Life expectancy after compression fracture. Life expectancy after fracture of the hip.

30) Mu ltilevel compression fractures involving the thoracic and lumbar levels: 91 (14. 5% and 30. Compression fractures impact life expectancy in several ways. Whether or not you have surgery, you'll need to wear braces for around 8-12 weeks. T6-T12 spinal cord injuries affect sensation and motor control around the trunk and abdominal areas. Given the fact that life expectancy is inherently shorter with increasing age, the population was divided into subgroups defined as ages 65–74, 75–84, 85-94 and >95 for this May 26, 2023 · Background Lower mortality has been demonstrated when vertebral compression fractures (VCFs) are treated surgically (vertebral augmentation) vs. 2017 Sep 29. In Spain, people over 65 have experienced an increase in life expectancy by about 25% in the last 30 years. Mortality is also high and in patients older than 65 years of age it is around 20 per cent in the first year after the fracture . 9 years in the present study) and female predominance in 74. Hatgis J, Granville M, Jacobson RE. 14, 15 Shorter treatment courses of 8 Gy once or 20 Gy in 5 fractions are particularly valuable for patients with a life expectancy < 3 months to avoid long courses of treatment, and thereby improve QOL as patients transition into hospice. A compression fracture is a spine injury where a vertebra collapses, often due to osteoporosis or trauma. An estimated 25 percent of all post-menopausal women in the United States experience a compression fracture. In three months after their hip fracture, a total of 21 patients had died. 76 years for those with 5 episodes to 36. Such injuries often result from high-impact events like vehicle accidents, falls, or sports injuries. 2 All-cause mortality 12 months following a hip fracture. Compression fractures are most common among the elderly and women. There were also no reports of damage to the spinal cord caused by the radiation treatments. Aug 26, 2023 · Purpose The aim of this study is to identify risk factors for vertebral compression fracture (VCF) progression in patients treated conservatively with a brace. Summary The life expectancy of vertebral compression fracture (VCF) patients was evaluated as a function of their treatment. The treatment approach for a pelvic fracture may differ for older adults due to the type of fracture, its cause, and a person’s overall health and mobility. Therefore, it is essential for at-risk individuals to be aware of potential triggers and avoid them. Bone pain is the most common symptom, but bone fracture also often happens. Stage 2: The cancer is progressing and causing multiple symptoms. The risk of compression fractures was also similar in both groups, and the risk of serious fractures was minimal, the researchers reported. There are some surgical procedures that can be done to alleviate the pain associated with vertebral fracture. Continuous back pain 5. 2 years May 15, 2012 · The most significant increases in mortality were seen in those with tetraplegia and American Spinal Injury Association Impairment Scale (AIS) grades A–C lesions, with SMRs between 5. When the spinal cord is damaged the messages between our brain and the rest of our body can’t get through, resulting in a loss of movement and sensation from below the level of injury. Jan 1, 1995 · To describe the life expectancy after cervical spine fracture, Kaplan-Meier survival curves were used to analyze risk of death over time after cervical spine fracture. It’s linked to a long recovery period and May 5, 2021 · Type I: This is the mildest and most common form of OI. Summary. 2% of participants without and with coronary heart disease, respectively Life Expectancy after Compression Fracture. Further Pushing the Limits An analytic method for longitudinal mortality studies. Hip fractures incurred the greatest loss of life years. At least 30% of older patients will die within a year after having a hip fracture. Jan 30, 2023 · Vertebral compression fractures (VCF) are the most common low-energy fractures in older people and are associated with increased mortality. 53. Jul 1, 2016 · Vertebral compression fractures (VCFs) are the most common complication of osteoporosis, affecting more than 700,000 Americans annually. In the near future, more patients older than Nov 17, 2023 · A majority of patients (66%) had a SINS of <7 with most tumors (79%) rated as Bilsky grade 0. I live in UK and, although my doctor has Mar 15, 2019 · Isolated cervical compression fractures: 15 (2. We hypothesized that surgical Aug 4, 2023 · Vertebral compression fractures (VCFs) of the spinal column occur secondary to an axial/compressive (and to a lesser extent, flexion) load with resultant biomechanical failure of the bone resulting in a fracture. In this study, 1,495 patients with a displaced femoral neck fracture were randomized to undergo either total hip arthroplasty or hemiarthroplasty. ’’ After a detailed search, only 27 articles were found in the literature. Severely deformed vertebrae predominantly (92%) occurred among the crush fracture type. Those complications include: Fractures: Roughly 8. There are about 20,000 fractures of the proximal end of the femur treated in Poland and VCFs are the most common fractures in patients with osteoporosis, which affect more than 750,000 U. 16 years. 