Scientific Letter
A New Cyanoacrylate Used as Bronchial Sealant in the Endoscopic Treatment of Bronchopleural Fistula
Utilización de un nuevo cianoacrilato como sellante bronquial en el tratamiento endoscópico de la fístula broncopleural
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b) Muñón de herida quirúrgica de lobectomía de LSI, con fístula bronquial de 3<span class="elsevierStyleHsp" style=""></span>mm de diámetro en la zona superior; c) Cierre de fístula broncopulmonar tras instilación de Glubran<span class="elsevierStyleSup">®</span>2, y d) Resolución del enfisema mediastínico y subcutáneo en la TC de tórax de control, tras 6 meses de la instilación del sellante endobronquial.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sonia Cepeda, Virginia Pajares, Juan Carlos Trujillo-Reyes, Alfons Torrego" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Sonia" "apellidos" => "Cepeda" ] 1 => array:2 [ "nombre" => "Virginia" "apellidos" => "Pajares" ] 2 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "Trujillo-Reyes" ] 3 => array:2 [ "nombre" => "Alfons" "apellidos" => "Torrego" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916303433" "doi" => "10.1016/j.arbr.2016.12.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916303433?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961630206X?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000003/v4_201705130114/S030028961630206X/v4_201705130114/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212916303445" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.12.010" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1434" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:170-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1704 "formatos" => array:3 [ "EPUB" => 139 "HTML" => 1028 "PDF" => 537 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Pleural Effusion: A Rare Manifestation of Sarcoidosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "170" "paginaFinal" => "171" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Derrame pleural: una presentación poco frecuente de sarcoidosis" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1524 "Ancho" => 1350 "Tamanyo" => 273612 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) PA chest radiograph. (B) Radiograph of lateral thorax, showing patchy alveolar infiltrates in the left middle and upper lobes. Predominantly right-sided bilateral pleural effusion. Hilar and mediastinal lymphadenopathy of pathological appearance. (C) Axial image of chest CT with intravenous contrast medium showing lymphadenopathy component in the mediastinal, bilateral hilar and periesophageal compartments. Bilateral alveolar involvement predominantly in the subpleural region of both bases, with accumulated nodal lesions and patchy air bronchogram in the subpleural region.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Fontecha Ortega, Sergio Julio Rodríguez Álvarez, Jose Luis García Satué" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María" "apellidos" => "Fontecha Ortega" ] 1 => array:2 [ "nombre" => "Sergio Julio" "apellidos" => "Rodríguez Álvarez" ] 2 => array:2 [ "nombre" => "Jose Luis" "apellidos" => "García Satué" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302125" "doi" => "10.1016/j.arbres.2016.07.006" "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/S0300289616302125?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916303445?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000003/v1_201703240112/S1579212916303445/v1_201703240112/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212916303408" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.12.006" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1423" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:167-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1950 "formatos" => array:3 [ "EPUB" => 125 "HTML" => 1343 "PDF" => 482 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Subacute Pneumonia as a Manifestation of Acute Fibrinous and Organizing Pneumonia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "167" "paginaFinal" => "168" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumonía subaguda como manifestación de una neumonía organizada fibrosante aguda" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1125 "Ancho" => 1500 "Tamanyo" => 246450 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest radiograph: infiltrate in right upper lobes. (B) Infiltrates in right upper lobe, right lower lobe and left upper lobe with loss of volume in the right hemithorax. (C) Favorable radiological progress. (D) Computed tomography-guided lung biopsy: inflammatory thickening of the septa with intra-alveolar fibrin balls.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Irene Nieto-Codesido, Teresa Hermida-Romero, Pedro J. Marcos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Irene" "apellidos" => "Nieto-Codesido" ] 1 => array:2 [ "nombre" => "Teresa" "apellidos" => "Hermida-Romero" ] 2 => array:2 [ "nombre" => "Pedro J." "apellidos" => "Marcos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302010" "doi" => "10.1016/j.arbres.2016.07.001" "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/S0300289616302010?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916303408?