February 2018 Briefing – Pharmacy

February 2018 Briefing – Pharmacy
Advertisement

Here are what the editors at HealthDay consider to be the most important developments in Pharmacy for February 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Early Studies Often Show Exaggerated Treatment Effect

TUESDAY, Feb. 27, 2018 (HealthDay News) — Trials to evaluate drugs or devices used to treat chronic medical conditions that are published early in the chain of evidence often show an exaggerated treatment effect compared with subsequent trials, according to research published online Feb. 21 in the Mayo Clinical Proceedings.

Abstract/Full Text
Editorial

Low Risk of Serotonin Syndrome for Triptans + SSRI/SNRI

TUESDAY, Feb. 27, 2018 (HealthDay News) — A low risk of serotonin syndrome is seen in association with concomitant use of triptans and selective serotonin reuptake inhibitor (SSRI) or selective norepinephrine reuptake inhibitor (SNRI) antidepressants, according to a study published online Feb. 26 in JAMA Neurology.

Abstract/Full Text

Treatment Effect of Fenofibrate Varies in Patients With T2DM

TUESDAY, Feb. 27, 2018 (HealthDay News) — For individual patients with type 2 diabetes mellitus (T2DM), the effect of fenofibrate treatment varies and is larger in patients with dyslipidemia, according to a study published online Feb. 22 in Diabetes Care.

Abstract/Full Text (subscription or payment may be required)

Female Infertility Tied to Asthma Managed With Rescue Inhalers

TUESDAY, Feb. 27, 2018 (HealthDay News) — Women with current asthma who use intermittent reliever treatment with short-acting beta-agonists have reduced fertility, according to a study published online Feb. 14 in the European Respiratory Journal.

Abstract
Full Text (subscription or payment may be required)

Understanding Rx Nonadherence Can Improve Adherence

MONDAY, Feb. 26, 2018 (HealthDay News) — Understanding nonadherence in patients and encouraging a change in attitude toward patients and their medication can improve medication adherence, according to a report published by the American Medical Association (AMA).

More Information

No Link Found for Metformin or Statins and Ovarian Cancer

MONDAY, Feb. 26, 2018 (HealthDay News) — In women with type 2 diabetes, no evidence was found of an association between the use of metformin or statins and the incidence of ovarian cancer, according to a study published online Feb. 7 in BJOG: An International Journal of Obstetrics and Gynaecology.

Abstract
Full Text (subscription or payment may be required)

Treatment-Free Remission Feasible After Nilotinib in CML

MONDAY, Feb. 26, 2018 (HealthDay News) — For patients with chronic-phase chronic myeloid leukemia (CML), treatment-free remission (TFR) appears to be feasible after second-line nilotinib, according to a study published online Feb. 20 in the Annals of Internal Medicine.

Abstract/Full Text (subscription or payment may be required)

FDA Warns of Possible Heart Risks Linked to Clarithromycin

FRIDAY, Feb. 23, 2018 (HealthDay News) — The antibiotic clarithromycin (brand name: Biaxin) may increase the long-term risk of heart problems and death in patients with heart disease, according to U.S. health officials.

More Information

Benzodiazepine Use Declining in Older Adults

FRIDAY, Feb. 23, 2018 (HealthDay News) — There have been small but significant reductions in the incidence and prevalence of benzodiazepine use in older adults in Canada, the United States, and Australia, according to a brief report published online Feb. 12 in the Journal of the American Geriatrics Society.

Abstract
Full Text (subscription or payment may be required)

Artificial Intelligence May Help Prevent Physician Burnout

FRIDAY, Feb. 23, 2018 (HealthDay News) — Artificial intelligence (AI), in which computers can be trained to recognize patterns in large quantities of data, may be able to reduce physicians’ burdens, saving them time and energy, according to a report published in Medical Economics.

More Information

Private Insurance Coverage of Infused Chemo Varies by Setting

FRIDAY, Feb. 23, 2018 (HealthDay News) — From 2004 to 2014, there was an increase in the provision of infused chemotherapy in hospital outpatient departments (HOPDs), which is associated with increased spending, according to a research letter published online Feb. 22 in JAMA Oncology.

