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Severity Levels of Interstitial Nephritis
Interstitial nephritis can present in varying degrees of severity, each requiring different approaches to diagnosis and treatment. Understanding these severity levels is crucial for patients and healthcare providers to determine the most appropriate course of action. It's important to note that all severity levels require at least an in-person consultation with a healthcare provider for proper diagnosis and treatment.
Mild Interstitial Nephritis
- Symptoms and risk factors:
- Mild flank pain or lower back discomfort
- Slight changes in urine output or color
- Recent use of certain medications (e.g., antibiotics, NSAIDs)
- No significant impact on daily activities
- Diagnosis method: In-person doctor visit
- Physical examination and detailed medical history required
- Face-to-face consultation allows for thorough assessment and proper diagnosis
- Imaging/lab tests needed:
- Basic urinalysis to check for abnormalities
- Blood tests to assess kidney function (creatinine and BUN levels)
- Treatment options:
- Over-the-counter pain relievers for discomfort
- Discontinuation of offending medications (if identified)
- Possible short-term oral corticosteroids in some cases
Moderate Interstitial Nephritis
- Symptoms and risk factors:
- More pronounced flank pain or lower back pain
- Noticeable changes in urine output, color, or consistency
- Fatigue, mild fever, or nausea
- Recent medication changes or known exposure to nephrotoxic substances
- Diagnosis method: In-person doctor visit
- Physical examination and detailed medical history required
- Face-to-face consultation allows for more thorough assessment
- Imaging/lab tests needed:
- Comprehensive urinalysis
- Blood tests for kidney function and inflammation markers
- Kidney ultrasound to visualize kidney structure and potential inflammation
- Treatment options:
- Prescription medications, including oral corticosteroids
- Antibiotics if a bacterial infection is suspected
- Careful monitoring of kidney function and symptom progression
Severe Interstitial Nephritis
- Symptoms and risk factors:
- Severe flank pain or abdominal pain
- Significant changes in urine output (oliguria or anuria)
- High fever, severe fatigue, confusion
- Known exposure to severe nephrotoxins or autoimmune conditions
- Diagnosis method: Emergency room visit
- Immediate medical attention required due to potential for rapid kidney function decline
- Comprehensive evaluation in a hospital setting
- Imaging/lab tests needed:
- Urgent and comprehensive urinalysis and blood tests
- Kidney ultrasound and possible CT scan
- Potential kidney biopsy for definitive diagnosis
- Treatment options:
- Intensive intravenous corticosteroid therapy
- Targeted antibiotics or antiviral medications if infection is present
- Possible immunosuppressive therapy
- Dialysis may be necessary in cases of severe kidney function impairment
- Consideration of kidney transplant in end-stage cases
Summary Table: Severity Levels
Severity Level | Characteristics | Diagnosis | Labs/Imaging | Treatment |
---|---|---|---|---|
Mild | Subtle symptoms, minimal kidney function impairment | In-person doctor visit | Basic urinalysis, blood tests | OTC pain relievers, possible short-term corticosteroids |
Moderate | More pronounced symptoms, noticeable kidney function decline | In-person doctor visit | Urinalysis, comprehensive blood panel, kidney ultrasound | Prescription medications, including corticosteroids and possibly antibiotics |
Severe | Significant symptoms, severe kidney function impairment | Emergency room visit | All of the above plus possible kidney biopsy | Intensive medication regimen, possible dialysis or transplant consideration |
Understanding these severity levels helps patients and healthcare providers make informed decisions about the most appropriate and cost-effective treatment approach for interstitial nephritis. It's crucial to emphasize that even in mild cases, an in-person consultation with a healthcare provider is essential for accurate diagnosis and appropriate treatment.
Getting a Diagnosis
Obtaining an accurate diagnosis is the crucial first step in treating interstitial nephritis. The method you choose can significantly impact both the cost and timeline of your treatment. Let's explore the various options available:
Self-assessment
While self-assessment can be a starting point, it's important to note that interstitial nephritis often requires professional diagnosis. However, online symptom checkers can help you decide if you need to seek medical attention.
- Cost: Free
- Time estimate: 15-30 minutes
Virtual doctor consultation
Virtual consultations offer a convenient and often cost-effective way to get an initial assessment. Here are some options:
- Teladoc
- With Insurance:
- General Medical visits can be as low as $0 per visit, depending on your benefits.
