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Patient outcomes after surgery in 17 Latin American countries (LASOS): a 7 day prospective cohort study. Lancet Glob Health 2025; 13:e635-e645. [PMID: 40155102 DOI: 10.1016/s2214-109x(24)00558-8] [Show More Authors] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Collaborators] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 10/13/2024] [Accepted: 12/16/2024] [Indexed: 04/01/2025]
Abstract
BACKGROUND Access to safe surgical treatment across Latin America is limited by underfunded and fragmented health systems. Epidemiological data are required to describe surgical activity and patient outcomes. METHODS We did this 7 day prospective cohort study in 17 Latin American countries, collecting data describing inpatient surgery in adults (aged ≥18 years). The primary outcome was in-hospital postoperative complications within 30 days after surgery. Secondary outcomes were in-hospital mortality, duration of hospital stay, and admission to critical care within 30 days after surgery. This study is registered with ClinicalTrials.gov, NCT05169164. FINDINGS Between June 1, 2022, and April 30, 2023, we included 22 126 patients (mean age 49·7 years [SD 18·2]; 9260 [41·9%] male and 12 866 [58·1%] female; 10 180 [46·0%] White) from 284 hospitals. Of the 22 126 patients, 657 (3·0%) patients for the outcome of complications and 380 (1·7%) patients for mortality had missing data. Most patients were low risk (American Society of Anesthesiologists [ASA] grade I or II: 17 311 [78·7%] of 21 979 patients), undergoing non-major surgery (14 944 [68·0%] of 21 986 patients), and on an elective basis (14 837 [67·5%] of 21 988 patients). Despite this low-risk profile, 3163 (14·6%) of 21 632 patients developed postoperative complications resulting in 477 (2·2%) deaths. The most frequent complication category was infection, affecting 1795 (8·2%) patients. The high mortality from complications (failure to rescue) of 15·1% (477 deaths in 3163 patients with complications) suggests significant problems with postoperative care. 2978 (13·6%) patients were admitted to a critical unit immediately after surgery, but 180 (37·7%) of 477 patients who died never received critical care. Patients with complications had a median hospital stay of 8 days (IQR 3-18), compared with 2 days (1-3) for patients without complications. Postoperative mortality and complications were strongly associated with increasing ASA grade, urgency of surgery, and grade of surgery (intermediate and major). INTERPRETATION Patients receiving inpatient surgery in Latin America experienced high mortality rates, likely relating to standards of ward care after surgery. Given the rising demand for surgical treatments, resource-efficient measures are urgently needed to improve patient outcomes after surgery across Latin America. FUNDING None. TRANSLATIONS For the Spanish and Portuguese translations of the abstract see Supplementary Materials section.
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Collaborators
