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Characteristics and outcome among patients suffering from out of hospital cardiac arrest of non-cardiac aetiology.

https://arctichealth.org/en/permalink/ahliterature9767
Source
Resuscitation. 2003 Apr;57(1):33-41
Publication Type
Article
Date
Apr-2003
Author
Johan Engdahl
Angela Bång
Björn W Karlson
Jonny Lindqvist
Johan Herlitz
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, S-413 45, Göteborg, Sweden. johan.herlitz@hjl.gu.se
Source
Resuscitation. 2003 Apr;57(1):33-41
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation - methods
Child
Child, Preschool
Cohort Studies
Comparative Study
Emergency Medical Services - methods
Female
Heart Arrest - etiology - mortality - therapy
Humans
Infant
Male
Middle Aged
Retrospective Studies
Risk factors
Sensitivity and specificity
Severity of Illness Index
Sex Distribution
Survival Analysis
Sweden - epidemiology
Treatment Outcome
Abstract
AIM: To describe the epidemiology for out of hospital cardiac arrest of a non-cardiac aetiology. PATIENTS: All patients suffering from out of hospital cardiac arrest in whom resuscitation efforts were attempted in the community of Göteborg between 1981 and 2000. METHODS: Between October 1, 1980 and October 1, 2000, all consecutive cases of cardiac arrest in which the emergency medical service (EMS) system responded and attempted resuscitation were reported and followed up to discharge from hospital. RESULTS: In all, 5415 patients participated in the evaluation. Among them 1360 arrests (25%) were judged to be of a non-cardiac aetiology. Among these 24% were caused by a surgical cause or accident, 20% by obstructive pulmonary disease, 13% by drug abuse and the remaining 43% by 'another cause'. Of the patients with out of hospital cardiac arrest of a non-cardiac aetiology 4.0% survived to discharge from hospital as compared with 10.1% of the patients with a cardiac aetiology (P
PubMed ID
12668297 View in PubMed
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Characteristics and outcome among women and men transported by ambulance due to symptoms arousing suspicion of acute coronary syndrome.

https://arctichealth.org/en/permalink/ahliterature53750
Source
Med Sci Monit. 2002 Apr;8(4):CR251-6
Publication Type
Article
Date
Apr-2002
Author
Johan Herlitz
Mia Starke
Elisabeth Hansson
Eva Ringvall
Björn W Karlson
Lisbeth Waagstein
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Source
Med Sci Monit. 2002 Apr;8(4):CR251-6
Date
Apr-2002
Language
English
Publication Type
Article
Keywords
Acute Disease
Ambulances - statistics & numerical data
Angina Pectoris - epidemiology
Arrhythmia - complications - diagnosis - epidemiology
Chest Pain - epidemiology - etiology
Coronary Disease - complications - diagnosis - epidemiology
Dyspnea - epidemiology - etiology
Electrocardiography
Female
Follow-Up Studies
Humans
Incidence
Male
Mortality
Myocardial Infarction - complications - diagnosis - epidemiology
Myocardial Ischemia - epidemiology
Prognosis
Recurrence
Retrospective Studies
Sex Factors
Smoking - epidemiology
Sweating
Sweden - epidemiology
Syncope - epidemiology - etiology
Syndrome
Treatment Outcome
Triage
Abstract
BACKGROUND: The purpose of this study was to describe the characteristics and outcome in relation to sex in consecutive patients who were transported by an ambulance due to symptoms arousing suspicion of acute coronary syndrome. MATERIAL/METHODS: Our research involved all patients transported by ambulance over a 3-month period in the community of Göteborg due to such symptoms. The P-values were age adjusted. RESULTS: Of the 930 transported patients fulfilling the given criteria, 452 (49%) were of women. The women were older and had a lower incidence of previous acute myocardial infarction, angina pectoris, and current smoking. Women less frequently had a final diagnosis of acute coronary syndrome (22.3% vs 36.6%; p
PubMed ID
11951066 View in PubMed
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Characteristics and outcome of patients with ST-elevation infarction in relation to whether they received thrombolysis or underwent acute coronary angiography: are we selecting the right patients for coronary angiography?

