H Pylori Guideline Revision Supplement 2022 - Revision history

AndyS at 13:39, 22 March 2022

2022-03-22T13:39:22Z

← Older revision		Revision as of 13:39, 22 March 2022
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	* The YKHC H. pylori guideline continues to be consistent with the ANMC H. pylori guideline.		* The YKHC H. pylori guideline continues to be consistent with the ANMC H. pylori guideline.
	* For adults, the YKHC guideline is very different than the standard of care in the remainder of the U.S. which endorsed the "test-and-treat" strategy. The prevalence of H. pylori in the Alaska Native population is far too high for such a strategy.		* For adults, the YKHC guideline is very different than the standard of care in the remainder of the U.S. which endorsed the "test-and-treat" strategy. The prevalence of H. pylori in the Alaska Native population is far too high for such a strategy.
	* For pediatrics, the ~~local~~ guideline (which treats pediatrics identical to adults) is consistent with national guidelines (i.e. NASPGHAN<ref name="Nolen2020"/>)		* For pediatrics, the YKHC guideline (which treats pediatrics identical to adults) is consistent with national guidelines (i.e. NASPGHAN<ref name="Nolen2020"/>)
	* The only minor issue with the YKHC guideline is that it does not address recent recommendations ~~to utilize newly developed~~, commercially available, rapid H. pylori culture and sensitivities to guide initial ~~H. pylori~~ antimicrobial choice.		* The only minor issue with the YKHC guideline is that it does not address recent recommendations regarding new, commercially available, rapid H. pylori culture and sensitivities to guide initial antimicrobial choice.
	<br>		<br>

AndyS at 13:36, 22 March 2022

2022-03-22T13:36:39Z

← Older revision		Revision as of 13:36, 22 March 2022
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	== Discussion ==		== Discussion ==
	* The YKHC H. pylori guideline continues to be consistent with the ANMC H. pylori guideline.		* The YKHC H. pylori guideline continues to be consistent with the ANMC H. pylori guideline.
	* For adults, the ~~local~~ guideline is very different than the standard of care in the remainder of the U.S. which endorsed the "test-and-treat" strategy. The prevalence of H. pylori in the Alaska Native population far to high for such a strategy.		* For adults, the YKHC guideline is very different than the standard of care in the remainder of the U.S. which endorsed the "test-and-treat" strategy. The prevalence of H. pylori in the Alaska Native population is far too high for such a strategy.
	* For pediatrics, the local guideline (which treats pediatrics identical to adults) is consistent with national guidelines (i.e. NASPGHAN<ref name="Nolen2020"/>)		* For pediatrics, the local guideline (which treats pediatrics identical to adults) is consistent with national guidelines (i.e. NASPGHAN<ref name="Nolen2020"/>)
	* The only minor issue with the ~~local~~ guideline is that it does address recent recommendations to utilize newly developed, commercially available, rapid H. pylori culture and sensitivities to guide initial H. pylori antimicrobial choice.		* The only minor issue with the YKHC guideline is that it does not address recent recommendations to utilize newly developed, commercially available, rapid H. pylori culture and sensitivities to guide initial H. pylori antimicrobial choice.
	<br>		<br>