Adrian Alvarez, Sean Bagshaw, Bruce Biccard, Luis Boccalatte, Delia Borunda, Jose Andre Calvache, Maria José C Carmona, Nicole M Castillo-Huerta, Shane Charles, Antonio R De-la Medina, Martha Beatriz Delgado-Ramirez, Alex Fowler, Melba Frias, Ludhmila A Hajjar, Russell Hewson, Maria Laura Illescas, Kelly Kon-Liao, Sylvia B Lemaire, Eddy P Lincango, Monica B Martinez, Santiago Mc Loughlin, Cindy Montoya, Letícia N Nakada, Lizbeth G Ortiz, Greg Padmore, Akshaykumar Patel, Rupert M Pearse, Vinícius C Quintão, Juan Riva, Ismael D Rosado, Sebastian Shu, Rodrigo Soza-Argaña, Luciana C Stefani, Mayra Vaca, Nicolas Villablanca, Duminda Wijeysundera, Ozama B Zachi, Adriana Pérez, Agustin Roca, Florencia P Prieto, Laura I Villarino, Carolina Bocci, Maria A Bilos, Virgina E Aredes, Leonardo Masri, Victor H Serafini, Alejandra V Currao, Maria V Feola, Ana I Leone, Alex R López, Pablo E Martin, Ingrid Warnes, Victoria D Turesso, Tomas E Hudson, Camila Bof, Andrea Del Carretto, Analía Ciccola, Federico E De Nicola, Horacio A Mazzini, Amira L Dayoub, Clara Baldi, Mariana Ceretti, Macarena Risso, Lucas Bacino, Jorge E Filisetti, Milton Szakura, Ailen Furlan, Lautaro Alvarez, Javier Márquez, Alan P Cragnulini, Jerónimo Matassa, Bianca Ballarino, Paula Albarracin, Agustín E Collia, Nicolás Celso, Valeria P Boschini, Carlos D Romero, Jose Mendez, Alberto J Veloso, Guadalupe Saco, Julian Capurro, Hernan E Szmulewicz, Martin Montanaro, Federico A Díaz, Rodolfo Sanz, Diego M Toscana, Esteban J Lafuente, Valeria P Boschini, In H Hwang, Germán Masnata, Maria F Pedemonte, Bautista Alfonso, Lautaro Felix, Federico J Tano, Silvia E Vargas, Raul L Varela, Agustina Olmedo, Matias Olivares, Mauro Bottegal, Andrea B Fenoglio, Raul L Varela, Mónica Molinari, Walter Chalco, Eduardo Featherston, Gabriela Mallón, Marina Nicotera, Matías Olozaga, Hugo Palumbo, Andrea Valle, Jezabel Bravo, Nicolás Passone, María S Fernandez, Maria P Marton, Federico E De Bonis, Esteban G Jauregui, Sofia Tobio, Santiago Mata-Suarez, Agustina S Aspiazu, Marcelo N Presinky, Marcelo A Silvero, Maria L Cueli, Laura M Fernandez, Diego Segovia, Gabriela Branda, Carolina Caputti, Fernando Nannini, Alejandro S Quiroga, Mónica Vergara, Leonardo J Pizzi, Emiliano D Arabia, Carolina Saracco, Lucas N Baleato, Marcelo Cobeña, Juan F Mateucci, Morena Torre, José M Fornero, Mauro Blanco, Agustin Duro, Sonia Matthiess, Maria M Caubet, Malena Rius, Marcos González, Alejandro Manfredi, Eliana Cian, Mariana B Gace, Evelyn Russo, Naida Bernal, Rocío Martínez, Tatiana Letowski, Juan G Acosta, María S Jue, Javier Alvarez, Luis P Campuzano, Augustin R Altamirano, Jesica P Angeloni, Juan P Despuy, Analía Priotto, Juan Siri, Esteban E Masino, Victoria Lenza, María F R Merialdo, Ramiro Barboza, Liliana Vaula, Mariela E Gutierrez, Ana Aquino, Jesus D Arancibia, Rodrigo X Morales, Diego A Saravia, Cesar V Sanguino, Juan Pablo R Campos, Carla L Herrera, Pedro A Gonzales, Marcelo O Zamar, Eduardo N Luis, Valeria G Cistola, Carina Chwat, Guillermo Rosato, Flavia A Alexandre, Diego J Valli, Guido D Duarte, Mauro R Duarte, Gustavo Lemme, Luciano M Bria, Federico Pineda, Sandra Ferro, Ana P Sierra, David H Neira, Marco Rottari, Nicolas A Nigro, Carlos M Esquivel, Nicolas A Airaldi, Manuel Garcia, Fernando M Lascano, Lucas A Ruggiero, Mariana Costa, Aldana B Laprida, Lucia Carreras, Federico Gorganchian, Jesica Fischer, Maria F Castellano, Maria G Vidal, Lucas Casanova, Victor Serafini, Zambelli M Milagro, Gabriela A Raffa, Carlos F Colas, Vega