2 years, while a man age 75 had an expectancy of 7. However, it increases the risk of fractures, which may directly affect overall health and mortality Back in the 1940s, the life expectancy for a person with a spinal cord injury was an average of just over a year. In this procedure, a needle is placed into the fractured bone to create a tunnel. A person who scores 65 or less on the scale has a 1–6% chance of dying Sep 12, 2022 · Fracture types. Bone metastasis typically affects your spine, but can also affect arms and legs. }, author={William T. Phrenic nerve. Life expectancy after fracture of the hip. But you also want to lower your odds of getting more broken Mar 26, 2018 · Fractures often lead to the loss of ability to perform basic and instrumental activities of daily living, and such patients may have to be admitted to institutional care . This causes a little difficulty in breathing, and lots of stitch like pain in my sides, which I believe is compression on my hips. In 24 patients, the surgical intervention consisted in hip prosthesis and in 18 patients, a dynamic compression hip screw with a plate. Within the first 6 months after fracture, 20. “Halos” (rings that go around your head that are attached to a vest) may also be needed to stabilize your injury at first. For instance, a 60-year-old individual with a hip fracture is estimated to have a skeletal age of 66 for men and 65 for women. Apr 24, 2023 · First, the percentage of participants who died following a hip fracture and the relative risk for dying compared with participants without a hip fracture were high, especially in the early period following fracture. 6%, while that of patients receiving placebo instead of denosumab declined by 1. Or if you broke your wrist, you Apr 10, 2016 · Physical Therapist Margaret Martin describes six vertebral compression fracture symptoms. 4% of cases (72. Other causes include injuries to the spine and tumors. Methods Patients over 65 years old A fracture in any of these vertebrae can be classified as a broken neck. Doctors said more interventions are needed to help these patients. Methods In a retrospective cohort study with prospective mortality follow-up May 23, 2022 · Without proper management, autonomic dysreflexia can be life-threatening. Now, life expectancy is much better, hovering just below the average for the general population. Learn how to diagnose, treat, and prevent this condition, and how it can affect your quality of life and longevity. Fractures are not uncommon – they will happen to half of all women over the age of 50, and one third of men. Kyphoplasty patients had a 34% greater adjusted life expectancy than Jan 7, 2024 · Bone metastasis is when cancer spreads to your bones from another part of your body. We included articles from 2006 to the present and studies published in the English language. org. Delayed Recognition of Thoracic and Lumbar Vertebral Compression Fractures in Minor Accident Cases. 13-15 For elderly patients with osteoporotic fractures, there is a paucity of Keywords Fractures · Compression · Spinal fractures · Survival rate · Bone diseases · Metabolic Background The longevity of the population has undergone a signicant change in recent decades. Cancer / Oncology Factors affecting life expectancy after bone metastasis in adults — results of a 5 Mar 30, 2023 · Outlook. Life expectancy reflects the average experience of a group of similar individuals. impaired mobility. It can also be felt on the sides or in the front of the spine. Oct 25, 2022 · Aging with a spinal cord injury means huge changes to lifestyle and expectations of work, family position, leisure interests, and effectively every part of a person’s life needs some adjustment. While osteoporosis and ankylosis are generally thought to place elderly individuals at Jun 20, 2023 · Fractures can be very painful, and some can cause long-term disability. conservatively. Stage 3 Mar 16, 2012 · Summary The life expectancy of vertebral compression fracture (VCF) patients was evaluated as a function of their treatment. Oct 17, 2021 · Fragility fractures are frequent in the elderly. None of the patients could return to pre-injury functional level despite the good clinical outcome. We aimed to determine the short- and long-term mortality rates of older patients with a pelvic ring fracture compared with both an age-matched cohort of patients with a femoral neck fracture and a general population, and to investigate 30- and 60-day readmission rates after pelvic fracture. Dec 18, 2021 · Introduction Osteoporotic vertebral compression fractures (VCFs) are common. We only included articles that listed one of their primary or Jul 9, 2019 · They followed the participants’ journey and life after the fracture. Introduction Balloon Oct 12, 2021 · Hip fracture has a substantial impact on survival and health-related quality of life of older people 1,2. 