Abstract/Full Text (subscription or payment may be required)

FDA Cracks Down on Kratom Products

THURSDAY, Feb. 22, 2018 (HealthDay News) — A number of kratom-containing dietary supplements are being recalled and destroyed by the manufacturer, the U.S. Food and Drug Administration announced Wednesday.

More Information

CDC: No Change in Percentage of Uninsured in U.S. From ’16 to ’17

THURSDAY, Feb. 22, 2018 (HealthDay News) — The percentage of uninsured U.S. persons of all ages did not change significantly from 2016 to the first nine months of 2017, according to a report published online Feb. 22 by the National Center for Health Statistics.

Abstract/Full Text

21 Reviewed Antidepressants Top Placebo for Major Depression

THURSDAY, Feb. 22, 2018 (HealthDay News) — For adults with major depressive disorder, all antidepressants are more efficacious than placebo, according to research published online Feb. 21 in The Lancet.

Abstract
Full Text
Editorial

Haloperidol for Delirium in Critically Ill No Help for Survival

THURSDAY, Feb. 22, 2018 (HealthDay News) — For critically ill adults at high risk of delirium, prophylactic haloperidol does not improve survival at 28 days compared with placebo, according to a study published online Feb. 20 in the Journal of the American Medical Association.

Abstract/Full Text
Editorial (subscription or payment may be required)

Increasing Demands Leading to Pharmacist Burnout

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — Increasing demands are leading to burnout among pharmacists, which can be addressed at different levels, according to a report published in Drug Topics.

More Information

Aspirin, Rivaroxaban Similar After Total Hip, Knee Arthroplasty

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — For patients who have undergone total hip or knee arthroplasty, extended prophylaxis with aspirin does not differ significantly from rivaroxaban for venous thromboembolism prevention, according to a study published in the Feb. 21 issue of the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Chronic Opioid Users May Wish to Taper Opioid Use

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — Many patients with non-cancer-related chronic pain prescribed long-term opioids may wish to taper their opioid use, according to a research letter published online Feb. 19 in JAMA Internal Medicine.

Abstract/Full Text

Prenatal Valproate Exposure May Impact School Performance

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — School performance is significantly lower for children with prenatal exposure to valproate, according to a study published online Feb. 19 in JAMA Neurology.

Abstract/Full Text
Editorial

Obesity Linked to Improved Survival in Metastatic Melanoma

WEDNESDAY, Feb. 21, 2018 (HealthDay News) — For men with metastatic melanoma treated with targeted or immune therapy, obesity is associated with improved survival, according to a study published online Feb. 13 in The Lancet Oncology.

Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Maternal Vaccination Not Tied to Infant Hospitalization, Death

TUESDAY, Feb. 20, 2018 (HealthDay News) — Maternal receipt of influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines is not associated with infant hospitalization or death in the first six months of life, according to a study published online Feb. 20 in Pediatrics.

Abstract/Full Text

Hydroxychloroquine No Better Than Placebo for Hand OA

TUESDAY, Feb. 20, 2018 (HealthDay News) — For patients with moderate-to-severe hand pain and radiographic osteoarthritis, hydroxychloroquine is no more effective than placebo for relieving pain, according to a study published online Feb. 20 in the Annals of Internal Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Ulipristal Achieves Amenorrhea for Symptomatic Leiomyomas

TUESDAY, Feb. 20, 2018 (HealthDay News) — For women with symptomatic uterine leiomyomas, ulipristal is well tolerated and superior to placebo for the rate of and time to amenorrhea, according to a study published online Feb. 5 in Obstetrics & Gynecology.

Abstract/Full Text (subscription or payment may be required)

Anticoagulants in Seniors With A-Fib, CKD Ups Stroke, ICH Risk

TUESDAY, Feb. 20, 2018 (HealthDay News) — For older patients with concomitant chronic kidney disease and a new diagnosis of atrial fibrillation, anticoagulants are associated with increased risk of ischemic stroke and hemorrhage, but with reduced risk of all-cause mortality, according to a study published online Feb. 14 in The BMJ.

