• Mammograms and breast ultrasound are often used depending on the risks, and diagnosis can be confirmed by core needle biopsy or excision biopsy. (cgh.com.sg)
  • It may be difficult to differentiate a large fibroadenoma from the phyllodes tumour, another type of breast tumour, based on ultrasound or even core needle biopsy. (cgh.com.sg)
  • The best test to determine the true nature of a thyroid nodule is a fine needle aspiration biopsy (FNAB) with ultrasound guidance, which is performed if the nodule exceeds a half inch or 10 millimeters in diameter. (mhs.net)
  • Thankfully, her doctor ordered a follow-up ultrasound for a closer look, and later performed a needle biopsy. (bestlifeonline.com)
  • Newly available technology can fuse MRI images with real time ultrasound to help guide the prostate needle biopsies to any areas of specific concern. (hopkinsmedicine.org)
  • Imaging of the abdomen by ultrasound and a liver biopsy, where a sample of liver tissue is removed with a small needle, can help confirm the diagnosis and assess the degree of liver damage. (healthywomen.org)
  • An option for confirming diagnosis of this condition is ultrasound-guided fine needle aspirates of the lesion (as opposed to surgical biopsy for histologic diagnosis). (ethosvet.com)
  • These two conditions often appear similar on ultrasound scans, leading to potential confusion and anxiety. (dailypresslive.com)
  • However, it's important to note that not all cancerous tumors display these specific ultrasound findings, highlighting the need for further evaluation and biopsy. (dailypresslive.com)
  • There was evidence of After ultrasound examination, a biopsy left pleural effusion on chest radiography. (who.int)
  • Figure I.2 - Excisional Biopsy/Pathology Report, June 1, 1985. (iptq.com)
  • An excisional biopsy of the breast mass was done on 6/1/85 revealing an infiltrating ductal adenocarcinoma (figure I. 2). (iptq.com)
  • An excisional biopsy is when the entire lump or all of the suspicious tissue is removed. (healthline.com)
  • Excisional biopsy. (stillwater-medical.org)
  • For PD-L1 assessment, newly obtained (core or excisional) biopsy or archival tumour tissue sample (obtained within 12 weeks from the date of Randomisation) from locations not irradiated prior to biopsy is acceptable and formalin-fixed paraffin embedded (FFPE) tumour tissue sample blocks are preferred. (who.int)
  • Figure IX.2 - Open Biopsy/Pathology Report, July 24, 1970. (iptq.com)
  • The patients were subjected to clinical assessment, fine needle aspiration cytology (FNAC) and open biopsy histopathology (as standardreference test).Results:One hundred andseventy-fourpatients with both FNACand histopathology reports were initially evaluated, 96 (55.2%) had benign while the rest (78, 44.8%) harbored malignant lumps. (bvsalud.org)
  • In rare cases, a patient can have multiple giant cell tumors in different bones, a condition called multi-centric giant cell tumor of bone. (orthoinfo.org)
  • Since we expect histiocytomas to disappear in less than 3 months, growths that last longer are surgically removed and tested to confirm the tumor type. (petmd.com)
  • Although most mutations in SMARCB1 primarily occur de novo, familial cases have been reported and if inherited leads to a condition called rhabdoid tumor predisposition syndrome (RTPS). (goldenhelix.com)
  • Removing the tumor with surgery often cures the condition. (medlineplus.gov)
  • Your doctor will choose the method of biopsy based on the location and size of the tumor. (healthline.com)
  • In an incisional biopsy, part of the tumor will be removed to provide a tissue sample. (healthline.com)
  • Among the conditions that resemble ALS are some forms of muscular dystrophy, the neurologic conditions known as spinal-bulbar muscular atrophy , intraspinal tumor, the nerve-to-muscle transmission disorder known as myasthenia gravis , and more. (mda.org)
  • The risk for bleeding and for tumor seeding are a problem when you start doing percutaneous biopsies. (medscape.com)
  • During the procedure, a small amount of liver tissue is removed, using a thin needle that's passed into your liver through a small incision in your skin. (sparrow.org)
  • Bone marrow aspiration is a procedure used to remove bone marrow for biopsy purposes. (attorneyatlaw.com)
  • Many asbestos-related lung conditions, including mesothelioma can be discovered through an aspiration procedure. (attorneyatlaw.com)
  • A needle biopsy of the liver is a procedure to take a very small sample of your liver tissue. (healthplan.org)
