What Is A Normal Nafld Fibrosis Score. When the heart squeezes, it's called a contraction. . 1, 7 6 days

When the heart squeezes, it's called a contraction. . 1, 7 6 days ago · Fatty liver is the initial, and often silent, stage of a broader spectrum of liver diseases. Patients with NAFLD should be assessed for alcohol use and be encouraged to abstain from alcohol Sep 27, 2023 · Why was fatty liver disease renamed steatotic liver disease? Previously, steatotic liver disease was known as “fatty liver disease. FibroScan (TE) in Hepatitis C When the elastography and FibroTest (e. The enhanced liver fibrosis (ELF) blood test is the first-line investigation for assessing fibrosis in non-alcoholic fatty liver disease. The heart squeezes and relaxes Dec 19, 2023 · Overview A ferritin test measures the amount of ferritin in the blood. 1%; specificity 66. Mar 15, 2024 · Unfortunately, NAFLD is diagnosed by exclusion, and the gold standard for identifying NAFLD/NASH and reliably measuring liver fibrosis remains liver biopsy, which is an invasive, costly, time-consuming procedure and involves variable inter-observer diagnosis. steatosis), non-alcoholic steatohepatitis (steatosis with liver damage/NASH), fatty liver with liver fibrosis (i. We therefore aimed to describe the accuracy of FIB-4 and NFS to detect elevated liver stiffness as an indicator of hepatic fibrosis in low-prevalence populations. g. A mental health disorder may affect how well you can: Jul 18, 2025 · Hyponatremia is the term used when your blood sodium is too low. Ejection fraction is just one of many tests your healthcare professional may use to see how your heart works. This buildup of fat is not caused by heavy alcohol use. The risk of advanced liver fibrosis should be assessed using a non-invasive scoring system, such as the NAFLD Fibrosis Score (NFS), Fibrosis (FIB)-4 score or the Enhanced Liver Fibrosis (ELF) test. Your actual fibrosis score (as told by your doctor) may not even match the fibrosis score in the Feb 3, 2025 · Fatty liver on imaging Alcohol Use in NAFLD Chronic alcohol use can contribute to liver fat accumulation and fibrosis progression in patients with risk factors for NAFLD. 3 Liver Fibrosis? Kay Que Reverse Fatty Liver Support Group 2y · Public Was just diagnosed with Stage 3 Liver Fibrosis today. The FIB-4 Index is a blood-based diagnostic test that looks at underlying fibrosis that can be used as a measure to help determine NAFLD/NASH status. It measures three markers (HA, PIIINP and TIMP-1) and uses an algorithm to provide a result that indicates whether they have advanced fibrosis of the liver: Dec 15, 2019 · Cirrhosis is the 12th leading cause of death in the United States. Jan 12, 2026 · A reduction in the CAP score directly indicates that the amount of fat within the liver has decreased. ) NAFLD is an abbreviation for Non-Alcoholic Fatty Liver Disease. Feb 3, 2025 · Fatty liver on imaging Alcohol Use in NAFLD Chronic alcohol use can contribute to liver fat accumulation and fibrosis progression in patients with risk factors for NAFLD. While originally developed to detect liver fibrosis among patients with Hepatitis C and HIV, FIB-4 scoring has been increasingly used by the diabetes and NAFLD/NASH communities. If a ferritin test shows that the blood ferritin level is low, it means the body's iron stores are low. liver scarring), or fatty liver with advanced liver fibrosis/cirrhosis. There is no evidence of benefit in frequent monitoring of LFTs in NAFLD where there is simple fatty liver with no evidence of fibrosis or cirrhosis. Find out about symptoms and treatment for this vision-stealing eye condition. This study aimed to reappraisal In India, the prevalence of NAFLD is estimated up to 09 -32% and found to have an association with non-communicable diseases. The NAFLD Fibrosis Score (NAFLD-FS) is the preferred non-invasive diagnostic option for detecting advanced fibrosis in NASH and is recommended by experts. This test can be used to find out how much iron the body stores. 67 suggests advanced liver fibrosis. The normal range of fibro scans is between 2 to 7 kpa. The risk of cardiovascular disease should be assessed using a validated tool. The BARD Score for NAFLD Fibrosis predicts the risk of advanced fibrosis for NAFLD patients. A mental health condition may be present when patterns or changes in thinking, feeling, or behaving cause distress or disrupt a person's ability to do daily activities. Fib 4 score is a combination of: Serum AST, ALT, platelets, albumin. This NAFLD fibrosis score calculator determines the degree of hepatic fibrosis in patients with non-alcoholic fatty liver disease. Enter the required values to calculate the FIB-4 value. 