Abstract/Full Text

Ertugliflozin Tied to Improved Glycemic Control in T2DM

TUESDAY, Feb. 20, 2018 (HealthDay News) — For adults with inadequately controlled type 2 diabetes, ertugliflozin treatment is associated with improved glycemic control over 52 weeks, according to a study published online Feb. 8 in Diabetes, Obesity and Metabolism.

Abstract
Full Text (subscription or payment may be required)

Automated Central System Offers Time Savings for Pharmacists

FRIDAY, Feb. 16, 2018 (HealthDay News) — An automated central pharmacy system, Omnicell XR2, is helping pharmacists save time, allowing them to take on additional roles as part of a transition-of-care team, according to a report published in Drug Topics.

More Information

Bariatric Surgery Linked to Discontinuing Diabetes Meds

FRIDAY, Feb. 16, 2018 (HealthDay News) — Antidiabetes treatment discontinuation rates are higher for obese individuals undergoing bariatric surgery, according to a study published online Feb. 14 in JAMA Surgery.

Abstract/Full Text
Editorial (subscription or payment may be required)

Influenza A(H3N2) Viruses Predominate 2017-2018 Season

FRIDAY, Feb. 16, 2018 (HealthDay News) — Most influenza viruses identified in the 2017 to 2018 season are influenza A, with A(H3N2) viruses predominating, according to research published in the Feb. 16 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Abstract/Full Text – Budd
Abstract/Full Text – Flannery

Anti-Heroin Vaccine Shows Promise Against Lethal Doses

FRIDAY, Feb. 16, 2018 (HealthDay News) — A toll-like receptor 9 (TLR9) agonist in the presence of alum is stable over a month and elicits strong anti-heroin antibody titers and blockade of heroin-induced antinociception, according to a study published online Feb. 8 in Molecular Pharmaceutics.

Abstract/Full Text (subscription or payment may be required)

Long-Term Inhaled Corticosteroid Use May Raise Fracture Risk

FRIDAY, Feb. 16, 2018 (HealthDay News) — Long-term, high-dose use of inhaled corticosteroids (ICSs) is associated with a modest increase in the risk of hip and upper extremity fractures in patients with chronic obstructive pulmonary disease (COPD), according to a study published in the February issue of CHEST.

Abstract/Full Text

Induced Pluripotent Stem Cell Vaccine Promising for Cancer

THURSDAY, Feb. 15, 2018 (HealthDay News) — Induced pluripotent stem cell (iPSC) vaccines prevent tumor growth in syngeneic murine cancer models in a prophylactic setting, according to a study published online Feb. 15 in Cell Stem Cell.

Abstract/Full Text

Opioids Plus Acetaminophen, Ketorolac Cost-Effective Post-Sx

THURSDAY, Feb. 15, 2018 (HealthDay News) — Intravenous acetaminophen with or without ketorolac is associated with reduced opioid consumption and cost of care after scoliosis surgery in adolescents, compared with opioids alone, according to a study published online Jan. 29 in Pediatric Anesthesia.

Abstract
Full Text (subscription or payment may be required)

Metformin After Induction Tx May Preserve Beta-Cell Function

THURSDAY, Feb. 15, 2018 (HealthDay News) — After induction short-term intensive insulin therapy (IIT), metformin is superior to intermittent IIT for maintaining beta-cell function and glycemic control over two years, according to a study published online Jan. 27 in Diabetes, Obesity and Metabolism.

Abstract
Full Text (subscription or payment may be required)

Rise in Use of Antihypertensives in Delivery With Preeclampsia

THURSDAY, Feb. 15, 2018 (HealthDay News) — Use of antihypertensive treatments during delivery hospitalizations in women with preeclampsia has increased since 2006, according to a study published online Feb. 5 in Obstetrics & Gynecology.