- Therapy visits range from $0 to $119.
- First-time psychiatry visits range from $0 to $299, and subsequent visits range from $0 to $129.
- Without Insurance:
- General Medical visits cost $89 per visit.
- Other services like Dermatology, Mental Health, Nutrition, and Back and Joint Care have varying costs.
- With Insurance:
- MDLive
- Therapy:
- $108 per session for uninsured patients. Costs may be lower with insurance coverage.
- Psychiatry:
- Initial Session: $248 for uninsured patients.
- Follow-Up Sessions: $108 per session for uninsured patients.
- Other Services:
- Urgent Care: $0 to $82.
- Primary Care: As low as $0 (depending on insurance plans).
- Dermatology: $0 to $95.
- Therapy:
- OptimalMD: Free with OptimalMD membership ($47/month for the entire family)
- Time estimate: 15-30 minutes, usually same-day appointment
In-person doctor visit
For a more thorough examination, an in-person visit to a primary care physician or nephrologist may be necessary. Here are some typical costs:
- Primary Care Physician (PCP) Visit
- Average Cost without insurance: $171
- Level of Care:
- Level 1 (Minor Problem): Around $68
- Level 5 (Complex Medical Problem): Around $234
- With insurance: Typically $25 to $50 copayment
- Nephrologist Visit
- Costs vary but are generally higher than a PCP visit
- Specific data on average costs not available
- OptimalMD: Free with OptimalMD membership
- Time estimate: 30-60 minutes, may require scheduling in advance
Emergency room visit
For severe cases or sudden onset of symptoms, an emergency room visit might be necessary.
- With Insurance: Average out-of-pocket cost is around $646
- Without Insurance: Average cost is approximately $2,715 (2024 estimate, adjusted for inflation)
- Overall average total cost: $2,715 (2024 estimate)
- Time estimate: 2-6 hours, immediate attention
Summary Table: Assessment Options
Modality | Appropriate Severity Level | Price Without Insurance | Price With Insurance | Efficiency |
---|---|---|---|---|
Self-assessment | Mild | Free | Free | High |
Teladoc Virtual Consultation | Mild to Moderate | $89 | $0-$119 | High |
MDLive Virtual Consultation | Mild to Moderate | $82 | $0-$82 | High |
OptimalMD Virtual Consultation | Mild to Moderate | Free with membership | Free with membership | High |
Primary Care Physician Visit | Mild to Moderate | $68-$234 | $25-$50 copay | Medium |
This table provides a quick overview of the diagnosis options, their appropriate use cases, associated costs, and efficiency. Keep in mind that these are average costs and may vary based on location, specific services required, and individual insurance plans.
Imaging and Laboratory Tests
When diagnosing and monitoring interstitial nephritis, several imaging and laboratory tests are commonly used. The costs and efficiency of these tests can vary significantly depending on the provider and payment method. Let's explore the options:
Urinalysis
Urinalysis is a crucial test for diagnosing interstitial nephritis. It can detect abnormalities in the urine that may indicate kidney inflammation.
- LabCorp: $28.00 - $372.99 (cash price range)
- Quest Diagnostics: Prices vary; contact for specific estimate
- Free with OptimalMD membership
Time estimate: Results typically available in 1-2 days
Blood tests (including creatinine and BUN)
Blood tests are essential for assessing kidney function and detecting inflammation markers associated with interstitial nephritis.
- LabCorp: $29.99 - $199.00 (cash price range)
- Quest Diagnostics: $6.43 (cash price)
- Free with OptimalMD membership
Time estimate: Results typically available in 1-3 days
Kidney ultrasound
A kidney ultrasound can help visualize the structure of the kidneys and detect any abnormalities associated with interstitial nephritis.
- RadNet: Contact for specific pricing
- Hospital: $337 - $913 (price range, varies by hospital)
- Heavily discounted with OptimalMD membership
Time estimate: 30-60 minutes for procedure, results often available same day
Kidney biopsy
In some cases, a kidney biopsy may be necessary to confirm the diagnosis of interstitial nephritis and determine its cause.
