Nice guidelines pdf. It also updates and replaces NICE evidence summary .

Nice guidelines pdf Section 6 on assessment and stratification of risk and section 8 on managing and treating sepsis in acute Apr 7, 2021 · in line with the NICE guideline for the underlying chronic pain condition if the underlying condition adequately accounts for the pain and its impact (see the NICE guidelines on headaches, low back pain and sciatica, rheumatoid arthritis, osteoarthritis, spondyloarthritis, endometriosis, neuropathic pain and irritable bowel syndrome). 3 Yet fewer than half of people affected receive treatment, 2 despite increased provision of psychological therapies 4 and antidepressants. Follow the recommendations on patient involvement in decisions about medicines in NICE's guideline on medicines adherence and patient decision aids in NICE's guideline on medicines optimisation. This guideline covers identifying and caring for adults who are malnourished or at risk of malnutrition in hospital or in their own home or a care home. This guideline covers identifying and treating primary hypertension (high blood pressure) Jan 15, 2021 · Acute coronary syndromes (ACS), comprising ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina, are an important cause of morbidity and mortality in the UK and worldwide. . It outlines NICE's vision, ambition, priorities and changes for the next 5 years, in response to the COVID-19 pandemic and other challenges and opportunities. Feb 20, 2013 · Is this guideline up to date? June 2015: We checked the evidence and decided to update this guideline. A PDF document that explains how NICE develops clinical guidelines for health and social care in the UK. 5 . NICE's guideline on generalised anxiety disorder and panic disorder in adults. See the NICE guideline to find out why we made this recommendation and how it might affect practice. This guideline should be read in conjunction with NG193. Jun 22, 2022 · This guideline replaces CG186 and ESUOM9. This guideline is the basis of QS181, QS28 and QS209. Future updates: August 2021: We have checked this guideline and plan to update the recommendation on oral antiplatelet therapy for reducing cardiovascular disease in people This guideline updates and replaces NICE guidelines CG182 (published July 2014), NG8 (published June 2015), CG157 (published March 2013) and NICE evidence summary ESNM51. Jul 27, 2022 · For guidance on when to consider sexual abuse, see recommendation 1. This article summarises the most The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. It also updates and replaces NICE evidence summary Jan 25, 2016 · [NICE guideline or type of guidance] Publication expected [Month Year] Guidelines Osteoarthritis in over 16s: diagnosis and management (2022) NICE guideline NG226 Mar 31, 2022 · This guidance has been updated and replaced by NICE health technology evaluation 19, which covers using myCOPD for self-management of chronic obstructure pulmonary disease (COPD), and NICE health technology evaluation 18, which covers using myCOPD for pulmonary rehabilitation. 2 Information about this manual. 2 3 4 Nov 18, 2020 · This guideline updates and replaces: NICE guideline CG172 (published November 2013) NICE guideline CG167 (published July 2013) NICE technology appraisal guidance 230 (published July 2011) NICE guideline CG94 (published March 2010) It incorporates unchanged NICE guideline CG130 (published October 2011). This guideline is the basis of QS33. Nov 27, 2024 · This asthma pathway links to recommendations and resources from the British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) on diagnosing, monitoring and managing asthma in adults, young people and children Guidance programme Guidance programme Antimicrobial prescribing guidelines (20) Cancer service guidelines (8) Clinical guidelines (225) COVID-19 rapid guidelines (3) Diagnostics guidance (50) Health technology evaluations (20) Highly specialised technologies guidance (28) Interventional procedures guidance (606) Medical technologies guidance (66) Medicines practice guidelines (5) NICE Updated Guidelines Manual Date: 21 March 2018 [Reference: 18/025] National Institute for Health and Care Excellence Updated Guidelines Manual This paper gives details of changes made to Developing NICE Guidelines: the manual following a scheduled review. This guideline updates and replaces: NICE guidelines CG66 (published May 2008) and CG87 (published May 2009) NICE technology appraisal guidance 203 and 248; NICE evidence summaries ESNM20, ESNM26 and ESNM59. NICE Pathways brings together all connected NICE guidance. Mar 31, 2021 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. 