<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2307-3349</journal-id>
<journal-title><![CDATA[Revista de salud publica del Paraguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. salud publica Parag.]]></abbrev-journal-title>
<issn>2307-3349</issn>
<publisher>
<publisher-name><![CDATA[INSTITUTO NACIONAL DE SALUD - MSP Y BS]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2307-33492023000100035</article-id>
<article-id pub-id-type="doi">10.18004/rspp.2023.abril.05</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Aislamiento de gérmenes oportunistas en pacientes internados en Unidad de Cuidados Intensivos]]></article-title>
<article-title xml:lang="en"><![CDATA[Isolation of opportunistic germs in patients admitted in the Intensive Care Unit]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Brizuela Centurión]]></surname>
<given-names><![CDATA[Amanda María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martí Ruiz]]></surname>
<given-names><![CDATA[Analia del Carmen María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fusillo Montanaro]]></surname>
<given-names><![CDATA[José Domingo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oleynick Goncalves]]></surname>
<given-names><![CDATA[Alexis Fabián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ayala Careaga]]></surname>
<given-names><![CDATA[Jessica Berenise]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Sanatorio Adventista de Asunción Unidad de Cuidados Intensivos ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2023</year>
</pub-date>
<volume>13</volume>
<numero>1</numero>
<fpage>35</fpage>
<lpage>39</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2307-33492023000100035&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2307-33492023000100035&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2307-33492023000100035&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La infección es una de las complicaciones que afecta frecuentemente al paciente crítico.  Objetivo: Determinar la presencia de gérmenes oportunistas en pacientes internados en la Unidad de Cuidados Intensivos (UCI) durante el periodo de enero a junio del 2021 en el Sanatorio Adventista de Asunción.  Materiales y Métodos:  Estudio descriptivo, de corte transversal, en el periodo comprendido de enero a junio de 2021. Los datos fueron analizados por EPIINFO, utilizándose estadística descriptiva. En todos los pacientes evaluados se recogieron variables demográficas, comorbilidades, presencia del COVID-19, instrumentaciones realizadas (intubación, ventilación mecánica, traqueotomía), días de estancia en UCI, gérmenes aislados, tratamiento realizado, antibióticos más frecuentes utilizados. La variable "días de estancia en UCI" corresponde a la estancia total de los pacientes en dicha unidad.  Resultados:  Fueron incluidos 90 pacientes en el periodo de tiempo de estudio. De ellos: 72 fueron de sexo masculino que correspondió al (80%). La edad promedio fue de 55 ± 5,6 años. La estancia hospitalaria total de los mismos fue en promedio de 11 días (1-62). Las comorbilidades más frecuentes fueron: hipertensión, obesidad y diabetes mellitus II Los microorganismos identificados prevalentes fueron Escherichia coli (n=9), Acinetobacter baumannii (n=9), Enterobacter cloacae (n=3); Pseudomonas aeruginosa (n=5), Staphylococcus aureus (n=1) Candida spp. (n=13), Klebsiella pneumoniae (n=7), Acinobacter sp(n=18). La mortalidad global fue del 63,3% (57 pacientes).  Conclusión: Acinobacter sp. fue el microorganismo que se aisló con mayor frecuencia. Los niveles de resistencia a los antimicrobianos fueron elevados siendo todos los gérmenes aislados ciprofloxacina resistente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Infection is one of the complications that frequently affects critically ill patients.  Objective:  To determine the presence of opportunistic microorganisms in patients admitted to the Intensive Care Unit (ICU) from January to June 2021 at the Asunción Adventist Sanatorium.  Materials and methods:  Descriptive, cross-sectional study, in the period January to June 2021. The data were analyzed by EPIINFO, using descriptive statistics. Demographic variables, comorbidities, presence of COVID-19, performed procedure (intubation, mechanical ventilation, tracheostomy), length of stay in the ICU, isolated germs, administered treatment, and most frequently used antibiotics were collected from all the patients evaluated. The variable "length of stay in the ICU" corresponds to the total hospital stay of the patients in that unit.  Results:  90 patients were included in the study period. 72 were male, which corresponded to 80%. The average age was 55 ± 5.6 years. Their average hospital stay was 11 days (1-62). The most frequent comorbidities were hypertension, obesity and diabetes mellitus II. The prevalent identified microorganisms were Escherichia coli (n=9), Acinetobacter baumannii (n=9), Enterobacter cloacae (n=3); Pseudomonas aeruginosa (n=5), Staphylococcus aureus (n=1), Candida spp. (n=13), Klebsiella pneumoniae (n=7), Acinobacter sp (n=18). Overall mortality was 63.3% (57 patients).  Conclusion: Acinobacter sp. was the most frequently isolated microorganism. Antimicrobial resistance levels were high, with all isolated germs being resistant to ciprofloxacin.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[infección hospitalaria]]></kwd>
<kwd lng="es"><![CDATA[resistencia antimicrobiana]]></kwd>
<kwd lng="es"><![CDATA[fármaco resistencia microbiana]]></kwd>
<kwd lng="es"><![CDATA[unidades de cuidados intensivos]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[cross infections]]></kwd>
<kwd lng="en"><![CDATA[drug resistance microbial]]></kwd>
<kwd lng="en"><![CDATA[intensive care unit]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[García-Castellanos]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Microorganismos aislados de pacientes hospitalizados en unidad de cuidados intensivos. Identificacióny resistencia antimicrobiana]]></article-title>
<source><![CDATA[Revista cubana de medicina intensiva y emergencias]]></source>
<year>2014</year>
<volume>13</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="">
<collab>Organización Mundial de la Salud</collab>
<collab>World Health Organization</collab>
<source><![CDATA[COVID 19 - China]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vargas-Correa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mereles]]></surname>
<given-names><![CDATA[EF]]></given-names>
</name>
<name>
<surname><![CDATA[Segovia Coronel]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Gimenez Ayala]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Santacruz]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Ojeda]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Características clínico-epidemiológicas de pacientes confirmados con COVID-19 del Departamento de Alto Paraná, Paraguay]]></article-title>
<source><![CDATA[Rev. salud publica Parag]]></source>
<year>2021</year>
<volume>11</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>54-61</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Su]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Shi]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lai]]></surname>
<given-names><![CDATA[ACK]]></given-names>
</name>
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses]]></article-title>
<source><![CDATA[TrendsMicrobiol]]></source>
<year>2016</year>
<volume>24</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>490-502</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lai]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Shih]]></surname>