  • In this procedure, the doctor uses a needle to remove a small sample of bone marrow from a large bone in the body, such as the pelvis. (hostandcare.com)
  • This procedure uses a thin needle inserted through the rectum to remove a small tissue sample from the prostate. (tanner.org)
  • Targeted fusion biopsy is an advanced imaging procedure used to diagnose prostate cancer. (tanner.org)
  • Needle localisation (also called wire localisation) is a procedure done before breast cancer surgery to find where the breast abnormality is (the wire marks the spot) so that the surgeon knows exactly what tissue to take out. (btchealth.com.au)
  • Although patient 1 was working in this area on the day of the biopsy, the extent of his contact, if any, with the lymphadenopathy patient or materials used in the biopsy procedure is unknown. (cdc.gov)
  • During this procedure, a small sample of liver tissue is taken using a needle and sent to a laboratory for analysis. (peptiko.gr)
  • Bone biopsy uses a needle and imaging guidance to remove a small sample of bone for examination under a microscope. (btchealth.com.au)
  • A bone marrow biopsy is performed to confirm a diagnosis of MPN. (ucsfhealth.org)
  • During this test, a needle is inserted into the bone and marrow is extracted. (ucsfhealth.org)
  • Many types of bone tumors and other conditions (including normal bone) contain giant cells. (orthoinfo.org)
  • Bone marrow aspiration and biopsy can also be utilized to diagnose chromosomal abnormalities and potential causes of low blood counts or fever. (attorneyatlaw.com)
  • Bone marrow biopsy. (hostandcare.com)
  • To confirm the diagnosis, a bone marrow biopsy can be performed. (hostandcare.com)
  • Bone biopsies may be used to confirm the diagnosis of a bone disorder, investigate an abnormality, determine the cause of pain or infection, or distinguish bone tumour from other conditions. (btchealth.com.au)
  • Fine needle aspirates or biopsy, brushing, cell blocks, or tumour tissue from bone metastases that is subject to decalcification are not acceptable. (who.int)
  • The tissue sample is usually obtained through outpatient surgery or, in some cases, by using a long, thin needle to draw fluid from the area where cancer is suspected. (moffitt.org)
  • Less invasively, a needle aspirate can be used to harvest some cells from the affected foot and check for an abundance of plasma cells. (vin.com)
  • If the physical appearance of the foot is not classic for plasma cell pododermatitis, a needle aspirate or even biopsy of the foot pad should confirm the presence of plasma cells thus leaving no question. (marvistavet.com)
  • If the lump appears to be a cyst, your provider may aspirate the lump with a needle, which confirms the lump was a cyst and sometimes may improve the symptoms. (medlineplus.gov)
  • Testing a sample of your blood for antibodies can distinguish autoimmune hepatitis from viral hepatitis and other conditions with similar symptoms. (sparrow.org)
  • Psoriatic arthritis and psoriasis are autoimmune diseases - conditions that occur when the immune system mistakenly attacks healthy tissues, such as your skin and joints . (mypsoriasisteam.com)
  • Having thymic carcinoma in combination with autoimmune conditions is much rarer than with thymoma. (uniqacare.com)
  • Using polymerase chain reaction (PCR) technology on fine needle aspirates and biopsied specimens from 89 children with cervicofacial lymphadenitis, we assessed the importance of M. haemophilum . (cdc.gov)
  • Although myeloproliferative neoplasms usually cannot be cured, there are treatments for all patients with the condition. (ucsfhealth.org)
  • In June 1982, 4 months after the needlestick injury and 7 months before patient 1 became ill, a homosexual man with a history of chronic, unexplained lymphadenopathy underwent a lymph node biopsy in the ambulatory surgery area of the hospital. (cdc.gov)
  • A fibroadenoma may be monitored for long-term stability or they may be removed by vacuum-assisted needle biopsy (VAB) or surgery. (cgh.com.sg)
  • Fibroadenoma is a common benign (non-cancerous) breast condition that primarily affects women in their reproductive years. (dailypresslive.com)
  • Once a diagnosis is confirmed, the management and treatment options for fibroadenoma and cancer differ significantly. (dailypresslive.com)
  • lumbar puncture (spinal tap) - A special needle is placed into the lower back, into the spinal canal. (childrenshospital.org)