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000003/v1_201703240112/S1579212916303408/v1_201703240112/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "A New Cyanoacrylate Used as Bronchial Sealant in the Endoscopic Treatment of Bronchopleural Fistula" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "168" "paginaFinal" => "169" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sonia Cepeda, Virginia Pajares, Juan Carlos Trujillo-Reyes, Alfons Torrego" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Sonia" "apellidos" => "Cepeda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Virginia" "apellidos" => "Pajares" "email" => array:1 [ 0 => "vpajares@santpau.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Juan Carlos" "apellidos" => "Trujillo-Reyes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Alfons" "apellidos" => "Torrego" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Dr. Peset, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilización de un nuevo cianoacrilato como sellante bronquial en el tratamiento endoscópico de la fístula broncopleural" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1346 "Ancho" => 1400 "Tamanyo" => 268603 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Significant mediastinal and subcutaneous emphysema; (b) LUL lobectomy surgical stump with a 3<span class="elsevierStyleHsp" style=""></span>mm bronchial fistula in the upper area; (c) bronchopleural fistula closure after instillation of Glubran<span class="elsevierStyleSup">®</span> 2; and (d) resolution of mediastinal and subcutaneous emphysema on follow-up chest CT, 6 months after instillation of the bronchial sealant.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A bronchopleural fisutal is a comunication between the pleural space and the bronchial tree. The most common cause of BPF is dehiscence of the surgical suture after lung resection, which happens between in about 0.8% and 15% of cases. Therapeutic options are limited and depend, among other factors, on the size and site of the fistula. Endoscopic treatment is a feasible therapeutic option, particularly in BFP measuring <5<span class="elsevierStyleHsp" style=""></span>mm.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Good final outcomes of BPF closure with Histoacryl<span class="elsevierStyleSup">®</span> (<span class="elsevierStyleItalic">N</span>-butyl-2-cyanoacrylate) in respiratory endoscopy have been reported.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> However, in practice, the rapid polymerization of <span class="elsevierStyleItalic">N</span>-butyl-2-cyanoacrylate makes management and endoscopic placement difficult. Other cyanoacrylates that polymerize at a different rate and at different temperatures are available, and these may be easier to use with an endoscope. No comparative studies have been published on the use of other cyanoacrylates, such as Glubran<span class="elsevierStyleSup">®</span> 2 (<span class="elsevierStyleItalic">N</span>-butyl-2-cyanoacrylate+metacryloxisulfolane), as synthetic surgical sealants.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of an 80-year-old man, active smoker, COPD, GOLD B, who underwent left posterolateral thoracotomy with lobectomy of the left upper lobe (LUL) and systemic lymph node resection, with a diagnosis of squamous lung cancer, stage pT2aN0M0. Two weeks after the intervention, the patient presented progressive subcutaneous and mediastinal emphysema, with significant facial edema, but no upper airway compromise (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a). During the endoscopic examination with flexible bronchoscope, a 3<span class="elsevierStyleHsp" style=""></span>mm fistula was observed in the LUL lobectomy stump wound (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b). In view of the endoscopic findings, persistent air leak, and worsening subcutaneous emphysema, the fistula was sealed using cyanoacrylate, as follows: 1<span class="elsevierStyleHsp" style=""></span>ml <span class="elsevierStyleItalic">N</span>-butyl-2-cyanoacrylate+metacryloxisulfolane (Glubran<span class="elsevierStyleSup">®</span> 2 Ref.G-NB-2, GEM srl, Italy), applied using a syringe via a 5 Fr angioplasty catheter (Angiographic Cathether Tempo<span class="elsevierStyleSup">®</span> Vertebral [VERT] Ref. 451-514H0 Cordis<span class="elsevierStyleSup">®</span>). Due to the characteristics of the sealant, a safety margin between the distal tip of the catheter and the bronchoscope lens was maintained. Immediately after applying the bronchial sealant, complete closure of the fistula was confirmed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>c), the bronchoscope was withdrawn together with the angioplasty catheter placed in the working channel to avoid any sealant remnants entering the interior of the working channel and damaging the equipment during withdrawal. The distal end of the catheter was then closed to avoid any sealant remnant entering the working channel. Five days after the application of Glubran<span class="elsevierStyleSup">®</span> 2, correct closure of the fistula was confirmed in a second endoscopic procedure; the patient had improved clinically with progressive resolution of the subcutaneous emphysema. The patient was followed up as an outpatient, and a follow-up chest computed tomography was performed 6 months after surgery, confirming clinical stability and complete resolution of the subcutaneous emphysema (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>d), with no recurrence or other serious long-term complications.