1% of patients; and FIB-4 < 1. It outlines the lifestyle changes and pharmacological treatments that can manage NAFLD and advanced liver fibrosis. : Fibro Sure, Fibro Test-ActiTest) results agreed, liver biopsy examination confirmed the stage of fibrosis in: 84 percent of cases for F ≥2 fibrosis, 95 percent for F ≥3 fibrosis, and 94 percent for F = 4 fibrosis Jun 16, 2025 · If your liver is damaged due to inflammation, the level of these enzymes may be higher than normal. You can read more about the different names and what they mean below. ” In 2023, experts renamed the condition and its subcategories to reflect its causes more accurately. Not everyone gets that far, though. The Fibrosis-4 (FIB-4) Index for Liver Fibrosis is a non-invasive scoring system based on several laboratory tests that help to estimate the amount of scarring in the liver. FibroScan What it measures: fibrosis, steatosis Who should take it: undiagnosed and diagnosed NAFLD/NASH patients Where to get it: specialty care centers, hospitals, some primary care providers FibroScan is an imaging-based diagnostic test developed by Echosens that looks at liver fibrosis (stiffness, scarring) and steatosis (fat) using transient-elastography technology. Only one in FIB-4 Calculator for NAFLD NB This is only valid for non-alcoholic fatty liver disease (NAFLD) and is intended for use in conjunction with the NCL Abnormal LFT pathway. Nov 15, 2020 · Nonalcoholic fatty liver disease (NAFLD) is the most common form of liver disease in the United States, affecting up to 30% of adults. 1 Fibrosis-4 (FIB-4) Calculator Share The Fibrosis-4 score helps to estimate the amount of scarring in the liver. Aug 26, 2013 · Nonalcoholic fatty liver disease (NAFLD) at large is relatively benign, but some individuals with NAFLD develop major hepatic and extrahepatic complications (NAFLD-at-risk). 20 hours ago · Risk Stratification for Fibrosis Calculate the FIB-4 score using age, ALT, AST, and platelet count to determine risk of advanced fibrosis. The NAFLD Activity Score assesses histological injury of patients with NAFLD. Mar 28, 2025 · The nonalcoholic fatty liver disease (NAFLD) fibrosis score is a less invasive alternative to a liver biopsy that can help predict your risk for liver damage. 676 Step 3: Further Evaluation 2 Low risk: manage in primary care with lifestyle modification 4 days ago · Non-alcoholic fatty liver disease (NAFLD or MASLD) Alcohol-associated fatty liver disease (AFLD) When fatty liver persists, it can cause inflammation (steatohepatitis), scarring (fibrosis), and in dire cases, cirrhosis or even liver failure. NAFLD Fibrosis Score (NFS) — an intermediate or high score (greater than minus 1. 45 - should exclude the presence of advanced fibrosis (F3-F4) in 94. 9% and 65. 1 The AST:ALT ratio is typically <1 in NAFLD, which helps distinguish it from alcoholic liver disease. Changed my diet up and lost 40 lbs since then mostly 3 days ago · The pattern of hepatocellular injury (elevated ALT/AST) with normal bilirubin and normal GGT in a prediabetic patient most strongly suggests NAFLD, which affects >70% of prediabetic individuals and represents the leading cause of liver transplantation in the United States. Learn how to interpret FibroScan results, including CAP score and liver stiffness values, and understand what they mean for fatty liver and fibrosis diagnosis. 25 - should confirm the presence of advanced fibrosis (F3-F4) in 82. Age is a factor, as the prevalence of NAFLD and its progression to fibrosis tend to increase with advancing years. LFTs seem to have little predictive value for severity of liver disease or future mortality risk until late disease when the bilirubin rises or the albumin falls. Apr 22, 2023 · Learn about how to track your menstrual cycles and what any changes may mean. If the person is at high risk of advanced liver fibrosis, refer to a hepatology specialist for further assessment and management. The NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score estimates amount of scarring in the liver based on several laboratory tests. Please note that the ranges of fibrosis results in the table are estimates. This