  • Additional tests may include imaging of the spinal cord and brain, usually by MRI (magnetic resonance imaging), and sometimes a test of the fluid surrounding the spinal cord (spinal tap or lumbar puncture), which involves inserting a needle into the back between two lower vertebrae. (mda.org)
  • The doctor may use X-ray pictures on a screen to help guide the needle into the liver. (healthplan.org)
  • This biopsy can be done via a bronchoscope (a tube that goes down your throat) or a needle biopsy using CT to guide the needle. (drjyotiranjanswain.com)
  • Diagnosis of mycobacterial infection is performed by using mycobacterial differential skin tests and fine needle aspiration biopsy. (cdc.gov)
  • Aspiration is commonly employed to diagnose conditions such as cancers, cysts, meningitis, abdominal infections, or complications arising from pregnancy. (attorneyatlaw.com)
  • In its simplest form, aspiration only requires a needle or syringe to withdraw fluid from cells. (attorneyatlaw.com)
  • If you have been exposed to asbestos and have had health complications confirmed by pleural aspiration, an experienced Personal Injury attorney may be able to improve the outcome of your case by utilizing experience and expert knowledge. (attorneyatlaw.com)
  • People who have been exposed to asbestos , and are concerned about developing an asbestos pleural disease may be recommended to undergo pleural aspiration to diagnose or treat their condition. (attorneyatlaw.com)
  • Most aspiration performed in a sensitive organ like the lungs is known as fine needle aspiration. (attorneyatlaw.com)
  • Whether or not the fine needle aspiration will be able to detect mesothelioma depends on the size of the tissue sample removed and the type of mesothelioma cells that are present. (attorneyatlaw.com)
  • Biopsy methods include fine-needle aspiration, mediastinotomy, and VATS (video-assisted thoracoscopic surgery). (uniqacare.com)
  • VATS is the most commonly used method due to its higher accuracy compared to fine-needle aspiration biopsy. (uniqacare.com)
  • The fine-needle aspiration (FNA) smear was negative for acid-fast bacilli (AFB). (who.int)
  • To definitively confirm a prostate cancer diagnosis, you'll need to have a biopsy, which is when doctors remove a tissue sample from the prostate. (hopkinsmedicine.org)
  • While a PSA test is an indicator that something may be wrong in the prostate, the only way to confirm a prostate cancer diagnosis is by biopsy, which a doctor may recommend if the results from the PSA test come back abnormal. (tanner.org)
  • Many people with these conditions have few, if any, symptoms, but complications can occur, including stroke in patients with poorly controlled disease. (ucsfhealth.org)
  • When symptoms begin, they are often similar to those caused by a wide variety of other health conditions, which makes mantle cell lymphoma somewhat challenging to diagnose. (moffitt.org)
  • Because patients with this type of lymphoma often display no symptoms or have symptoms that are similar to those of other health conditions, mantle cell lymphoma is often diagnosed in its late stages. (moffitt.org)
  • A rheumatologist is trained to diagnose and treat joint and tendon symptoms, while a dermatologist is focused on the skin symptoms of psoriasis and other skin conditions. (mypsoriasisteam.com)
  • Thymoma tumors often progress without any noticeable symptoms, and they are typically discovered incidentally during tests conducted for other medical conditions. (uniqacare.com)
  • Symptoms of fibrosarcoma are similar to those of many other conditions. (healthline.com)
  • We may also use additional tests to confirm an MMIHS diagnosis or rule out other possible causes of your child's symptoms. (childrens.com)
  • In the early stages of NAFLD, there are usually no symptoms, and individuals may not realize they have the condition until it is detected during tests performed for another reason. (peptiko.gr)
  • This technique can diagnose many lung conditions and can incidentally detect the most serious asbestos-related disease: mesothelioma. (attorneyatlaw.com)
  • A needle biopsy of the lung may be performed to confirm the diagnosis of cancer. (drjyotiranjanswain.com)
  • Lung cancers tend to develop in some smokers more than 50 years of age, who very often have other lung disease or serious medical conditions that increase the risk of surgery. (drjyotiranjanswain.com)
  • Doctors perform a liver biopsy to confirm the diagnosis and to determine the degree and type of liver damage. (sparrow.org)
