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Ocak T, Lermı N, Yılmaz Bozkurt Z, Yagız B, Coskun BN, Dalkılıc E, Pehlıvan Y. Pan-immune-inflammation value could be a new marker to differentiate between vascular Behçet's disease and non-vascular Behçet's disease. Eur Rev Med Pharmacol Sci 2024; 28:1751-1759. [PMID: 38497857 DOI: 10.26355/eurrev_202403_35588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Behçet's disease etiology is uncertain, and no specific diagnostic markers exist in the laboratory. This retrospective study aimed to evaluate the role of inflammatory and hematological parameters, mainly Pan-Immune-Inflammation-Value (PIV), in predicting vascular Behçet's disease (VBD). PATIENTS AND METHODS A total of 85 patients with VBD and 92 patients without vascular involvement (non-VBD) were included in this study. Neutrophil, monocyte, platelet, and lymphocyte subsets are all included in the PIV, a new blood-based biomarker. RESULTS The optimal cut-off values for the PIV were determined to be ≥261.6. White blood cell, neutrophil, monocyte, hemoglobin, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (MCHC), red cell distribution, platelet, plateletcrit, PIV, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, sedimentation, c-reactive protein (CRP) values were significantly associated with VBD in univariate analysis. After multivariate analysis, PIV [odds ratio (OR): 2.758; 95% confidence interval (CI): 1.327-5.736; p=0.007] and CRP (OR: 4.029; 95% CI: 1.924-8.438; p<0.001) were found to be a positive predictor for VBD, while MCHC (OR: 0.722; 95% CI: 0.530-0.983; p=0.039) was seen as a negative predictor. CONCLUSIONS Based on our results, PIV, an easily accessible, cost-effective, and new composite biomarker, has a significant predictive value in VBD.
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Affiliation(s)
- T Ocak
- Division of Rheumatology, Faculty of Medicine, Uludag University, Bursa, Turkey.
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Inanc N, Abacar K, Ozturk MA, Tufan A, Karadeniz H, Sari İ, Can G, Erez Y, Pehlivan Y, Dalkiliç E, Ocak T, Cefle A, Yazici A, Senel A, Akar S, Durak Ediboglu E, Koca SS, Piskin Sagir R, Yilmaz S, Gulcemal S, Soysal Gündüz Ö, Başibüyük CS, Alkan S, Cesur TY, Onen F. AB0420 UNINTENTIONAL MONOTHERAPY IN RHEUMATOID ARTHRITIS PATIENTS RECEIVING TOFACITINIB AND DRUG SURVIVAL RATE OF TOFACITINIB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundCombination of MTX with a bDMARDs or tsDMARDs is considered the most effective treatment regimen currently available for patients with RA who have failed to respond to conventional DMARDs. However, approximately 30% of patients receive bDMARDs as monotherapy in daily clinical practice. Studies in the literature do not assess unintentional monotherapy in general. However, it is thought that some patients may switch to monotherapy unintentionally. In other words, some patients who are prescribed combination therapy switch to monotherapy without informing their physicians.ObjectivesTo determine the rate of unintentional monotherapy in rheumatoid arthritis (RA) patients receiving tofacitinib and to evaluate tofacitinib survival rate.MethodsThis national, multicentre, retrospective study included patients’ data from the TURKBIO Registry. Data on demographics, clinical characteristics, disease duration and activity, comorbidities, and treatment were analysed.ResultsData of 231 RA patients (84.8% female, median age, 56 years) were included; 153 were initially prescribed combination therapy and continued to their therapies; 31 were initially prescribed combination therapy but switched to monotherapy of their own will (unintentional monotherapy); 21 were initially prescribed monotherapy and switched to combination therapy; 26 were initially prescribed monotherapy and continued to their therapies. The combination and unintentional monotherapy groups did not differ regarding remission rate assessed by DAS28-CRP (60.5% and 70%, respectively, p=0.328). The rate of comorbidities at the time of data retrieval was significantly higher in the unintentional monotherapy group compared with the combination group (83.3% vs. 60.3%, p=0.031). Presence of comorbidities was a significant factor affecting switching to monotherapy (p=0.039, Odds ratio: 3.29, 95% CI: 1.06-10.18). Drug survival rates of the unintentional monotherapy and combination groups did not differ. The median drug survival duration of tofacitinib was 27+ months with a 1-year and 4-year drug survival rates of 89.6% and 60.2%, respectively, in the unintentional monotherapy group.ConclusionAlthough 13.4% of the study population started monotherapy unintentionally, drug survival rates of the unintentional monotherapy and combination groups were not different. Comorbidity was an important factor affecting transition from combination therapy to monotherapy.This study was sponsored by Pfizer.Figure 1.Disclosure of InterestsNevsun Inanc: None declared, Kerem Abacar: None declared, mehmet akif ozturk: None declared, Abdurrahman Tufan: None declared, Hazan Karadeniz: None declared, İsmail Sari: None declared, gercek can: None declared, Yesim Erez: None declared, yavuz Pehlivan: None declared, Ediz Dalkiliç: None declared, Tuğba Ocak: None declared, Ayse Cefle: None declared, Ayten Yazici Grant/research support from: Ayten Yazici has received project grant from Roche Pharmaceuticals, Turkey., Abdurrahman Senel: None declared, Servet Akar: None declared, Elif Durak Ediboglu: None declared, Süleyman Serdar Koca: None declared, Rabia Piskin Sagir: None declared, Sema Yilmaz: None declared, Semral Gulcemal: None declared, Özgül Soysal Gündüz: None declared, Canberk Sami Başibüyük Employee of: employee of Pfizer Pharmaceuticals, Istanbul, Turkey., Serdar Alkan Employee of: employee and shareholder of Pfizer Inc., Istanbul, Turkey., Teoman Yusuf Cesur Employee of: employee of Pfizer Pharmaceuticals, Istanbul, Turkey., Fatos Onen: None declared