Abstract/Full Text (subscription or payment may be required)

Pimavanzserin Cuts Alzheimer’s Psychosis at Six Weeks

THURSDAY, Feb. 15, 2018 (HealthDay News) — Pimavanserin is efficacious at six weeks for patients with Alzheimer’s disease psychosis but not at 12 weeks, according to a study published in the March issue of The Lancet Neurology.

Abstract
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

FDA Approves Erleada to Treat Non-Metastatic Prostate Cancer

WEDNESDAY, Feb. 14, 2018 (HealthDay News) — Erleada (apalutamide) has been approved by the U.S. Food and Drug Administration to treat non-metastatic, castration-resistant prostate cancer.

More Information

Nusinersen Beneficial in Later-Onset Spinal Muscular Atrophy

WEDNESDAY, Feb. 14, 2018 (HealthDay News) — Nusinersen is associated with significant and clinically meaningful improvement in motor function among children with later-onset spinal muscular atrophy (SMA), according to a study published in the Feb. 15 issue of the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)

Four Best Practices Outlined to Prevent Health Care Cyberattacks

TUESDAY, Feb. 13, 2018 (HealthDay News) — Four best practices outlined that can help prevent health care cyberattacks, which increased from 2016 to 2017, according to a report published in Managed Healthcare Executive.

Abstract/Full Text

Treating Depression Found to Up Successful Opioid Cessation

TUESDAY, Feb. 13, 2018 (HealthDay News) — Antidepressant medication (ADM) adherence is associated with cessation of long-term prescription opioid use among patients with non-cancer pain, according to a study published in the February issue of the British Journal of Psychiatry.

Abstract/Full Text

Omalizumab Effective for Chronic Spontaneous Urticaria

TUESDAY, Feb. 13, 2018 (HealthDay News) — Omalizumab, alone or in combination with a short-term course of corticosteroids, is highly effective for the treatment of refractory chronic spontaneous urticaria (CSU), according to a study published online Feb. 5 in the International Journal of Dermatology.

Abstract
Full Text (subscription or payment may be required)

Disparities Seen in Gastric Cancer Patients’ Receipt of Pre-Op Chemo

TUESDAY, Feb. 13, 2018 (HealthDay News) — Racial and ethnic disparities in the use of preoperative chemotherapy exist among patients with gastric cancer in the United States, according to a study published online Feb. 2 in Cancer.

Abstract
Full Text (subscription or payment may be required)

Losartan May Improve Endothelial Function in Marfan Syndrome

TUESDAY, Feb. 13, 2018 (HealthDay News) — The therapeutic significance of losartan in Marfan syndrome (MFS) may lie in its ability to activate protective endothelial function, not in its angiotensin II (AngII) receptor type 1 (ATR1) inhibition, according to a study published online Feb. 9 in the American Journal of Pathology.

Abstract
Full Text

Opioid Use Linked to Risk of Invasive Pneumococcal Disease

MONDAY, Feb. 12, 2018 (HealthDay News) — Opioid use is associated with elevated risk of invasive pneumococcal disease (IPD), especially for long-acting, high-potency, and high-dose opioids, according to a study published online Feb. 13 in the Annals of Internal Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

EHRs Not Sufficient to Ensure Success in Value-Based Care

MONDAY, Feb. 12, 2018 (HealthDay News) — Electronic health records (EHRs) are not sufficient to ensure success in value-based care, according to an article published in Medical Economics.

More Information

Criteria for Prostate Cancer Trials Disproportionately Exclude Blacks

MONDAY, Feb. 12, 2018 (HealthDay News) — Almost half of clinical trials for prostate cancer use criteria that disproportionately exclude black men, according to a research letter published online Feb. 8 in JAMA Oncology.

Abstract/Full Text (subscription or payment may be required)

Open-Label Placebo May Reduce Fatigue in Cancer Survivors

MONDAY, Feb. 12, 2018 (HealthDay News) — Open-label placebo (OLP) may reduce fatigue in cancer survivors, according to a study published online Feb. 9 in Scientific Reports.