  • In a prostate biopsy, doctors have traditionally taken eight to 12 needle biopsies along the prostate, in a random sample. (hopkinsmedicine.org)
  • Due to imaging improvements, doctors can now use MRI imaging technology before a biopsy to look for areas in the prostate that are suspicious for cancer. (hopkinsmedicine.org)
  • Doctors suspect Reye syndrome in children who suddenly develop changes in mental condition and vomiting. (msdmanuals.com)
  • Biopsy of the Liver Doctors can obtain a sample of liver tissue during exploratory surgery, but more often they obtain a sample by inserting a hollow needle through the person's skin and into the liver. (msdmanuals.com)
  • This test can also help your doctor determine whether a biopsy is necessary. (hopkinsmedicine.org)
  • No specific blood test can confirm a PsA diagnosis. (mypsoriasisteam.com)
  • The test may be repeated once or twice to confirm the results. (cdc.gov)
  • 9. Female subjects of nonchildbearing potential female (e.g., having congenital or acquired condition that prevents childbearing, having history of hysterectomy and-or bilateral oophorectomy, bilateral salpingectomy or bilateral tubal ligation or occlusion, or postmenopausal, OR childbearing potential who have a negative urine or serum pregnancy test within 3 days prior to receiving the first dose of study treatment. (who.int)
  • If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. (who.int)
  • Biopsies can often be completed in the doctor's office and are used to help determine the next best steps in diagnosis and treatment. (tanner.org)
  • sinus tract also confirmed a granulomatous lesion and there was no sign of malignancy. (who.int)
  • This is a rare lesion, and its true nature has not yet been clarified, with doubt remaining on whether it is a hyperplasic or hamartomatous condition. (bvsalud.org)
  • Your doctor will order an X-ray to help confirm the diagnosis. (orthoinfo.org)
  • Your doctor will take three small skin samples (called biopsies) from behind your ears and send them to the manufacturer. (drugs.com)
  • Your doctor will check and confirm if it came from your own skin. (drugs.com)
  • If a diagnosis of mantle cell lymphoma is confirmed, the doctor will determine what stage the cancer is in. (moffitt.org)
  • Your doctor may arrange some tests to find out if the nephrotic syndrome is caused by FSGS or IgM nephropathy - children with these conditions need further treatment. (infokid.org.uk)
  • If your doctor thinks that your child has FSGS or IgM nephropathy, he or she may be referred to a paediatric renal unit, a special unit for children with kidney conditions, which may be in a different hospital to your own. (infokid.org.uk)
  • Then the doctor puts a long needle through your skin between two of your lower ribs on your right side. (healthplan.org)
  • After the doctor gets the sample, he or she removes the needle and puts a bandage on the spot where the needle went in. (healthplan.org)
  • For complete diagnosis your doctor may perform a physical exam, low-dose computed tomography (LDCT) or sputum cytology to help diagnose your condition. (drjyotiranjanswain.com)
  • A newly diagnosed adnexal mass was confirmed by imaging (computed tomography, ultrasonography, or magnetic resonance imaging) prior to enrollment. (mayo.edu)
  • For a biopsy, a small tissue sample is removed and analyzed under a microscope to determine whether cancer cells are present. (moffitt.org)
  • A needle is used to take a sample of tissue from the liver. (denverhealth.org)
  • The needle goes into your liver to take the tissue sample. (healthplan.org)
  • The same can be accomplished with a core biopsy, in which a wide needle is used to remove the sample. (healthline.com)
  • In some instances, a muscle biopsy, which involves taking a small sample of muscle under local anesthesia, is performed. (mda.org)
  • In some cases, genetic tests (performed on a blood sample) can confirm the diagnosis (see Causes/Inheritance ). (mda.org)
  • Medications are used to control the inflammation in the brain, seizures, fever , or other conditions that may be present. (childrenshospital.org)
  • Patients with MPN may have moderate or severe anemia, a condition where there are not enough red blood cells to carry oxygen. (ucsfhealth.org)
  • Adrenal nodules are often discovered accidentally when patients have abdominal CT scans or MRIs for other conditions. (mhs.net)
  • Skin cancer, history of-Use of Laviv® is not recommended in patients with these conditions. (drugs.com)
  • Skin infections of the face-Should not be used in patients with these conditions. (drugs.com)
