Profile of patients in private home care who developed ventilator-associated pneumonia
to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data. this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic....
Gespeichert in:
Veröffentlicht in: | Revista Brasileira de Enfermagem 2024-01, Vol.77 (3), p.e20230146-6 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 6 |
---|---|
container_issue | 3 |
container_start_page | e20230146 |
container_title | Revista Brasileira de Enfermagem |
container_volume | 77 |
creator | Cezar, Fabiana Schimidt Jacober, Fabiana Camolesi Gonçalves, Heloísa Amaral Gaspar Cantarini, Katia Vanessa Oliveira, Claudio Flauzino de |
description | to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data.
this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic. Patients using intermittent ventilation or without ventilatory support were excluded.
the utilization rate of mechanical ventilation was 15.9%. The incidence density of pneumonia in pediatrics was 2.2 cases per 1000 ventilation-days and in adults was 1.7 cases per 1000 ventilation-days, figures lower than those reported by the National Health Surveillance Agency. There were 101 episodes of pneumonia in 73 patients, predominantly male (65.8%), adults (53.4%), and those with neurological diseases (57.5%). The treatment regimen predominantly took place at home (80.2%), and there was one death.
patients in home care showed a low incidence and mortality rate from ventilator-associated pneumonia. |
doi_str_mv | 10.1590/0034-7167-2023-0146 |
format | Article |
fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11290723</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><scielo_id>S0034_71672024000700166</scielo_id><doaj_id>oai_doaj_org_article_90f6a664214d45b99789b4bd1a0ffae9</doaj_id><sourcerecordid>3086382631</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-742dbd4099ad6e593a9877fae244c979f8ca199b0be12222ffc800be6d41b14e3</originalsourceid><addsrcrecordid>eNpdUluL1TAYDKK4h3V_gSABX3zp-uXStHkSWbwsLCh4eQ1p8nVPlrapSXvEf2_qWQ-ueQlJZibzDUPIcwaXrNbwGkDIqmGqqThwUQGT6hHZMd3KCqRUj8nuhDgjFzmHDqCumeCqfUrOhIaW10LuyPfPKfZhQBp7Otsl4LRkGiY6p3CwC9J9HJE6m5D-3Efq8YBDnNHTQwGGwS4xVTbn6EIBezpPuI5xCvYZedLbIePF_X5Ovr1_9_XqY3Xz6cP11dubykmml6qR3HdegtbWK6y1sLptmt4il9LpRvets0zrDjpkvKy-dy2Ug_KSdUyiOCfXR10f7Z0ppkebfplog_lzEdOtsWkJbkCjoVdWKcmZ9LLutG5a3cnOMwt9-VEXrcujVnahTGnu4pqmYt582aI0W5QlawkADQBTqhDeHAnz2o3oXYkk2eGBi4cvU9ib23gwjHENDRdF4dW9Qoo_VsyLGUN2OAx2wrhmI6BVouVKsAJ9-R_05E-AVnUxJ3lBiSPKpZhzwv7khoHZimNOs5itOGYrTmG9-HeQE-dvTcRvNHW75g</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3096567242</pqid></control><display><type>article</type><title>Profile of patients in private home care who developed ventilator-associated pneumonia</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Cezar, Fabiana Schimidt ; Jacober, Fabiana Camolesi ; Gonçalves, Heloísa Amaral Gaspar ; Cantarini, Katia Vanessa ; Oliveira, Claudio Flauzino de</creator><creatorcontrib>Cezar, Fabiana Schimidt ; Jacober, Fabiana Camolesi ; Gonçalves, Heloísa Amaral Gaspar ; Cantarini, Katia Vanessa ; Oliveira, Claudio Flauzino de</creatorcontrib><description>to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data.
this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic. Patients using intermittent ventilation or without ventilatory support were excluded.
the utilization rate of mechanical ventilation was 15.9%. The incidence density of pneumonia in pediatrics was 2.2 cases per 1000 ventilation-days and in adults was 1.7 cases per 1000 ventilation-days, figures lower than those reported by the National Health Surveillance Agency. There were 101 episodes of pneumonia in 73 patients, predominantly male (65.8%), adults (53.4%), and those with neurological diseases (57.5%). The treatment regimen predominantly took place at home (80.2%), and there was one death.