Abstract/Full Text

Limited Opioid Prescribing Among Dermatologists

MONDAY, Feb. 12, 2018 (HealthDay News) — Opioid prescribing among dermatologists is limited, with most of the top prescribing dermatologists working in surgical practice, according to research published online Feb. 7 in JAMA Dermatology.

Abstract/Full Text

Top Consumer Concerns Reported About Physicians

FRIDAY, Feb. 9, 2018 (HealthDay News) — Health care consumers have four major concerns regarding their physicians, according to a report published by Managed Healthcare Executive.

More Information

Direct Oral Anticoagulants Plus Antiplatelets Effective in ACS

FRIDAY, Feb. 9, 2018 (HealthDay News) — For patients with acute coronary syndrome (ACS), treatment with direct oral anticoagulants (DOACs) in addition to antiplatelet therapy (APT) appears efficacious for those with ST-segment elevation myocardial infarction (STEMI), according to a review published online Feb. 7 in JAMA Cardiology.

Abstract/Full Text (subscription or payment may be required)

Poll: Personal Beliefs Shouldn’t Allow Doctors to Refuse to Treat

THURSDAY, Feb. 8, 2018 (HealthDay News) — Most people do not believe that professionals including health care providers should be allowed to refuse to provide services based on their conscience or beliefs, according to a recent HealthDay/The Harris Poll.

More Information

FDA Says Herbal Drug Kratom Contains Opioids

WEDNESDAY, Feb. 7, 2018 (HealthDay News) — The popular botanical drug kratom essentially is an opioid, the U.S. Food and Drug Administration declared Tuesday.

More Information

Prenatal Natalizumab Exposure Linked to Miscarriage Risk in MS

WEDNESDAY, Feb. 7, 2018 (HealthDay News) — For pregnant women with multiple sclerosis (MS), natalizumab exposure is associated with an increased risk of spontaneous abortion (SA), and longer periods of natalizumab washout predict relapse during pregnancy, according to two studies published online Feb. 7 in Neurology.

Abstract/Full Text 1 (subscription or payment may be required)
Abstract/Full Text 2 (subscription or payment may be required)
Editorial (subscription or payment may be required)

Prazosin Doesn’t Alleviate Distressing Dreams in PTSD

WEDNESDAY, Feb. 7, 2018 (HealthDay News) — Prazosin does not alleviate distressing dreams among veterans with chronic posttraumatic stress disorder (PTSD), according to a study published in the Feb. 8 issue of the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Mogamulizumab Cuts Infected Cells in HTLV-1 Myelopathy

WEDNESDAY, Feb. 7, 2018 (HealthDay News) — For patients with human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy-tropical spastic paraparesis (HAM-TSP), treatment with the humanized anti-CCR4 monoclonal antibody that targets infected cells, mogamulizumab, decreases the number of HTLV-1-infected cells, according to a study published in the Feb. 8 issue of the New England Journal of Medicine.

Abstract/Full Text (subscription or payment may be required)

Marked Variation Seen in Care Quality for TIA, Minor Stroke

WEDNESDAY, Feb. 7, 2018 (HealthDay News) — Care quality for patients with transient ischemic attack (TIA) or minor stroke varies substantially across elements of care and facilities, according to a study published online Feb. 5 in JAMA Neurology.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

2018 Immunization Schedule Issued for U.S. Children

TUESDAY, Feb. 6, 2018 (HealthDay News) — The recommended childhood and adolescent immunization schedule for the United States has been issued for 2018 and published online Feb. 6 in Pediatrics.

Abstract/Full Text

Anti-Vaccination Attitudes Linked to Belief in Conspiracies

TUESDAY, Feb. 6, 2018 (HealthDay News) — Those with anti-vaccination beliefs are more likely to believe in conspiracy theories and hold strong individualistic/hierarchical worldviews, according to a study published online Feb. 1 in Health Psychology.