<given-names><![CDATA[TP]]></given-names>
</name>
<name>
<surname><![CDATA[Ko]]></surname>
<given-names><![CDATA[WC]]></given-names>
</name>
<name>
<surname><![CDATA[Tang]]></surname>
<given-names><![CDATA[HJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hsueh]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) and coronavirus disease-2019 (COVID-19) The epidemic and the challenges]]></article-title>
<source><![CDATA[Int J Antimicrob Agents]]></source>
<year>2020</year>
<volume>55</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>105924</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guanche Garcell]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[COVID-19. Un reto para los profesionales de la salud]]></article-title>
<source><![CDATA[Revista Habanera de Ciencias Médicas]]></source>
<year>2020</year>
<volume>19</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Madrigal Rojas]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Quesada Loría]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[García Sánchez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Solano Chinchilla]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[SARS CoV-2, manifestaciones clínicas y consideraciones en el abordaje diagnóstico de COVID-19]]></article-title>
<source><![CDATA[Rev Med Cos Cen]]></source>
<year>2020</year>
<volume>86</volume>
<numero>629</numero>
<issue>629</issue>
<page-range>13-21</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Zhou]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Dong]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Qu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gong]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China a descriptive study]]></article-title>
<collab>Han Y et al</collab>
<source><![CDATA[Lancet]]></source>
<year>2020</year>
<volume>395</volume>
<numero>10223</numero>
<issue>10223</issue>
<page-range>507-13</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lopes Araújo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia de la infección relacionada con la asistencia a la salud en pacientes hospitalizados en unidad de cuidados intensivos]]></article-title>
<collab>Oliveira de Mendonça AE.Álvares de Medeiros R.Souza Neto VL.Nobre Thaiza Teixeira X.Fernandes Costa IK</collab>
<source><![CDATA[Enferm. glob]]></source>
<year>2018</year>
<volume>17</volume>
<numero>52</numero>
<issue>52</issue>
<page-range>278-315</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Monté Cerero]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Casanueva]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Microorganismos aislados en pacientes ingresados. Hospital "Salvador Allende", La Habana. Febrero a junio de 2015]]></article-title>
<source><![CDATA[Revista Habanera de Ciencias Médicas]]></source>
<year>2017</year>
<volume>16</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Díaz Medina]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Medina García]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Duque González]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Miguélez Nodarse]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Susceptibilidad antimicrobiana en muestras clínicas de pacientes con infecciones asociadas a la atención de salud]]></article-title>
<source><![CDATA[Revista Habanera de Ciencias Médicas]]></source>
<year>2017</year>
<volume>16</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>aprox. 14 p.</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Favarin]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Camponogara]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perfil dos pacientes internados na unidade de terapia intensiva adulto de um Hospital Universitário]]></article-title>
<source><![CDATA[Rev Enferm UFSM]]></source>
<year>2012</year>
<volume>2</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>320-9</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nangino]]></surname>
<given-names><![CDATA[GO]]></given-names>
</name>
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[PC]]></given-names>
</name>
<name>
<surname><![CDATA[Machado]]></surname>
<given-names><![CDATA[NM]]></given-names>
</name>
<name>
<surname><![CDATA[Dias]]></surname>
<given-names><![CDATA[ATB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impacto financeiro das infecções nosocomiais em unidades de terapia intensiva em hospital filantrópico de Minas Gerais]]></article-title>
<source><![CDATA[Rev Bras Ter Intensiva]]></source>
<year>2012</year>
<volume>24</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>357-61</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Finger-Jardim]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Bosso]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalência de infecção nosocomial um estudo retrospectivo em uma unidade de terapia intensiva]]></article-title>
<source><![CDATA[Rev Vittalle;]]></source>
<year>2011</year>
<volume>23</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>57-64</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Deleri]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ozayar]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Degerli]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sahin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Koç]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Three-year evaluation of nosocomial infection rates of the ICU]]></article-title>
<source><![CDATA[Rev Bras Anestesiol]]></source>
<year>2013</year>
<volume>63</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>73-84</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Howhors]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acinetobacter baumannii An emerging opportunistic pathogen]]></article-title>
<collab>O'Donoghue M.Feeney A.Sleator RD</collab>
<source><![CDATA[Rev Virulence]]></source>
<year>2012</year>
<volume>3</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>243-50</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Barth]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acinetobacter multirresistente um desafio para a saúde pública]]></article-title>
<source><![CDATA[Rev Scientia Medica]]></source>
<year>2013</year>
<volume>23</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>56-62</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aguado]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz-Camps]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Muñoz]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Mensa]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Almirante]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Vázquez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recomendaciones sobre el tratamiento de la candidiasis invasiva y otras infecciones por levaduras de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) Actualización 2011]]></article-title>
<source><![CDATA[Enferm Infecc Microbiol Clin]]></source>
<year>2011</year>
<volume>29</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>345-61</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fears]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Meulen]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[What do we need to do to tackle antimicrobial resistance]]></article-title>
<source><![CDATA[Rev The lancet global health]]></source>
<year>2014</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>73-84</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