guideline covers how to identify the adults, young people and children with non- alcoholic fatty liver disease (NAFLD) who have advanced liver fibrosis and are most at risk of further complications. e. 3-2. The score has been developed for patients between 35 and 65 years of age. NAFLD-FS is calculated using age, AST, ALT, platelet level, albumin level, presence of hyperglycemia, and Body Mass Index (BMI): all factors inversely related to severity of liver fibrosis in MASLD, NAFLD and fatty liver disease MASLD, NAFLD and fatty liver disease are different names for the same condition. FLI was correlated with the severity of fatty liver by abdominal US, predict fat component percent and NAFLD fibrosis score, especially in the female subjects. Hepatic complications of NAFLD include progressive liver disease leading to cirrhosis and liver failure and the development of hepatocellular carcinoma which is largely confined to those with advanced fibrosis and Dec 17, 2023 · 2. Sep 28, 2023 · Abdominal ultrasound is often the method of choice for initial NAFLD screening in clinical practice, followed by NITs (FIB-4, NFS) for initial risk stratification to rule out advanced fibrosis; BARD score, APRI, and Hepamet fibrosis score are cited as alternative NITs. The NAFLD Fibrosis Score is a validated, noninvasive tool for identifying patients whose MASLD has advanced to liver fibrosis. NAFLD Key risk factors for non-alcoholic fatty liver disease (NAFLD) include obesity, impaired glucose regulation/T2DM, hypertension and hyperlipidaemia. Jul 6, 2016 · Overview This guideline covers how to identify the adults, young people and children with non-alcoholic fatty liver disease (NAFLD) who have advanced liver fibrosis and are most at risk of further complications. An ELF Score ≥10. The Enhanced Liver Fibrosis (ELF) Score is a noninvasive test that indicates whether a patient with NASH and advanced fibrosis has a higher or lower risk of disease progression to cirrhosis (for those with F3 fibrosis) or other liver-related clinical events (for those with F3 or F4 fibrosis) within 1 to 4 years. Metabolic dysfunction-associated steatotic liver disease (MASLD) is a long-lasting liver condition caused by having too much fat in the liver. (read more in article by Vallet-Pichard et al. Abstract Background & aims: Fibrosis-4 (FIB-4) and the nonalcoholic fatty liver disease fibrosis score (NFS) are the 2 most popular noninvasive blood-based serum tests proposed for widespread fibrosis screening. In some people with NAFLD these liver enzymes may be normal as well Fibrosis assessment tests Nov 1, 2022 · Fibrosis-4 (FIB-4) and the nonalcoholic fatty liver disease fibrosis score (NFS) are the 2 most popular noninvasive blood-based serum tests proposed for widespread fibrosis screening. 3 if age > 35 y (intermediate / high risk It can be normal in NAFLD. We This NAFLD fibrosis score calculator stratifies the degree of fibrosis to the liver in nonalcoholic fatty liver disease patients by assigning a specific stage. FIB-4 > 3. 3 or NFS <-1. In late August I had an ultrasound and found a 6cm mass on liver which ended up being benign hemangioma. Dec 24, 2025 · Ideal blood pressure is categorized as normal. Liver stiffness measurement is a helpful tool for the diagnosis of hepatic fibrosis and its association with various stages of Non-Alcoholic Fatty Liver Disease. , fibrosis-4 index or FIB-4) with a high negative predictive value (NPV) to exclude advanced fibrosis. Normal: This means your liver has no scarring, or mild scarring. Jan 7, 2026 · Is there such a thing as normal AST and ALT levels by age? And what are their implications for fatty liver disease? Keep reading as top hepatologists (read: liver doctors) translate this liver lexicon and reveal what it all means for your health—including a simple score that can help assess your liver risk. 1, 2 Imaging Evaluation Jan 12, 2026 · Do not defer fibrosis risk stratification - every patient requires FIB-4 calculation regardless of presumed etiology 1 Do not rely on normal ALT to exclude significant disease - 50% of NAFLD patients have normal liver enzymes 2, 3, 4 Do not assume simple steatosis is static - up to 30% of patients progress or regress in fibrosis stage over 5 Jan 12, 2026 · If metabolic risk factors are present (obesity, diabetes, hyperlipidemia) and other causes are excluded, calculate FIB-4 or NAFLD Fibrosis Score (NFS) to stratify fibrosis