5% of the patients in the denosumab group developed vertebral body fractures, compared to 3. Dec 11, 2015 · Summary Vertebral compression fractures (VCF) cause pain and decreased physical ability, with no known well-established treatment. VCF patients treated with BKP or VP have been associated with lower mortality risk, but what this represents in terms of a patient’s life expectancy is unmeasured. Feb 4, 2011 · After two years of treatment with denosumab, their bone density increased by 5. " Pain can be disabling, and take weeks to months to go away. Sep 13, 2023 · For many people, a spinal compression fracture will hurt less as the bone heals. Survival rates following VCF diagnosis at 3, 5, and 7 years were 53. Osteoporosis does not directly affect life expectancy. due to the above I have lost 2” in height. Kyphoplasty. 5%, respectively. It doesn’t cause any bone deformity. 9%, and 10. May 15, 2023 · The stages of myeloma are: Smoldering: Non-active disorder, no symptoms. Methods All patients over 50 years old with diagnosis of thoracic or lumbar VCF (T5 to L5) in absence of underlying oncological process, treated conservatively with brace, and consecutively Balloon kyphoplasty (BKP) and vertebroplasty (VP) are minimally invasive procedures for the treatment of painful vertebral compression fractures (VCFs). Dec 15, 2021 · Due to the fact that life expectancy has increased, we can observe an increasing trend of hip fractures. The women in the kyphoplasty cohort were ages 65 to 69 years, and they had 5. The first year after a hip fracture is considered to be the most critical time in terms of an increased risk in mortality. . SUMMARY: The life expectancy of vertebral compression fracture (VCF) patients was evaluated as a function of their treatment. sexual dysfunction. Braces on your back and neck can help relieve pressure and keep your spine straight while it heals. It often affects people with breast, lung and prostate cancer. How do Healthcare Providers Treat Compression Fractures? Jan 23, 2021 · Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Several osteoporosis-related complications can significantly reduce a person’s quality of life and cause a shortened life expectancy. Regular follow-up visits during this time allow your doctor to evaluate the fractured Sep 29, 2023 · Fractures: Bone metastases including spinal cord compression and high calcium levels. adults each year. 2 years' increase in predicted life expectancy compared with vertebroplasty female patients. 0 Jul 24, 2009 · Thirty patients suffered an intertrochanteric hip fracture, and 12 patients suffered a femoral neck fracture. Increased risk of mortality for patients undergoing nonsurgical management 6. In general, the one-year mortality rate of untreated SAH is up to 65%, meaning up to 65% of people who had an SAH that wasn’t treated died within one year of the episode. To assess mortality risk in patients suffering from VCF, we conducted a retrospective observational long-term cohort study. Dec 7, 2023 · Life Expectancy After Compression Fracture. 9 (9):e1729. Our experts offer nonsurgical care to help you build bone strength, maintain stability in the spine, and walk without pain. The mean number of concomitant diseases was 2. 9%, 30. 1 The true incidence of MSCC is Mar 21, 2024 · Compression fractures are a common type of injury that occurs when the vertebrae in the spine collapse or break. 0001 for SF36 PCS and 0. uk › daily-living-after-fractures-fact-sheet-december-2016 Although bones heal over the next six to eight weeks, multiple compression fractures in the spine can cause problems that don't improve with healing. Spinal cord injuries can be debilitating, but there are great options out there to help patients live with these injuries. 45) Isolated thoracic compression fractures: 149 (24. The aim of this study was to illuminate the experience of living with a VCF. These estimates should be interpreted cautiously. In this section, the number of Canadians 40 years and older who died of any cause 12 months following a hip fracture is presented. Jan 12, 2023 · Common Complications. Aims To analyze the overall survival in patients over 65 who suffer a VCF, to review the principal causes of death, and to detect which factors are associated with a greater risk of mortality. 