Marcelo, Pablo E Martin, Gonzalo Delía, Ariel A Corsaro, Violeta Volpe, María A Ghezzi, Natalia Orso, Cristian Zamponi, Virginia Vazquez, Hernán H Lago, Lucia B Jimenez, Florencia Terradillos, Maria C Candel, Carlos Oyenard, Patricio J Gerbaudo, Élan Howell, Keisha Y Walkes, Elsa-Ruth Arthur, Dale Springer, Dime R Pembleton, Damien Barker, Alan Smith, Ninon M Forter-Chee-A-Tow, Clémentine Forter-Chee-A-Tow, Courtenay Chase, Dominique Marshall, Alana Francis, Nina Yhap, Perry Ellis, Makeda Edmee-Kelly, Israël F Pinto, João D Neto, Cassia Silva, Stênio Zequi, Rafael Meduna, Jayme Nobre, Bruna E C Kupper, Samuel Aguiar, Vanessa S Alves, Luis P Kowalski, Glauco Baiocchi, Bruna T Gonçalves, Fernanda Pintor, Erick Ferreira, Silvana Santos, Fabiana B Makdissi, Jefferson L Gross, Narimã Marques, Felipe J F Coimbra, José G Vartanian, Desire T Maioli, Caroline C Zaro, Ricardo L Menegazzo, Claudio Piras, Felipe Christo, Rodrigo Conti, Vera Azevedo, Gustavo Ferreira, Mariana Reis, Ana C B Suzart, Felipe M De Almeida, Michelle N Lorentz, Bruna Vianna, Marcela N Pimenta, Thaís N Pimenta, Raquel R Soares, Alvaro J Lança, Patrícia Beato, Karen T Galdino, Gabrielle Rodrigues, Elaine C D Moisés, Ana C T Zani, Caio A C Prado, Alice Yasuda, Murilo L Brazan, Sarah Recife, Luis H Cangiani, Luiz G Vazquez, Lucas F G Pereira, Tássio Franco, Renan Murad, Maria E S Silva, João P J Pontes, Plinio Mourão, Fernando B Curci, Rodrigo Cardoso, Gleice C L Cardoso, Caroline F Matos, Nubia A C Pereira, Paloma C Martins, Isadora S N Miranda, Igor D Michalick, Walkiria W Vilas Boas, Matheus H Gomes, Larissa C de Sena, Igor A Procópio, Jadson L Lemes, Talita F Souza, Maurício Machado, Vanessa H Carvalho, Eder Reis, Paulo N Junior, Norma S P Modolo, Leandro G Braz, Guilherme A M de Barros, Ursula B Guirro, Antonio Brandão, Rafael A Nunes, Alessandro de Rinaldis, Daniel Daniachi, Fernando Abrao, Guilherme Zuiani, Pedro Ciaralo, Kenji Nishinari, Leandro Costa, Ithyara Bueno, Rafael Cavalcante, Gilberto Silva, Augusto C M Vilela, Lara F de Abreu, Isabella Marcondes, Yuri R Teixeira, Rafaela Morais, Daniel A B Coura, Juliana C Gonçalves, Karina Faria, Francielly A Sampaio, Júnia A R Melgaço, Neander Ferreira, Sanderland Gurgel, Guilherme H Cota, Natalia T Marques, Wescley P Coca, Rodolfo Espinoza, Giulliana Moralez, Deborah R Petronilho, Sandro R Dainez, Gabriel M de Freitas, Guilherme L Franco, Giovanni V Goulart, Leandro Miksche, Bruna Rebelatto, Anderson J Gonçalves, Roberto R Barbosa, Bruno Prati, Layla Pasolini, Valentin T Neto, Darlan Dadalt, Henrique Serpa, Gabriel A Brandão, Edwaldo E Joviliano, Fabiana Valera, Antonio A Rodrigues Junior, Edwin Tamashiro, Rodolfo Reis, Flora Bisinotto, Ariele P da Silva, Igor R Camargo, Laura B Martins, Ana M Caetano, Nádia M C Duarte, Debora A Dornelles, Isabela S Sirtoli, Paulo C Silva Neto, Cleiton S Pando, Gilberto Braulio, Carolina L Schiavo, Adriene Stahlschmidt, Sávio C Passos, Angela R Andre, Edicarlos A Pereira, Fernanda Leite, Bruyére P Rodrigues, Neusa T Onari, Valeria M Sousa, Raphael P Chaves, Luciana C Sanches, Marina V Milani, Fernando Bueno, Roberta Cattaneo, Camila Mahl, Lucas Zimmermann, João Cossetin, Gabriella Remedil, Sílvia Souza, Clarice L Park, Cesar Dusilek, Gabrielly Lech, Cesar B Ferreira, Carlos Ferreira, Renato