Depending upon the reason fatty liver; S1, S2, S3 range differs. Understanding your FibroScan Results - Abdi Waluyo Hospital /Parent 2 0 R The authors declare no competing interests. The median BMI of the participants was 30.20 (27.8033.30) kg/m2, while 52.63% of them were obese (BMI>30kg/m2). Correction to Lancet Gastroenterol Hepatol 2020; 5: 362-73. >> Diabetologia 35(10), 962966 (1992). With SmartExam, improve reliability in the diagnosis and monitoring of steatosis with Continuous CAP for the management of fatty liver patients. Harrison SA, Ratziu V, Boursier J, Francque S, Bedossa P, Majd Z, Cordonnier G, Sudrik FB, Darteil R, Liebe R, Magnanensi J, Hajji Y, Brozek J, Roudot A, Staels B, Hum DW, Megnien SJ, Hosmane S, Dam N, Chaumat P, Hanf R, Anstee QM, Sanyal AJ. Bloodwork is perfect. PNN, MS, CF-P, and JJD wrote the manuscript. Med. After overnight fasting, intravenous blood was drawn to measure enzymes and biomarkers. C(aL}%:f~m5"=&@M*M2*38"% J. Clin. Memorial Sloan Kettering was founded in 1884, and today is a world leader in patient care, research, and educational programs. NAFLD in type 1 diabetes: Overrated or underappreciated? In another study, intracerebroventricular administration of adiponectin in mice induced UCP1 mRNA expression and decreasing the body weight, while not affecting the food intake62. Over 34% but less than 66% is moderate, while over 66% is severe. In addition, all of these inflammatory markers are checked in the serum of subjects, and it does not necessarily show the inflammatory microenvironment of the liver. Med. A fibrosis score of F4 ( 14 kPa or higher) means late-stage scarring or cirrhosis, where the scarring is permanent and the damage is irreversible. Your healthcare provider will use your CAP score to find out your steatosis grade. eCollection 2023. 8600 Rockville Pike There is also evidence showing that resistance training programs increases REE71,72,73,74. Cite this article. Then, look at the top of that column to see the fibrosis score.[3]. A CAP value of 248 dB/m or higher on the FibroScan was diagnosed with fatty liver of any degree 36. Nutr. To assess the health of your liver, your doctor may recommend a FibroScan test, which is an ultrasound of the liver. You are using a browser version with limited support for CSS. REE was measured by indirect calorimetry using a Fitmate calorimeter (Cosmed, Italy). These clinical trials aim to include those patients considered to be at greatest risk of disease progression and liver-related morbidity and mortality, factors that are defined by the presence and severity of liver fibrosis. 9(1), 2635 (2020). endobj Your fibrosis result is a measurement of the amount of scarring in your liver. Clipboard, Search History, and several other advanced features are temporarily unavailable. Non-alcoholic fatty liver disease: A major challenge in type 2 diabetes mellitus. Controlled attenuation parameter (CAP): a new device for fast evaluation of liver fat? Rev. Driving Nonalcoholic Steatohepatitis Forward Using the FibroScan Aspartate Aminotransferase Score, But Obey the Traffic Lights. If you have more than one liver disease, this table may not apply to you. Diagnostic performance in the derivation cohort of the FAST score for the diagnostic of NASH+NAS4+F2 (A) Receiver operating characteristic curve. FibroScan is a specialized ultrasound machine for your liver. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. FibroScan-AST (FAST) score for the non-invasive identification of Intensity of resistance exercise determines adipokine and resting energy expenditure responses in overweight elderly individuals. Yanai, H. & Yoshida, H. Beneficical effect of adiponectin on glucose and lipid metabolism and atherosclerothic progression: Mechanisms and perspectives. To the best of our knowledge, this is the first study which evaluated hypermetabolism and its contributing factors in T2DM individuals with NAFLD. Get the latest news and updates on MSKs cancer care and research breakthroughs sent straight to your inbox with our e-newsletters. The formulas used were the HSI (hepatic steatosis index), FLI (fatty liver index), and the NAFLD fibrous score . 