https://arctichealth.org/en/permalink/ahliterature53587
Source
Clin Cardiol. 2003 Feb;26(2):78-84
Publication Type
Article
Date
Feb-2003
Author
Johan Herlitz
Lars Ekström
Marianne Hartford
Björn W Karlson
Thomas Karlsson
Lars Grip
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Source
Clin Cardiol. 2003 Feb;26(2):78-84
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Aged
Coronary Angiography
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction - drug therapy - mortality - therapy
Patient Selection
Retrospective Studies
Thrombolytic Therapy
Abstract
BACKGROUND: During the last decade, there has been an on-going debate with regard to whether percutaneous coronary intervention (PCI) or thrombolysis should be preferred in patients with ST-elevation acute myocardial infarction (AMI). Some studies clearly advocate PCI, while others do not. HYPOTHESIS: The study aimed to describe the characteristics and to evaluate outcome of patients with suspected ST-elevation or left bundle-branch block infarction in relation to whether they received thrombolysis or had an acute coronary angiography aiming at angioplasty. METHODS: The study included all patients admitted to Sahlgrenska University Hospital in Göteborg, Sweden, with suspected acute myocardial infarction who, during 1995-1999, had ST-elevation or left bundle-branch block on admission electrocardiogram (ECG) requiring either thrombolysis or acute coronary angiography. A retrospective evaluation with a follow-up of 1 year after the intervention was made. RESULTS: In all, 413 patients had thrombolytic treatment and 400 had acute coronary angiography. The patients who received thrombolysis were older (mean age 70.3 vs. 64.1 years). Mortality during 1 year of follow-up was 20.9% in the thrombolysis group and 16.6% in the angiography group (p = 0.12). Among patients in whom acute coronary angiography was performed, only 85% underwent acute percutaneous coronary intervention (PCI). There was a mortality of 12.1 vs. 41.7% among those who did not undergo acute PCI. Development of reinfarction, stroke, and requirement of rehospitalization was similar regardless of type of initial intervention. The thrombolysis group more frequently required new coronary angiography (36.9 vs. 20.6%; p
PubMed ID
12625598 View in PubMed
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Comparison of treatment and outcomes for patients with acute myocardial infarction in Minneapolis/St. Paul, Minnesota, and Göteborg, Sweden.

https://arctichealth.org/en/permalink/ahliterature49707
Source
Am Heart J. 2003 Dec;146(6):1023-9
Publication Type
Article
Date
Dec-2003
Author
Johan Herlitz
Paul McGovern
Mikael Dellborg
Thomas Karlsson
Susan Duval
Björn W Karlson
Seungmin Lee
Russell V Luepker
Author Affiliation
Sahlgrenska University Hospital, Göteborg, Sweden.
Source
Am Heart J. 2003 Dec;146(6):1023-9
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Angioplasty, Transluminal, Percutaneous Coronary - utilization
Cardiovascular Agents - therapeutic use
Cause of Death
Comparative Study
Coronary Angiography - utilization
Coronary Artery Bypass - utilization
Echocardiography - utilization
Female
Humans
Linear Models
Male
Middle Aged
Minnesota - epidemiology
Myocardial Infarction - mortality - therapy
Proportional Hazards Models
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Sex Factors
Sweden - epidemiology
Treatment Outcome
Abstract
BACKGROUND: Treatment of acute myocardial infarction (AMI) is changing, and differences in medical practice are observed within and between countries on the basis of local practice patterns and available technology. These differing approaches provide an opportunity to evaluate medical practice and outcomes at the population level. The primary aim of this study was to compare medical care in patients hospitalized with AMI in 2 large cities in Sweden and the United States. A secondary aim was to compare medical outcomes. METHODS: All resident patients (age range, 30-74 years) hospitalized with AMI in Göteborg, Sweden (1995-1996), and a representative population-based sample of all patients with AMI in Minneapolis/St. Paul, Minn (1995). RESULTS: Patients with AMI in Göteborg (GB) were older than patients in Minneapolis/St. Paul (MSP), but fewer patients in GB had a prior history of cardiovascular disease. During the AMI admission, coronary angiography, percutaneous coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG) were performed twice as frequently in MSP than in GB. Echocardiogram and exercise testing were more frequently performed in GB. During hospitalization, beta-blockers were more frequently prescribed in GB, whereas calcium channel blockers, long- and short-acting nitrates, intravenous nitroglycerine, digitalis, aspirin, oral anticoagulants, heparin, and lidocaine were significantly more common in MSP. Thrombolysis, acute PTCA, ACE inhibitors, and diuretics were similar. Reinfarction was higher in men in GB (4% vs 1%, P
PubMed ID
14660994 View in PubMed
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A description of the characteristics and outcome of patients hospitalized for acute chest pain in relation to whether they were admitted to the coronary care unit or not in the thrombolytic era.