  • BACKGROUND: Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) is a condition that impacts the patients' brain with SLE, and cognitive dysfunction (CD) is the most common manifestation. (bvsalud.org)
  • The abdominal difficult and needs a high suspicion index, computer tomography (CT) scan with oral especially in patients with perianal involve- and IV contrast confirmed the para-aor- ment as the first presentation of tuberculo- tic and mesenteric adenopathies, and mild sis. (who.int)
  • The percentage of unsatisfactory smears in breast cytology appears to behigher in benign conditions compared to malignant ones.The aim of this study is to determine the effectiveness of cytopathology in the diagnosis of benign breast disease in our institution.Methodology: This is a prospective study of 96 patients with benign breast disease seen during the study period. (bvsalud.org)
  • Elle était rétrospective et prospective incluant tous les patients dont l'étude cytologique des liquides d'ascitea mis en évidence des cellules malignes. (bvsalud.org)
  • This report describes the demographic characteristics of confirmed and likely jALS cases in a large cohort of ALS patients ascertained in the National ALS Registry (Registry) from 2010 to 2018. (cdc.gov)
  • We summarize here 4 cases of tubercu- raphy results, the patient underwent biopsy lous mastitis presenting to the National Re- with a suspicion of malignancy. (who.int)
  • Together, these tests confirmed her breast cancer diagnosis. (bestlifeonline.com)
  • The diagnosis is based on sudden changes in the child's mental condition and on the results of blood tests and a liver biopsy. (msdmanuals.com)
  • Imaging Tests Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination. (msdmanuals.com)
  • However, NAFLD can be asymptomatic, so additional tests may be necessary to confirm the diagnosis. (peptiko.gr)
  • She developed a secondary condition following her treatment. (bestlifeonline.com)
  • Unfortunately, five years after undergoing extensive chemotherapy treatment, Roberts developed a secondary condition known as myelodysplastic syndromes (MDS), which is also considered a form of cancer. (bestlifeonline.com)
  • If the patient's general condition permits, anthracycline-based chemotherapy can be used for the treatment of stage 4 pleomorphic liposarcoma. (biomedcentral.com)
  • Gastrectomy, or surgical removal of the stomach, is the only treatment for gastric cancer that can cure the condition. (memorialhermann.org)
  • While it is a useful diagnostic tool, it is not the exclusive option for the treatment of diseases or conditions. (attorneyatlaw.com)
  • Genetic testing of genes associated with RTPS may confirm diagnosis and help guide treatment options. (goldenhelix.com)
  • Biopsy and culture confirmed that he was suffering from an NTM infection, and the tattoo artist reported that other clients had complained of similar reactions. (cdc.gov)
  • Through the use of intra-operative parathyroid hormone testing, Dr. Bimston can confirm the results of the operation before the patient leaves the operating room. (mhs.net)
  • It can take several days to get the results of the biopsy. (healthplan.org)
  • He said radiation would not have stopped the spread of this type of cancer, and by the time it was large enough to detect with a mammogram I would be in a far more serious condition. (selfgrowth.com)
  • If a diagnosis of cancer is confirmed, specialized thyroid surgery will be necessary. (mhs.net)
  • The primary purpode of this study is to determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the InterVenn Ovarian Cancer Liquid Biopsy among women with ovarian adnexal mass for which a surgery is planned. (mayo.edu)
  • Surgery is never done to treat this condition. (medlineplus.gov)
  • The patient had a history of hepatitis C virus (HCV) carrier, but no other major preexisting medical conditions were noted. (biomedcentral.com)
  • Select a topic below for related health information or search for a topic in the search bar for more information on other medical conditions. (healthplan.org)
  • She next sought medical attention for her condition in August of 1986 - some fourteen months later. (iptq.com)
  • If your condition has been diagnosed as ALS outside a major medical center or without extensive testing, it may be worth getting a second opinion. (mda.org)
  • When the immune system has been weakened by some other medical condition. (medifee.com)
  • Several conditions are also more common in people with celiac disease. (rochester.edu)