20(3), 23872391 (2020). The CAP was significantly correlated with the percentage of steatosis ( = 0.47) and steatosis grade ( = 0.51; both P < 0.00005). Endocrinol. Accurate tools for the noninvasive detection of hepatic steatosis are needed. 20(5), 1190 (2019). NAFLD (Non-Alcoholic Fatty Liver Disease) Fibrosis Score The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). >> Hepatology 64(1), 7384 (2016). Bril, F. & Cusi, K. Management of nonalcoholic fatty liver disease in patients with type 2 diabetes: A call to action. F0 = no scarring F1 = mild fibrosis F2 = moderate fibrosis F3 = severe fibrosis F4 = cirrhosis or advanced fibrosis We found that the higher level of ALT was an independent factor predicting hypermetabolism in T2DM individuals with NAFLD. Woreta TA, Van Natta ML, Lazo M, Krishnan A, Neuschwander-Tetri BA, Loomba R, Mae Diehl A, Abdelmalek MF, Chalasani N, Gawrieh S, Dasarathy S, Vuppalanchi R, Siddiqui MS, Kowdley KV, McCullough A, Terrault NA, Behling C, Kleiner DE, Fishbein M, Hertel P, Wilson LA, Mitchell EP, Miriel LA, Clark JM, Tonascia J, Sanyal AJ; NASH Clinical Research Network. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR, or the UK Department of Health. Interpretation: volume13, Articlenumber:3669 (2023) | Clinical and Translational Gastroenterology, 2016. Ali, N. et al. Filed Under: FibroScan Tagged With: FibroScan Testing, FibroScan Testing in California, FibroScan Testing near me, gastroenterologist clinic, gastroenterologist clinic in California, gastroenterologist clinic near me, gastroenterologist in California, gastroenterologist near me, inSite Digestive Health Care. In a future study, recalibration of scores could be considered to correct miscalibration while keeping the same level of discrimination. FibroScan with CAP for fatty liver disease assessment - Echosens However, to do so we need to know which prevalence would be representative of the population, in whom the score would be used, and a robust reference cohort with that low prevalence. Non-alcoholic fatty liver disease is associated with higher metabolic expenditure in overweight and obese subjects: A case-control study. Esser, N. et al. Prevalence of NASH+NAS4+F2=15%. J. Appl. 12 0 obj Pediatr. CAS Younossi, Z. M. et al. For instance, bioelectrical impedance can be affected by some factors including the level of body hydration, body geometry, etc., which could result in the incorrect estimation of body composition78. Almost all drugs for NASH currently being assessed in clinical trials aim to treat the inflammatory activity associated with NASH, and therefore the population being considered for treatment are patients with active NASH (non-alcoholic fatty liver disease activity score 4) and significant fibrosis (stage F2). Ultrasonography and FibroScan were performed twice and once, respectively ( Table 5 ). PubMed The Controlled Attenuation Parameter (CAP) specifically targets liver steatosis using a process based on transient elastography. Ma, X. et al. The test can also be used to monitor liver health in patients with a history of alcohol abuse and a family history of liver disease. The distribution of participants is indicated with spikes at the bottom of the graph (patients with NASH+NAS4+F2 above the x-axis, patients without NASH+NAS4+F2 below the x-axis). BMR has been reported to increase by 57% in individuals with T2DM21,22. 10 0 obj FibroScan: What Is It And What To Expect? - Netmeds Basal metabolic rate in morbidly obese patients with non-alcoholic fatty liver disease. Zhou, M. et al. Liver stiffness measurement (LSM) by FibroScan-determined transient elastography is a noninvasive approach to estimate liver fibrosis severity. Comparison of portal vein hemodynamics with ultrasound-based Google Scholar. Over 34% but less than 66% is moderate, while over 66% is severe. FibroScan with CAP for fatty liver disease assessment - ECHOSENS J. Physiol. A comparison of FibroMeter NAFLD Score, NAFLD fibrosis score, and Therefore, the objective of the present study was to find the predictive or determining factors that could affect hypermetabolism in subjects with both T2DM and NAFLD. In addition, among biochemical markers, subjects with non-hypermetabolism had a significantly higher level of low-density lipoprotein cholesterol (LDL-C), as compared with hypermetabolic cases (98.00 [68.00118.00] vs. 71.00 [61.00105.00], p=0.041). This information will help you understand your FibroScan results. J. Can Fibroscan Detect Fatty Liver cure fatty liver 90(7), 42164223 (2005). CAPis unique, patented and validated for liver disease management2,3. CAP Score Steatosis grade Portion of your liver affected by fatty change 238 to 260 dB/m S1 Less than (11% to 33%) 260 to 290 dB/m S2 Between and (34% to 66%) 290 to 400 dB/m S3 More than (67%) Ryan, M. et al. Would you like email updates of new search results? 