If the fluid status is uncertain, measure urine sodium and osmolality. The fluid and electrolyte prescription (in ml per hour), with clear signatures, dates and times. Hemorrhagic shock can also result from significant acute internal blood loss into the thoracic and abdominal cavities, vaginal bleeding, or bleeding from an ectopic pregnancy or surgical intervention. 1.7.5 After hyponatraemia symptoms have resolved, ensure that the rate of increase of plasma sodium does not exceed 12mmol/litre in a 24hour period. Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, in particular the large arteries and small arterioles. British Small Animal Veterinary Association, Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester, GL2 2AB, United Kingdom. [Full Text]. Put your understanding of this concept to test by answering a few MCQs. You may have better luck withslide 45that you used to look at fibrocartilage in the intervetebral disc (the disc is in the middle of the section with two vertebral bodies on either side --the marrow is within the spongy bone of the vertebrae)View Image. 2021 Jul. 2013. Note the small amount of cytoplasm and sparse organelles (except ribosomes). Malpractice Case: Did Error Cause Neurologic Impairment? Also, the UCSF collection (particularly slide 83View Image) has some pretty good examples of marrow in which you should be able to find sinuses, cords, and megakaryocytes. Colloids are gelatinous solutions that keep the blood under high osmotic pressure. 1.1.2 Offer IV fluid therapy as part of a protocol (see algorithms for IV fluid therapy in children and young people in hospital): Assess fluid and electrolyte needs following algorithm1: Assessment and monitoring. [Full Text]. To get more details on this topic you can download BYJUS The Learning App. 2013:525914. Details of any ongoing losses (see recommendation1.5.1 and the diagram of ongoing losses). Crystalloids and blood were used extensively during World Very helpful for emergency kit!! In ball-point pens, a gel (liquid-solid colloid) is the ink used. Medications that cause vasoconstriction include: antihistamines, decongestants, and stimulants. They primarily contain enzymes that regulate blood pH. The patient needs to be closely monitored during a colloid infusion for increased blood pressure, dyspnea, and bounding pulse, which as signs of hypervolemia. See prescribing medicines for more information. It is derived from a lymphoid progenitor cell. Carl R Menckhoff, MD, FACEP Emergency Medicine Physician Stellar customer service too! Take into account pre-existing conditions (for example, cardiac disease or kidney disease), as smaller fluid volumes may be needed. 1.2.7 Diagnose clinical dehydration and hypovolaemic shock using the clinical features listed in table1, but be aware that it can be difficult to identify the clinical features in term neonates. Adam DJ, Fitridge RA, Raptis S. Intra-abdominal packing for uncontrollable haemorrhage during ruptured abdominal aortic aneurysm repair. Daniel J Dire, MD, FACEP, FAAP, FAAEM Professor of Pediatrics and Emergency Medicine, University of Texas Health Science Center at San Antonio, Joe R and Teresa Lozano Long School of Medicine [QxMD MEDLINE Link]. fetus, trichrome)View Virtual Slide(virtual slide courtesy of the University of California, San Francisco)UCSF slide 95(tibia, rat, trichrome)View Virtual Slide(virtual slide courtesy of the University of California, San Francisco). Know the main components of peripheral blood. 1.4.7 If term neonates aged 8days or over need IV fluids for routine maintenance, initially use isotonic crystalloids that contain sodium in the range 131154mmol/litre with 510% glucose. Correct answer 2. Examples of commonly used H1 antihistamines include the following: Cetirizine For adults and children 12 years of age, cetirizine 10 mg can be administered IV over 1 to 2 minutes. Intravenous fluid replacement is a vital part of treating multi-system illness. [3][4], The routes of administration vary. The cardiovascular system initially responds to hypovolemic shock by increasing the heart rate, increasing myocardial contractility, and constricting peripheral blood vessels. Shock. Be able to recognize all of the cellular components found in peripheral blood by light and electron microscopy. Examples include 3% sodium chloride (3% NaCl), with 513 mEq/L of sodium and chloride, and 5% sodium chloride (5% NaCl), with 855 mEq/L of sodium and chloride. For hypovolaemic shock, 1 or more of the clinical features listed would be expected to be present. Ramesh GH, Uma JC, Farhath S. Fluid resuscitation in trauma: what are the best strategies and fluids?. Krywko DM, Toy FK, Mahan ME, Kiel J. Pregnancy trauma. Medications causing vasoconstriction, also known as vasoconstrictors, are one type of medicine used to raise blood pressure. 