- Hospital: $1,500 - $5,031.81 (price range, varies by hospital and country)
- Outpatient center: $1,500 - $3,000 (estimated range)
- Heavily discounted with OptimalMD membership
Time estimate: 1-2 hours for procedure, results typically available in 3-7 days
It's important to note that costs can vary significantly depending on your location, the specific provider, and your insurance coverage. Many insurance plans cover a portion of these tests, but you may still be responsible for copays, deductibles, or coinsurance. Always check with your insurance provider and healthcare facility for the most accurate cost estimates.
For those without insurance or looking to reduce out-of-pocket expenses, the OptimalMD membership offers significant savings. At $47 per month for the entire family, it provides free virtual urgent care, access to 800+ generic medications at no additional cost, and heavily discounted labs, procedures, and imaging. This can be an excellent option for managing the costs associated with diagnosing and monitoring interstitial nephritis.
Summary Table: Diagnostics
Modality | Severity Level | Price Without Insurance | Price With Insurance | Efficiency |
---|---|---|---|---|
Urinalysis | All levels | $28 - $373 | Varies, typically lower | Results in 1-2 days |
Blood tests (CMP) | All levels | $6.43 - $199 | Varies, typically lower | Results in 1-3 days |
Kidney ultrasound | Moderate to Severe | $337 - $913 | Varies, typically lower | 30-60 min procedure, same-day results |
Kidney biopsy | Severe | $1,500 - $5,032 | Varies, typically lower | 1-2 hour procedure, results in 3-7 days |
Note: All tests are either free or heavily discounted with OptimalMD membership ($47/month for family).
Prescription Medications
Prescription medications play a crucial role in treating interstitial nephritis. The type and duration of medication depend on the severity of the condition and its underlying cause. Here are the main categories of prescription medications used in treating interstitial nephritis:
Corticosteroids
Corticosteroids are often the first-line treatment for interstitial nephritis, especially for moderate to severe cases.
- Prednisone (generic)
- Dosage: Typically 40-60 mg daily for 1-2 weeks, then tapering
- Duration: 4-6 weeks total
- Cash price: Approximately $13 for a 10-day supply (20 mg tablets)
- With insurance: Costs may vary, but typically lower, around $5-$10 for a 10-day supply
- With discount cards: As low as $4.63 for a 10-day supply
- OptimalMD: Free with OptimalMD membership
- Methylprednisolone (brand name: Medrol)
- Dosage: Often prescribed as a dose pack with tapering doses
- Duration: Usually 6 days
- Cash price: Approximately $17-$25 for a 6-day dose pack
- With insurance: Costs may vary, but typically lower, around $10-$15 for a dose pack
- With discount cards: As low as $8 for a dose pack
- OptimalMD: Free with OptimalMD membership
Antibiotics
If a bacterial infection is the underlying cause of interstitial nephritis, antibiotics may be prescribed. The choice of antibiotic depends on the specific bacteria involved.
- Amoxicillin (generic)
- Dosage: Typically 500 mg three times daily
- Duration: 7-14 days
- Cash price: Approximately $17 for a 7-day course (500 mg, 3 times daily)
- With insurance: Costs may vary, but typically lower, around $10-$15 for a 7-day course
- With discount cards: As low as $9 for a 7-day course
- OptimalMD: Free with OptimalMD membership
- Ciprofloxacin (brand name: Cipro)
- Dosage: Typically 500 mg twice daily
- Duration: 7-14 days
- Cash price: Approximately $95 for a 7-day course (500 mg, twice daily)
- With insurance: Costs may vary, but typically lower, around $30-$50 for a 7-day course
- With discount cards: As low as $6.79 for a 7-day course
- OptimalMD: Free with OptimalMD membership
Immunosuppressants
For severe or persistent cases, especially those caused by autoimmune disorders, immunosuppressants may be prescribed.
- Mycophenolate mofetil (brand name: CellCept)
- Dosage: Typically 1000 mg twice daily
- Duration: Several months or longer, as needed
- Cash price: Approximately $230-$250 per month for a typical dose (1000 mg twice daily)
- With insurance: Costs may vary, but typically lower, around $50-$100 per month
- With discount cards: As low as $150-$200 per month
- OptimalMD: Heavily discounted with OptimalMD membership
Summary Table: Prescription Medications
Medication | Severity Level | Price without Insurance | Price with Insurance | Efficiency |
---|---|---|---|---|
Prednisone | Mild to Severe | $13-$25 / 10-day supply | $5-$10 / 10-day supply | High |
Methylprednisolone | Moderate to Severe | $17-$25 / 6-day pack | $10-$15 / 6-day pack | High |
Amoxicillin | Mild to Moderate | $17 / 7-day course | $10-$15 / 7-day course | Moderate |
Ciprofloxacin | Moderate to Severe | $95 / 7-day course | $30-$50 / 7-day course | High |
Mycophenolate mofetil | Severe | $230-$250 / month | $50-$100 / month | Moderate |
Note: All medications listed are free or heavily discounted with OptimalMD membership ($47/month for the entire family).