patients in home care showed a low incidence and mortality rate from ventilator-associated pneumonia.</description><identifier>ISSN: 0034-7167</identifier><identifier>ISSN: 1984-0446</identifier><identifier>EISSN: 1984-0446</identifier><identifier>DOI: 10.1590/0034-7167-2023-0146</identifier><identifier>PMID: 39082534</identifier><language>eng</language><publisher>Brazil: Associação Brasileira de Enfermagem</publisher><subject>Adolescent ; Adult ; Aged ; Artificial ; Brazil - epidemiology ; Catheters ; Child ; Child, Preschool ; Clinical outcomes ; Disease control ; Electronic health records ; Epidemiology ; Ethics ; Female ; Health surveillance ; Health Systems Agencies ; Home Care Services ; Home Care Services - standards ; Home Care Services - statistics & numerical data ; Home Care Services - trends ; Hospitals ; Humans ; Incidence ; Infant ; Infections ; Intensive care ; Intensive Care Units ; Male ; Medical equipment ; Middle Aged ; NURSING ; Observational studies ; Original ; Patients ; Pediatrics ; Pneumonia ; Pneumonia, Ventilator-Associated - epidemiology ; Pneumonia, Ventilator-Associated - etiology ; Prevention ; Respiration ; Respiration, Artificial - adverse effects ; Respiration, Artificial - statistics & numerical data ; Retrospective Studies ; Ventilator-Associated ; Ventilators</subject><ispartof>Revista Brasileira de Enfermagem, 2024-01, Vol.77 (3), p.e20230146-6</ispartof><rights>2024. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c419t-742dbd4099ad6e593a9877fae244c979f8ca199b0be12222ffc800be6d41b14e3</cites><orcidid>0000-0002-5442-1172 ; 0000-0001-9316-9873 ; 0000-0003-3525-3887 ; 0000-0003-4470-5435 ; 0000-0001-7399-2352</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290723/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290723/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39082534$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cezar, Fabiana Schimidt</creatorcontrib><creatorcontrib>Jacober, Fabiana Camolesi</creatorcontrib><creatorcontrib>Gonçalves, Heloísa Amaral Gaspar</creatorcontrib><creatorcontrib>Cantarini, Katia Vanessa</creatorcontrib><creatorcontrib>Oliveira, Claudio Flauzino de</creatorcontrib><title>Profile of patients in private home care who developed ventilator-associated pneumonia</title><title>Revista Brasileira de Enfermagem</title><addtitle>Rev Bras Enferm</addtitle><description>to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data.
this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic. Patients using intermittent ventilation or without ventilatory support were excluded.
the utilization rate of mechanical ventilation was 15.9%. The incidence density of pneumonia in pediatrics was 2.2 cases per 1000 ventilation-days and in adults was 1.7 cases per 1000 ventilation-days, figures lower than those reported by the National Health Surveillance Agency. There were 101 episodes of pneumonia in 73 patients, predominantly male (65.8%), adults (53.4%), and those with neurological diseases (57.5%). The treatment regimen predominantly took place at home (80.2%), and there was one death.