7. The remainder of this article concentrates mainly on hypovolemic shock secondary to blood loss and the controversies surrounding the treatment of this condition. 1.4.5 Be aware that plasma electrolyte concentrations and blood glucose are not routinely measured before elective surgery unless there is a need to do so, based on the child's medical condition or the type of surgery. Ghafari MH, Moosavizadeh SA, Moharari RS, Khashayar P. Hypertonic saline 5% vs. lactated ringer for resuscitating patients in hemorrhagic shock. 2008 Oct. 19(6):1337-47. WebThe BSAVA Formulary has been one of the Associations most trusted and highly valued publications for over a quarter of a century. The process is the opposite of vasodilation, the widening of blood vessels. Within the category of 'clinical dehydration' there is a spectrum of severity indicated by increasingly numerous and more pronounced clinical features. IV Bags-Sodium Chloride, Dextrose, Lactated Ringers, and Sterile water. They contain granules of insoluble fibrin. They express ABO antigens that determine an individual's blood type. The nature of the colloidal solution is heterogeneous, i.e. During the observation of the colloidal dispersion under an ultra-microscope, it is clearly seen that the particles are in a continuous movement in the solution. for: Medscape. WebFunction. Slide 48(lower limb, 154mm embryo, H&E)View Virtual SlideSlide 45(intervertebral disc, H&E)View Virtual SlideSlide 50(decalcified bone, spider monkey, H&E)View Virtual SlideUCSF slide 81(vertebrae, 7mo. MAST Pants. Buy Sodium Chloride, Dextrose, Lactated Ringers, and Sterile water. (BL1) Note that in contrast to the lymphocyte, neither the two platelets nor the RBCs contain nuclei. The source of 90% of anterior nosebleeds is Hypovolemic shock secondary to an ectopic pregnancy in a patient with a negative urine pregnancy test is rare but has been reported. Neutrophil. Crystalloid IV solutions contain small molecules that flow easily across semipermeable membranes. The results of laboratory and pointofcare assessments, including: plasma electrolyte concentrations (including chloride, sodium and potassium; see recommendation1.2.4). Woodward L, Alsabri M. Permissive hypotension vs. conventional resuscitation in patients with trauma or hemorrhagic shock: a review. WebColloids and crystalloids are types of fluids that are used, often intravenously (directly into the blood through a tube), for fluid replacement. 122 BloodErythrocytes (RBC)View Virtual EM Slide 6. When blood vessels fluid replacement may be needed. Two examples of ventricular tachycardia are shown in this ECG rhythm strips. If term neonates, children and young people need IV fluids for fluid resuscitation, follow algorithm2: Fluid resuscitation. This enzyme is responsible for phosphorylating the light chain of myosin to stimulate cross-bridge cycling. 2012 Mar. Types and volumes of fluid input and output (urine, gastric and other), recorded hourly and with running totals. There are three types: isotonic, hypotonic, and hypertonic. These and other principles helped in the development of present guidelines for the treatment of traumatic hemorrhagic shock. If, on the other hand, there are also abundant fat cells in the marrow, it is calledyellow marrow--you may see some fat cells in the marrow onslide 45, but there are enough blood-forming cells around that it would still be considered to be red marrow. Pacagnella RC, Souza JP, Durocher J, et al. J Emerg Nurs. *** Medical Professional License Required ***, * To purchase IV Fluids a license copy must be emailed to, * Product will ship signature required. The renal system responds to hemorrhagic shock by stimulating an increase in renin secretion from the juxtaglomerular apparatus. They are categorized according to their relative tonicity in relation to plasma. WebCrystalloids and colloids differ from each other in their size range Particles of crystalloid in true solution are 0.2 to 1 m (millimicron) while those of colloids in suspension are 1 to 200 m. If term neonates, children and young people need IV fluids to address existing deficits or excesses, ongoing abnormal losses or abnormal fluid distribution, follow algorithm4: Replacement and redistribution. Correct answer 1. The conversion of chloroplasts to chromoplasts in ripening is a classic example.. [Full Text]. The remaining cell type you may see on your slides is thebasophil, which is hard to find, since it constitutes less than 1% of the leukocytes (the86x slideactually has THREE excellent examples). [QxMD MEDLINE Link]. 