AndyS at 13:34, 22 March 2022

2022-03-22T13:34:24Z

← Older revision		Revision as of 13:34, 22 March 2022
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	== Reason[s] for update ==		== Reason[s] for update ==
	Routine ~~2-year~~ review/update.		Routine review/update.
	<br>		<br>
	<br>		<br>
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	==Results==		==Results==
	# ANMC H. Pylori Treatment Guideline has no significant changes pertinent to the YKHC guideline. Of note, ANMC has started a study of offering EGD for gastric cancer screening for patients with a first-degree relative (parent, sibling, or child) with gastric cancer; they are treating to eradicate H. pylori in this group regardless of findings; but this treatment is limited to the study patients and thus is not applicable to our practice in Bethel.		# ANMC H. Pylori Treatment Guideline has no significant changes pertinent to the YKHC guideline. Of note, ANMC has started a study of offering EGD for gastric cancer screening for patients with a first-degree relative (parent, sibling, or child) with gastric cancer; they are treating to eradicate H. pylori in this group regardless of findings; but this treatment is limited to the study patients and thus is not applicable to our practice in Bethel.
	# PubMed search returned 49 articles, 12 of which were published since the last literature review. Only one of these articles addresses treatment in our setting, which is the CDC conference summary,<ref name="Nolen2020"> which continues to explicitly advocate the current algorithm/guideline (which was originally published by an international, circumpolar expert group in 2016<ref name=mcmahon2016>McMahon BJ, Bruce MG, Koch A, et al. The diagnosis and treatment of Helicobacter pylori infection in Arctic regions with a high prevalence of infection: Expert Commentary. Epidemiology and Infection. 2016;144(2):225-233. PMID:[https://pubmed.ncbi.nlm.nih.gov/26094936/ 26094936]. PMCID:[http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4697284/ PMC4697284]. doi:[https://doi.org/10.1017/s0950268815001181 10.1017/S0950268815001181].</ref>)		# PubMed search returned 49 articles, 12 of which were published since the last literature review. Only one of these articles addresses treatment in our setting, which is the CDC conference summary,<ref name="Nolen2020"/> which continues to explicitly advocate the current algorithm/guideline (which was originally published by an international, circumpolar expert group in 2016<ref name=mcmahon2016>McMahon BJ, Bruce MG, Koch A, et al. The diagnosis and treatment of Helicobacter pylori infection in Arctic regions with a high prevalence of infection: Expert Commentary. Epidemiology and Infection. 2016;144(2):225-233. PMID:[https://pubmed.ncbi.nlm.nih.gov/26094936/ 26094936]. PMCID:[http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4697284/ PMC4697284]. doi:[https://doi.org/10.1017/s0950268815001181 10.1017/S0950268815001181].</ref>)
	# Pediatric PubMed search returned 50 results, the most pertinent being the ''Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)''<ref name=NASPGHAN>Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, Czinn S, Gold BD, Guarner J, Elitsur Y, Homan M, Kalach N, Kori M, Madrazo A, Megraud F, Papadopoulou A, Rowland M; ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):991-1003. doi: 10.1097/MPG.0000000000001594. PMID: 28541262.</ref>		# Pediatric PubMed search returned 50 results, the most pertinent being the ''Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)''<ref name=NASPGHAN>Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, Czinn S, Gold BD, Guarner J, Elitsur Y, Homan M, Kalach N, Kori M, Madrazo A, Megraud F, Papadopoulou A, Rowland M; ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):991-1003. doi: 10.1097/MPG.0000000000001594. PMID: 28541262.</ref>
	<br>		<br>

AndyS at 13:08, 22 March 2022

2022-03-22T13:08:22Z

← Older revision		Revision as of 13:08, 22 March 2022
Line 21:		Line 21:
	==Results==		==Results==
	# ANMC H. Pylori Treatment Guideline has no significant changes pertinent to the YKHC guideline. Of note, ANMC has started a study of offering EGD for gastric cancer screening for patients with a first-degree relative (parent, sibling, or child) with gastric cancer; they are treating to eradicate H. pylori in this group regardless of findings; but this treatment is limited to the study patients and thus is not applicable to our practice in Bethel.		# ANMC H. Pylori Treatment Guideline has no significant changes pertinent to the YKHC guideline. Of note, ANMC has started a study of offering EGD for gastric cancer screening for patients with a first-degree relative (parent, sibling, or child) with gastric cancer; they are treating to eradicate H. pylori in this group regardless of findings; but this treatment is limited to the study patients and thus is not applicable to our practice in Bethel.
	# PubMed search returned 49 articles, 12 of which were published since the last literature review. Only one of these articles addresses treatment in our setting, which is the CDC conference summary,<ref name="Nolen2020"/> which continues to explicitly advocate the current algorithm/guideline (which was originally published by an international, circumpolar expert group in 2016<ref name=mcmahon2016>McMahon BJ, Bruce MG, Koch A, et al. The diagnosis and treatment of Helicobacter pylori infection in Arctic regions with a high prevalence of infection: Expert Commentary. Epidemiology and Infection. 2016;144(2):225-233. PMID:[https://pubmed.ncbi.nlm.nih.gov/26094936/ 26094936]. PMCID:[http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4697284/ PMC4697284]. doi:[https://doi.org/10.1017/s0950268815001181 10.1017/S0950268815001181].</ref>)		# PubMed search returned 49 articles, 12 of which were published since the last literature review. Only one of these articles addresses treatment in our setting, which is the CDC conference summary,<ref name="Nolen2020"> which continues to explicitly advocate the current algorithm/guideline (which was originally published by an international, circumpolar expert group in 2016<ref name=mcmahon2016>McMahon BJ, Bruce MG, Koch A, et al. The diagnosis and treatment of Helicobacter pylori infection in Arctic regions with a high prevalence of infection: Expert Commentary. Epidemiology and Infection. 2016;144(2):225-233. PMID:[https://pubmed.ncbi.nlm.nih.gov/26094936/ 26094936]. PMCID:[http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4697284/ PMC4697284]. doi:[https://doi.org/10.1017/s0950268815001181 10.1017/S0950268815001181].</ref>)
	# Pediatric PubMed search returned 50 results, the most pertinent being the ''Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)''<ref>Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, Czinn S, Gold BD, Guarner J, Elitsur Y, Homan M, Kalach N, Kori M, Madrazo A, Megraud F, Papadopoulou A, Rowland M; ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):991-1003. doi: 10.1097/MPG.0000000000001594. PMID: 28541262.</ref>		# Pediatric PubMed search returned 50 results, the most pertinent being the ''Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)''<ref name=NASPGHAN>Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, Czinn S, Gold BD, Guarner J, Elitsur Y, Homan M, Kalach N, Kori M, Madrazo A, Megraud F, Papadopoulou A, Rowland M; ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):991-1003. doi: 10.1097/MPG.0000000000001594. PMID: 28541262.</ref>
			<br>