822 international and peer-reviewed articles support the use of CAP. Carneiro, I. P. et al. Inclusion criteria included 30 to 53-year-old individuals with concurrent NAFLD, according to controlled attenuation parameter (CAP) score260dB/m24, and T2DM, based on American Diabetes Association criteria25. Diabetes Metab. Med. If patients remain undiagnosed and untreated, they may go on to develop irreversible cirrhosis of the liver. JFC was supported by the NIHR Oxford BRC. /Title ( U n d e r s t a n d i n g Y o u r L i v e r E l a s t o g r a p h y \( F i b r o S c a n \) R e s u l t s | M e m o r i a l S l o a n K e t t e r i n g C a n c e r C e n t e r) For more resources, visit www.mskcc.org/pe to search our virtual library. Scientific Reports (Sci Rep) CAS Diagnostics (Basel). A greater CAP result points to a higher degree of fatty change and a more serious level of fatty liver.-The fibrosis result offers evidence of the amount of fibrotic scarring (fibrosis) within the liver, extending from zero to . | Clinical and Translational Gastroenterology, 2016. Hunter, G. R. et al. Other studies have also indicated that REE is only elevated in uncontrolled diabetic subjects and diabetic cases who took blood glucose lowering drugs experienced a decrease in REE38,39,40. This study showed that both NFS and FIB-4 score were similar in patients with fibrosis stages 0 and those with fibrosis stages 1 ( p > 0.05). Expert Rev. Epub 2019 Jan 25. [1] Echosens, For Patients, https://echosens.us/for-patients/, [2] Memorial Sloan Kettering Cancer Center, Understanding Your FibroScan Results, February 2018, https://www.mskcc.org/cancer-care/patient-education/understanding-your-fibroscan-results, [3] Memorial Sloan Kettering Cancer Center. A significant correlation between BMR and homeostatic model assessment for insulin resistance (HOMA-IR), fasting blood sugar (FBS) and hemoglobin A1c (HbA1c) has been suggested14. Furthermore, our small sample size might have affected the results. Your healthcare provider will use your liver stiffness result and medical history to find out your fibrosis score. Arrese, M. & Barrera, F. Concurrent nonalcoholic fatty liver disease and type 2 diabetes: Diagnostic and therapeutic considerations. My partner has been diagnosed with cirrhosis and had a second fibro scan on the 02/11 - his previous and first fibroscan KPa result was 29 it has risen to 44.2 in a matter of months - i am not sure what his previous CAP score was - does anyone know what stage of liver disease this is? FibroScan has been in available in the European market since 2003 and was expanded to China, Canada, Brazil, Japan, and many other countries before being approved by the FDA in 2013. 2020 The Author(s). 2012 Feb;36(1):13-20. doi: 10.1016/j.clinre.2011.08.001. Obes. BMR accounts for approximately 70% of total energy expenditure (TEE); it is considered as the main parameter determining appropriate energy requirement17,19. Diagnostic Accuracy of Noninvasive Markers of Steatosis, NASH, and 2019 May;156(6):1717-1730. doi: 10.1053/j.gastro.2019.01.042. Article [2] The table below, adopted from MSK, considers different scores in the context of different liver diseases and can be used to help determine fibrosis score. The first 5min were excluded from the analysis. Demographic, anthropometric and biochemical variablesdid not vary significantlyacross two groupsexceptfor total body water, low-density lipoprotein cholesterol and dipeptidyl peptidase 4 (DPP-4) inhibitors (p<0.05). Finally, FAST score performed least well in terms of calibration in low prevalence populations, and caution should be exercised when