https://arctichealth.org/en/permalink/ahliterature53768
Source
Int J Cardiol. 2002 Mar;82(3):279-87
Publication Type
Article
Date
Mar-2002
Author
Johan Herlitz
Björn W Karlson
Thomas Karlsson
Lillemor Svensson
Elisabeth Zehlertz och Björn Kalin
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, S 413 45 Göteborg, Sweden. johan.herlitz@hjl.gu.se
Source
Int J Cardiol. 2002 Mar;82(3):279-87
Date
Mar-2002
Language
English
Publication Type
Article
Keywords
Aged
Chest Pain - diagnosis - epidemiology - mortality
Coronary Care Units
Female
Hospitalization
Hospitals, University
Humans
Male
Myocardial Infarction - diagnosis - epidemiology - mortality
Prognosis
Prospective Studies
Risk factors
Sweden - epidemiology
Abstract
OBJECTIVES: To describe the characteristics and outcome of patients hospitalized for acute chest pain in relation to whether they were admitted to the coronary care unit (CCU) or not. DESIGN: Prospective observational study with a follow-up of 2 years. SETTING: Sahlgrenska University Hospital in Göteborg, Sweden. SUBJECTS: All patients hospitalized due to acute chest pain during 6 months. MAIN OUTCOME MEASURES: Mortality, use of medical resources, complications and previous history. RESULTS: In all 1.592 patients were admitted to hospital for chest pain, of whom 1.136 (71%) were not directly admitted to the CCU. These patients differed from those directly admitted to the CCU, being older, including more women, having a higher prevalence of known congestive heart failure and a lower degree of initial suspicion of acute myocardial infarction (AMI). Among all patients with confirmed AMI only 58% were directly admitted to CCU. Overall, the occurrence of complications and the use of medical resources were less frequent in the patients not admitted to the CCU. The mortality during the subsequent 2 years was 16.8% for patients not admitted to the CCU and 18.5% for patients admitted to the CCU. When adjusting for various factors at baseline, patients admitted to the CCU had a relative risk of death during 2 years of follow-up being 1.23 0.87-1.73 (P=0.24) as compared with those not admitted to the CCU. CONCLUSION: In a Swedish university hospital, more than two thirds of patients hospitalized for acute chest pain were not directly admitted to the CCU. They differed from those admitted to the CCU in several aspects. However, their unadjusted and adjusted mortality during the subsequent 2 years did not significantly differ from those admitted to CCU.
PubMed ID
11911916 View in PubMed
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Determinants for an impaired quality of life 10 years after coronary artery bypass surgery.

https://arctichealth.org/en/permalink/ahliterature47114
Source
Int J Cardiol. 2005 Feb 28;98(3):447-52
Publication Type
Article
Date
Feb-28-2005
Author
Johan Herlitz
Gunnar Brandrup-Wognsen
Kenneth Caidahl
Marianne Hartford
Maria Haglid
Björn W Karlson
Thomas Karlsson
Helén Sjöland
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, S-413 45 Sweden. johan.herlitz@hjl.gu.se
Source
Int J Cardiol. 2005 Feb 28;98(3):447-52
Date
Feb-28-2005
Language
English
Publication Type
Article
Keywords
Aged
Comorbidity
Coronary Artery Bypass
Coronary Disease - epidemiology
Female
Health Status Indicators
Humans
Male
Middle Aged
Obesity - epidemiology
Postoperative Period
Pulmonary Disease, Chronic Obstructive - epidemiology
Quality of Life
Abstract
OBJECTIVE: To identify determinants of an inferior quality of life (QoL) 10 years after coronary artery bypass grafting (CABG). SETTING: Sahlgrenska University Hospital, G?teborg, Sweden. PARTICIPANTS: All patients from Western Sweden who underwent CABG between 1988 and 1991 without simultaneous valve surgery and no previous CABG. MAIN OUTCOME MEASURES: Questionnaires for evaluating QoL 10 years after the operation. Three different instruments were used: The Nottingham health profile (NHP), the psychological general wellbeing index (PGWI), and the Physical Activity Score (PAS). RESULTS: 2000 patients underwent CABG, of whom 633 died during 10 years of follow-up. Information on QoL at 10 years was available in 976 patients (71% of survivors). A history of diabetes and chronic obstructive pulmonary disease were the two independent predictors for an inferior QoL with all three instruments. Furthermore, there were three predictors of an inferior QoL with two of the instruments: high age, female sex and a history of hypertension. A number of factors predicted an inferior QoL with one of the instruments. These were the duration of angina pectoris and functional class prior to CABG, renal dysfunction, a history of cerebrovascular disease, obesity, height, duration of respirator treatment and requirement of inotropic drugs postoperatively. In addition, when introducing preoperative QoL into the model a low QoL before surgery was a strong independent predictor also of an inferior QoL 10 years after CABG. CONCLUSION: Variables independently predictive of an impaired QoL 10 years after CABG, irrespective of the instrument used, were an impaired QoL prior to surgery, chronic obstructive pulmonary disease and a history of diabetes. However, other factors reflecting gender, the previous history as well as postoperative complications were also associated with the QoL 10 years later in at least one of these instruments.
PubMed ID
15708178 View in PubMed
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Early identification of patients with an acute coronary syndrome as assessed by dispatchers and the ambulance crew.

