Rhabdomyolysis after correction of severe hyponatremia due to an attack of acute intermittent porphyria
Rabdomiolisis tras la corrección de hiponatremia severa en una crisis de porfiria aguda intermitente
Read
9176
Timeswas read the article
2384
Total PDF
6792
Total HTML
Share statistics
array:21 [ "pii" => "X2013251408004120" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:563-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4586 "formatos" => array:3 [ "EPUB" => 342 "HTML" => 3653 "PDF" => 591 ] ] "Traduccion" => array:1 [ "es" => array:17 [ "pii" => "X0211699508004123" "issn" => "02116995" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2008;28:563-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7272 "formatos" => array:3 [ "EPUB" => 255 "HTML" => 6654 "PDF" => 363 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "Rabdomiolisis tras la corrección de hiponatremia severa en una crisis de porfiria aguda intermitente" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "563" "paginaFinal" => "564" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Rhabdomyolysis after correction of severe hyponatremia due to an attack of acute intermittent porphyria" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mélida García-Martul, Luciano Santana-Cabrera, Zenaida Santos-Moyano, Manuel Sánchez-Palacios" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Mélida" "apellidos" => "García-Martul" ] 1 => array:2 [ "nombre" => "Luciano" "apellidos" => "Santana-Cabrera" ] 2 => array:2 [ "nombre" => "Zenaida" "apellidos" => "Santos-Moyano" ] 3 => array:2 [ "nombre" => "Manuel" "apellidos" => "Sánchez-Palacios" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251408004120" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004120?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004123?idApp=UINPBA000064" "url" => "/02116995/0000002800000005/v0_201502091416/X0211699508004123/v0_201502091416/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X2013251408004112" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:564-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3157 "formatos" => array:3 [ "EPUB" => 267 "HTML" => 2368 "PDF" => 522 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Biliptysis as the initial symptom of a rare complication of autosomal dominant polycystic kidney disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "564" "paginaFinal" => "565" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Biliptisis, síntoma de presentación de una rara complicación en el paciente con enfermedad renal poliquística autosómica dominante." ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Lázaro L. Capote Pereira, Sigifredo Montero Ferrer, Ana E. Mera Fernández, Eliseo Capote Leyva, Mileydis Pozo Calderón, Yanet Artimes Hernández" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Lázaro L." "apellidos" => "Capote Pereira" ] 1 => array:2 [ "nombre" => "Sigifredo" "apellidos" => "Montero Ferrer" ] 2 => array:2 [ "nombre" => "Ana E." "apellidos" => "Mera Fernández" ] 3 => array:2 [ "nombre" => "Eliseo" "apellidos" => "Capote Leyva" ] 4 => array:2 [ "nombre" => "Mileydis" "apellidos" => "Pozo Calderón" ] 5 => array:2 [ "nombre" => "Yanet" "apellidos" => "Artimes Hernández" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699508004115" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004115?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004112?idApp=UINPBA000064" "url" => "/20132514/0000002800000005/v0_201502091635/X2013251408004112/v0_201502091635/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X2013251408004139" "issn" => "20132514" "doi" => " " "estado" => "S300" "fechaPublicacion" => "2008-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2008;28:562-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3259 "formatos" => array:3 [ "EPUB" => 270 "HTML" => 2481 "PDF" => 508 ] ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Recovery of total innmunoglobulin and immunoglobulin subclasses in nephrotic syndrome: deflazacort vs methylprednisone" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "562" "paginaFinal" => "563" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Recuperación de la inmnoglobulina total y sus subclases en el síndrome nefrótico: deflazacort vs metilprednisona." ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Miguel Liern, StellaMaris Dieguez, Carlos Canepa" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Miguel" "apellidos" => "Liern" ] 1 => array:2 [ "nombre" => "StellaMaris" "apellidos" => "Dieguez" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Canepa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699508004131" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508004131?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004139?idApp=UINPBA000064" "url" => "/20132514/0000002800000005/v0_201502091635/X2013251408004139/v0_201502091635/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Rhabdomyolysis after correction of severe hyponatremia due to an attack of acute intermittent porphyria" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "563" "paginaFinal" => "564" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Mélida García-Martul, Luciano Santana-Cabrera, Zenaida Santos-Moyano, Manuel Sánchez-Palacios" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Mélida" "apellidos" => "García-Martul" "email" => array:1 [ 0 => "mgarciamartul@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Luciano" "apellidos" => "Santana-Cabrera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "nombre" => "Zenaida" "apellidos" => "Santos-Moyano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "nombre" => "Manuel" "apellidos" => "Sánchez-Palacios" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitario Insular de Gran Canaria, Gran Canaria, Islas Canarias, España, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Rabdomiolisis tras la corrección de hiponatremia severa en una crisis de porfiria aguda intermitente" ] ] "textoCompleto" => "To the editor: A vascular mechanism responsible for renal damage during attacks  of  acute  intermittent  porphyria <br></br>(AIP), due to sustained  vasospasm, appears  to  exist.1 Hyponatremia  is  a common complication in this disease, that  is  usually  related  to  a  syndrome of  inappropriate  secretion of antidiuretic hormone (SIADH).2,3 Rhabdomyolysis may  be  a  frequent  complication  during  hyponatremia  correction in which elevation of creatine phosphokinase  (CPK)  levels  runs  parallel to  the  recovery of  sodium  levels  and renal  function  is  not  usually  impaired. <br></br><br></br>We report the case of a 16-year-old female patient born  in Mauritania, with a family  history  of  acute  intermittent <br></br>porphyria, who was admitted to hospital for abdominal pain and vomiting for the past several days associated to an impaired  consciousness  level  and  two  episodes of generalized tonic-clonic seizures, after which  she  remained  in  a  postictal state and required orotracheal intubation and mechanical  ventilation.  Laboratory test results include severe hyponatremia (Na  95 mM/L;  normal,  135-145)  associated to plasma (244 mOsm/L) and urinary hyposmolarity (222 mOsm/L), urinary  frequency  and  data  suggesting hypovolemia (central venous pressure of <br></br>4 mmHg).  Isotonic  saline  infusion was therefore  started.  Rhabdomyolysis  was detected 24 hours after admission. Maximum  CPK  levels  of  35628  U/L were found at 48 hours, but no renal function impairment  was  noted.  Patient  clinical signs  and  history  suggested  an AIP attack, that was confirmed by measuring in a spot urine sample  levels of deltaaminolevulinic acid of 39.7 mg/g (normal, 0-5), as well as values in 24-hour urine of 154.3 mg of porphobilinogen (normal,  0-2),  484  μg/24  h  of  coproporphyrin  (normal,  0-60),  and  1,471μg/24  h  of  uroporphyrin  (normal,  0- 22).  Once  diagnosis  was  confirmed, treatment was started with intravenous <br></br>human  hemin  at  3  mg/kg/day  for  4 days.  The  patient  developed  arterial hypertension  that required administration  of  beta-blockers.  