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Aksakal E, Ulus T, Taş H, Ocak T, Sevimli S. Prolonged Qt Interval after Fexofenadine Overdose in the Presence of Hypokalemia and Hypocalcaemia. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791001700114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 23-year-old healthy woman was admitted to our emergency department because of syncope and unconsciousness. She had taken 20 tablets of fexofenadine (total 2400 mg) and 9 tablets of furosemide (total 360 mg) for suicide. The electrocardiogram demonstrated bradycardia (48/min) and markedly prolonged QTc interval (684 msec). Endotracheal intubation and nasogastric tube insertion were performed. Gastric lavage was implemented and activated charcoal was given. A transient pacemaker was implanted. Hypokalemia and hypocalcaemia were also present and the electrolyte disturbances were corrected. The heart rate and QTc interval returned to normal limits after treatment. She stayed in our hospital for seven days. She recovered completely and ventricular arrhythmia was not seen during the hospitalization period.
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Affiliation(s)
| | - T Ulus
- Erzurum Region Research and Educational Hospital, Ministry of Health, Department of Cardiology, Erzurum, Turkey
| | | | - T Ocak
- Atatük University, School of Medicine, Department of Emergency Medicine, 25070 Erzurum, Turkey
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Ocak T, Duran A, Basturk M, Sahin I. Mad Honey Poisoning Presenting with Ventricular Tachycardia and Acute Myocardial Infarction: A Case Report. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791302000506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Apart from its role as an important nutrient, honey is used for alternative medicinal purposes. Cases presenting with severe hypotension, bradycardia, atrioventricular block and asystole have been reported following ingestion of honey in northern parts of Turkey, and certain parts of Japan, Brazil and Nepal. Herein, we report a case presenting with ventricular tachycardia and acute inferoposterolateral myocardial infarction after ingestion of mad honey (grayanotoxin). According to our knowledge, such case is being reported for the first time in the literature.
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Affiliation(s)
| | | | - M Basturk
- Bagcilar Education and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
| | - I Sahin
- Bagcilar Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
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Duran A, Öztürk H, Terzi EH, Tosun M, Öztürk H, Ocak T, Kühner3 A. Protective Effect of Montelukast, a Cysteinyl Leukotriene Receptor-1 Antagonist, against Intestinal Ischemia-Reperfusion Injury in the Rat. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2013.11680954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Duran
- Department of Emergency Medicine,Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - H. Öztürk
- Department of Pediatric Surgery,Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - E. H. Terzi
- Department of Histology and Embryology,Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - M. Tosun
- Department of Medical Biochemistry,Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - H. Öztürk
- Department of Pediatric Surgery,Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - T. Ocak
- Department of Emergency Medicine,Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - A. Kühner3
- Department of Histology and Embryology,Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
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Erkuran MK, Duran A, Ocak T, Citisli V, Kaya H. The impact of the duration of admission to the emergency room on the mortality of intensive care patients. Niger J Clin Pract 2014; 17:320-3. [PMID: 24714010 DOI: 10.4103/1119-3077.130233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE There are many factors affecting the mortality of patients admitted to the intensive care unit (ICU). Among these are the patients' age, diagnosis, and concomitant pathology. The aim of this retrospective study was to investigate whether there is an adverse effect of the time between admission to the Emergency Room (ER) and admission to the ICU on the mortality of these patients. MATERIALS AND METHODS The medical records of the patients who were admitted to the Emergency Department (ED) of the Bolu Izzet Baysal State Hospital and subsequently were admitted to the ICU between December 2009 and August 2011 were analyzed in terms of the time of admission, the season of admission, and the waiting and the stand-by times in the ER. RESULTS A total of 2380 patients, who were admitted to the ED of the Bolu Izzet Baysal State Hospital and subsequently to the ICU, were included in the study. The median waiting time in the ER was 1.23 h (10 min to 10.02 h). After completion of the admission procedures, the median hospitalization time in the ER was 0.16 h (3 min to 2.58 h). There was no statistically significant difference between the patients who died after admission to the ICU and the ones who survived, in terms of the waiting and the stand-by times in the ER ( P > 0.05). CONCLUSION The waiting times at the ED did not affect the mortality of the ICU patients.