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The physical and chemical properties of cyanoacrylate derivatives were described in 1959 by Coover et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Methyl-2-cyanoacrylate was the first derivative used as surgical glue. Differences in polymerization speed depend on chain length: short-chain cyanoacrylates are faster, but they also cause greater cytotoxicity and inflammatory reactions. Currently, long-chain cyanoacrylates (butyl and octyl-cyanoacrylate) are more commonly used as surgical sealants in different medical and surgical areas.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The use of endobronchial valves<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> and other biological materials, such as stromal cell preparations,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> have been described as possible treatments for bronchopleural fistula. With regard to sealants, many materials and devices offering similar sealing results have been used, although no comparative studies have been published on the use of different products. Glubran<span class="elsevierStyleSup">®</span> 2 is a new cyanoacrylate derivative that demonstrates excellent capacity for joining biological material. The polymerized layer is highly resistant to rupture, and polymerization time is slow. In our patient, BPF was closed with the use of cyanoacrylate and the air leak was controlled in a single endoscopy procedure, placement of the material was easy, and there were no complications. In our experience, the use of Glubran<span class="elsevierStyleSup">®</span> 2 for endoscopic sealing of BPF was a feasible, safe procedure, offering immediate closure with no subsequent complications.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cepeda S, Pajares V, Trujillo-Reyes JC, Torrego A. Utilización de un nuevo cianoacrilato como sellante bronquial en el tratamiento endoscópico de la fístula broncopleural. Arch Bronconeumol. 2017;53:168–169.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1346 "Ancho" => 1400 "Tamanyo" => 268603 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Significant mediastinal and subcutaneous emphysema; (b) LUL lobectomy surgical stump with a 3<span class="elsevierStyleHsp" style=""></span>mm bronchial fistula in the upper area; (c) bronchopleural fistula closure after instillation of Glubran<span class="elsevierStyleSup">®</span> 2; and (d) resolution of mediastinal and subcutaneous emphysema on follow-up chest CT, 6 months after instillation of the bronchial sealant.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 1 | 8 |
| 2024 October | 45 | 16 | 61 |
| 2024 September | 49 | 15 | 64 |
| 2024 August | 76 | 35 | 111 |
| 2024 July | 60 | 23 | 83 |
| 2024 June | 64 | 24 | 88 |
| 2024 May | 84 | 19 | 103 |
| 2024 April | 62 | 30 | 92 |
| 2024 March | 58 | 21 | 79 |
| 2024 February | 34 | 17 | 51 |
| 2023 March | 11 | 5 | 16 |
| 2023 February | 64 | 25 | 89 |
| 2023 January | 56 | 35 | 91 |
| 2022 December | 78 | 33 | 111 |
| 2022 November | 81 | 41 | 122 |
| 2022 October | 66 | 39 | 105 |
| 2022 September | 62 | 21 | 83 |
| 2022 August | 43 | 42 | 85 |
| 2022 July | 45 | 42 | 87 |
| 2022 June | 48 | 37 | 85 |
| 2022 May | 38 | 37 | 75 |
| 2022 April | 49 | 33 | 82 |
| 2022 March | 63 | 41 | 104 |
| 2022 February | 52 | 32 | 84 |
| 2022 January | 65 | 40 | 105 |
| 2021 December | 65 | 47 | 112 |
| 2021 November | 56 | 42 | 98 |
| 2021 October | 51 | 64 | 115 |
| 2021 September | 53 | 57 | 110 |
| 2021 August | 39 | 39 | 78 |
| 2021 July | 35 | 17 | 52 |
| 2021 June | 54 | 38 | 92 |
| 2021 May | 66 | 34 | 100 |
| 2021 April | 147 | 86 | 233 |
| 2021 March | 75 | 27 | 102 |
| 2021 February | 44 | 30 | 74 |
| 2021 January | 36 | 11 | 47 |
| 2020 December | 36 | 11 | 47 |
| 2020 November | 39 | 25 | 64 |
| 2020 October | 59 | 24 | 83 |
| 2020 September | 46 | 18 | 64 |
| 2020 August | 32 | 20 | 52 |
| 2020 July | 44 | 25 | 69 |
| 2020 June | 41 | 12 | 53 |
| 2020 May | 42 | 15 | 57 |
| 2020 April | 50 | 25 | 75 |
| 2020 March | 26 | 12 | 38 |
| 2020 February | 52 | 25 | 77 |
| 2020 January | 52 | 19 | 71 |
| 2019 December | 57 | 28 | 85 |
| 2019 November | 75 | 31 | 106 |
| 2019 October | 25 | 14 | 39 |
| 2019 September | 32 | 22 | 54 |
| 2019 August | 43 | 21 | 64 |
| 2019 July | 37 | 25 | 62 |
| 2019 June | 43 | 16 | 59 |
| 2019 May | 45 | 31 | 76 |
| 2019 April | 36 | 32 | 68 |
| 2019 March | 36 | 25 | 61 |
| 2019 February | 27 | 19 | 46 |
| 2019 January | 18 | 13 | 31 |
| 2018 December | 23 | 16 | 39 |
| 2018 November | 73 | 25 | 98 |
| 2018 October | 59 | 21 | 80 |
| 2018 September | 38 | 8 | 46 |
| 2018 May | 16 | 0 | 16 |
| 2018 April | 15 | 6 | 21 |
| 2018 March | 25 | 6 | 31 |
| 2018 February | 33 | 10 | 43 |
| 2018 January | 86 | 6 | 92 |
| 2017 December | 84 | 5 | 89 |
| 2017 November | 31 | 11 | 42 |
| 2017 October | 20 | 10 | 30 |
| 2017 September | 17 | 6 | 23 |
| 2017 August | 25 | 23 | 48 |
| 2017 July | 22 | 12 | 34 |
| 2017 June | 28 | 16 | 44 |
| 2017 May | 2 | 1 | 3 |
| 2017 April | 0 | 0 | 0 |
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