Clinical  course was  satisfactory,  with  a  progressive improvement  in  consciousness  level. Mechanical ventilation was withdrawn 6  days  after  admission,  and  patient was  discharged  with  a  normal  consciousness  level  and  no  symptoms. A genetic  study  to  search  for mutations and screen for heterozygous family carriers was requested. <br></br><br></br>AIP is  the most  common  and  severe of hepatic porphyrias.4 Disease transmission  is  autosomal  dominant, and  the gene encoding AIP is located in the long arm of chromosome 11. AIP causes deficiency of the enzyme uroporphyrinogen I synthetase, formerly called porphobilinogen  synthetase  (PBG),  thereby  blocking  heme  synthesis.  The most  typical clinical  signs  include nausea, vomiting, constipation, diarrhea, urinary retention, <br></br>tachycardia, hypertension, mental symptoms,  and  muscle  pain  and  weakness. These attacks may be triggered by barbiturates,  anticonvulsants,  estrogens,  oral contraceptives,  alcohol,  or  low-calorie diets.  Seizures  may  occur  in  20%  of cases, particularly in patients with hyponatremia. <br></br><br></br>The relationship between hyponatremia  and  rhabdomyolysis  may  apparently result  from intracellular potassium efflux  to  compensate  for  the  cell edema caused by decreased sodium levels, which would  cause  a decrease  in transmembrane  potential  and  hence  in muscle metabolism.5 Other authors postulate that it is hyponatremia correction itself which  causes  changes  in muscle cells ion concentrations and osmolarity resulting  in  incapacity  to maintain  homeostasis  in  cell  volume  regulation. This  would  cause  membrane  fragility <br></br>and  muscle  enzyme  release  into  the bloodstream.6 " "pdfFichero" => "P-E-S-A369-EN.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "Parece que existe un mecanismo vascular responsable del daño renal durante las crisis de porfiria aguda intermitente (PAI), debido al vasoespasmo mantenido1. La hiponatremia es una complicación frecuente en esta enfermedad, que suele estar en relación con un Síndrome de Secreción Inadecuada de Hormona Antidurética (SIADH)2,3. La rabdomiolisis puede ser una complicación frecuente durante la corrección de la hiponatremia y donde la elevación de la Creatin Fosfo Kinasa (CPK) va paralela a la recuperación de los valores de natremia y que, habitualmente, no cursa con afectación de la función renal. " ] "en" => array:1 [ "resumen" => "To the editor: A vascular mechanism responsible for renal damage during attacks of acute intermittent porphyria (AIP), due to sustained vasospasm, appears to exist.1 Hyponatremia is a common complication in this disease, that is usually related to a syndrome of inappropriate secretion of antidiuretic hormone (SIADH).2,3 Rhabdomyolysis may be a frequent complication during hyponatremia correction in which elevation of creatine phosphokinase (CPK) levels runs parallel to the recovery of sodium levels and renal function is not usually impaired." ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "1- Andersson C, Wikberg A, Stegmayr B, Lithner F. Renal symptomatology in patients with acute intermittent porphyria. A population-based study. J Intern Med. 2000; 248(4):319-25." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "2-Salgueira M, Monroy A, Jarava C, Molas R, Páez MC, Amor J, y col. Hiponatremia en la Porfiria aguda intermitente. Un problema diagnóstico en urgencias. Nefrología 1997; 17(1): 88-91." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "3-López Montes A, Lorenzo I, Pérez Martínez J. Síndrome de secreción inadecuada de hormona antidiurética y Porfiria. Nefrología 2004; 24(Extr 3):85-88." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "4- Anderson KE, Bloomer JR, Bonkovsky HL, Kushner JP, Pierach CA, Pimstone NR," "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:1 [ "itemHostRev" => array:3 [ "pii" => "S0735109710048059" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Desnick RJ. Recommendations for the diagnosis and treatment of the acute porphyrias." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ann Intern Med. 2005;142(6):439-50. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15767622" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "5- Trimarchi H, Gonzalez J, Olivero J. Hyponatremia-associated rhabdomyolysis. Nephron. 1999;82(3):274-7." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "6- Rizzieri DA. Rhabdomyolysis after correction of hyponatremia due to psychogenic polydipsia. Mayo Clin Proc. 1995;70(5):473-6." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002800000005/v0_201502091635/X2013251408004120/v0_201502091635/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002800000005/v0_201502091635/X2013251408004120/v0_201502091635/en/P-E-S-A369-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408004120?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 11 | 17 | 28 |