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Affiliation(s)
| | - A Duran
- Abant Izzet Baysal University Medical School, Bolu, Turkey
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Ocak T, Duran A, Tekelioglu U, Demirhan A, Bekdaş M, Cetin A. Two cases of lightning strikes resulting in Lichtenberg figures. DERMATOL SIN 2014. [DOI: 10.1016/j.dsi.2013.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Ocak T, Bekdas M, Duran A, Göksügür SB, Küçükbayrak B. The Obstetrics Gynecology and Children's Hospital Emergency Room waiting time before hospitalization. Afr Health Sci 2013; 13:1162-9. [PMID: 24940347 DOI: 10.4314/ahs.v13i4.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND One of the most substantial factors affecting patient satisfaction in the Obstetrics-Gynecology and Children's Hospital is the wait time in the emergency room. OBJECTIVE We retrospectively studied the waiting periods of patients visiting the emergency room patients in Bolu Izzet Baysal Obstetrics-Gynecology and Children's hospital. METHOD Using an automated documentation system for each patient that recorded the season in which the patients consulted the emergency room, the month, day, time, examination time, hospitalization decision time, the hospitalization clinic following the decision to hospitalize, and the time to hospitalization, we retrospectively studied the waiting periods of emergency room patients in Bolu Ýzzet Baysal Obstetrics-Gynecology and Children's Hospital. RESULTS A total of 15,004 patients who consulted the hospital emergency room between November 24, 2009, and August 25, 2011, and who were hospitalized in a clinic were included in this study. The highest frequency of emergency room patient visits occurred during the summer season (28.1%), in the month of July (10.2%), on Mondays (16.1%), and between 8 and 11 AM (22.1%; p < 0.05). The emergency room wait time of patients consulting the pediatric clinic was (55 ± 67 min), which was significantly shorter than the wait time of patients consulting other clinics (p < 0.05). CONCLUSION The majority of patients who were hospitalized in any clinic through the emergency room consulted the hospital during the daytime hours. The time to hospitalization for the admitted patients was within an acceptable time frame. We believe that conducting comprehensive research to determine whether it is possible to reduce wait times even further to increase patient satisfaction will be instructive.
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Affiliation(s)
- T Ocak
- Abant Izzet Baysal University Faculty of Medicine, Department of Emergency Medicine, Bolu, Turkey
| | - M Bekdas
- Abant Izzet Baysal University Faculty of Medicine, Department of Pediatrics, Bolu, Turkey
| | - A Duran
- Abant Izzet Baysal University Faculty of Medicine, Department of Emergency Medicine, Bolu, Turkey
| | - S B Göksügür
- Abant Izzet Baysal University Faculty of Medicine, Department of Pediatrics, Bolu, Turkey
| | - B Küçükbayrak
- Bolu Izzet Baysal Government Hospital, Department of Pediatrics, Bolu, Turkey
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Duran A, Otiük H, Terzi EH, Tosun M, Oziiü H, Ocak T, Kiiüer A. Protective effect of montelukast, a cysteinyl leukotriene receptor-1 antagonist, against intestinal ischemia-reperfusion injury in the rat. Acta Chir Belg 2013; 113:401-405. [PMID: 24494466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Ischemia-reperfusion (I-R) injury of the intestine is a significant problem because the initial damage caused by ischemia is exacerbated by reperfusion. In this study, we examined the protective effect of montelukast against I-R-induced intestinal tissue damage. MATERIALS AND METHODS Eight-week-old male Sprague-Dawley rats were randomly divided into three treatment groups : a sham-operated group, a group receiving I-R, and a group receiving I-R plus montelukast (I-R/M). Tissue samples were evaluated and scored histologically. The blood levels of malondialdehyde (MDA), myeloperoxidase (MPO), glutathione (GSH), and cardiotrophin-1 (CT-1) were measured. RESULTS In the I-R group, the histological score and the levels of serum MDA and MPO were increased compared with those in the control group. In the I-R/M group, the histological score and serum MDA and MPO levels were significantly decreased compared with those in the I-R group. Additionally, compared with the IR group, the I-R/M group had increased serum GSH and CT-1 levels and a decreased intestinal injury score. Ileal sections from the I-R/M group showed minimal alterations, characterized by moderate lifting of the epithelial layer from the lamina propria, and few apoptotic enterocytes were observed compare with the number in the I-R group. CONCLUSION The findings of the present study demonstrated that montelukast can protect I-R-induced intestinal damage in rats.