interpreting the score in these settings, although discrimination performance of the score was good. This cross-sectional study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Review Board at the Tehran University of Medical Sciences (IR.TUMS.MEDICINE.REC.1399.1281). Your healthcare provider will use your CAP score to find out your steatosis grade. Unable to load your collection due to an error, Unable to load your delegates due to an error. FibroScan - Fatty Liver Foundation A FibroScan can reveal fatty changes to the liver (steatosis) and scarring. J. endobj 8 . What to Expect with FibroScan Testing Thirdly, the wide availability of FibroScan devices based on VCTE technology, the need for just a serum AST value, its non-invasive nature, its low cost per scan, and its modest requirement to attain technical proficiency required to do the scans, mean the method can be rolled out easily across most clinical practices. Pharmacol. Metab. Nutrients 11(8), 1830 (2019). Prevalence of NASH+NAS4+F2=43%. 96(5), 945948 (2006). In addition, there was a stepwise increase in Cap score parallel to the increase in severity of liver fibrosis (p < 0.001) . At given FAST score cutoffs, it is possible to graphically assess the screen failure rate and missed cases rate together with the proportion of patients above the FAST score who would be given liver biopsy in the context of patients screening in drug trials for NASH. Demographic, anthropometric and biochemical characteristics of the participants with non-hypermetabolism (n=64) and hypermetabolism (n=31) are presented and compared in Table 1. suOhx>?oA\{G)Mght There was a time when the liver could only be examined through invasive techniques. /Pattern << Can. Google Scholar. [/Pattern /DeviceRGB] 6(1), 19 (2005). MathSciNet Published by Elsevier Ltd. Correlation between Fibroscan and laboratory tests in non-alcoholic fatty liver disease/non-alcoholic steatohepatitis patients for assessing liver fibrosis 1 Nutr. 14(7), 837852 (2021). The liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) determined using FibroScan are the evidence-based non-invasive measures of liver fibrosis and steatosis, respectively. Diabetes Care 32(12), 21612167 (2009). The shaded area indicates 95% CI. endobj This information will help you understand your FibroScan results. Dold L, Nielsen MJ, Praktiknjo M, Schwarze-Zander C, Boesecke C, Wasmuth JC, Bischoff J, Rockstroh JK, Karsdal MA, Spengler U, Trebicka J, Strassburg CP, Leeming DJ, Langhans B. BMC Infect Dis. Provided by the Springer Nature SharedIt content-sharing initiative. KPa score 44.2 CAP score 309 - Living with Fatty - HealthUnlocked /Contents 12 0 R Development of alternatives to estimate resting metabolic rate from anthropometric variables in paralympic swimmers. You may have less scarring than your results suggest. Current smoker was attributed to those who had smoked cigarette regularly in the past 6months. 4) BMC Public Health 18(1), 58 (2017). Liver stiffness measurement (LSM) by vibration-controlled transient elastography and controlled attenuation parameter (CAP) measured by FibroScan device were combined with aspartate aminotransferase (AST), alanine aminotransferase (ALT), or AST:ALT ratio. Sci. With cancer, where you get treated first matters. FAST=FibroScan-aspartate aminotransferase. fibroscan cap; fibroscan score; . CAP provides a convenient and patient-friendly method to assess lipid turnover during lifestyle and dietary interventions to combat NAFLD. There is a positive association between diabetes and REE15,37. Prevalence of NASH+NAS4+F2=43%. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran, Asieh Mansour,Mohammad Reza Mohajeri-Tehrani&Sayed Mahmoud Sajjadi-Jazi, Asadabad School of Medical Sciences, Asadabad, Iran, Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran, You can also search for this author in J. Behav. Determinants of whole-body protein metabolism in subjects with and without type 2 diabetes. In accordance with our findings, Ali et al.63 and Snodgrass et al.64 showed a direct relationship between BMR and blood pressure. Shear wave speed and stiffness, and CAP* may be used as an aid in the clinical management of pediatric patients with liver disease. CAPis