| 2024 October | 66 | 44 | 110 |
| 2024 September | 65 | 40 | 105 |
| 2024 August | 79 | 70 | 149 |
| 2024 July | 66 | 32 | 98 |
| 2024 June | 89 | 44 | 133 |
| 2024 May | 62 | 44 | 106 |
| 2024 April | 68 | 52 | 120 |
| 2024 March | 52 | 26 | 78 |
| 2024 February | 52 | 37 | 89 |
| 2024 January | 41 | 26 | 67 |
| 2023 December | 36 | 26 | 62 |
| 2023 November | 52 | 31 | 83 |
| 2023 October | 40 | 40 | 80 |
| 2023 September | 32 | 30 | 62 |
| 2023 August | 41 | 35 | 76 |
| 2023 July | 42 | 27 | 69 |
| 2023 June | 56 | 28 | 84 |
| 2023 May | 68 | 25 | 93 |
| 2023 April | 58 | 25 | 83 |
| 2023 March | 59 | 19 | 78 |
| 2023 February | 59 | 21 | 80 |
| 2023 January | 38 | 25 | 63 |
| 2022 December | 64 | 26 | 90 |
| 2022 November | 51 | 34 | 85 |
| 2022 October | 51 | 39 | 90 |
| 2022 September | 49 | 33 | 82 |
| 2022 August | 52 | 39 | 91 |
| 2022 July | 41 | 46 | 87 |
| 2022 June | 52 | 27 | 79 |
| 2022 May | 50 | 35 | 85 |
| 2022 April | 47 | 49 | 96 |
| 2022 March | 57 | 50 | 107 |
| 2022 February | 50 | 28 | 78 |
| 2022 January | 42 | 35 | 77 |
| 2021 December | 72 | 46 | 118 |
| 2021 November | 54 | 37 | 91 |
| 2021 October | 68 | 45 | 113 |
| 2021 September | 56 | 38 | 94 |
| 2021 August | 46 | 34 | 80 |
| 2021 July | 92 | 40 | 132 |
| 2021 June | 56 | 26 | 82 |
| 2021 May | 69 | 37 | 106 |
| 2021 April | 88 | 77 | 165 |
| 2021 March | 94 | 35 | 129 |
| 2021 February | 76 | 20 | 96 |
| 2021 January | 77 | 16 | 93 |
| 2020 December | 59 | 16 | 75 |
| 2020 November | 54 | 14 | 68 |
| 2020 October | 34 | 17 | 51 |
| 2020 September | 37 | 12 | 49 |
| 2020 August | 41 | 14 | 55 |
| 2020 July | 44 | 8 | 52 |
| 2020 June | 42 | 15 | 57 |
| 2020 May | 38 | 10 | 48 |
| 2020 April | 39 | 20 | 59 |
| 2020 March | 47 | 7 | 54 |
| 2020 February | 47 | 18 | 65 |
| 2020 January | 61 | 17 | 78 |
| 2019 December | 58 | 22 | 80 |
| 2019 November | 58 | 25 | 83 |
| 2019 October | 42 | 16 | 58 |
| 2019 September | 51 | 14 | 65 |
| 2019 August | 41 | 20 | 61 |
| 2019 July | 38 | 26 | 64 |
| 2019 June | 30 | 11 | 41 |
| 2019 May | 50 | 17 | 67 |
| 2019 April | 76 | 29 | 105 |
| 2019 March | 36 | 15 | 51 |
| 2019 February | 22 | 15 | 37 |
| 2019 January | 33 | 15 | 48 |
| 2018 December | 85 | 45 | 130 |
| 2018 November | 94 | 12 | 106 |
| 2018 October | 93 | 16 | 109 |
| 2018 September | 68 | 16 | 84 |
| 2018 August | 57 | 21 | 78 |
| 2018 July | 50 | 16 | 66 |
| 2018 June | 42 | 19 | 61 |
| 2018 May | 43 | 14 | 57 |
| 2018 April | 48 | 5 | 53 |
| 2018 March | 48 | 9 | 57 |
| 2018 February | 45 | 4 | 49 |
| 2018 January | 44 | 7 | 51 |
| 2017 December | 54 | 9 | 63 |
| 2017 November | 72 | 7 | 79 |
| 2017 October | 80 | 8 | 88 |
| 2017 September | 51 | 11 | 62 |
| 2017 August | 69 | 5 | 74 |
| 2017 July | 51 | 16 | 67 |
| 2017 June | 47 | 8 | 55 |
| 2017 May | 46 | 10 | 56 |
| 2017 April | 40 | 4 | 44 |
| 2017 March | 33 | 16 | 49 |
| 2017 February | 21 | 7 | 28 |
| 2017 January | 26 | 10 | 36 |
| 2016 December | 45 | 11 | 56 |
| 2016 November | 49 | 10 | 59 |
| 2016 October | 69 | 10 | 79 |
| 2016 September | 99 | 4 | 103 |
| 2016 August | 140 | 2 | 142 |
| 2016 July | 170 | 3 | 173 |
| 2016 June | 126 | 0 | 126 |
| 2016 May | 115 | 0 | 115 |
| 2016 April | 61 | 0 | 61 |
| 2016 March | 81 | 0 | 81 |
| 2016 February | 87 | 0 | 87 |
| 2016 January | 100 | 0 | 100 |
| 2015 December | 115 | 0 | 115 |
| 2015 November | 105 | 0 | 105 |
| 2015 October | 64 | 0 | 64 |
| 2015 September | 64 | 0 | 64 |
| 2015 August | 68 | 0 | 68 |
| 2015 July | 64 | 0 | 64 |
| 2015 June | 37 | 0 | 37 |
| 2015 May | 56 | 0 | 56 |
| 2015 April | 6 | 0 | 6 |
Show all