3 %âãÏÓ 46 0 obj > endobj xref 46 21 0000000016 00000 n 0000001059 00000 n 0000001140 00000 n 0000001341 00000 n 0000001483 00000 n 0000002222 00000 n 0000002276 00000 n 0000002353 00000 n 0000002428 00000 n 0000002814 00000 n 0000008604 00000 n 0000009124 00000 n 0000009535 00000 n 0000010333 00000 n 0000011069 00000 n 0000011378 full guideline. Nov 27, 2024 · Making decisions using NICE guidelines and Using SIGN guidelines explains how we use words to show the strength (or certainty) of our recommendations, information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. For more information on the other types of NICE guidance and advice (including technology appraisal guidance), see About NICE on the NICE website. 23 in this guideline), people whose disease has a PASI 75 response but whose PsARC response does not justify continuing treatment should be assessed by a dermatologist to Jun 25, 2019 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards %PDF-1. This guideline partially replaces CG122. This guideline covers assessing and managing low back pain and sciatica in people Nov 27, 2024 · This asthma pathway signposts recommendations and resources from the British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) on diagnosing, monitoring and managing asthma in adults, young people and children, so you can see what guidance is available all in one place. This guideline is partially replaced by DG56. recommendations on referral for suspected lung cancer in the NICE guideline on suspected cancer. NICE's information on making decisions about your care. Jan 26, 2011 · This guideline updates and replaces NICE's guideline on anxiety: management of anxiety (CG22) and evidence summary ESUOM12, as well as NICE's guideline on common mental health disorders (CG123). Apr 27, 2022 · This guideline updates and replaces NICE guideline CG137 (January 2012) and NICE evidence summaries ESNM7, ESNM17 and ESNM37. Next review: This guideline will be reviewed if there is new evidence that is likely to change the recommendations. This guideline is the basis of QS68, QS99 and QS167. 20–1. [2003] 1. Dec 5, 2018 · We checked this guideline in January 2022 and it will not be updated at this time. NICE's guideline on post-traumatic stress disorder. Sep 29, 2023 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. This guideline replaces CG27. 10). 6 . NICE guidelines are evidence-based recommendations for health and care in England and Wales. 1 NICE guideline recommendations. See the guideline in development page for progress on the update. Updates planned or in progress and areas we’re actively monitoring are listed for each guideline, and there are links to the individual update pages for more information. This manual explains the processes and methods used to develop and update NICE guidelines. carer, and the level of care and support that can be provided in the community. Guideline development process. 1. It aims to improve quality of life by ensuring that people with rheumatoid arthritis have the right treatment to Dec 14, 2023 · The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. 3. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using Jan 28, 2009 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. Dec 5, 2018 · This guideline replaces CG101, ES18, ES17, ESNM72, ESNM57, ESNM8, ESNM9, ESNM21, ESNM33, ESNM47, ESNM49, ESNM52 and ESNM54. In November 2023 , we updated our guidance on measuring and managing postural hypotension. NICE guidance offers evidence-based recommendations made by independent Committees on a broad range of topics. This guideline covers diagnosing and managing rheumatoid arthritis. clinical diagnosis of community Aug 28, 2019 · NICE has also produced a guideline on hypertension in pregnancy. Next review: This guidance will be reviewed if there is new evidence that is likely to change the recommendations. This PDF document provides evidence-based recommendations for diagnosing and treating high blood pressure in people aged 18 and over, including those with type 2 diabetes. 3 Consider an ARB, in preference to an ACE inhibitor in adults of African and Caribbean family origin. 1 The National Institute for Health and Care Excellence (NICE) previously published four guidelines to improve care for people in the UK who have had an ACS. It covers the scope, the guideline development group, the systematic review, the economic analysis, the recommendations and the implementation of the guidelines. The Board is asked to approve the manual for public consultation. Making decisions using NICE guidelines. It aims to improve the treatment of GORD and dyspepsia by making detailed recommendations on Helicobacter pylori eradication, and specifying when to consider laparoscopic fundoplication and referral to specialist services with a link to the section on lumbar puncture in the updated NICE guideline on bacterial meningitis and meningococcal disease. This guideline is the basis of QS39. NICE guideline CG31. Find guidance we've produced around treating and managing specific conditions and diseases. Guidelines Common mental health conditions Oct 9, 2019 · NICE also publishes a summary of the recommendation in this guideline, known as ‘the NICE guideline’. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using Nov 20, 2015 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. For more information, see the surveillance decision. org. January 2024: NICE's original guidance on sepsis was published in 2016. It covers topics such as measuring blood pressure, assessing cardiovascular risk, monitoring treatment and referring for specialist review. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using This standard is based on NG109, NG112 and NG12. Cor pulmonale . This guideline partially replaces CG123. [2018] 1. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using Guidance programme (1 selected) Guidance programme Antimicrobial prescribing guidelines (20) Cancer service guidelines (8) Clinical guidelines (225) COVID-19 rapid guidelines (3) Diagnostics guidance (50) Health technology evaluations (20) Highly specialised technologies guidance (28) Interventional procedures guidance (606) Medical technologies guidance (66) Medicines practice guidelines (5 Apr 17, 2014 · Both short-term (used for 28 days or less) and long-term (used for more than 28 days) urinary catheters are used. 4 on traumatic birth, stillbirth and miscarriage in the NICE guideline on antenatal and postnatal mental health expectant management Nov 30, 2012 · The 'NICE guideline' contains only the recommendations from the full guideline, without the information on methods and evidence. May 18, 2022 · ### What you need to know The National Institute for Health and Care Excellence (NICE) last updated the drug treatment section of the type 2 diabetes guideline in 2015. General Medical Council \(GMC\) guidance. When exercising their judgement, professionals %PDF-1. This guideline is the basis of QS10 and QS181. We would like to show you a description here but the site won’t allow us. This guideline covers the general principles for managing intravenous (IV) fluid therapy in hospital inpatients aged 16 and over with a range of conditions. ’ Adobe PDF (175 KB) This guideline is the basis of QS66. 13. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using NICE guidelines make evidence-based recommendations on a wide range of topics, from preventing and managing specific conditions, improving health, and managing medicines in different settings, to providing social care and support to adults and children, and planning NICE guideline on patient experience in adult NHS services recommendation 1. This Nov 29, 2017 · This guideline has been updated and replaced by the NICE guideline on asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) [NG245] Nov 27, 2024 · It updates and replaces NICE guideline 80 (published November 2017) and parts of BTS/SIGN British guideline SIGN 158 (published July 2019). NICE's guideline on shared decision making. Feb 25, 2015 · For women with diabetes who are planning a pregnancy and who have a body mass index (BMI) above 27 kg/m 2, offer advice on how to lose weight, in line with the NICE guideline on identifying, assessing and managing obesity. Overview . 5 Who Jun 20, 2018 · This guideline is an update of the NICE guideline on dementia (CG42, published November 2006) and replaces it. Chronic heart failure 2010, CG108: https://www. The table presents the guidelines alphabetically. 3 Key principles for developing NICE guideline recommendations. How we develop NICE guidelines. This standard should be read in conjunction with QS15, QS36, QS45, QS61, QS121 and QS195. This March 2020: Cross reference to NICE’s guideline on supporting adult carers added to recommendation 1. NICE clinical guidelines: Dec 2, 2015 · How we develop NICE guidelines. This guideline is the basis of QS155. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using Jul 11, 2018 · This guideline replaces CG79. recommendations on referral for suspected lung cancer in the NICE guideline on suspected cancer Apr 27, 2021 · Discuss the risks and benefits of different drugs with the person and follow the recommendations in NICE's guideline on shared decision making. Mar 14, 2018 · This guideline replaces CG72, TA98, ESNM19, ESUOM8 and ESNM70. Nursing and Midwifery Council \(NMC\) Code. the section on shared decision making in NICE's guideline on babies, children and young people's experience of healthcare. Jun 23, 2015 · The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. 