patients in home care showed a low incidence and mortality rate from ventilator-associated pneumonia.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Artificial</subject><subject>Brazil - epidemiology</subject><subject>Catheters</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical outcomes</subject><subject>Disease control</subject><subject>Electronic health records</subject><subject>Epidemiology</subject><subject>Ethics</subject><subject>Female</subject><subject>Health surveillance</subject><subject>Health Systems Agencies</subject><subject>Home Care Services</subject><subject>Home Care Services - standards</subject><subject>Home Care Services - statistics & numerical data</subject><subject>Home Care Services - trends</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Medical equipment</subject><subject>Middle Aged</subject><subject>NURSING</subject><subject>Observational studies</subject><subject>Original</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pneumonia</subject><subject>Pneumonia, Ventilator-Associated - epidemiology</subject><subject>Pneumonia, Ventilator-Associated - etiology</subject><subject>Prevention</subject><subject>Respiration</subject><subject>Respiration, Artificial - adverse effects</subject><subject>Respiration, Artificial - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Ventilator-Associated</subject><subject>Ventilators</subject><issn>0034-7167</issn><issn>1984-0446</issn><issn>1984-0446</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNpdUluL1TAYDKK4h3V_gSABX3zp-uXStHkSWbwsLCh4eQ1p8nVPlrapSXvEf2_qWQ-ueQlJZibzDUPIcwaXrNbwGkDIqmGqqThwUQGT6hHZMd3KCqRUj8nuhDgjFzmHDqCumeCqfUrOhIaW10LuyPfPKfZhQBp7Otsl4LRkGiY6p3CwC9J9HJE6m5D-3Efq8YBDnNHTQwGGwS4xVTbn6EIBezpPuI5xCvYZedLbIePF_X5Ovr1_9_XqY3Xz6cP11dubykmml6qR3HdegtbWK6y1sLptmt4il9LpRvets0zrDjpkvKy-dy2Ug_KSdUyiOCfXR10f7Z0ppkebfplog_lzEdOtsWkJbkCjoVdWKcmZ9LLutG5a3cnOMwt9-VEXrcujVnahTGnu4pqmYt582aI0W5QlawkADQBTqhDeHAnz2o3oXYkk2eGBi4cvU9ib23gwjHENDRdF4dW9Qoo_VsyLGUN2OAx2wrhmI6BVouVKsAJ9-R_05E-AVnUxJ3lBiSPKpZhzwv7khoHZimNOs5itOGYrTmG9-HeQE-dvTcRvNHW75g</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Cezar, Fabiana Schimidt</creator><creator>Jacober, Fabiana Camolesi</creator><creator>Gonçalves, Heloísa Amaral Gaspar</creator><creator>Cantarini, Katia Vanessa</creator><creator>Oliveira, Claudio Flauzino de</creator><general>Associação Brasileira de Enfermagem</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>CLZPN</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>GPN</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-5442-1172</orcidid><orcidid>https://orcid.org/0000-0001-9316-9873</orcidid><orcidid>https://orcid.org/0000-0003-3525-3887</orcidid><orcidid>https://orcid.org/0000-0003-4470-5435</orcidid><orcidid>https://orcid.org/0000-0001-7399-2352</orcidid></search><sort><creationdate>20240101</creationdate><title>Profile of patients in private home care who developed ventilator-associated pneumonia</title><author>Cezar, Fabiana Schimidt ; Jacober, Fabiana Camolesi ; Gonçalves, Heloísa Amaral Gaspar ; Cantarini, Katia Vanessa ; Oliveira, Claudio Flauzino de</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-742dbd4099ad6e593a9877fae244c979f8ca199b0be12222ffc800be6d41b14e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Artificial</topic><topic>Brazil - epidemiology</topic><topic>Catheters</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical outcomes</topic><topic>Disease control</topic><topic>Electronic health records</topic><topic>Epidemiology</topic><topic>Ethics</topic><topic>Female</topic><topic>Health surveillance</topic><topic>Health Systems Agencies</topic><topic>Home Care Services</topic><topic>Home Care Services - standards</topic><topic>Home Care Services - statistics & numerical data</topic><topic>Home Care Services - trends</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Medical equipment</topic><topic>Middle Aged</topic><topic>NURSING</topic><topic>Observational studies</topic><topic>Original</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pneumonia</topic><topic>Pneumonia, Ventilator-Associated - epidemiology</topic><topic>Pneumonia, Ventilator-Associated - etiology</topic><topic>Prevention</topic><topic>Respiration</topic><topic>Respiration, Artificial - adverse effects</topic><topic>Respiration, Artificial - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Ventilator-Associated</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cezar, Fabiana Schimidt</creatorcontrib><creatorcontrib>Jacober, Fabiana Camolesi</creatorcontrib><creatorcontrib>Gonçalves, Heloísa Amaral Gaspar</creatorcontrib><creatorcontrib>Cantarini, Katia Vanessa</creatorcontrib><creatorcontrib>Oliveira, Claudio Flauzino de</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Latin America & Iberia Database</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SciELO</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Revista Brasileira de Enfermagem</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cezar, Fabiana Schimidt</au><au>Jacober, Fabiana Camolesi</au><au>Gonçalves, Heloísa Amaral Gaspar</au><au>Cantarini, Katia Vanessa</au><au>Oliveira, Claudio Flauzino de</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Profile of patients in private home care who developed ventilator-associated pneumonia</atitle><jtitle>Revista Brasileira de Enfermagem</jtitle><addtitle>Rev Bras Enferm</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>77</volume><issue>3</issue><spage>e20230146</spage><epage>6</epage><pages>e20230146-6</pages><issn>0034-7167</issn><issn>1984-0446</issn><eissn>1984-0446</eissn><abstract>to analyze the profile and clinical outcomes of patients who developed Ventilator-Associated Pneumonia (VAP) in private home care and to compare the incidence with national data.