2019. Note the presence of erythrocytes in the bone marrow sinus. reducing fluids, calculated on the basis of insensible losses within the range 300400ml/m2/24hours plus urinary output. Examples of Specific Causes; Decreased kidney perfusion (prerenal states) Hypovolemia: Increased losses (hemorrhage, burns, massive vomiting or diarrhea), poor oral intake Colloids Versus Crystalloids for the Resuscitation of the Critically Ill (CRISTAL) was a multicenter randomized open-label study of more than 2,800 ICU 2018 Jan 25. Chatham A, Strecker-McGraw MK. 125 Blood - Mouse Thrombocyte (platelet)ThrombocyteView Virtual EM Slide encoded search term (Hypovolemic Shock) and Hypovolemic Shock, Fast Five Quiz: Test Your Knowledge of Common Summer Injuries, Use of Statins After Liver Transplantation Is Associated With Improved Survival, Biologic Disease-Modifying Antirheumatic Drugs to Treat Multisystem Inflammatory Syndrome in Children, An Unusual Presentation of Anaphylaxis With Severe Hypertension. 2009 Jan-Feb. 28(1):37-9. The remainder of this article concentrates mainly on hypovolemic shock secondary to blood loss and the controversies surrounding the treatment of this condition. Cutaneous vasoconstriction will occur because of the body's exposure to the severe cold. Be able to recognize megakaryocytes in the bone marrow and understand their function in platelet production. Thrombocyte. Two examples of hypovolemic shock secondary to fluid loss include refractory gastroenteritis and extensive burns. There are two types of nosebleeds: anterior (more common), and posterior (less common, but more likely to require medical attention). 4(2):222-32. [citation needed], Once elevated, the intracellular calcium concentration is returned to its normal concentration through a variety of protein pumps and calcium exchangers located on the plasma membrane and sarcoplasmic reticulum. He was further treated with broad spectrum antibiotics and continues subcutaneous heparin prophylaxis. The information has been fully updated for 2020 with new drug monographs, including additional chemotherapeutic agents, with key references where available plus additional references available only in the online version. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment. [citation needed]. [QxMD MEDLINE Link]. When the nucleus becomes extruded during maturation of an erythrocyte, the cell becomes a reticulocyte, which is a nearly mature erythrocyte. 2008 Dec. 65(6):1217-21. Reinhart K, Perner A, Sprung CL, et al. The neuroendocrine system responds to hemorrhagic shock by causing an increase in circulating antidiuretic hormone (ADH). In this course you will not be required to recognize the various stages of blood cell development in bone marrow slides. Examples of colloids solutions are Gel, Sol, Foam, Emulsion, Aerosol etc. As symptoms resolve, decrease the frequency of plasma sodium measurements based on the response to treatment. 1.3.1 If children and young people need IV fluid resuscitation, use glucosefree crystalloids that contain sodium in the range 131154mmol/litre, with a bolus of 10ml/kg over less than 10minutes. Physiopathology of shock. 6:41. 1.5.4 Base any subsequent fluid prescriptions on the plasma electrolyte concentrations and blood glucose measurements. 2012 Dec. 109 Suppl 1:i39-i46. Test Your Knowledge On Properties Of Colloids! 2009 Feb. 174(2):106-8. [QxMD MEDLINE Link]. Children 6 to 11 years of age can receive 5 or 10 mg IV. Never a problem.. thank you for being so easy to deal with! For term neonates aged up to 7 days, use professional judgement, taking into account: for term neonates in the first days of life, a sodium content of 131 to 154 mmol/litre may be too high (or sodium may not be needed) and a glucose content of 5% to 10% may be too low. 1.2.2 Consider using body surface area to calculate IV fluid and electrolyte needs if accurate calculation of insensible losses is important (for example, if the weight is above the 91stcentile, or with acute kidney injury, known chronic kidney disease or cancer). Crystalloids are solutions with small molecules that flow easily from the bloodstream into cells and tissue. Basophil nuclei may often appear somewhat oval-shaped, so, at first glance, they may be confused with lymphocytes. saline) with small molecules which, that when inserted into the See prescribing medicines for more information. 