risk: 1 20 hours ago · Most Likely Diagnoses by Frequency Nonalcoholic Fatty Liver Disease (NAFLD) NAFLD is the leading cause of isolated transaminase elevation in developed countries, affecting 20-30% of the general population and up to 70% in obese individuals. A diagnosis of high blood pressure is usually based on the average of two or more readings taken on separate visits. This accumulation is a sign that the liver’s normal processes for handling fats are overwhelmed or disrupted. In nonalcoholic fatty liver disease (NAFLD), advanced fibrosis has been identified as an important prognostic factor with increased liver-related mortality and treatment need. If the ELF Score is <10. Using your liver stiffness result to find your fibrosis score Your healthcare provider will use your liver stiffness result and medical history to find out your fibrosis score. Primary risk assessment of patients with fatty liver disease You should start with a serologic test (e. Due to the high prevalence of NAFLD, noninvasive risk stratification is Fibrosis score F3: Severe liver scarring Fibrosis score F4: Advanced liver scarring (cirrhosis) Using your FibroScan fibrosis result to estimate your fibrosis score The table below shows liver diseases, ranges of fibrosis results, and the matching fibrosis score. NAFLD can range from mild to severe. Many people turn things around with some changes to their daily habits. 676 High risk: FIB-4 >2. 67 or NFS >0. It is closely linked with obesity as well as type 2 diabetes. NAFLD-FS is calculated using age, AST, ALT, platelet level, albumin level, presence of hyperglycemia, and Body Mass Index (BMI): all factors inversely related to severity of liver fibrosis in 4. Your results can range from normal to advanced. The nonalcoholic fatty liver disease fibrosis score (NFS) is comprised of unique metabolic risk indicators that may accurately predict residual cardiovascular (CV) risk in patients with established coronary disease and metabolic dysfunction. As per the locally agreed primary care pathway, the ELF test should be considered for the assessment of liver fibrosis in adult patients with NAFLD. 3 (<2. Patients with NAFLD may have normal LFTs. It relies on readily available clinical information and routinely measured laboratory data. In cases where LFTs are abnormal, this is typically mildly raised transaminases (ALT, AST) and/or gamma-glutamyltransferase (γGT). Clinical Question Which patients with nonalcoholic fatty liver disease (NAFLD) have a low likelihood of fibrosis or cirrhosis? The NAFLD fibrosis score is used to distinguish between patients with nonalcoholic fatty liver disease who have (F3-F4) and do not have (F0-F2) advanced fibrosis. NASH stands for Non-Alcoholic SteatoHepatitis. 5%, respectively). Non-Alcoholic Fatty Liver Disease (NAFLD) & Non-Alcoholic Steatohepatitis (NASH) Nonalcoholic Fatty Liver Disease (NAFLD) is a condition in which excess fat builds up in your liver. Jan 16, 2024 · If you have diabetes, it's important to check the level of sugar in your blood. Reduce the need for liver biopsy by identifying patients with non-alcoholic fatty liver disease likely or unlikely to have advanced fibrosis We would like to show you a description here but the site won’t allow us. Use a first-line non-invasive tool to assess the level of fibrosis, such as Fibrosis- 4 (FIB-4) or NAFLD Fibrosis Score (NFS). Mount Sinai Health System offers patients the full range of clinical care specialties and treatments, as well as a vast network of facilities. What are AST and ALT? Jan 11, 2026 · NAFLD Fibrosis Score - uses age, BMI, hyperglycemia, AST/ALT ratio, platelet count, albumin Step 2: Interpret Results 2 Low risk: FIB-4 <1. Please note: The use of the FIB-4 score is not validated where a patient is over 75 years of age. A score <1. There is no known safe level of alcohol use for patients with NAFLD/NASH. It can be defined as the liver manifestation of a metabolic disorder, and is the most severe form of non The Nonalcoholic fatty liver disease (NAFLD) Activity Score (NAS) has been applied as a method for evaluating treatment response, and a ≥2-point improvement in NAS has been commonly used as an accepted end point in phase 2b clinical trials in nonalcoholic steatohepatitis. The AST to Platelet Ratio Index (APRI) determines the likelihood of hepatic fibrosis and cirrhosis in patients with Hepatitis C. Mar 27, 2020 · Baseline BMI, liver fat content, NAFLD activity score, liver enzymes, waist circumference, CD4 count, and HIV duration, a median of 16 years in the study, did not predict progression, but activity scores, hemoglobin A 1C, and C-reactive protein increased as fibrosis progressed. A decrease in the LSM score signifies structural reversal, showing that fibrosis, or scarring, is either stabilizing or regressing. May 30, 2022 · Background: The objective of this study is to retrospectively analyze the correlation between the thyroid hormones and nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM) patients with normal thyroid function. 