Abstract/Full Text (subscription or payment may be required)

Guideline-Directed Medical Tx Adherence Low Post CABG

TUESDAY, Feb. 6, 2018 (HealthDay News) — Compliance with guideline-directed medical therapy (GDMT) is low, and remains higher in percutaneous coronary intervention (PCI) than in coronary artery bypass grafting (CABG), according to a review published in the Feb. 13 issue of the Journal of the American College of Cardiology.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

2018 Immunization Schedule Issued for U.S. Adults

MONDAY, Feb. 5, 2018 (HealthDay News) — The recommended immunization schedule for U.S. adults aged 19 years and older has been issued for 2018 and published online Feb. 6 in the Annals of Internal Medicine.

Abstract/Full Text

Low Rates of Abx Prophylaxis for Pediatric Sickle Cell

MONDAY, Feb. 5, 2018 (HealthDay News) — Children with sickle cell anemia (SCA) have low rates of receiving ≥300 days of antibiotic prophylaxis, according to a study published online Feb. 5 in Pediatrics.

Abstract/Full Text (subscription or payment may be required)

Opioid Prescribing Trends in the VA Similar to Other Settings

MONDAY, Feb. 5, 2018 (HealthDay News) — Opioid prescribing trends in the Veterans Health Administration (VHA) from 2010 to 2016 followed similar trajectories as non-VHA settings, peaking around 2012 then declining, according to a study published online Jan. 29 in the Journal of General Internal Medicine.

Abstract/Full Text

Patient, Provider Characteristics Tied to Unnecessary Antibiotic Rx

MONDAY, Feb. 5, 2018 (HealthDay News) — Patient, practice, and provider characteristics are associated with inappropriate antimicrobial prescribing in the outpatient setting, according to a study published online Jan. 30 in Infection Control & Hospital Epidemiology.

Abstract/Full Text (subscription or payment may be required)

IV Bevacizumab Effective for Severe HHT-Related Bleeding

MONDAY, Feb. 5, 2018 (HealthDay News) — For patients with severe hereditary hemorrhagic telangiectasia (HHT)-related bleeding, intravenous bevacizumab is effective, according to a study published in the February issue of the Mayo Clinic Proceedings.

Abstract
Full Text
Editorial

Factors Identified That Impact Physicians IT Adoption

FRIDAY, Feb. 2, 2018 (HealthDay News) — Physicians have considerable concerns about the efficacy and evidence base of health information technology (IT), according to a report published by the American Medical Association (AMA).

More Information

Persistent DME More Likely With Bevacizumab Treatment

FRIDAY, Feb. 2, 2018 (HealthDay News) — For patients with diabetic macular edema (DME), persistence is more likely with bevacizumab than with aflibercept or ranibizumab, according to a study published online Feb. 1 in JAMA Ophthalmology.

Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Ibuprofen May Harm Fetal Ovaries During First Trimester

FRIDAY, Feb. 2, 2018 (HealthDay News) — Exposure to ibuprofen is harmful to developing human fetal ovaries ex vivo in the first trimester, according to a study published online Feb. 2 in Human Reproduction.

Abstract/Full Text

Using Hands Is Best Method for Splitting Aspirin Tablets

THURSDAY, Feb. 1, 2018 (HealthDay News) — Using your hands may be best for splitting an aspirin tablet, according to a study published online Jan. 24 in the Journal of Pharmacy Practice and Research.

Abstract
Full Text (subscription or payment may be required)

Medicaid Expansion Cuts Out-of-Pocket Spending

THURSDAY, Feb. 1, 2018 (HealthDay News) — States that expanded Medicaid cut the probability of non-elderly near-poor adults being uninsured and lowered average out-of-pocket spending, according to a study published online Jan. 24 in Health Affairs.

Abstract/Full Text (subscription or payment may be required)

NSAID Users Commonly Exceed Daily Limit

THURSDAY, Feb. 1, 2018 (HealthDay News) — The number of users who exceed the daily limit of nonsteroidal anti-inflammatory drugs (NSAIDs) is “nontrivial,” according to a study published online Jan. 26 in Pharmacoepidemiology and Drug Safety.

Abstract
Full Text (subscription or payment may be required)

Copyright © 2018 ScoutNews, LLC. All rights reserved.
healthday

Submit a Comment

Your email address will not be published. Required fields are marked *

one + 20 =