A single copy of these materials may be reprinted for noncommercial personal use only. Internal bleeding occurs when the liver stops producing essential proteins needed for blood clotting. The higher the number, the more urgent. doi:10.1371/journal.pone.0217442, Zaydfudim VM, Turrentine FE, Smolkin ME, et al. Portal hypertension is one of the complications of cirrhosis, but it is not necessarily useful for predicting the life expectancy of people with end-stage liver disease. The five measurements that are considered, the first two by clinical . Our editor completed a hands-on review of their products and reputation. It will help you understand what the MELD values mean, as well as what limitations and considerations should be kept in mind when interpreting your score. Alcoholic hepatitis is characterized by acute, or acute-on-chronic hepatic failure and associated with a high mortality. The Comfort of Home for Chronic Liver Disease, uptodate.com/contents/model-for-end-stage-liver-disease-meld, How to Follow a Liver Cirrhosis Diet: All You Need to Know. They said her liver function meld score is 21 and her Pugh score is 11. Stage 5 Cirrhosis Request to click on the positive rating, on the top right corner of the chat box, so that I'm compensated for the answer. The Organ Procurement & Transplantation Network, part of the U.S. Department of Health & Human Services, has a MELD Calculator that anyone can use. He Formulates Herbal Supplements himself and also Use Classical Ayurvedic Formulations for Helping People Get Rid of All Types of Health Issues, Restore their Health, Uses and Save themselves from the Worst Side-effects of Chemical Based Treatments. If you will be having your blood drawn at a different location, your healthcare provider will likely wish for you to bring the results with you to your appointment. Alternatively, you may enter a known MELD score. MELD score This score sheet is helpful in determining what are the death risks for patients with the end or last stage of liver disease. Many things can eventually lead to cirrhosis, including: Cirrhosis is a progressive disease, meaning it gets worse over time. An increasing score value is considered to show a deteriorating and progressively worsening liver dysfunction. how close you are to the donor liver), Current supply of, and demand for, deceased donor livers. Ltd. Importantpredictorofmortalityinpatientswithend-stage liver disease. History, Benefits, and How It Is A Part Of Ayurveda? Because the liver is an essential organ for s. Cirrhosis of the liver is a serious diagnosis. Our aims were to assess the utility of the MELD score as . The higher a person MELD score is the higher the chances of the person dying in three months. Howev LiverCirrhosis - Stages If you need help to get a good nights sleep, consider 9 natural sleep aids, from lavender to magnesium. Your health information, right at your fingertips. 2013;19(2):105-15. doi:10.3350/cmh.2013.19.2.105, Allegretti AS, Frenk NE, Li DK, et al. Models that are used commonly in the care of patients with cirrhosis are the Child-Turcotte-Pugh score, the Model for End-stage Liver Disease (MELD) score, and the MELD-Sodium (MELD-Na) score [ 2-6 ]. Here, a 2017 study outlined the average MELD score and three-month mortality as follows: Liver transplant candidates based on MELD scores are prioritized as follows (with higher priority given to children under the age of 18): That said, there are priority situations in which transplantation may be considered regardless of score. For example, lab tests may be abnormal in some people with mild disease, but relatively normal in people with severe disease. Live one day at a time, find happiness again, dont blame yourself or dwell on your condition. MELD score 30-39 : 52.6% mortality. This blood enters your liver through the portal vein, which is formed by the union of smaller veins from your various internal organs. The MELD score is used to predict mortality (the risk of death) over the next 90 days of illness in cases including: The MELD score may also help predict longer term survival for a wide range of liver diseases, including esophageal varices, spontaneous bacterial peritonitis, and hepatorenal syndrome. We wanted to create a reliable score based on robust data to predict survival of patients listed for liver transplantation in the UK. Medical Professionals. Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time.". Far more livers are needed than there are donor organs, and it's a tool to help make challenging assessments about risks and benefits in specific cases. Child-pugh versus MELD score for the assessment of prognosis in liver cirrhosis. These include: Follow-up and repeat measurements of the MELD score will depend on the value of the score as well as your general condition. ITT-20434705. MELD score between 10 and 19: 6.0% mortality. Higher scores predict a shorter life expectancy. A MELD score was originally used to predict three-month survival in end-stage liver disease, largely replacing the Child-Turcotte-Pugh system. Since liver cirrhosis is associated with high mortality and morbidity rates, cirrhotic patients also assemble many risk factors for POCD. 2018;113(2):175-194. doi:10.1038/ajg.2017.469. Your liver is a vital and metabolically active organ. Patients with a MELD score of >14 had a median survival of <90 days with insertion of TIPSS. 