Over-the-Counter Treatments
Over-the-counter (OTC) treatments can play a supportive role in managing symptoms associated with interstitial nephritis or side effects from prescription medications. While these treatments don't address the underlying condition, they can provide relief and improve quality of life during the recovery process.
Pain relievers (e.g., Acetaminophen)
Pain relievers can help manage discomfort associated with interstitial nephritis. However, it's crucial to consult with a healthcare provider before using these medications, as some may affect kidney function.
Acetaminophen (e.g., Tylenol)
- National average price (out-of-pocket): $3.16 per unit
- Generic acetaminophen:
- 6 tablets (500 mg): Around $10
- 50 tablets (325 mg): Around $14
- 100 tablets (500 mg): $10.64 to $14.20
- Bulk purchase: 600 caplets (500 mg): Around $14.65
- With SingleCare savings card: As low as $2.52 for 100 tablets (500 mg)
Time estimate: As needed, typically every 4-6 hours
Antacids (to manage stomach upset from medications)
Antacids can help alleviate gastrointestinal side effects that may occur from other medications used to treat interstitial nephritis.
1. Calcium carbonate (e.g., Tums)
- Pharmaceutical grade:
- 20 tablets (500 mg each): Around $10
- 100 tablets: Around $10.23
- Compounding powder: $39.60 for 454 grams (approximately $0.09 per gram)
Time estimate: As needed, typically after meals or when experiencing indigestion
2. Magnesium hydroxide (e.g., Milk of Magnesia)
- Bulk purchases: $1.80 to $3.30 per kilogram (minimum order of 25 kilograms)
- Large quantities: $1,100 to $1,400 per ton
Note: For consumer-grade products like Milk of Magnesia, prices may be significantly lower and are typically sold in smaller quantities.
Time estimate: As needed, typically at bedtime or when experiencing constipation
It's important to note that while these OTC treatments can provide relief, they should be used under the guidance of a healthcare provider, especially when managing a condition like interstitial nephritis. Always consult with your doctor before starting any new medication, even if it's available over the counter.
Summary Table: OTCs
Modality | Appropriate Severity Level(s) | Price Without Insurance | Price With Insurance/Discount | Efficiency |
---|---|---|---|---|
Acetaminophen | Mild to Moderate | $3.16 per unit (average) | As low as $2.52 for 100 tablets with discount card | 4-6 hours of pain relief |
Calcium carbonate (Tums) | All levels | $10 for 20 tablets, $10.23 for 100 tablets | N/A | As needed for indigestion |
Magnesium hydroxide (Milk of Magnesia) | All levels | $1.80 to $3.30 per kg (bulk) | N/A | As needed for constipation |
Note: Prices may vary depending on location, quantity, and specific formulation. Always consult with a healthcare provider before using these medications, especially for kidney-related conditions.
Procedures
In severe cases of interstitial nephritis, especially when the condition progresses to kidney failure, more intensive procedures may be necessary. The two main procedures that may be required are dialysis and kidney transplantation. Let's explore each of these options in detail, including their costs and time considerations.
Dialysis
Dialysis is a life-saving procedure for patients whose kidneys can no longer effectively filter waste from the blood. There are two main types of dialysis: hemodialysis and peritoneal dialysis. Here, we'll focus on hemodialysis as it's more commonly used for acute cases of kidney failure that might result from severe interstitial nephritis.