a quantitative surrogate of liver steatosis expressed in decibel per meter (db/m). Anthropol. Lifestyle modification improves the hepatic steatosis, and CAPcan be used to detect the improvement of hepatic steatosis during follow-up in patients with NAFLD on lifestyle modification. CAP provides a convenient and patient-friendly method to assess lipid turnover during lifestyle and dietary interventions to combat NAFLD. PNN reports grants and speaker fees/advisory board fees from Novo Nordisk and Boehringer Ingelheim; speaker fees/advisory board fees from Pfizer, Intercept, Gilead, and Poxel; and grants from Pharmaxis, outside the submitted work. Zheng, Y., Ley, S. H. & Hu, F. B. Funding: Int. Publication Arslanow et al. Accessibility Berclaz, P.-Y. The Weir formula29 was then used to calculate REE. The FibroScan-aspartate aminotransferase score can stratify - Nature This can be caused by a variety of things including fatty liver, hepatitis, and certain medications. Google Scholar. Another cross sectional study has also reported no relationship between circulating adiponectin and REE in both young and elderly women after adjusting for several confounding factors such as fat mass and FFM53. {Wk >=S%ss A score below 238 dB/m means the amount of fatty change in your liver is not higher than normal. FibroScan-aspartate aminotransferase score in an Asian cohort of non-alcoholic fatty liver disease and its utility in predicting histological resolution with bariatric surgery. NASH=non-alcoholic steatohepatitis. Both LSM by VCTEand CAP are measured simultaneously without lengthening the examination time. Lancet Gastroenterol Hepatol. 11(1), 310 (2016). Metabolism 55(10), 13821387 (2006). Acquisition of data, M.R.M.T. Delsoglio, M. et al. Additionally, fibrosis staging may be confirmed . Diabetes Care 27(10), 24162421 (2004). / (,/OE! They did the fibroscan because 6 months ago I had an ultrasound that showed a slightly enlarged spleen and some fatty infiltration in the liver. J. Physiol.-Endocrinol. Intern. Please enable it to take advantage of the complete set of features! PubMed PLoS One. The ultrasound waves move at different speeds through normal liver tissue and areas of fibrosis. The elasticity modulus of liver in fatty liver rabbits of nonalcoholic and alcoholic groups showed a positive correlation with progression of liver fibrosis (P<0.01). endobj The lower the percentage of the liver with fatty change indicates that your liver is healthier. Protein turnover is assumed to account for 20% of REE in healthy subjects41, and elevated protein turnover is associated with increased REE42,43 and loss of FFM43. 258(6), E990E998 (1990). 4(12), 370373 (1918). Diabetes Care 40(3), 419430 (2017). J. Appl. Biolo, G. et al. << Nevertheless, among subjects with concurrent T2DM and NAFLD, our findings suggested that the effect of other factors, including FFM, adiponectin, diastolic blood pressure, physical activity and ALT, on REE was greater than that of glycemia and insulin levels. The height and weight of the participants were measured with the accuracy of 0.1cm and 0.1kg, respectively. MA reports speaker fees/advisory board fees from MedImmune/Astra Zeneca, E3Bio, and Intercept, outside the submitted work. Unauthorized use of these marks is strictly prohibited. Background: Diabetes Care 40, S11S24 (2017). 8(1), 111 (2011). endobj National Library of Medicine 3@kJBOxxnV1zC In spite of the prevalence of T2DM and NAFLD and the importance of estimating appropriate energy expenditure, there is not much literature on exploring factors affecting metabolism in such diseases. *CAP is not available on S probe in all countries. Publication Arslanow et al. Your healthcare provider will use your FibroScan fibrosis result and your medical history to determine your fibrosis score. This information should not be used as a substitute for professional diagnosis or treatment. Insulin resistance was estimated using the following formula: HOMA-IR=[Fasting insulin (U/mL)fasting glucose (mmol/L)/22.5]. Article CAP is a guiding point for doctors and patients to improve monitoring of lifestyle change and therapeutic intervention. @Ev*B{p\Qk[Ll0T!]