			== Discussion ==
			* The YKHC H. pylori guideline continues to be consistent with the ANMC H. pylori guideline.
			* For adults, the local guideline is very different than the standard of care in the remainder of the U.S. which endorsed the "test-and-treat" strategy. The prevalence of H. pylori in the Alaska Native population far to high for such a strategy.
			* For pediatrics, the local guideline (which treats pediatrics identical to adults) is consistent with national guidelines (i.e. NASPGHAN<ref name="Nolen2020"/>)
			* The only minor issue with the local guideline is that it does address recent recommendations to utilize newly developed, commercially available, rapid H. pylori culture and sensitivities to guide initial H. pylori antimicrobial choice.
	<br>		<br>

AndyS at 12:43, 22 March 2022

2022-03-22T12:43:44Z

← Older revision		Revision as of 12:43, 22 March 2022
Line 17:		Line 17:
	* Pediatric H. pylori literature review:		* Pediatric H. pylori literature review:
	:: >PUBMED, [https://pubmed.ncbi.nlm.nih.gov/?term=pylori%5BTitle%5D+AND+%28pediatric%5BTitle%5D+OR+child%5BTitle%5D%29+AND+%28review%5BTitle%5D+OR+overview%5BTitle%5D+OR+guideline%5BTitle%5D%29 pylori[Title<nowiki>]</nowiki> AND (pediatric[Title<nowiki>]</nowiki> OR child[Title<nowiki>]</nowiki>) AND (review[Title<nowiki>]</nowiki> OR overview[Title<nowiki>]</nowiki> OR guideline[Title<nowiki>]</nowiki>)]		:: >PUBMED, [https://pubmed.ncbi.nlm.nih.gov/?term=pylori%5BTitle%5D+AND+%28pediatric%5BTitle%5D+OR+child%5BTitle%5D%29+AND+%28review%5BTitle%5D+OR+overview%5BTitle%5D+OR+guideline%5BTitle%5D%29 pylori[Title<nowiki>]</nowiki> AND (pediatric[Title<nowiki>]</nowiki> OR child[Title<nowiki>]</nowiki>) AND (review[Title<nowiki>]</nowiki> OR overview[Title<nowiki>]</nowiki> OR guideline[Title<nowiki>]</nowiki>)]
	:: >Review of the ''Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)''<ref>Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, Czinn S, Gold BD, Guarner J, Elitsur Y, Homan M, Kalach N, Kori M, Madrazo A, Megraud F, Papadopoulou A, Rowland M; ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):991-1003. doi: 10.1097/MPG.0000000000001594. PMID: 28541262.</ref>
	<br>		<br>