Let's look at the costs associated with hemodialysis:
- National average cost: Approximately $300 per session
- Frequency: Typically 3 sessions per week
- Duration: Each session lasts 3-5 hours
Supplier examples:
- DaVita Kidney Care
- Location: North Carolina clinics
- Cash price: $17,871 per session
- Insurance price: Varies, but typically much lower due to negotiated rates
- Fresenius Kidney Care
- Location: Nationwide
- Cash price: $250 - $350 per session
- Insurance price: Varies, but typically 10-20% of the cash price after meeting deductible
It's important to note that most patients with end-stage renal disease qualify for Medicare, which covers about 80% of the costs associated with dialysis. Many patients also have secondary insurance to cover the remaining 20%.
Kidney Transplant
For patients with end-stage renal disease resulting from severe interstitial nephritis, a kidney transplant may be the best long-term solution. However, it's important to understand that this is a complex and expensive procedure.
Details about kidney transplantation:
- National average cost: Approximately $400,000 - $500,000 for the transplant procedure alone
- Additional costs: Pre-transplant evaluation, post-transplant care, and lifelong immunosuppressant medications
- Duration: 3-5 hours for surgery, several months for recovery
Supplier examples:
- UCLA Health
- Location: Los Angeles, CA
- Cash price: Not explicitly stated
- Insurance price: Varies based on individual insurance plans
- Mayo Clinic
- Location: Multiple locations (Rochester, MN; Phoenix, AZ; Jacksonville, FL)
- Cash price (out-of-pocket): Approximately $500,000
- Insurance price: Varies, but most insurances cover a significant portion of the costs
It's crucial to note that the costs associated with kidney transplantation extend beyond the surgery itself. Patients must also consider the expenses related to pre-transplant evaluations, post-transplant care, and lifelong immunosuppressant medications to prevent rejection of the new kidney.
Summary Table: Procedures
Modality | Severity Level | Price without Insurance | Price with Insurance | Efficiency |
---|---|---|---|---|
Hemodialysis | Severe | $250 - $17,871 per session | 20% of cash price after deductible | 3-5 hours, 3x weekly |
Kidney Transplant | Severe (End-stage) | $400,000 - $500,000 | Varies, significant coverage | 3-5 hours surgery, months recovery |
Note: Prices are approximate and can vary significantly based on location, specific provider, and individual circumstances. Insurance coverage can dramatically reduce out-of-pocket costs for these procedures.
Optimizing for Cost
When managing interstitial nephritis, cost-effectiveness is a crucial consideration for many patients. Here are strategies for optimizing costs at each severity level, keeping in mind that an in-person consultation is necessary for all cases:
Mild Interstitial Nephritis
- Schedule an in-person consultation with a primary care physician rather than a specialist initially
- Choose an in-network provider to reduce out-of-pocket expenses
- Opt for generic medications when available, particularly for corticosteroids
- Utilize over-the-counter pain relievers as recommended by your healthcare provider
- Follow up with virtual consultations when possible to minimize additional office visit costs
Moderate Interstitial Nephritis
- See an in-network primary care physician or nephrologist for your initial consultation
- Request generic versions of prescribed medications
- Ask about outpatient options for any necessary procedures or tests
- Explore patient assistance programs for more expensive medications like immunosuppressants
- Consider telemedicine for follow-up appointments when appropriate
Severe Interstitial Nephritis
- Seek immediate in-person medical attention, preferably at an in-network hospital or emergency room
- Discuss the necessity of each test and procedure with your healthcare team to avoid unnecessary costs
- For long-term treatments like dialysis, consider home dialysis options which may be more cost-effective
- Explore clinical trials for new treatments, which may provide access to care at reduced or no cost
General cost-saving tips:
- Always review your insurance coverage and understand your benefits
- Consider setting up a Health Savings Account (HSA) or Flexible Spending Account (FSA) to save on taxes for medical expenses
- Ask your healthcare provider about lower-cost alternatives for any recommended treatments or medications
- Look into charitable organizations that may offer financial assistance for kidney disease treatment
By implementing these cost-optimizing strategies, patients can manage their interstitial nephritis treatment more affordably while still receiving necessary in-person care. Remember to always consult with your healthcare provider before making any changes to your treatment plan.