80) Isolated lumbar compression fractures: 272 (44. Research has shown that older adults who experience a compression fracture are at higher risk for complications and mortality compared to those without fractures. Compression fractures can occur suddenly. Jan 30, 2024 · Congestive heart failure is a condition that can make the heart too weak or too stiff to pump blood properly. My top half is now compressing my lower half. Nov 24, 2020 · Measurements of spinal stability after 6 months were about the same in both groups. Margaret discusses how to detect if you have a vertebral compressio Dec 14, 2016 · Actually, it is uncertain whether osteoporotic fractures with the similar fracture pattern as high-energy trauma result in the same instability. One year after the fracture, irrespective of fracture level, fracture type or grade of fracture deformation, 4/5 still had pronounced pain and deteriorated QoL. 3 years and an even higher increase (110%) in the risk of death from pulmonary disease. For example, if you had a spine fracture, you might need to bend and lift differently than you did before. Recently, several studies have found a risk of acute (inhospital) mortality of >20% for elderly patients with isolated cervical spine fractures 14, 15. The most common types of spinal fractures include: Compression fractures: Compression fractures are small breaks or cracks in your vertebrae that are caused by traumas or develop over time as a result of osteoporosis. @article{Fitts1959LifeEA, title={Life expectancy after fracture of the hip. The life expectancy of vertebral compression fracture (VCF) patients was evaluated as a function of their treatment. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. 6 million hip fractures occur worldwide each year and by 2050 this Aug 10, 2022 · Thanks to advances in modern medicine, treatment techniques, and assistive devices and therapies, people with quadriplegia can live for years or even decades. Osteoporosis plays a key role in both fracture risks and survival rates. Oct 15, 2018 · Kyphoplasty patients had 115% and 34% greater adjusted life expectancy compared with the nonoperated and vertebroplasty groups, respectively. Preventing and treating osteoporosis is the best way to decrease your risk for compression fractures. Jun 5, 2015 · Cetin et al evaluated the incidence of bone metastasis and skeletal-related events (spinal cord compression, fracture, bone surgery, radiation) in patients with lung cancer, demonstrating a 1-year survival of 37. Compared to non-operated patients, the kypho-plasty and vertebroplasty patient cohort had 115% and 44% greater adjusted life expectancy, respectively. 034 for SF36 MCS). Osteoporosis is a disease that weakens your bones, making them more susceptible to sudden and unexpected fractures. 1% for patients Jul 3, 2023 · A 50-year-old man beginning osteoporosis treatment had an average life expectancy of 18. May 27, 2023 · In the short term, treatments like pain medicines, physical therapy, and bracing might help ease your pain and get you moving again. 9 years (78. The lifetime risk of a hip fracture in women (almost 20%) is likely higher than the risk of developing breast cancer Jan 1, 2004 · According to data collected in 1995, the annual direct medical cost of vertebral compression fractures in the United States is estimated to be $746 million. While compression fractures themselves may not significantly affect life expectancy, associated complications and the underlying causes, especially in older individuals, can impact overall health. Thus, the probability of surviving to Being homebound (no outings) was associated with a life expectancy of 31. Type II: Babies born with Type II often can’t breathe and die young. In the past, 3. Ejection fraction is a measure of this pumping force in the left ventricle of the heart. According to the study, a 50-year-old man starting osteoporosis treatment had an estimated life expectancy of 18. What would you like to read? Choose There has been recent interest in using predictive models to estimate life expectancy to avoid long courses of RT at the end of life. Age-related complications, such as osteoporosis and reduced bone density, can greatly impact an individual’s overall life expectancy after experiencing a compression fracture. Type II causes multiple broken bones even before the baby is born. 21 The life expectancy of vertebral compression fracture (VCF) patients was evaluated as a function of their treatment. The pain is often sharp and "knife-like. It is estimated that 1. The results show that fear and concerns are a major part of daily life. Compared to non-operated patients, the kyphoplasty and vertebroplasty patient cohort had 115% and 44% greater adjusted life expectancy, respectively. 5 years. Progressive thoracic kyphosis 5. 