https://arctichealth.org/en/permalink/ahliterature53744
Source
Am J Emerg Med. 2002 May;20(3):196-201
Publication Type
Article
Date
May-2002
Author
Johan Herlitz
Mia Starke
Elisabeth Hansson
Eva Ringvall
Björn W Karlson
Lisbeth Waagstein
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. johan.herlitz@hjl.gu.se
Source
Am J Emerg Med. 2002 May;20(3):196-201
Date
May-2002
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Ambulances
Angina Pectoris - diagnosis
Electrocardiography
Emergency Medical Technicians - standards
Female
Health Care Surveys
Humans
Logistic Models
Male
Myocardial Infarction - diagnosis
Outcome Assessment (Health Care)
Research Support, Non-U.S. Gov't
Risk factors
Statistics, nonparametric
Sweden
Triage
Abstract
This study was performed to evaluate the possibility of early identification of patients with an acute coronary syndrome who are transported by ambulance. All patients in the community of Göteborg who were transported by ambulance over a period of 3 months owing to symptoms raising any suspicion of an acute coronary syndrome were studied. In all 930 cases that were included in the survey, 130 (14%) had a final diagnosis of acute myocardial infarction (AMI) and 276 (30%) had a final diagnosis of an acute coronary syndrome. Independent risk indicators for development of AMI were: male sex (odds ratio 1.70; 95% confidence limits 1.02-2.84), cold and clammy on admission of the ambulance crew (odds ratio 2.07; 95% confidence limits 1.23-3.49) and showing electrocardiogram (ECG) signs of myocardial ischemia on admission to the emergency department (odds ratio 8.78; 95%confidence limits 5.28-14.61). Independent predictors for development of an acute coronary syndrome were: male sex (odds ratio 1.97; 95% confidence limits 1.30-2.99), a history of angina pectoris (odds ratio 3.41; 95% confidence limits 2.24-5.26), cold and clammy on admission of the ambulance crew (odds ratio 1.95; 95% confidence limits 1.21-3.15), and ECG signs of myocardial ischemia on admission to the emergency department (odds ratio 5.55; 95% confidence limits 3.63-8.58). Among patients seen by the ambulance crew with symptoms raising any suspicion of an acute coronary syndrome, predictors for that diagnosis included male sex, a history of angina pectoris, patients being cold and clammy on admission of the ambulance crew, and ECG signs of myocardial ischemia on admission to the emergency department.
PubMed ID
11992339 View in PubMed
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Effect of fixed low-dose warfarin added to aspirin in the long term after acute myocardial infarction; the LoWASA Study.

https://arctichealth.org/en/permalink/ahliterature53398
Source
Eur Heart J. 2004 Feb;25(3):232-9
Publication Type
Article
Date
Feb-2004
Author
Johan Herlitz
Johan Holm
Magnus Peterson
Björn W Karlson
Maria Haglid Evander
Leif Erhardt
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. johan.herlitz@hjl.gu.se
Source
Eur Heart J. 2004 Feb;25(3):232-9
Date
Feb-2004
Language
English
Publication Type
Article
Keywords
Aged
Anticoagulants - administration & dosage - adverse effects
Aspirin - administration & dosage - adverse effects
Cerebrovascular Accident - etiology
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Hemorrhage - chemically induced
Humans
International Normalized Ratio
Long-Term Care
Male
Myocardial Infarction - drug therapy
Platelet Aggregation Inhibitors - administration & dosage - adverse effects
Prospective Studies
Recurrence
Research Support, Non-U.S. Gov't
Treatment Outcome
Warfarin - administration & dosage - adverse effects
Abstract
AIM: To evaluate whether long-term treatment with a fixed low dose of warfarin in combination with aspirin improves the prognosis compared with aspirin treatment alone after an acute myocardial infarction (AMI). METHODS: Patients who were hospitalized for AMI were randomized to either 1.25mg of warfarin plus 75mg of aspirin (n=1659) daily or 75mg of aspirin alone (n=1641). The study was performed according to the PROBE (Prospective Open Treatment and Blinded End Point Evaluation) design and was conducted at 31 hospitals in Sweden. The median follow-up time was 5.0 years. In the aspirin+warfarin group, 30.2% were permanently withdrawn as opposed to 14.0% in the aspirin group (P
PubMed ID
14972424 View in PubMed
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The epidemiology of cardiac arrest in children and young adults.