Optimizing for Efficiency
When addressing interstitial nephritis, efficiency in diagnosis and treatment is crucial. Here are strategies for maximizing efficiency at each severity level, ensuring all cases receive appropriate in-person medical attention:
Mild Interstitial Nephritis
- Schedule an urgent in-person appointment with a primary care physician or nephrologist
- Conduct same-day urinalysis and blood tests with rapid results
- Perform a kidney ultrasound within 24-48 hours of the initial consultation
- Begin prescription medications immediately after diagnosis confirmation
- Use generic corticosteroids for faster prescription fulfillment
Moderate Interstitial Nephritis
- Arrange an immediate in-person consultation with a nephrologist
- Undergo comprehensive evaluation, including urinalysis and blood tests, during the initial visit
- Schedule a kidney ultrasound on the same day or within 24 hours
- Start prescription medications, including corticosteroids and antibiotics (if necessary), immediately after diagnosis
- Set up close follow-up appointments to monitor treatment efficacy
Severe Interstitial Nephritis
- Seek immediate care at an emergency room with on-site nephrology specialists
- Undergo rapid diagnostic tests, including urinalysis, blood tests, and kidney ultrasound
- If necessary, perform an expedited kidney biopsy with rush results
- Begin aggressive treatment with intravenous corticosteroids and other medications as needed
- Prepare for potential dialysis if kidney function is severely compromised
- Arrange for admission to the nephrology department for continuous monitoring and treatment
By ensuring in-person medical evaluation for all severity levels and prioritizing rapid diagnosis and treatment initiation, patients can potentially reduce the risk of complications and achieve faster symptom relief. This approach balances the need for thorough medical assessment with the urgency of addressing interstitial nephritis promptly. Patients should work closely with their healthcare providers to determine the most appropriate and efficient course of action for their individual circumstances.
Balancing Cost and Efficiency
When balancing cost and efficiency in treating interstitial nephritis, consider the following strategies for each severity level, keeping in mind that an in-person consultation is essential for all cases:
Mild Interstitial Nephritis
- Schedule an in-person doctor visit for accurate diagnosis and assessment
- Opt for basic urinalysis and blood tests to confirm diagnosis
- Use generic over-the-counter pain relievers if needed
- If prescribed, use generic corticosteroids, with follow-up appointments as recommended
Moderate Interstitial Nephritis
- Attend an in-person doctor visit for a thorough examination
- Complete recommended blood tests and kidney ultrasound
- Use generic prescription medications when available
- Balance follow-up care between in-person visits and telemedicine consultations as appropriate
Severe Interstitial Nephritis
- Seek immediate care at an emergency room or specialist for prompt treatment
- Complete all necessary tests, including kidney biopsy if recommended
- Use a combination of generic and brand-name medications as required
- For ongoing care, explore outpatient treatment options when possible to reduce hospital stays
When balancing cost and efficiency, prioritize necessary treatments while seeking cost-effective options where appropriate. Discuss with your healthcare provider about generic alternatives, outpatient care options, and the potential for some follow-up consultations via telemedicine to optimize both cost and time efficiency without compromising the quality of care.
Remember that investing in proper treatment early, starting with an in-person consultation, can prevent more costly complications in the long run. Always consult with your healthcare provider to determine the most appropriate treatment plan for your specific situation and severity of interstitial nephritis.
Conclusion
Treating interstitial nephritis involves various steps, from diagnosis to potential long-term management, each with associated costs and time investments. The severity of the condition significantly impacts the treatment approach and overall expenses.
For mild cases, cost-effective strategies often involve virtual consultations and basic lab tests, with over-the-counter pain management and short courses of prescription medications. Moderate cases may require in-person doctor visits, more extensive testing, and longer medication regimens. Severe cases necessitate emergency care, advanced diagnostics like kidney biopsies, and potentially costly procedures such as dialysis or kidney transplantation.
Balancing cost and efficiency in interstitial nephritis treatment involves:
- Promptly seeking medical attention to prevent progression to more severe stages
- Utilizing telemedicine when appropriate to reduce costs and save time
- Opting for generic medications when available
- Following treatment plans diligently to avoid complications and additional expenses
- Considering health insurance coverage and exploring financial assistance programs for more intensive treatments
Ultimately, the most effective approach to managing interstitial nephritis costs combines early intervention, appropriate use of healthcare resources, and adherence to prescribed treatments. Patients should work closely with their healthcare providers to develop a treatment plan that addresses their medical needs while considering financial constraints.
By understanding the various cost factors and treatment options available, patients can make informed decisions about their care, potentially reducing both the financial burden and the impact of interstitial nephritis on their overall health and quality of life.
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