Line 23:		Line 22:
	# ANMC H. Pylori Treatment Guideline has no significant changes pertinent to the YKHC guideline. Of note, ANMC has started a study of offering EGD for gastric cancer screening for patients with a first-degree relative (parent, sibling, or child) with gastric cancer; they are treating to eradicate H. pylori in this group regardless of findings; but this treatment is limited to the study patients and thus is not applicable to our practice in Bethel.		# ANMC H. Pylori Treatment Guideline has no significant changes pertinent to the YKHC guideline. Of note, ANMC has started a study of offering EGD for gastric cancer screening for patients with a first-degree relative (parent, sibling, or child) with gastric cancer; they are treating to eradicate H. pylori in this group regardless of findings; but this treatment is limited to the study patients and thus is not applicable to our practice in Bethel.
	# PubMed search returned 49 articles, 12 of which were published since the last literature review. Only one of these articles addresses treatment in our setting, which is the CDC conference summary,<ref name="Nolen2020"/> which continues to explicitly advocate the current algorithm/guideline (which was originally published by an international, circumpolar expert group in 2016<ref name=mcmahon2016>McMahon BJ, Bruce MG, Koch A, et al. The diagnosis and treatment of Helicobacter pylori infection in Arctic regions with a high prevalence of infection: Expert Commentary. Epidemiology and Infection. 2016;144(2):225-233. PMID:[https://pubmed.ncbi.nlm.nih.gov/26094936/ 26094936]. PMCID:[http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4697284/ PMC4697284]. doi:[https://doi.org/10.1017/s0950268815001181 10.1017/S0950268815001181].</ref>)		# PubMed search returned 49 articles, 12 of which were published since the last literature review. Only one of these articles addresses treatment in our setting, which is the CDC conference summary,<ref name="Nolen2020"/> which continues to explicitly advocate the current algorithm/guideline (which was originally published by an international, circumpolar expert group in 2016<ref name=mcmahon2016>McMahon BJ, Bruce MG, Koch A, et al. The diagnosis and treatment of Helicobacter pylori infection in Arctic regions with a high prevalence of infection: Expert Commentary. Epidemiology and Infection. 2016;144(2):225-233. PMID:[https://pubmed.ncbi.nlm.nih.gov/26094936/ 26094936]. PMCID:[http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4697284/ PMC4697284]. doi:[https://doi.org/10.1017/s0950268815001181 10.1017/S0950268815001181].</ref>)
			# Pediatric PubMed search returned 50 results, the most pertinent being the ''Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)''<ref>Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, Czinn S, Gold BD, Guarner J, Elitsur Y, Homan M, Kalach N, Kori M, Madrazo A, Megraud F, Papadopoulou A, Rowland M; ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):991-1003. doi: 10.1097/MPG.0000000000001594. PMID: 28541262.</ref>
	<br>		<br>

Line 32:		Line 32:
	:::* Regardless of test, no antibiotics or bismuth for FOUR weeks prior.		:::* Regardless of test, no antibiotics or bismuth for FOUR weeks prior.
	:::* Regardless of test, no PPI for TWO weeks prior.		:::* Regardless of test, no PPI for TWO weeks prior.
			<br>

			==Topics for Exploration==
			Commercial (i.e. non-CDC) rapid H. pylori culture/sensitivities which can be used to guide antimicrobial therapy for primary treatment.
			<br>
	<br>		<br>
	<br>		<br>