77) American Spinal Injury Association score A: 4 (0. VCFs by definition compromise the anterior column of the spine, thereby resulting in compromise to the anterior half of the vertebral body (VB) and the anterior longitudinal ligament May 3, 2024 · New research found survival rates after a broken hip in older adults are less than those of cancer. The rate of secondary hip procedures–the main study Dec 15, 2021 · Background: Displaced femoral neck fractures in geriatric patients are typically treated with either hemiarthroplasty or total hip arthroplasty. 9% in the placebo group (relative risk reduction, 62%). Fracture risk increases with age, with four in 10 white fragility fractures can cause substantial pain and severe disability, often leading to a reduced quality of life, and hip and vertebral fractures are associated with decreased life expectancy. Lehr Aug 12, 2022 · After a fracture, you have to learn how to move again. Kyphoplasty patients had a 34% greater adjusted life expectancy than vertebroplasty patients. About 43% of patients had at least one EP disruption (43%), whereas 18% of patients had disruption of two EPs (Table 1). Dec 12, 2008 · The grade of fracture deformation was not related to gender, age or fracture location. Dec 15, 2021 · A recent prospective controlled trial, the HEALTH study [ 5 ], suggests that the two-year life expectancy is an important line of demarcation. 13-15 For elderly patients with osteoporotic fractures, there is a paucity of Jan 13, 2024 · Compression Fractures And Mortality. 1% for patients with bone metastasis and no skeletal-related events, and 5. 0% in the study sample). Metastases to the spine occur in 3–5% of all patients who have cancer and are more common in patients with breast, prostate and lung cancer, in whom the incidence is 19%. Moreover, only 1. [PDF] daily living after fractures - Royal Osteoporosis Society theros. The lifetime risk of osteoporotic fractures lies within the range of 40–50% in women and 13–22% for men [ 1, 2 ], with mortality higher in men [ 3 ]. 1 Vertebral compression fractures are Mar 20, 2024 · A compression fracture, or vertebral compression fracture, is a spinal injury that occurs when a crack or fracture develops in one or more bones that form the spine. T6, T7, T8, T9, T10, T11, and T12 Spinal Cord Injures. Metastatic spinal cord compression (MSCC) is a well-recognised complication of cancer and usually presents as an oncological emergency. These complications often lead to prolonged recovery times and increased risks of secondary health issues. 9 million fractures are caused by osteoporosis each year. Almost half of patients (52%) did not receive systemic therapy during a 4-week range from radiation. Doctors may recommend physical therapy if a spine compression fracture has interrupted your regular exercise routine long enough that your core muscles—located in the back, thighs, abdomen, and buttocks—have lost strength. These fractures can lead to significant pain, limited mobility, and other complications. The choice between hemiarthroplasty and total hip arthroplasty requires a good estimate of the patient's life expectancy, as the recent HEALTH trial suggests that the benefits of the two operations do not diverge, if at all, until the second year post Dec 14, 2016 · Actually, it is uncertain whether osteoporotic fractures with the similar fracture pattern as high-energy trauma result in the same instability. The women’s initial contact with health-care providers should focus on making them feel acknowledged by offering Mar 21, 2024 · Life expectancy after a compression fracture can vary depending on a variety of factors, including the individual’s age, overall health, and the severity of the fracture. An increase in mortality associated with osteoporotic VCFs has been well documented. Patients aged 65 years and above suffer fragility status and increased risk of adverse health outcomes [ 4, 5] such as impaired mobility bral compression fracture and patient longevity has been less well studied. January 28, 2024 December 7, 2023 by Usman. 1 Although the trauma itself is not usually associated with mortality, these fractures are associated with loss of sagittal alignment and acute and chronic back pain, 2,3 leading to general physical deterioration and impaired quality of life, factors Mortality associated with cervical spine fractures in elderly patients is less well studied 4, 10 - 13. Sep 6, 2023 · Christine Rose Photography/Getty Images. Oct 12, 2022 · Life expectancy after a subarachnoid hemorrhage (SAH) varies based on its severity and how quickly it’s diagnosed and treated. Physical Therapy. By six months, five more patients had succumbed to Jan 30, 2023 · Vertebral compression fractures (VCF) are the most common low-energy fractures in older people. Apr 29, 2022 · Doctors use a pulmonary embolism severity scale to assess the likelihood or a person with a PE surviving 30 days or longer. If you have osteoporosis, a full recovery may take as long as a year. In the immediate to short-term, the psychological impact of a new spinal cord injury can be incredibly taxing. Fitts and Herndon B. Dec 12, 2012 · Background: Vertebral compression fractures (VCFs) can be treated by nonsurgical management or by minimally invasive surgical treatment including vertebroplasty and balloon kyphoplasty. Errp82 •. Decreased respiratory capacity 5. 