N Pazini, Daniel M Tsuchie, Hilton R Guesse, Ariane R Santos, Gabriel A S Torres, Miki Mochizuki, Laura M Vidotto, Maria P Q Vilela, Pedro W R da Silva, Isabele H R Dias, Henrique B Florindo, Marcia R F Jorge, Alexandre Slullitel, Leonardo Lima, Vinicius Andrade, Milena C Campeone, Claudia R R Bagio, Victor A F Avezum, Thiago H S Pereira, Maira Benatti, João P Santos, João A Assis, Ellen Vaz, Mayara Sanches, Onesimo D Ribeiro Junior, Paulo A Herrera, Rodrigo S Matsuda, Liana Silva, Érica T Marin, Renata C A Dos Santos, Gabriel G da Silva, Claudia H R da Silva, Gabriela Gontijo, Bruno Procopio, Taisa G Mesquita, Nubia C F Isoni, Fabiano S Araújo, Aline V C Amorim, Victória S Coelho, Lucas N Vaz, Pedro E Morato, Veronica Dias, Victor Reis, Thiago Furtado, José Nascimento, Sarita F C Duda, Vinicius F Barchin, Daniel S Cesar, Viviane Suzuki, Odair A Abdala, Milena V Perez, Johngersen S Pereira, João P Beolchi, Eliana V Martins, Nicole B Gonçalves, Luciano Ferreira, Lucas M Drumond, Kátia D S Milagres, Juliano V Mesquita, João A M Rodrigues, Maristela Lopes, Dina Hatanaka, Filippe Torres, Carolina Rodrigues, Klisman A de Melo, Alice J Koyama, Carolina Baeta, Lilia Constantino, Livia M Valim, Mateus Cruz, Matheus Miranda, Alexandre Teruya, Paulo F Tierno, Bianca D Bocalon, Stefany S Robis, Ana Paula S Araujo, Paulo F Tierno, Bianca D Bocalon, Stefany S Robis, Mayara Tigulini, Victoria Burnier, Verônica P Damião, Rileide F Costa, Gisele Fernandes, Antonio Bedin, Matheus Fronza, Natália C Vieira, Rafael A C Bedin, Marcelo M Patti, Eduardo Patruni, Manfredo K Naritomi, Valquiria Ritter, Gisele Sagawa, Arnaldo Tanaka, Andre P Schmidt, Fernanda Milagre, Artur S Porciúncula, Mariana Berto, Rafaela Scheid, Eduarda R Paiva, João A Bittencourt, Camila P Kruger, Elida P Rossi, Rene R Pereira, Fabio H Lacerda, Felipe M Pena, Carlos Eduardo Bosso, Isabela C M Vasconcellos, Guilherme P A Damo, Aline Silva, Carolina Miranda, Pedro B Silva, Rodrigo P Pedrosa, Edilberto Rocha, Juliana Zaidan, Rebeca Santos, Ludmila Nicastro, Sophia B Lucchesi, José H Araújo, Ana T Lopes, Cristhieni Rodrigues, Gloria Selegatto, Ramy Marino, Barbara Santana, Luiz F Falcão, Ivanize Alves, Cristiano F Souza, Marcelo R M Queiroz, Mariana R Polezi, Larissa P S Santos, Amanda C Bellini, Sarah L Candido, Julia Hoffmann, Victor S Silva, Adriana N Martins, Guilherme Burgos, Amanda L Pires, Daline Santos, Plinio C Leal, Wildney L Lima, Artur Rocha, Prisco B Queiroz Neto, Hiago B Parreao, Sergio S Santos, Vitor F Rios, Marcos V A Brito, Renato L Mafioleti, Eric Lineburger, Danusa Damasio, Andreia Rodrigues, Denize Moretti, Leopoldo M Silva, Saullo Silveira, Fernando N Bellicieri, Leonardo B Santos, Rafael Nersessian, Edilson C Sousa Junior, Neylany R F Silva, Ana Cristina, Shazma H Schazma, Andressa D Giordani, Paloma Berton, Aloma S Menegasso, Kéli M Martins, Alexandre Tognon, Marilini Gonçalves, Lauro Bogniotti, Mauricio Daher, Arthur Segurado, Sonciarai Baldin, Maria B Bastos, Matheus Castilho, Rebecca Assis, Wenceslau K Silveira Neto, Guilherme Moura, Aline Fernandes, Claudia M Simões, Beatriz A Fernandes, George Sales, Regiane Xavier, Segio Arap, Luan C M de Oliveira, Jamil Schneider, Fernando Aranha, Luiz E K de São Thiago, Tania L Lunardeli, Thais O Cancado, Fernando