1. Remit The Department of Health and Social Care England asked NICE to develop a clinical guideline on perioperative care. [Adapted from NICE's full guideline on healthcare-associated infections and epic3: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England] Nov 27, 2024 · This asthma pathway links to recommendations and resources from the British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) on diagnosing, monitoring and managing asthma in adults, young people and children Apr 11, 2019 · section on timing of antibiotic administration in NICE's guideline on caesarean birth. 2. May 18, 2023 · See NICE's guideline on major trauma: service delivery for recommendations on pre- hospital triage, transfer and pre-alert procedures, procedures for receiving people in trauma units and major trauma centres, documentation, monitoring and audit, and access NICE clinical guidelines are recommendations on the appropriate treatment and care of people with specific diseases and conditions within the NHS in England and Wales. NICE's guideline on suspected acute respiratory infection in over 16s. This guideline updates and replaces NICE guideline CG11 Aug 19, 2021 · NICE's information on making decisions about your care. 2015 Montgomery ruling Jun 29, 2022 · This guideline replaces CG90. Unfortunately, the NICE guideline does not provide any guidance in what signs and symptoms should be considered indicative of UTI. This guideline is the basis of QS96, QS124, QS130, QS203 and QS90. Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards Jan 24, 2025 · NG241 - Ovarian cancer: identifying and managing familial and genetic risk Adobe PDF (169 KB) NG240 - Meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management. 4. 5 %âãÏÓ 4 0 obj > stream xœÍ]msÛ8’þžªü ~”¶Î ^ ²*å*O^öfkæ&·ÉÝ}˜Ý Š¢8ª‘­¬"g6ÿþÐ)‹VÃ‚í …©šX–)õƒ&Ù ý ñâb³ Aug 25, 2021 · the information on enabling patients to actively participate in their care in NICE's guideline on patient experience in adult NHS services. nice. This guideline replaces CG88. Mar 14, 2018 · NICE guideline on suspected cancer: recognition and referral • they have risk factors for endometrial pathology (see recommendation 1. 4 At the time of publication (August 2019), not all preparations of spironolactone have a UK marketing authorisation for this indication. This guideline updates and replaces NICE guideline CG101 (June 2010), and evidence summaries ESNM8, ESNM9, ESNM21, ESNM33, ESNM47, ESNM49, ESNM52, ESNM54, ESNM57, ESNM72, ES17 and ES18. NICE guideline on antimicrobial See also NICE’s guideline on hypertension in pregnancy. 6 Assess the woman's risk of and, if appropriate, discuss female genital mutilation (FGM) in a kind, sensitive manner. This document is a strategic plan for NICE, a UK organisation that provides evidence-based guidance and advice to improve health and wellbeing. NICE's guideline on obsessive-compulsive disorder and body May 1, 2019 · Is this guideline up to date? May 2023: We have found no new evidence that affects the recommendations. Oct 9, 2019 · NICE guidelines are recommendations for the care of individuals in specific clinical conditions or circumstances within the NHS – from prevention and self-care through primary and secondary care to more specialised services. 9. Suspect a diagnosis of cor pulmonale for people with: peripheral oedema (swelling) a raised venous pressure a systolic parasternal heave a loud pulmonary second heart sound. The primary care team should 1 • enabling patients to actively participate in their care in NICE's guideline 2 on patient experience in adult NHS services 3 • putting shared decision making into practice in NICE's guideline on 4 shared decision making 5 • delivering an approach to care that takes account of multimorbidity in 6 NICE's guideline on multimorbidity. Feb 28, 2017 · As recommended in NICE technology appraisal guidance on etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis (see recommendations 1. Dec 14, 2023 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. See the NICE guideline on BMI for guidance on using variations on the BMI cut-off, based on the risk for different ethnic Mar 15, 2023 · However, specifically in these patients LUTS are less reliable and in older patient systemic symptoms may be absent. Oct 31, 2018 · The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. Future updates: August 2021: We have checked this guideline and plan to update the recommendation on oral antiplatelet therapy for reducing cardiovascular disease in people Mar 14, 2018 · This guideline updates and replaces NICE guideline CG72 (September 2008), NICE technology appraisal guidance 98 (2006) and NICE evidence summaries ESUOM8, ESNM19 and ESNM70. NICE commissioned the NGC to produce the guideline. This guideline covers diagnosing and managing multiple sclerosis in people aged 18 and Jun 29, 2022 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. November 2017: Footnotes for some recommendations were updated with current UK marketing This guideline is the basis of QS24. For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on symptoms and signs of urinary tract infection . Note this guidance updates and replaces NICE Clinical Guideline CG102, endorsed by the DoH in May 2011. 