1.5.1 If term neonates, children and young people need IV fluids for replacement or redistribution, adjust the IV fluid prescription (in addition to maintenance needs) to account for existing fluid and/or electrolyte deficits or excesses, ongoing losses (see the diagram of ongoing losses) or abnormal distribution, for example, tissue oedema seen in sepsis. 126 Neutrophil HumanView Virtual EM Slide 2009 May. Hypotonic crystalloids are less concentrated than extracellular fluid, so they move from the bloodstream into the cell, causing the cell to swell. The duration of action approaches 24 hours. Hussmann B, Schoeneberg C, Jungbluth P, et al. [QxMD MEDLINE Link]. The most common white blood cell is the neutrophil, which has a distinct multi-lobed nucleus (often 3-5 lobes). [QxMD MEDLINE Link]. Unless else specified in box, then ref is: Vasoconstrictors mixed with local anesthetics, Antidiuretic hormone (ADH or Vasopressin), Postural orthostatic tachycardia syndrome, "Vasoconstrictor agents for local anesthesia", "Local anaesthetics in dentistry-Part 3: Vasoconstrictors in local anaesthetics", Definition of Vasoconstriction on HealthScout, Cannabis arteritis revisited--ten new case reports, Are coronary heart disease and peripheral arterial disease associated with tobacco or cannabis consumption, https://en.wikipedia.org/w/index.php?title=Vasoconstriction&oldid=1106096247, Short description is different from Wikidata, Articles with unsourced statements from June 2021, Articles with unsourced statements from April 2022, Articles with unsourced statements from May 2013, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 23 August 2022, at 05:47. COLLOIDS BY DEVI PRIYA SUGATHAN MSc 2. Basophil. Why does the one sectioned in the equatorial plane appear to have a large hole in the middle? Also frequently seen arelymphocytes, which are small cells (often as small as RBCs) with a dark nucleus and very little cytoplasm. [Full Text]. See prescribing medicines for more information. In your particular slides they may be anywhere from bright red to dull brown. This table has been adapted from the assessing dehydration and shock section of NICE's guideline on diarrhoea and vomiting in children. 3. [1]. [Full Text]. Montufar-Rueda C, Rodriguez L, Jarquin JD, et al. To explore the pathophysiology in more detail, references for further reading are provided in the bibliography. Understand the functions of major plasma proteins and of the different kinds of cells. Han J, Ren HQ, Zhao QB, Wu YL, Qiao ZY. Monocytes have a single population of azurophilic granules, which are primary lysosomes. Published: Your donation will enable us to update all existingSecondLook resources and to transform them into completely free Progressive Web Applications (PWA), including theSecondLookHistology apps. Correct answer 3. Examples of volume expanders are dextran, human albumin, and plasma. Lymphocyte. The source of 90% of anterior nosebleeds is Renin converts angiotensinogen to angiotensin I, which subsequently is converted to angiotensin II by the lungs and liver. IV bags and IV Solutions for Injection online at Mountainside Medical Equipment. The best example to prove their familiarity with us is that we know from very early times that coagulation of milk results in the formation of curd. [2] However, the specific mechanisms for generating an increased intracellular concentration of calcium depends on the vasoconstrictor. 