B Cancado, Andrew R S Peral, Erica P Nery, Thiago F Gomes, Veronica F de Campos, Alessandra M Natal, Ricardo Pavón, Clístenes C Carvalho, Alex V M Sousa, Isabella B Ramos, Ana B S Souza, Stéphanie A Regueira, Duilio L Filho, Felipe Gois, Marianna P Fonseca, Gabriel Mattos, Milena S Andrade, Victoria M S Correia, Vera M S Azevedo, Arthur V A Lima, Ciro Alencar, Anderson M Almeida, Joshua Fontes, Pedro V C Barreto, Gabriel Valentim, Felipe B Santos, André L B Silva, Helena Noal, Alexandre Schwarzbold, Roberta Senger, Gabriela Barcellos, Gabriel S Rodrigues, Juliane G Golfetto, Thiago Nunes, Lucas Araujo, Danielle Dourado, Gabriel Guimarães, Henrique Pereira, Carlos R N Junior, Kelre Wannlen, Guilherme A Coelho, Arthur P Britzke, Antonio C Oliveira, Renan Pinheiro, Marcelo Reis, Liana Azi, Raphael Silva, Evandro A S Mariot, Jessica Malanowski, Elisangela Montes, Juliana Schleder, Julio Poppi, Mariana Gonçalves, Murillo O Antunes, Julia V S Matos, Thiago G Romano, Marcela Dutra, Israel Maia, Maiara Mazera, Maria E K Silva, Jorge Y H Murata, Felipe G R Alves, Alexandra P Z Vieira, Fabiana Agena, Ricardo P Burbano, Vivian L Amato, Carolina P Maldi, Marilia P Menezes, Silmara Friolani, Adriana R Garofalo, Tiago Yao, Kaytiussia Sena, Jacqueline P Oliveira, Lucas Vieira, Vanessa S Costa, Fernando Atik, Leiliandry A Melo, Thales P Batista, Arthur F K Gonçalves, Fabiana F Barbosa, Laryssa R L Oliveira, Daniel W Pragana, Beatriz C O de Melo, Klaiver L S Paiva, Nathalia Santos, Ligia Camara, Fernando A S Figueira, Déborah L Freitas, Verônica F de Campos, Juliano P de Almeida, Pedro D Ramos, Antonio J Moreira Junior, Lucas T Kawahara, Alysson V Barbosa, Patricia B Matos, Gisela Magnus, Maize Cordeiro, Yerkes P Silva, Luciana Laurentys, Lucileni Borin, Cesar Minelli, Thainara Palma, Ramon M Vilela, Rodrigo B Barcelos, Florentino F Mendes, Tiago G Pereira, Kérellyn Follador, Victoria K Lau, Sergio B Júnior, Guilherme R Cardoso, Natalia A Faria, Carolina G Grala, Pedro H Tietz, Marco A Dall Agnese, Augusto E Hinterholz, Angelo Z Giampaoli, Fábio B Duarte, Miguel Ricchetti, Leonardo R Silva, Andrei Nakagawa, Gustavo A Pinto, Eliane C Soares, Fabiano Carneiro, Felipe R Camargos, Magda L Fernandes, Wirleyde M Leão, Sofia M Pereira, Renata Furletti, Lígia N Amaral, Francisco Vieira, Patricia L Gabriel, Julia C Viana, Thayse F C Kayser, Juliana F de Freitas, Daniel W R Pessoa, Rafael N I Fortuna, Daniella Gonçalves, Marcos K C Fonseca, Maria E R da Silva, Marcel Souki, Cristina A Calixto, Caroline V Marroso, Rafael Tiburcio, Arthur M Lanna, Anelise Franklin, Walter A de Oliveira, Josiane Zague, Priscila Rodrigues, Dalton B Precoma, Mayara Barbosa, Cristina Correa, Carlos K Nakashima, Lilian Belinaso, Meire Yokota, Eliane Sehnem, Jose O Barbosa Neto, Daniela C S Vilar, Thiago P da Fonseca, Anajoana V Gomes, Heetor O Carvalho, Jose E G 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Marco A C Mayorga, Paula Leon, Rogelio Urzua, Pablo Carvacho, Gonzalo Rebolledo, Luz Moret, Nicholas S Turchan, Freddy M Perozo, Rocio Aedo, Nelson Zepeda, Aura Goncalves, Jessica P Alvarez, Jorge Novoa, Victor C Fuentes, Marcelo Yañez, Natasha Paravic, Karen S Guilisasti, Valentina M Almonacid, Ignacio Z Galleguillo, Karla Gonzales, Laura Beatriz Marcano, Josue Eduardo