0% (1, e4). Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site Mar 21, 2023 · pain. 26 years, whereas 1-3 weekly outings resulted in a life expectancy of 36. Other people will still have pain after the fracture has healed. J Insur Med 2000;32:217-225. Stage 1: Early in the disease, no symptoms. S. We calculated life expectancy based on 5, 10, or 15 binge drinking episodes in the last 30 days, and life expectancy ranged from a high of 40. Then, a case–control study was designed. This creates a small cave inside. These complications may occur if the fracture causes damage to a person’s nerves or organs. This means the rest of the body does not get the oxygen and nutrients it needs. May 16, 2023 · A fracture was associated with between 1 and 7 years of life lost, with the loss being greater in men than women. Easing symptoms is the most common treatment. 62 ± 1. Some individuals will not survive as long while others will survive longer. The severity of the break can vary widely, from minor fractures that may heal with minimal treatment to severe injuries that can lead to permanent disability or even be Feb 10, 2021 · Hip fractures are particularly dangerous, with 33% of adults over 50 dying within a year of fracturing their hips. If it is preserved, then the type of CHF is called diastolic heart Symptoms. Objective: The purpose of the present study was to characterize the cost to Medicare for treating VCF-diagnosed patients by nonsurgical management, vertebroplasty, or kyphoplasty. These messages enable us to move our body, feel pressure and control vital functions like our breathing, blood pressure, bladder and bowels. 4 and 9. Studies show they might face a higher mortality rate after a fracture. It can involve a ‘‘mortality,’’ ‘‘morbidity,’’ ‘‘vertebral compression fractures,’’ and ‘‘survivorship. Studies show that people report significantly lower Nov 19, 2019 · Research on mortality and comorbidity associated with pelvic fractures in older patients is scarce. Recovering from a spinal fracture. The pain is most commonly felt in the middle or lower spine. 79) Others: 17 (2. 1,11,12 Even in young patients, the literature is dissent about treatment strategies for lateral compression fractures. 9 (2):e1050. [QxMD MEDLINE Link]. That can take up to 2 or 3 months. Through this tunnel a small probe with an inflatable balloon on the tip is placed and the balloon inflated. Vertebral Compression Fractures after Lumbar Instrumentation. Mar 16, 2012 · Abstract. A 50-year-old woman beginning osteoporosis A compression fracture is a type of fracture or break in your vertebrae (the bones that make up your spine). This can cause severe back pain. 4 This can lead to: Impaired pulmonary function 5. 65) Apr 1, 2024 · Complications and Life Expectancy. Many spine compression fractures heal in two or three months. Type I leads to broken bones ( bone fractures) or muscle weakness. 2 years ago • 24 Replies. Granville M, Berti A, Jacobson RE. That amounts to one fracture every three seconds. The purpose of this study was to assess the impact of time to surgery on 1-year survival in patients with osteoporotic vertebral compression fractures. 37) Isolated sacral fractures: 60 (9. Sep 1, 2020 · On comparing HRQOL of patients sustaining pelvic fracture with general population norm (student t-test), the scores were significantly low in pelvic-fractured patients (P-value<0. Breaking a hip is a common fear in older adults. Elderly individuals often suffer from such fractures. 2017 Feb 23. In one study of the effect of vertebral compression fracture on survival7, the authors found a 23% increase in mortality risk after a mean duration of follow-up of 8. One important consideration for individuals who have experienced a compression fracture is the impact it may have on their life expectancy. However, because life expectancy can vary widely, a healthcare provider is the best person to tell you what’s most likely to happen in your case. Compared to non-operated patients, the kyphoplasty and vertebroplasty May 26, 2023 · In their study, they included patients over 65 years, as reported in this series, with a mean age of 79. 4% for patients with no bone metastasis, 12. Hip fracture nearly always requires hospitalisation, is fatal in 20% of cases Jul 31, 2022 · life after multiple compression fractures. Physical therapy may also be recommended if these muscles have never been properly conditioned. Osteoporosis is the most common cause of compression fractures. Cureus. id wt iq kg oq jb jx sq ly rg