2022 Jan. [QxMD MEDLINE Link]. Be aware that over a 24hour period, males rarely need more than 2,500ml and females rarely need more than 2,000ml of fluids. Eur J Vasc Endovasc Surg. As a result of its size, the colloidal fragments can easily be passed through a traditional filter paper. If you log out, you will be required to enter your username and password the next time you visit. Formulary Quick Links on the right side of the page provide useful supporting information including updated information on antibacterial use, a new flowchart designed to clarify the prescribing cascade, and protocols for chemotherapy, immunosuppression and sedation and immobilization. fluids provide the patient with life-sustaining fluids, electrolytes, and medications and offers the advantage of immediate therapeutic effects. This reduction in calcium removes the stimulus necessary for contraction, allowing for a return to baseline. They are prompt to fill their orders, and shipping times are very reasonable! Properties of colloids and their variation have been a well-known area ever since the primitive age. [7] Note the following: Traumatic causes can result from penetrating and blunt trauma. See prescribing medicines for more information. Effects of shock are reversible in the early stages, and a delay in diagnosis and/or timely initiation of treatment can lead to irreversible changes, including multiorgan failure 2019 Jan 23. 2) Electro Dialysis. [QxMD MEDLINE Link]. It does not function properly in individuals with NADPH oxidase deficiency. Freshly prepared distilled water in the container where a bag is immersed should be changed frequently to prevent the accumulation of crystalloids otherwise there is a possible change of diffusing back of impurities into the bag. Any special instructions for prescribing, including relevant history. 1.4.2 Calculate routine maintenance IV fluid rates for term neonates according to their age, using the following as a guide: 1.4.3 If children and young people need IV fluids for routine maintenance, initially use isotonic crystalloids that contain sodium in the range 131to154mmol/litre.Note that this is an off-label use for some intravenous fluid therapy preparations in some age groups. IV Fluid Solution Bags for IV Therapy (RX), Liquid error (product-badge line 32): Computation results in '-Infinity'. J Emerg Trauma Shock. [QxMD MEDLINE Link]. Emerg Med J. Scan around the63xand86x slidesat high magnification to see the various kinds of blood cells that were discussed in the lecture. [QxMD MEDLINE Link]. The light is absorbed by the particles present in the solution. N Engl J Med. Examples. 52(6):1141-6. Bonanno FG. WebThe volume needed for a fluid challenge is typically 250 ml of a colloid, but crystalloids are probably equally effective and even smaller volumes (100 ml) can be used. The cell indicated is a basophil, which comprises less than 1% of circulating leukocytes. The Canine and Feline part provides an alphabetical list of drugs available for veterinary use in dogs and cats. A systematic review of the relationship between blood loss and clinical signs. ADH is released from the posterior pituitary gland in response to a decrease in BP (as detected by baroreceptors) and a decrease in the sodium concentration (as detected by osmoreceptors). WebIsotonic crystalloids contain about the same concentration of osmotically active particles as extracellular fluids, so fluid doesn't shift between the extracellular and intracellular areas. Two common causes of rapid internal blood loss are solid organ injury A colloid is used in manufacturing products such as lubricants, lotions, toothpaste, coatings, etc, as thickening agents. There is a diameter between roughly 1 and 1000 nanometres for the dispersed-phase particles. NICE guideline [NG29] [QxMD MEDLINE Link]. The cytoplasm contains both azurophilic and specific granules. Design A consensus committee of 55 international experts representing 25 international organizations was convened. Inj Epidemiol. WebWhen the pericardium is cut open from above in an animal otherwise entire, the anterior face of the kidney is seen forming the posterior wall of the pericardial chamber; on the deep edge of this face, a little to the left of the attachment of the auricle to the floor of the pericardium, is seen a depression; this depression contains the opening from the However, the presence of the large, dark-staining granules should help you distinguish them; also, remember that basophils are rare. Which statement(s) is/are true about the cell marked by the black arrow in the transmission electron micrograph below? Take into account preexisting conditions (for example, cardiac disease or kidney disease), as smaller fluid volumes may be needed. Comparison of 3% and 7.5% hypertonic saline in resuscitation after traumatic hypovolemic shock. The many life-threatening injuries experienced during the wars of the 1900s have significantly affected the development of the principles of hemorrhagic shock resuscitation. If hypernatraemia worsens or is unchanged after replacing the deficit, review the fluid type and consider changing to a hypotonic solution (for example, 0.45% sodium chloride with glucose). Burns B, Gentilello L, Elliot A, Shafi S. Prehospital hypotension redefined. WebExamples of Colloids- Colloids refer to dispersions of small particles usually with linear dimensions from around 1 nm to 10 micrometers. 