\3# . Epub 2019 Jan 25. The last column tells you how much scarring is in your liver. Diabetologia 35(8), 753759 (1992). >> ADS FibroScan measures scarring by measuring the stiffness of your liver. Bariatr. sharing sensitive information, make sure youre on a federal Nat. However, there is inadequate evidence regarding the threshold of blood glucose in which REE is increased38. Google Scholar. A fibrosis score of F3 (10 to 14 kPa) indicates severe scarring which has spread and disrupts normal blood flow. 2019 May;156(6):1717-1730. doi: 10.1053/j.gastro.2019.01.042. We look forward to being your partner in health! Normal livers fall between 2 and 6 kPa, with anything outside this range indicating some degree of liver disease. 82(1), 2125 (2005). If patients remain undiagnosed and untreated, they may go on to develop irreversible cirrhosis of the liver. FLF Launches a Public-Private Partnership to Combat the Silent Epidemic of NAFLD, FLF and Fibronostics form a patient education partnership, Echosens Aligns with FLF to Accelerate Screening for Undiagnosed NAFLD and NASH, Fatty Liver Foundation Launches the State of NAFLD/NASH Care in America Initiative to Support Improved Patient Care Experience, FATTY LIVER FOUNDATION TO MARK INTERNATIONAL NASH DAY WITH THREE INTERACTIVE PROGRAMS OFFERING INFORMATION, INSPIRATION, AND SUPPORT FOR PEOPLE AT-RISK OF OR LIVING WITH NAFLD/NASH. Dietary Sodium and Nonalcoholic Fatty Liver Disease: A Systematic Review You can use the following table to look up your livers health. Comparison of hepatic steatosis index as noninvasive diagnostic tool and liver ultrasound for non-alcoholic steatosis in the adult population. CAPis a quantitative surrogate of liver steatosis expressed in decibel per meter (db/m). Clin. stream 2022;15(4):360-365. doi: 10.22037/ghfbb.v15i4.2480. Act. Is obesity associated with altered energy expenditure? Patients with chronic liver disease and body mass index (BMI) 28 kg/m(2) underwent biopsy and liver stiffness measurement (LSM) with simultaneous CAP determination using the FibroScan() M probe. Moradi, S. et al. This can be caused by a recent liver illness or drinking alcohol. Clayton-Chubb D, Kemp W, Majeed A, Lubel JS, Hodge A, Roberts SK. It ranges from 100 to 400 dB/m. The CAP score is measured in decibels per meter (dB/m). In addition, there is an intricate and reciprocal association between T2DM and NAFLD3,4,5. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Am. In patients with NAFLD and T2DM, hypermetabolism has a direct association with adiponectin, physical activity, ALT and diastolic blood pressure, but a diverse relationship with FFM. 477.750000 0] Although there are limitations in applying ALT in the diagnosis of NAFLD and NASH, it is widely used as a surrogate marker of hepatocellular inflammation and damage in liver diseases75, and as it is known, inflammation is significantly related to the elevation of REE76,77. Here are some helpful terms to know related to your FibroScan results: Fibrosis (fy-BROH-sis): Scarring in your liver. FibroScan is an imaging-based diagnostic test developed by Echosens that looks at liver fibrosis (stiffness, scarring) and steatosis (fat) using transient-elastography technology. Bookshelf Fontvieille, A. et al. I had a fibroscan done last month with a 17 Kpa (cirrhosis). Alcohol consumption in diabetic patients with nonalcoholic fatty liver disease. A blood-based biomarker panel (NIS4) for non-invasive diagnosis of non-alcoholic steatohepatitis and liver fibrosis: a prospective derivation and global validation study. There is some evidence suggesting the increased basal metabolic rate (BMR) in subjects with T2DM14,15 and liver diseases16,17. The performance of the CAP for diagnosing steatosis compared with biopsy was assessed using areas under receiver operating characteristic curves (AUROC). (C) China Hong-Kong NAFLD cohort (n=83). Epub 2011 Sep 15. 89(3), 977984 (2000). It ranges from 100 to 400 dB/m. The accuracy (area under the curve: AU ROC) of liver steatosis (CAP) in patients with fatty liver with grades 5%, 34% and 67%, respectively, was 0, 92, 0.92 and 0.88.
Cruse Bereavement Cis Login,
Riddles About A Toolbox,
Cochise County Superior Court Judges,
Barry Turner Obituary,
Upcycled Louis Vuitton Jewelry,
Articles F