	Author: Andrew W. Swartz, MD		Author: Andrew W. Swartz, MD
			<br>
	<br>		<br>

	==References==		==References==
	----		----

AndyS at 12:35, 22 March 2022

2022-03-22T12:35:57Z

← Older revision		Revision as of 12:35, 22 March 2022
Line 15:		Line 15:
	:: >Experts were longstanding, world-renown researchers		:: >Experts were longstanding, world-renown researchers
	:: >Results were published in ''Gastroenterology'' in April 2020<ref name="Nolen2020">Nolen LD, Vindigni SM, Parsonnet J; Symposium leaders. Combating Gastric Cancer in Alaska Native People: An Expert and Community Symposium. Gastroenterology. 2020 Apr;158(5):1197-1201. doi: 10.1053/j.gastro.2019.11.299. PMID: 31836529; PMCID: [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc7103478/ PMC7103478]. DOI:[https://doi.org/10.1053/j.gastro.2019.11.299 10.1053/j.gastro.2019.11.299]</ref>		:: >Results were published in ''Gastroenterology'' in April 2020<ref name="Nolen2020">Nolen LD, Vindigni SM, Parsonnet J; Symposium leaders. Combating Gastric Cancer in Alaska Native People: An Expert and Community Symposium. Gastroenterology. 2020 Apr;158(5):1197-1201. doi: 10.1053/j.gastro.2019.11.299. PMID: 31836529; PMCID: [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc7103478/ PMC7103478]. DOI:[https://doi.org/10.1053/j.gastro.2019.11.299 10.1053/j.gastro.2019.11.299]</ref>
			* Pediatric H. pylori literature review:
			:: >PUBMED, [https://pubmed.ncbi.nlm.nih.gov/?term=pylori%5BTitle%5D+AND+%28pediatric%5BTitle%5D+OR+child%5BTitle%5D%29+AND+%28review%5BTitle%5D+OR+overview%5BTitle%5D+OR+guideline%5BTitle%5D%29 pylori[Title<nowiki>]</nowiki> AND (pediatric[Title<nowiki>]</nowiki> OR child[Title<nowiki>]</nowiki>) AND (review[Title<nowiki>]</nowiki> OR overview[Title<nowiki>]</nowiki> OR guideline[Title<nowiki>]</nowiki>)]
			:: >Review of the ''Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016)''<ref>Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, Czinn S, Gold BD, Guarner J, Elitsur Y, Homan M, Kalach N, Kori M, Madrazo A, Megraud F, Papadopoulou A, Rowland M; ESPGHAN, NASPGHAN. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):991-1003. doi: 10.1097/MPG.0000000000001594. PMID: 28541262.</ref>
	<br>		<br>

AndyS: /* Guideline Changes */

2022-01-15T18:58:37Z

Guideline Changes

← Older revision		Revision as of 18:58, 15 January 2022
Line 25:		Line 25:
	# Under treatment indications, "Intestinal Metaplasia" is changed to "Gastric Intestinal Metaplasia" (to prevent any confusion with Barrett's esophagus).		# Under treatment indications, "Intestinal Metaplasia" is changed to "Gastric Intestinal Metaplasia" (to prevent any confusion with Barrett's esophagus).
	# Addition of box specifying test-of-cure details:		# Addition of box specifying test-of-cure details:
	:::* Either urea breath test (UBT), stool antigen test, or endoscopic biopsy (if indicated for other reasons; pathology or CLO-test).		:::* ≥4wks after COMPLETION of treatment.
	:::* No antibiotics or bismuth for FOUR weeks.		:::* Either urea breath test (UBT), stool antigen test, or endoscopic biopsy (if indicated for other reasons; using either pathology or CLO-test).
	:::* No PPI for TWO weeks.		:::* Regardless of test, no antibiotics or bismuth for FOUR weeks prior.
			:::* Regardless of test, no PPI for TWO weeks prior.
	<br>		<br>
	<br>		<br>

AndyS: /* Guideline Changes */

2022-01-15T18:53:07Z

Guideline Changes

← Older revision		Revision as of 18:53, 15 January 2022
Line 23:		Line 23:

	==Guideline Changes==		==Guideline Changes==
	#Under treatment indications, "Intestinal Metaplasia" is changed to "Gastric Intestinal Metaplasia" (to prevent any confusion with Barrett's esophagus).		# Under treatment indications, "Intestinal Metaplasia" is changed to "Gastric Intestinal Metaplasia" (to prevent any confusion with Barrett's esophagus).
	#Addition of box specifying test-of-cure details:		# Addition of box specifying test-of-cure details:
			:::* Either urea breath test (UBT), stool antigen test, or endoscopic biopsy (if indicated for other reasons; pathology or CLO-test).
			:::* No antibiotics or bismuth for FOUR weeks.
			:::* No PPI for TWO weeks.
	<br>		<br>
	<br>		<br>

AndyS at 18:49, 15 January 2022

2022-01-15T18:49:54Z

← Older revision		Revision as of 18:49, 15 January 2022
Line 4:		Line 4:

	== Reason[s] for update ==		== Reason[s] for update ==
	Routine 2-year review/update~~. Test~~.		Routine 2-year review/update.
	<br>		<br>
	<br>		<br>

AndyS at 18:49, 15 January 2022

2022-01-15T18:49:17Z

← Older revision		Revision as of 18:49, 15 January 2022
Line 4:		Line 4:

	== Reason[s] for update ==		== Reason[s] for update ==
	Routine 2-year review/update.		Routine 2-year review/update. Test.
	<br>		<br>
	<br>		<br>