7–10 ELF is included as a We would like to show you a description here but the site won’t allow us. 67 indicates high risk requiring hepatology referral. 51, then advanced liver fibrosis is unlikely. Management of NAFLD in primary care includes: Jan 16, 2023 · The highest possible result is 75 kPa. NAFLD Fibrose Score The NAFLD Fibrosis Score is used to estimate the extent of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). Worried about QT interval prolongation? This online evidence based resource will help guide you how to measure the QT interval and calculate the QTc value with an easy to use calculator which takes into account the patients underlying rhythm, gender and age. NAFLD score is a combination of: Serum AST, ALT, platelets, albumin age and presence of diabetes. Feb 5, 2022 · Can I estimate my Fibrosis Score using my FibroScan fibrosis result? The following table shows liver diseases, ranges of fibrosis results, and the matching fibrosis score. Algorithm for fibrosis assessment in MASLD Use either Fib 4 score (available on ICE/EPR) or NAFLD score. 67 or NFS -1. 455 Indeterminate: FIB-4 1. But the same lifestyle choices that promote overall health Jan 29, 2025 · Ejection fraction is a measurement of the percentage of blood leaving the heart each time it squeezes. Because it’s based on simple blood tests, the fib 4 score offers a convenient, cost-effective, and evidence-based way to monitor your liver health and guide follow-up testing when needed. Having a high level of triglycerides in your blood can increase your risk of heart disease. 7% of patients. FibroScan can be used Find out about non-alcoholic fatty liver disease (NAFLD), a common condition where fat builds up in the liver. 455), suggests advanced liver fibrosis. 2. Jul 27, 2025 · The NAFLD Fibrosis Score is calculated using six distinct variables, each offering insights into liver health and potential fibrosis progression. Currently there are no The NAFLD fibrosis score calculator identifies liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). Jan 1, 2020 · The optimal cut-off points of FLI to discriminate fatty liver by abdominal US were 20 in male and 10 in female (sensitivity 80. This allows the identification of advanced liver fibrosis without the need for a liver biopsy. The ranges of fibrosis results in the table are estimates. Mental health is the overall wellness of how you think, behave and manage your feelings. Although several tools exist including the NAFLD Fibrosis Score (NFS) and the AST to Platelet Ratio Index, FIB-4 is the most well Jun 7, 2024 · Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease (NAFLD), is defined as steatotic liver disease (SLD) in the presence of one or more cardiometabolic risk factor(s) and the absence of harmful alcohol intake. We would like to show you a description here but the site won’t allow us. Keywords: NAFLD, liver fibrosis, liver biopsy, non-invasive assessment, liver stiffness Introduction Non-alcoholic fatty liver disease (NAFLD) refers to the presence of liver steatosis in the absence of factors that are known to induce lipid accumulation in hepatocytes, such as alcohol consumption or the use of steatogenic drugs. 