4 Choice of guideline topics. Dec 5, 2018 · This guideline updates and replaces NICE guideline CG26 (March 2005). Recommendations. This guideline partially replaces TA152 and TA71. They help health and social care professionals to prevent ill health, promote good health and improve the quality of care and services. This guideline includes recommendations on: referral, assessment and diagnosis Apr 27, 2021 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards Aug 19, 2021 · Also see the NICE guideline on domestic violence and abuse and the section on pregnant women who experience domestic abuse in the NICE guideline on pregnancy and complex social factors. This guideline partially replaces NG28. 5 Most people who are May 19, 2010 · The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. Sep 3, 2014 · This guideline covers investigating and managing gastro-oesophageal reflux disease (GORD) and dyspepsia in people aged 18 and over. Diagnosing UTI in patients with an indwelling catheter remains a diagnostic challenge. It also replaces recommendation 1. [2008] May 23, 2017 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards Apr 27, 2022 · The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. Your responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. Nov 18, 2020 · This guideline replaces CG172, CG167, CG94, TA230, CG130 and MTG1. 21 in the NICE guideline on child maltreatment. 3 in the NICE technology appraisal guidance on donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease (TA217). Mar 26, 2020 · The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. They are based on the best available evidence and aim to improve the quality of healthcare by changing the process of healthcare and improving people's chances of getting as well as possible. 2015 Montgomery ruling. This guideline is the basis of QS108. This guideline is the basis of QS8. Recommendations NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales. This guideline includes new and updated recommendations on: access to care and supporting transitions between services Aug 28, 2019 · This guideline replaces CG127. This guideline updates and replaces NICE guideline CG68 (July 2008). Since then, further evidence on drug treatment from randomised trials investigating the effects of glucose lowering drugs on cardiovascular outcomes has emerged, prompting a further update. uk/guidance/cg108/evidence/full-guideline-pdf-136060525 Dec 14, 2022 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. We also added tables to the section on monitoring treatment and blood pressure targets to summarise blood pressure targets in this guideline and our guidelines on type 1 diabetes and chronic Jul 20, 2022 · Since the National Institute for Health and Care Excellence (NICE) published its last guideline on depression in 2009, 1 the prevalence of depression has increased, 2 particularly among vulnerable adults during the covid-19 pandemic. Apr 20, 2021 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. It also updates and replaces NICE technology appraisal guidance 10, 38, 131 and 138, and NICE diagnostics guidance 12. Mar 28, 2019 · NICE's information on making decisions about your care. Evidence-based recommendations for the health and social care sector, developed by independent committees, including professionals and lay members, and consulted on by stakeholders. Quality statements Jul 19, 2017 · Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards NICE guideline on acute heart failure. Aug 25, 2021 · This guideline updates and replaces NICE guidelines CG182 (published July 2014), NG8 (published June 2015), CG157 (published March 2013) and NICE evidence summary ESNM51. This guideline covers recognising, diagnosing and managing attention deficit hyperactivity This webpage covers all NICE’s guidelines on mental health. NICE guideline on antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. The NICE pathway is a practical online resource for healthcare and other professionals that contains all the recommendations from a guideline, as well as any other NICE guidance that is directly relevant to the topic. This guideline covers identifying, treating and managing depression in people aged 18 and Full guideline NICE guideline NG71 Methods, evidence and recommendations July 2017 Final, 2017 Developed by the National Institute for Health and Care Excellence . evtwxg ifemfi vaxxu rczcv tpp cooiuy pxej olwx qcc gpwhyrc