Mejias, Herman Francisco Guajardo, Colett Dube, Nicolás Valls, Pamela Pedrero, Victor Sepulveda, Juan Felipe Valencia, Daniel P Salazar, Juan C Bocanegra, Mauricio Tenjo, Pablo D Beltran, Carlos Mario Hernández, Grease Daniela Portilla, Vicente R Malte, Rafael F Casanova, Jussef N Enciso, Raúl G Barrero, Gabriela E Saavedra, Valetina A Cárdenas, Carlos A Montufar, Claudia P Aragon, Julián Arango, Maria V Barrera, Daniela P Poveda, Luz H Vargas, Luis M Borrero, Jhonatan R Murillo, Juan S Gómez, Cristhian L Puentes, Sandra M Valencia, Luisa Leon-Giron, Laura Isabela Bocanegra, Andrea Bravo, Claudia Orozco-Chamorro, Claudia Castellanos, Silvia Vanessa O Quiroga, Cesar Augusto S Paez, Iván D Casteñeda, Carolina L Sanches, Dayana A Ceballos, Maria F Lopez, Karen Marcela M Martinez, Luis Eduardo B Fong, Daniel Alejandro P Muñoz, Juan P Rivera, Andrea B Montilla, Martha I Villa, Luis Mauricio G Borrero, Pedro Ibarra, Jose David R Buitrago, Fabio Morales, Nercy Margarita G Olivieri, Juan M Gonzales, Jennifer Guevara, Andrea P Bulla, Maria Camila L Rodriguez, Francisco C Assis, Nicolas Lozano, Fernando Escobar, Efren Suzarez, Nicolas Peñalosa, Gabriel Carriel, Andres Felipe R Vasquez, Luis Maurico G Borrero, Mauricio E Diez, Marcela Lucia R Echeverry, Juan Pablo B Cadavid, Luis C Escorcia, Diana Cardeño, Angela C Penoth, Glória Ortegon, Laura Garcia, Nathaly A Ramos, Michael J Dennis, Andres F Caballero, Juan P Fernandez, Albaro Nieto, Stiven Sinisterra, Geraldine T Martinez, Juan C Mafla, Nathalia H Guativa, Jairo F Vinueza, Gisela Archbold, Walt A Corpus, Laura Sanchez, José H Botero, Juan Felipe V 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Arbelaez-Monsalve, Susana M Zuñiga, Maria F Deossa, Mauricio Vasco, Daniela Araya, José F Coto, Marta Vargas, Mireia Alemany, Jose Eduardo Fuentes, Sebastien S Batista, Aaron Villegas, Daniel Cabreja, Sarah A Diaz, Julia Rodriguez, Humberto G Castellanos, Dolores Mejía, Ricardo A Tolari, Maria F Cedeño-Bruzual, Marcos Baleta, Ana C Guaba, Victoria M Schnirpel, Diana Orta, Genesis C Vargas, Gabriella C Lantigua, Rosa E Heredia, Braulyn D G Santana, Michelle Matos, Yeirilyn Sosa, Audry M S Perez, Elianni R Valdez, Jiomar Figueroa, Fabio Ortiz, Hossein Ghazanfari, Julio A R Ramírez, Junior Gabriel, Miguel A Contreras, Mirna G Jiménez, Lorelys I Garcia, Hector J Pimentel, Jennifer M Garcia, Line M De Liu, Melissa Rodriguez, Sugeidy Diaz, Digno Perez, Kimberly Diaz, Sarah Cabrera, Juan Castellanos, Oelis Encarnacion, Nicolas Campuzano, Estefanie Otañez, Jose A R Enriquez, Joseline C Martinez, Luis Flores, Josselyn Velepucha-Iniguez, Humberto T Escalante, Santiago Ludeño, Vicente 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Rodríguez, Annette Aboumrad, Ricardo R Almazo, Juan C Trigos, Meztli Zarete, Guipson D Dhaity, Ludwigvan A Bustamante-Silva, Eros R Almeida, Jose A Cabrera, Karen L Santamaría, Sinue Cazarez-Huazano, Omar Quiroz, Carlos M Nuño-Guzmán, María E Gonzáles, Elvia R Flores-Fonseca, Juan J Ulloa Robles, Francisco M Martín-Del Campo, Aldo D Loza-Salazar, Angélica M Nava-Franco, Luis Bravo-Cuéllar, Antonio M Mora-Huerta, Ana A Ambriz-Plascencia, Tomás I Ibarra-Hurtado, María I Ibarra-Tapia, Santiago N Núñes-Velasco, Juan C Vazquez-Limón, Elia A Luna-Hernández, Francisco V