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Affiliation(s)
- A Duran
- Department of Emergency Medicine, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey.
| | - H Otiük
- Department of Pediatric Surgery, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - E H Terzi
- Department of Histology and Embryology, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - M Tosun
- Department of Medical Biochemistry, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - H Oziiü
- Department of Pediatric Surgery, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - T Ocak
- Department of Emergency Medicine, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - A Kiiüer
- Department of Medical Biochemistry, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
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Ocak T, Erdem A, Duran A, Tekelioglu U, Öztürk S, Ayhan S, Özlü FM, Yazici M. The importance of the mean platelet volume in the diagnosis of supraventricular tachycardia. Afr Health Sci 2013; 13:590-4. [PMID: 24250294 DOI: 10.4314/ahs.v13i3.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This retrospective study aimed to investigate the diagnostic relation between the mean platelet volume (MPV) and supraventricular tachyarrhythmia (SVT) in patient with documented atrial tachyarrhythmia in the emergency department (ED). METHODS Two study groups were compared; a SVT group with arrive at the ED with documented SVT (n=122) and 100 healthy adult without any palpitation symptom, arrhythmic disease, and with normal physical examination results that were brought for checkups to the cardiology polyclinic were classified as control group. Blood samples were obtained from all patients for determining the hematologic counts and MPV during first hour in ED period. RESULTS In terms of the focus of the study, hemoglobin, neutrophil count, mean cell volume (MCV), red cell distribution width (RDW), platelet, white blood cell (WBC), and lymphocyte counts were similar in both group (p>0.05). MPV in the SVT group was significantly higher than in the control group (9.12 ± 1.22 flvs 8.64 ± 0.89 fl, p<0.001). Multivariate logistic regression analysis showed that just MPV was independent predictor of SVT in patients with palpitation in ED (odds ratio [OR] 8.497, 95% confidence interval (6.181 to 12.325), p=0.012). CONCLUSION The present study described that MPV is helpful parameter for the diagnosis of SVT in emergency department, for the first time in the literature.
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Affiliation(s)
- T Ocak
- Department of Emergency Medicine, Abant Izzet Baysal University School of Medicine, Bolu, Turkey
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Duran A, Küçükbayrak A, Ocak T, Hakyemez NI, Taþ T, Karadað M, Mengeloðlu ZF. Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey. Afr Health Sci 2013; 13:233-42. [PMID: 24235918 DOI: 10.4314/ahs.v13i2.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention. OBJECTIVE In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF between 2006 and 2012 based on data obtained from the Bolu Provincial Directorate of Health (BPDH) were evaluated. METHODS BPDH data were reviewed for the period between 1 January 2006 and 31 July 2012. The locations where the tick had attached to the patient, the site of the tick bite on the patient's body, the dates of tick bite and removal, and the demographic characteristics of each patient were recorded. BPDH data on the total number of tick bites, patients with confirmed CCHF, and deaths due to CCHF in Bolu Province during the study period were also evaluated. RESULTS A total of 46 patients with CCHF and 38 patients without CCHF but who had been bitten by ticks were admitted to the BPDH. Of the patients with CCHF, 54.3% were female. The mean age of the patients was 46.88 ± 2.05 years (range, 1-79 years). The mortality rate was 8.82%. Patients were predominantly observed in June and July. When the patients were distributed according to their occupations, the majority was houswife (48.6%), followed by animal husbandry worker (27.0%), farmer (10.8%), health worker (5.4%), and other (8.1%). The symptoms of the patients with CCHF included fatigue (60.9%), fever (60.9%), and myalgia (60.9%). Of those patients with CCHF, 41.3% were determined to have a high fever. CONCLUSIONS The probability of developing CCHF decreased as the duration of tick attachment increased. Moreover, although the clinical presentation is important, it is not diagnostic. Physical examination and laboratory findings become more specific in later stages.
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