4.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.61 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1112119.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Change in stool consistency (Bristol stool scale).</p>" ] ] 5 => array:8 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at5" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">AR, abnormal range.</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 " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PEG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EL</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PEG</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">P</span> \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> \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">% \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> \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">% \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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No imbalance \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">At least 1 in AR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.02 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Only 1 in AR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.65 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Only 2 in AR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Only 3 in AR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.61<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-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">≥4 in AR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">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><td class="td" title="table-entry " align="char" valign="top">1<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1112116.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Fisher's exact test.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Electrolyte imbalances at 6 weeks.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0135" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of constipation in children and adults: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 19 | 14 | 33 |
| 2024 October | 126 | 52 | 178 |
| 2024 September | 101 | 45 | 146 |
| 2024 August | 118 | 60 | 178 |
| 2024 July | 109 | 45 | 154 |
| 2024 June | 112 | 44 | 156 |
| 2024 May | 118 | 33 | 151 |
| 2024 April | 91 | 44 | 135 |
| 2024 March | 80 | 43 | 123 |
| 2024 February | 84 | 31 | 115 |
| 2024 January | 86 | 29 | 115 |
| 2023 December | 100 | 25 | 125 |
| 2023 November | 113 | 25 | 138 |
| 2023 October | 83 | 33 | 116 |
| 2023 September | 89 | 28 | 117 |
| 2023 August | 77 | 29 | 106 |
| 2023 July | 93 | 37 | 130 |
| 2023 June | 73 | 31 | 104 |
| 2023 May | 89 | 29 | 118 |
| 2023 April | 72 | 25 | 97 |
| 2023 March | 121 | 34 | 155 |
| 2023 February | 90 | 17 | 107 |
| 2023 January | 79 | 21 | 100 |
| 2022 December | 125 | 37 | 162 |
| 2022 November | 102 | 47 | 149 |
| 2022 October | 125 | 45 | 170 |
| 2022 September | 161 | 38 | 199 |
| 2022 August | 103 | 59 | 162 |
| 2022 July | 99 | 42 | 141 |
| 2022 June | 99 | 46 | 145 |
| 2022 May | 95 | 39 | 134 |
| 2022 April | 75 | 41 | 116 |
| 2022 March | 103 | 41 | 144 |
| 2022 February | 61 | 28 | 89 |
| 2022 January | 99 | 57 | 156 |
| 2021 December | 60 | 49 | 109 |
| 2021 November | 72 | 63 | 135 |
| 2021 October | 82 | 83 | 165 |
| 2021 September | 68 | 56 | 124 |
| 2021 August | 74 | 48 | 122 |
| 2021 July | 61 | 33 | 94 |
| 2021 June | 77 | 53 | 130 |
| 2021 May | 82 | 53 | 135 |
| 2021 April | 187 | 94 | 281 |
| 2021 March | 89 | 51 | 140 |
| 2021 February | 56 | 27 | 83 |
| 2021 January | 74 | 27 | 101 |
| 2020 December | 62 | 28 | 90 |
| 2020 November | 80 | 27 | 107 |
| 2020 October | 78 | 22 | 100 |
| 2020 September | 58 | 27 | 85 |
| 2020 August | 49 | 33 | 82 |
| 2020 July | 54 | 29 | 83 |
| 2020 June | 57 | 17 | 74 |
| 2020 May | 63 | 40 | 103 |
| 2020 April | 77 | 16 | 93 |
| 2020 March | 65 | 34 | 99 |
| 2020 February | 64 | 12 | 76 |
| 2020 January | 136 | 29 | 165 |
| 2019 December | 63 | 21 | 84 |
| 2019 November | 59 | 16 | 75 |
| 2019 October | 58 | 27 | 85 |
| 2019 September | 69 | 26 | 95 |
| 2019 August | 105 | 31 | 136 |
| 2019 July | 62 | 46 | 108 |
| 2019 June | 61 | 29 | 90 |
| 2019 May | 112 | 37 | 149 |
| 2019 April | 73 | 33 | 106 |
| 2019 March | 63 | 26 | 89 |
| 2019 February | 89 | 29 | 118 |
| 2019 January | 79 | 33 | 112 |
| 2018 December | 70 | 51 | 121 |
| 2018 November | 123 | 41 | 164 |
| 2018 October | 176 | 26 | 202 |
| 2018 September | 64 | 23 | 87 |
| 2018 June | 3 | 0 | 3 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 31 | 0 | 31 |
| 2018 March | 23 | 0 | 23 |
| 2018 February | 4 | 0 | 4 |
| 2018 January | 15 | 0 | 15 |
| 2017 December | 11 | 0 | 11 |
| 2017 November | 28 | 0 | 28 |
| 2017 October | 16 | 0 | 16 |
| 2017 September | 13 | 0 | 13 |
| 2017 August | 19 | 0 | 19 |
| 2017 July | 22 | 0 | 22 |
| 2017 June | 41 | 11 | 52 |
| 2017 May | 47 | 6 | 53 |
| 2017 April | 24 | 9 | 33 |
| 2017 March | 8 | 5 | 13 |
| 2017 February | 14 | 10 | 24 |
| 2017 January | 8 | 3 | 11 |
| 2016 December | 27 | 14 | 41 |
| 2016 November | 24 | 26 | 50 |
| 2016 October | 28 | 24 | 52 |
| 2016 September | 28 | 11 | 39 |
| 2016 August | 47 | 11 | 58 |
| 2016 July | 45 | 33 | 78 |
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