Valadez-Correa, Jaime Becerra-Cárdenas, Jaime G López-Taylor, Alberto Ballesteros-Manzo, Mirian G Becerra-Cota, Gustavo Tafoya-Arreguín, Jose L Beristain-Hernandez, Dalilia Diaz-Baez, Diana Rivera-Salas, Mariana A Guillen-Gonzales, Alejandro G Ojeda, Clotilde F Orozco, Andrea E Valadez, Tania A Valadez, Irma V Perez, Fanny Y Ponce, Mel P Tellez, Maria F Casas, Kriscia V Diaz, Silvia A Camargo, Mario J Ruvalcaba, Bertha G Ramírez, Francisco J Camacho, Cornelio R Bravo, Jonathan M Ciociano, Gabino C Guevara, Enrique C Perez, Guillermo C Cardona, Luis R Gonzales, Edgar C Torres, Andrea A Villaseñor, Ana Olivia C Flores, Guadalupe C Cardiel, José A Martínez, Jesus O Gastelum, Natalia G Lopez, Noelia E Bernal, Rogelio A Aguado, Juan F Prado, Adriana F Palomino, Jazmín G Díaz, Erika G Mejia, Itzel O Rodríguez, Rodrigo Najar, María José M Lara, Irani Durán, Laura Martínez, Diana S Vázquez, Fredy P Quiroga, Arantza M Zarraluqui, Iran D Sánchez, Gustavo E Martínez, Mario Trejo-Avila, Katya E Gutiérrez, Maria F Morales, Aldo I Hernandez, Ruben R Lozano-Salazar, Erik Ruiz-Casanova, Manuel T Gonzales, Juan L Aguilar, Rafael J Mortera, Omar B Ferro, Rodrigo G Rodríguez, Alba C Vallejo, Jorge M Contreras, David R Domínguez, Abigail C Ahuatzin, Lorena G Medina, Elías E Robles, Eduardo C Flores, Zaid T Guzman, Edgard L Hernandez, Mariana N Perez, Catalina D Pardo, Bernardo Rea, Fernando P Galaz, Ana O Flores, Kelvin J Garcia, Zulema M Lopez, Luz Del Carmen M Namur, José R M Lores, Luis A Alvarez-Lozada, Juventino T Guerrero-Zertuche, Patricia L Gonzáles-García, Ethel V Orta-Guerra, Sergio J Cisneros-Barrios, Francisco J Arrambide-Garza, Daniela G Durán-Castro, Gerardo A Méndez-Morente, José L Maldonado-Calderón, Oscar A Verduzco-Sierra, Alejandro Q Garza, Rodrigo E Omaña, Santos G López, Guillermo J Baca, Marcela P Mercado, Yesika A Juárez, Jorge R Isais, Pedro E Ramos-Morales, Kassandra F Hernández-García, Andrea Z Treviño, Martín S Garza, Laura L Morán, Bernardo A Reyes, Nubia A Wong-Arce, Gustavo I Guajardo-Aspiazu, Yolanda S Alvarez, Gerardo V Peña-Campos, Diana V Compte, Javier M Ruan, Gustavo M Hirata, Jannet Navarrete, Martha L Garcia, Alicia R Figueroa, Eduardo R Navarrete, Alberto N Peón, Alejandro M Del Arenal, Adalberto L Del Angel, Ana Elena Escorcia, María J Medécigo, Honorio P Baca, Martín R Aguilar, Ivan K Hernandez, Diana L Lorenzo, Andrea R Torres, Carolina C Noya, Sergio A Islas, Sergio P Arteaga, Brenda R Montiel, Roque L Meníndez, Andrés M Acosta, Héctor M Gonzáles, Juan R Santamaría, José S Velázquez, Lupita E Roque, Karla G Callejas, Analiz Mejia, Nazareth García, Ana L Garcia, Gabriela McKay, Kathia De Salas, Dalvys Barria, Tiffany Lara, Maria Pasquel, Nicole Arrocha, Osvaldo Adames, Tharyn Sanchez, Abelardo D Alvarez, Amarildo Miranda, Lourdes Him, Howard I Ruiz, Arnulfo Nereira, Alfredo M Isaza, Gabriela P Tuñon, Myrla Esquivel, Marcia Gomez, Ricardo Burgos-Caballero, Mitsury Flores, Eduardo Moreno, William Chong, Alberto N Aguirre, Leonardo Pirro, Allissan Orobio, Tatiana R Gómez, Michelle Y Ruiz, Ender Bejerano, Jossiel A Olivares, Ramiro Barba, Jorge Mora, Yamileth I Hernández, Rafael de Gracia, Karim M Botello, Martha Quiodettis, Ernesto De Leon, Edgardo G Guerra, Ileana Jaén, Yorelda E Diaz, Jose I Gonzalez, Diana K