this was a retrospective study with data collected from July 2021 to June 2022 from patient records at a private clinic. Patients using intermittent ventilation or without ventilatory support were excluded.
the utilization rate of mechanical ventilation was 15.9%. The incidence density of pneumonia in pediatrics was 2.2 cases per 1000 ventilation-days and in adults was 1.7 cases per 1000 ventilation-days, figures lower than those reported by the National Health Surveillance Agency. There were 101 episodes of pneumonia in 73 patients, predominantly male (65.8%), adults (53.4%), and those with neurological diseases (57.5%). The treatment regimen predominantly took place at home (80.2%), and there was one death.
patients in home care showed a low incidence and mortality rate from ventilator-associated pneumonia.</abstract><cop>Brazil</cop><pub>Associação Brasileira de Enfermagem</pub><pmid>39082534</pmid><doi>10.1590/0034-7167-2023-0146</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-5442-1172</orcidid><orcidid>https://orcid.org/0000-0001-9316-9873</orcidid><orcidid>https://orcid.org/0000-0003-3525-3887</orcidid><orcidid>https://orcid.org/0000-0003-4470-5435</orcidid><orcidid>https://orcid.org/0000-0001-7399-2352</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0034-7167 |
ispartof | Revista Brasileira de Enfermagem, 2024-01, Vol.77 (3), p.e20230146-6 |
issn | 0034-7167 1984-0446 1984-0446 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11290723 |
source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access |
subjects | Adolescent Adult Aged Artificial Brazil - epidemiology Catheters Child Child, Preschool Clinical outcomes Disease control Electronic health records Epidemiology Ethics Female Health surveillance Health Systems Agencies Home Care Services Home Care Services - standards Home Care Services - statistics & numerical data Home Care Services - trends Hospitals Humans Incidence Infant Infections Intensive care Intensive Care Units Male Medical equipment Middle Aged NURSING Observational studies Original Patients Pediatrics Pneumonia Pneumonia, Ventilator-Associated - epidemiology Pneumonia, Ventilator-Associated - etiology Prevention Respiration Respiration, Artificial - adverse effects Respiration, Artificial - statistics & numerical data Retrospective Studies Ventilator-Associated Ventilators |
title | Profile of patients in private home care who developed ventilator-associated pneumonia |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T17%3A40%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Profile%20of%20patients%20in%20private%20home%20care%20who%20developed%20ventilator-associated%20pneumonia&rft.jtitle=Revista%20Brasileira%20de%20Enfermagem&rft.au=Cezar,%20Fabiana%20Schimidt&rft.date=2024-01-01&rft.volume=77&rft.issue=3&rft.spage=e20230146&rft.epage=6&rft.pages=e20230146-6&rft.issn=0034-7167&rft.eissn=1984-0446&rft_id=info:doi/10.1590/0034-7167-2023-0146&rft_dat=%3Cproquest_doaj_%3E3086382631%3C/proquest_doaj_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3096567242&rft_id=info:pmid/39082534&rft_scielo_id=S0034_71672024000700166&rft_doaj_id=oai_doaj_org_article_90f6a664214d45b99789b4bd1a0ffae9&rfr_iscdi=true |