  • If you are at low risk for celiac disease and have a negative result, it likely means you don't have the condition. (rochester.edu)
  • This condition is basically considered a children's disease, although it can occur at any age. (childrenshospital.org)
  • Both ALT and AST levels show liver damage and can help confirm liver disease. (healthplan.org)
  • See whether other liver conditions, such as hemochromatosis and Wilson's disease , are present. (healthplan.org)
  • Certain factors may increase your risk of developing the disease, including some inherited conditions. (healthline.com)
  • Formerly called fibrocystic breast disease, this common condition is, in fact, not a disease. (medlineplus.gov)
  • A biopsy is when tissue samples are removed from your body and checked under a microscope for signs of damage or disease. (stillwater-medical.org)
  • Nonalcoholic fatty liver disease (NAFLD) is a condition in which excess fat accumulates in the liver of people who drink little or no alcohol. (peptiko.gr)
  • Non-alcoholic fatty liver disease (NAFLD) is a condition that can affect anyone, but certain factors increase your risk. (peptiko.gr)
  • Chronic kidney disease (CKD) is a condition in which the kidneys become damaged over time and cannot filter blood as well as they should. (cdc.gov)
  • Disease over a 5-year period at Shaheed from biopsy. (who.int)
  • After that, the patient's next step is diagnostic testing, which will likely include a biopsy. (moffitt.org)
  • Risk factors for infections of the spine involve conditions that weaken the patient's immune system, such conditions include diabetes mellitus, use of immunosuppressant medications, cancer, HIV/AIDS, malnutrition, history of an organ transplant and intravenous drug abuse. (wheelessonline.com)
  • When cirrhosis of the liver or a cancer is suspected, the biopsy may be done during a laparoscopy . (healthplan.org)
  • PSA, a protein produced by the prostate, tends to be elevated in men with prostate cancer or other noncancerous prostate conditions. (tanner.org)
  • Your healthcare team may do a biopsy to rule out or confirm cancer or another condition. (stillwater-medical.org)
  • Introduction : en Côte d'Ivoire comme dans le monde, le cancer du col de l'utérus occupe la deuxième place des cancers féminins après celui du sein. (bvsalud.org)
  • Subjects who have a histologically confirmed or cytologically confirmed diagnosis of stage IV (M1a, M1b, or M1c of American Joint Committee on Cancer 8th edition) nonsquamous NSCLC. (who.int)
  • Abdominal taps may also be used to diagnose conditions such as peritonitis or bleeding caused by abdominal trauma. (attorneyatlaw.com)
  • Amniocentesis can be used to diagnose certain fetal or uterine conditions such as blood type incompatibility between the fetus and mother, infections, genetic abnormalities, and deficient or excessive amounts of amniotic fluid. (attorneyatlaw.com)
  • The only way to be sure that a thyroid nodule is not cancerous is to see an endocrinologist or an endocrine surgeon, who may perform a biopsy in the office. (mhs.net)
  • The tumors may also be associated with overactivity of the parathyroid glands - a condition known as hyperparathyroidism. (orthoinfo.org)
  • The extent of the problem depends on the severity of the condition and the presence of other organ system problems that could affect the child. (childrenshospital.org)
  • Biopsies are sometimes used to help confirm a diagnosis of PsA or rule out other conditions. (mypsoriasisteam.com)
  • Then, lab work and a colon biopsy can help confirm if they have MMIHS. (childrens.com)
  • Toxic hepatitis is a condition in which your liver becomes inflamed due to exposure to certain toxins. (cura4u.com)
  • A liver biopsy can find certain liver diseases (such as cirrhosis), infections (such as hepatitis), and liver tumors. (healthplan.org)
  • Needle biopsy from the liver was performed and the result was consist- ent with chronic granulomatous hepatitis. (who.int)
  • If these exams are normal but your provider still has concerns about a lump, a biopsy may be performed. (medlineplus.gov)
  • It can take years for fibrosis or cirrhosis to develop, so it is important to make lifestyle changes to prevent the condition from getting worse. (peptiko.gr)
  • If the physical appearance of the foot is not obvious, a biopsy of the foot pad should confirm the condition, thus leaving no question. (vin.com)
  • Figure VIII.1 - Biopsy Report (review of original slides), June 20, 1985. (iptq.com)