Ortega, Maria D Quinzada, Maria Diaz, Sandra Centurión, Aldo Ayvar, Alba S Zevallos-Ventura, Rodrigo Corcuera-Ciudad, Lucia V Vela, Andrei H Salas, Romina Velasquez, César F Landeo, Carlos L Cydejko, Miguel R Valencia, Yahaira Carpio, Fiorella Palomino, Félix J Camacho, Graham Acero, Jenner Betalleluz, Dana Menacho, Alina Romani, Carlos C Loyola, Dermalí A Alarcon, Angie P Acuña, Carlos V Purizaca-Rosillo, Noelia Morocho-Alburqueque, Hilda Ramírez-Hernández, Christopher G Valdiviezo-Morales, Bill Soldevilla, Hector R Miyasato, Fresia C Bueno, Johandi Delgado, Luis V Vásquez, Cesar O Castro, Alexander Espinoza, Eddar Llontop, Gelber E Arevalo, Cristian Caceres, Carlos H Alvarado, Victor D Caballero, Cristián E Cruz, Jorge M Wust, Roberto R Reyna, Jesús G Jara, Lena Pinillos, Edwin Torres-Alvarado, Javier Cabrera-Sanchez, Julissa E Llana, Carmen Sanchez-Gonzalez, Glenda M Pacheco, Elvrin P Condori, Arturo O Chagua, Jefferson Gonzales, Milagros O Condor, Victoria N Solano, Miguel A Sanchez, Ronald R Asto, Yuliana J Reyna, Juan P García, Rolando Y Colonio, Yeison S Mascaro, Gian Mendiola, Adolfo Salazar, Elizabeth G Melgarejo, Luis A Barrionuevo, Sandra Venegas, Brandon Ruben, Sawyer Moonilal, Mark Pilwah, Shiva K Chackan, Vaishali Maharaj, Joshua Duncan, Joanna Charles, Dominic Singh, Rocheal Peters, Kimberley R Caton, Ashrika Sookoo, Travis Austin, Juan Riva, Maria Laura Illescas, Patricia A Penza, Guillermo Ramos, Mariana Monteiro, María José Torrado, Angeles Brandolino, Florencia Galarraga, Maryana N Maryana, Martin Lotito, Vicente Cavalliere, Mauricio Berrutti, Andrea Gallo, Miguel Dutra, Leticia Duarte, Bárbara Andrade, Daniel P Rañon, Eliana Bentancur, Ana Schwartzmann, Teresa Vazquez, Ramiro C Gimenez, Guillermo Ingold, Pastorini Magela, Alejandro Ettlin, Aquilino M Perez, Martín P De Palleja, Maria C Bonelli, Rosanela Pedrón, Violeta Quintela, Lucia Castelgrande, Marcela Segredo, Alexandra Pires, Valeria Bentancor, Natalie M Ibarra, Gabriela Alvarez, Andres Castro, Emanuel Trinidad, Martin Pastor, Shury Altez, Fiama Guerra, Valentina Da Rosa, Jonatan Marchetti, Carolina Sorbara, Gonzalo M Lagurara, Gabriela Alvarez, Ana Laura Cebriá, Mauro Perdomo, Fernando Bonilla, Fabiana Dominguez, Catalina De Leon, Gonzalo Irizaga, Sandra Carro, Fredy Avellaneda, Veronica Gonzalez, Andrea M Gûida, Florencia Sosa, Gonzalo Martinez, Gonzalo Plà, Diego De Leòn, Pedro Batalla, Daniela S Dabarca, Carola Alfaro, Beatriz Alvez, Maria Jose O Falero, Alicia O Ami, Javier Hornos, Alejandra Pequeño, Jail Rey, Luis Alberti, Pablo Ramade, Julio Recoba, Lucia Olivera, Carolina Godoy, Soledad Castro, Mariana Soria, Rocio Estefanell, Soledad Dotti, Sylvia Correa, Lucía Ducan, Bernal Franklin, Losada Maria, Juan P Bouchacourt, Patricio Vanerio, Ignacio S Sambucetti, Beatriz Noya, Gonzalo Méndez, Gladys Urioste, Emiliano Landín, Luis R Martinez, Daniel González, Emilia Moreira, Rosana González, Federico M Cateura, Gonzalo Solla, Marcelo V Malet, Leticia Turconi, Andrés Miranda, Silvana M Cruz, Soledad G Sosa, Victoria Formoso, Lorena Pereira, Dinorah Asteggiante, Alejandro Ettlin, Pablo de Santa Ana, Valerie Hankus, Sergio Martinez-Millan, Aída Díaz, Oriana Sanchez, Maria Daniela R Guerrero, Dionisio Diaz,
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