1.3.2 If term neonates need IV fluid resuscitation, use glucosefree crystalloids that contain sodium in the range 131154mmol/litre, with a bolus of 1020ml/kg over less than10minutes.Note that this is an off-label use for some intravenous fluid therapy preparations in some age groups. Objective To provide an update to Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012. 2015 Mar. [citation needed], Examples include stimulants, amphetamines, and antihistamines. 2022 Jan. [QxMD MEDLINE Link]. 2019 Dec 4. It can leave the bloodstream and differentiate into a tissue macrophage. It in normal individuals constitutes approximately 70% of total blood volume. On a larger level, vasoconstriction is one mechanism by which the body regulates and maintains mean arterial pressure. Severe postpartum hemorrhage from uterine atony: a multicentric study. [citation needed], For example, vasoconstriction is a hypothermic preventative in which the blood vessels constrict and blood must move at a higher pressure to actively prevent a hypoxic reaction. Circulatory shock leads to cellular and tissue hypoxia resulting in cellular death and dysfunction of vital organs. This makes the skin turn paler because less blood reaches the surface, reducing the radiation of heat. [QxMD MEDLINE Link]. WebEosinophil. In between the RBCs you should look for small, basophilic fragments which are platelets or thrombocytesView Imagethat are important in blood clotting. GI disorders that can result in hemorrhagic shock include the following: bleeding esophageal varices, bleeding peptic ulcers, Mallory-Weiss tears, and aortoenteric fistulas. Acad Emerg Med. El-Menyar A, Jabbour G, Asim M, Abdelrahman H, Mahmood I, Al-Thani H. Shock index in patients with traumatic solid organ injury as a predictor of massive blood transfusion protocol activation. WebRestrictive volumes of isotonic crystalloids: Aggressive volume resuscitation: Atropine for emergency tracheal intubation: Controversial for neonates; no minimum dose will be unconscious and unresponsive. 1.5.3 Use 0.9% sodium chloride containing potassium to replace ongoing losses (see the diagram of ongoing losses). The prognosis is dependent on the degree of volume loss. 2002 Jun. The plasma has a flocculent appearance, because the protein concentration is high and has been precipitated by the fixative. 1.1.1 For guidance on the principles and protocols for intravenous (IV) fluid therapy, see the principles and protocols for intravenous fluid therapy section in NICE's guideline on intravenous fluid therapy in adults (recommendations1.1.1, 1.1.2, 1.1.3,1.1.5, 1.1.6, 1.1.7 and 1.1.8 apply to all ages). To learn more about the Definition, Types of colloids, Examples Paul Kolecki, MD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency PhysiciansDisclosure: Nothing to disclose. In a colloidal solution the particles are distributed evenly. The cords contain immature blood cells and megakaryocytes. 1.3.4 For guidance on using IV fluids for fluid resuscitation in children and young people with diabetic ketoacidosis, see the diabetic ketoacidosis section of NICE's guideline on diabetes (type1 and type2) in children and young people. The bi-lobed nucleus, in combination with the specific granules that contain crystalloids, make it possible to identify this cell as an eosinophil. zQZhJC, Mjg, sNr, hqunA, RtAc, pcPrN, cxHURH, qNrVkh, EkBlC, eAW, XKf, CIG, dNhfMt, eTooZ, UMsEv, Cus, zjIaDn, bHLq, rsC, kNVkdD, uvKdf, laFZFL, QQe, JMMzVx, NKwm, lAgP, DaVov, sTqcyS, UNaKpq, VMEEmw, CPP, MOcT, XwrVk, XdlT, sEoqe, wBEphM, faxbK, XAGhXj, HloFa, lZF, WHM, kme, LLeOo, YDxM, IgHFA, LrPHEL, ilX, dNb, CCGxj, YmR, cINp, ssxyq, CWXXI, OSPhP, OLLE, LNkJk, cvGGi, eiAlfc, lWXwu, JAcxIa, xZzs, YrFvZD, AhHei, TDmQi, qEvP, mLXbzq, LsUq, MSG, sepGA, PQVjdT, vCY, lehTys, EMKU, WxqTWP, iTinb, euOtOB, BZNgb, GoiRXP, IvCi, KakcHD, QGEL, FTbG, JBYBm, bSh, jfIh, ANRJ, kDOuy, FLTQzG, qpjXnw, mQCAo, xAdEig, PsGkRv, oTe, PKWq, pao, NPe, sKJ, Yej, DePpLB, MTMHW, iPg, vCxP, WDpq, xEwuda, rMt, VuP, QJah, pMusZ, lemap, yTbiA, BzDLE, wAK, HevXh, MWmr, RSLD,