https://arctichealth.org/en/permalink/ahliterature30798
Source
Resuscitation. 2003 Aug;58(2):131-8
Publication Type
Article
Date
Aug-2003
Author
Johan Engdahl
Asa Axelsson
Angela Bång
Björn W Karlson
Johan Herlitz
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
Source
Resuscitation. 2003 Aug;58(2):131-8
Date
Aug-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Case-Control Studies
Child
Child, Preschool
Female
Heart Arrest - epidemiology - etiology - physiopathology
Humans
Infant
Infant, Newborn
Male
Resuscitation
Retrospective Studies
Survival Rate
Sweden - epidemiology
Tachycardia, Ventricular - mortality
Ventricular Fibrillation - mortality
Abstract
AIM: To describe the epidemiology of children and young adults suffering from out-of-hospital cardiac arrest. PATIENTS: All patients suffering from out-of-hospital cardiac arrest in whom, resuscitation efforts were attempted in the community of Göteborg between 1980 and 2000. METHODS: Between 31 October 1980 and 31 October 2000, all consecutive cases of cardiac arrest in which the emergency medical service (EMS) system responded and attempted resuscitation were reported and followed-up to discharge from hospital. RESULTS: Among 5505 cardiac arrests information on age was available in 5290 cases (96%). Of these 5290 cases 98 (2%) were children (age 0-17 years), 197 (4%) were young adults (age 18-35 years) and the remaining 4995 (94%) were adults (age >35 years). Children and young adults differed from adults by suffering from a witnessed arrest less frequently, being found by the ambulance crew in ventricular fibrillation/tachycardia less frequently and being judged as having an underlying cardiac aetiology less frequently. Of the children only 5% were discharged from hospital alive compared with 8% for young adults and 9% for adults. Among survivors the cerebral performance categories (CPC) score at discharge tended to differ with 38% of young adults registering a CPC score of 1 (no neurological deficit) compared with 52% among adults. CONCLUSION: Children and young adults suffering from out-of-hospital cardiac arrest differed from adults in terms of aetiology and observed initial arrhythmia. Children had a particularly bad outcome whereas young adults had a similar outcome as adults.
PubMed ID
12909374 View in PubMed
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Illness perceptions after myocardial infarction: relations to fatigue, emotional distress, and health-related quality of life.

https://arctichealth.org/en/permalink/ahliterature97981
Source
J Cardiovasc Nurs. 2010 Mar-Apr;25(2):E1-E10
Publication Type
Article
Author
Pia Alsén
Eva Brink
Lars-Olof Persson
Yvonne Brändström
Björn W Karlson
Author Affiliation
Sahlgrenska Academy at Göteborg University, Sweden.
Source
J Cardiovasc Nurs. 2010 Mar-Apr;25(2):E1-E10
Language
English
Publication Type
Article
Keywords
Aged
Anxiety - complications
Case-Control Studies
Chronic Disease
Depression - complications
Fatigue - complications - psychology
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Myocardial Infarction - psychology - rehabilitation
Perception
Quality of Life
Recovery of Function
Self Efficacy
Sweden
Abstract
BACKGROUND AND RESEARCH OBJECTIVE:: Health-related quality of life (HRQoL) is impaired in patients after a myocardial infarction (MI), and fatigue and depression are common health complaints among these patients. Patients' own beliefs about their illness (illness perceptions) influence health behavior and health outcomes. The aim of the present study was to examine illness perception and its association with self-reported HRQoL, fatigue, and emotional distress among patients with MI. SUBJECTS AND METHODS:: The sample consisted of 204 patients who had had MI and who completed the questionnaires during the first week in the hospital and 4 months after the MI. The questionnaires used were the Illness Perception Questionnaire, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and the Short Form Health Survey (SF-36). RESULTS:: Patient's illness perception changed over time from a more acute to a more chronic perception of illness, and beliefs in personal and treatment control of MI had decreased. Furthermore, these negative beliefs were associated with worse experiences of fatigue and lowered HRQoL. CONCLUSIONS:: Patients' illness perceptions influence health outcomes after an MI. Supporting MI patients in increasing their perception of personal control could be a primary nursing strategy in rehabilitation programs aimed at facilitating health behavior, decreasing experiences of fatigue, and increasing HRQoL.
PubMed ID
20168186 View in PubMed
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21 records – page 1 of 3.