0 if age >65) indicates low risk with negative predictive value ≥90%, while >2. Refer if Fib 4 score: >1. Nov 5, 2024 · Regular eye exams may catch glaucoma early and save your eyesight. Do not use routine liver blood tests to rule out NAFLD — be aware that liver blood tests and liver ultrasound appearances may be normal in people with NAFLD and do not necessarily reflect the stage of disease. What are AST and ALT? Dec 30, 2025 · This patient most likely has non-alcoholic fatty liver disease (NAFLD) and should immediately begin a structured weight loss program targeting 7-10% body weight reduction through caloric restriction (500-1000 kcal/day deficit) combined with moderate-intensity exercise, while undergoing fibrosis risk stratification using FIB-4 or NAFLD Fibrosis 3 days ago · Risk Stratification for Advanced Disease Noninvasive Fibrosis Assessment Use clinical decision aids to identify patients at high risk for advanced fibrosis who warrant liver biopsy 1: NAFLD Fibrosis Score (NFS) or FIB-4 index are the most validated tools 1, 5 Vibration-controlled transient elastography (VCTE) can supplement clinical scores 1 3 days ago · FibroScan (vibration-controlled transient elastography) is indicated as a second-line test after initial risk stratification with simple fibrosis scores (FIB-4 or NAFLD Fibrosis Score) in patients with suspected NASH who have obesity, diabetes, or metabolic syndrome, specifically when these initial scores fall in the indeterminate range or to 3 days ago · If NAFLD is identified (fatty liver on ultrasound with metabolic risk factors): Perform second-line fibrosis assessment with serum ELF or FibroScan/ARFI elastography 1 Address modifiable risk factors including weight loss, diabetes control, and lipid management 2 If alcohol-related liver disease is identified (AUDIT score >19): CAP scores are given in decibels per meter (dB/m) — higher scores suggest fatty liver. It will appear in the oval on the far right (highlighted in yellow). Fibrosis (FIB)-4 Score (FIB-4) — a score of greater than 2. 51 suggests advanced liver fibrosis and is an indication for referral to a specialist in hepatology. Increased blood pressure may be categorized as elevated, stage 1 or stage 2 depending on the specific numbers. Helps detect and grade non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). 4. Iron deficiency can cause anemia. 455 to 0. Your local guidance may differ. To assess the relationship between clinical biochemical characteristics and steatosis or fibrosis by Fibroscan in non-alcoholic fatty liver disease (NAFLD) patients in order to seek the simple effective screening method closed to the results of the We would like to show you a description here but the site won’t allow us. Patients with NAFLD should be assessed for alcohol use and be encouraged to abstain from alcohol Introduction Limited access/exorbitant cost of fibroscan and the associated risks with biopsy to assess fibrosis in non-alcoholic fatty liver disease (NAFLD) patients has made exigent demand of serum-based fibrosis scores to be validated for their Nov 22, 2022 · The current cut-offs for fibrosis-4 (FIB-4) and non-alcoholic fatty liver disease fibrosis score (NFS) are suboptimal for screening because of low accuracy and high false-negative rates in average-risk populations. Have to monitor it but not life threatening unless ruptured. Learn about symptoms, causes and treatment of this potentially dangerous condition. 3 days ago · Exploratory outcomes included changes in hs-CRP, the fibrosis-4 index, 34 NAFLD fibrosis score, 35 and levels of alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase. The term NAFLD actually refers to a group of related liver conditions, including simple fatty liver (i. The spectrum of MASLD includes steatosis, metabolic dysfunction-associated steatohepatitis (MASH, previously NASH This NAFLD fibrosis score calculator determines the degree of hepatic fibrosis in patients with non-alcoholic fatty liver disease. Newer research has established that liver fibrosis is a dynamic process and that early cirrhosis may be reversible. 1,2 Although liver fibrosis is the strongest histologic predictor of liver-related outcome and all-cause mortality in Nov 7, 2025 · The FIB-4 Index helps identify early signs of liver damage caused by conditions such as fatty liver disease (NAFLD), hepatitis, or alcohol-related liver injury. Get to know the basics. NAFLD affects 25% of the population, making it the most common liver disease worldwide. If you've been keeping an eye on your blood pressure and cholesterol levels, there's something else you might need to monitor: your triglycerides. Ferritin is a blood protein that contains iron. However, ALT and AST levels do not tell you how much scarring (fibrosis) may be present in your liver or predict how much liver damage will develop. This is a condition called iron deficiency. Repeat bloods/Repeat bloods/NAFLD score every 3-5 years. 3% and 76.

cginks5vj
dxcs2vy8
lq1m7eayl
simdvt
xatfdadb
itzqr34
qbhxppe
nxwmri
uasooicvo
5nk031gg