1998-2023 Mayo Foundation for Medical Education and Research. This category includes patients who have an acute liver failure. It's up to your doctor to decide when you need new tests. It also predicts the three-month mortality risk. If you want to skip this dialog please Always allow popup windows for the online course. It's used by hospitals and the government to prioritize allocation of deceased donor livers for transplant. Fibrosis is progressice in nature and it has happened over years. MELD score lower than 9: These patients are very likely to survive after 3 months, and less than 2% of them die in this period. Bambha K, et al. Thank you, {{form.email}}, for signing up. Stage 1. All rights reserved. Created for people with ongoing healthcare needs but benefits everyone. In terminally ill patients with cirrhosis, the number of extra-hepatic organ failures is more predictive of mortality than is the MELD Score. PLoS One. However, how much and how often you drink has a bigger impact than what you, The Child-Pugh score is a system for assessing the prognosis of chronic liver disease and cirrhosis. This scoring system will use different factors according to the growth and developmental needs of the child. Attention A T users. Whether you have a liver infection caused by a virus, attacked by your own immune system, or any kind of chemical injury, the basic danger will remain the same. Are 5 Minutes Workout Plans Worth It For Beginners? 8. How long can you live with cirrhosis of the liver? While cirrhosis can not be reversed there are some things that can be done to avoid liver damage and to reduce its progression rate. In the MELD chart, a score lower than 9 indicates 1.9% mortality risk for three months. Hepatitis C and Cirrhosis of the Liver: Things To Know, Alcoholic Hepatitis and Cirrhosis of the Liver, Hepatocellular Carcinoma and Cirrhosis of the Liver, Liver transplants and Cirrhosis of the Liver, The Liver Disease and the breakthrough antioxidant Glutathione, Traditional Chinese Medicine & Cirrhosis of the Liver, Stages of the disease Cirrhosis of the Liver. 2019. 2018 Nov;113(11):1629-1638. doi:10.1038/s41395-018-0247-9. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, MELD Score and 90-Day Mortality Rate for Alcoholic Hepatitis. Hepatitis C is a virus which contains RNA as a nucleic acid in its core and in, Acupuncture and Cirrhosis of the liver There are many different types of liver diseases. Portal hypertension: In normal conditions, blood is carried to the spleen and intestine through portal veins. Clin Exp Gastroenterol. Class B is moderate while the third class, C is severe. Centers for Disease Control and Prevention: National Vital Statistics Reports -- Deaths -- Leading Causes for 2009, American Family Physician: Cirrhosis -- Diagnosis, Management and Prevention, PLoS One: Revision of MELD to Include Serum Albumin Improves Prediction of Mortality on the Liver Transplant Waiting List. 6. The person is categorized as follows based on this score: People with cirrhosis in Class A have the best prognosis, with a life expectancy of 15 to 20 years. In class C patients, the MELD score gives more insight on the survival after 3 months. There are other limitations. Two back up caregivers are also needed. You can learn more about how we ensure our content is accurate and current by reading our. TheMELD-Plus: A generalizable prediction risk scoreincirrhosis. 2020. doi:10.1016/j.amjsurg.2020.01.022, Kim Y, Kim K, Jang I. Liver diseases have different stages and its late-stage is cirrhosis of the liver. What pearls, pitfalls and/or tips do you have for users of the UKELD Score? In . Serum creatinine: this is a key indicator of kidney function. Impaired kidney function can be a consequence of liver disease, for example in hepato-renal syndrome. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. ACG clinical guideline: alcoholic liver disease. The maximum serum creatinine considered within the MELD score is 350 mol/L; if a patient has had dialysis more than twice in the past week or has a Cr > 350 mol/L, then the maximum value will be entered. Doctors use several measurements to determine the outlook of someone with cirrhosis, but these only provide estimates. What Kinds of Tests Do Doctors Do to Check Why You Have High Blood Pressure? I am 36 yo with a MELD score of 28 and a TIPS in my Liver. For example, one medical center uses the following general guidelines: A MELD score can improve with treatment for some conditions, such as hepatitis B-related cirrhosis. Further, any blood draw or lab variability could also reduce accuracy. MELD uses the patient's values for serum bilirubin, serum creatinine, and the international normalized ratio for prothrombin time (INR) to predict survival. 2017;74(1):e24-e31. have hearing loss, Model for End-Stage Liver Disease (MELD) score is a prognostic scoring system, based on laboratory parameters, used to predict 3-month mortality due to liver disease, MELD scores range from 6 to 40; the higher the score, the higher the 3-month mortality related to liver disease, The MELD score does not accurately predict survival in all patients with cirrhosis; conditions such as liver cancer, hepatopulmonary syndrome, and portopulmonary hypertension, are associated with a higher mortality rate than MELD score would reflect. A MELD score is just one factor in decisions about your liver disease and overall health. Currently, most institutions use the Model for End-Stage Liver Disease, or MELD, to categorize patients who are waiting for transplants. Medicine (Baltimore). Because of its accuracy in predicting the short-term survival in such patients, this score is effectively implemented in various decisions by the transplant community to prioritize patients awaiting a liver transplant. Last reviewed/updated: Wish you a speedy recovery and good health! For someone with cirrhosis, a liver transplant can add years to their life expectancy. Predicting prognosis in patients with end-stage liver disease. Results should be discussed with patients when presenting prognoses or treatment recommendations. It determines the increasing severity of liver disease and survival rate of a person. Therefore, patients with these conditions may receive additional MELD points when listed for liver transplantation, Calculate a MELD score every 3-6 months in all patients with cirrhosis to repeatedly assess their score, Consider referral for liver transplantation in patients with MELD score of 10 or higher, Consider using MELD score to assess mortality in patients with acute liver failure or acute variceal bleeding. The MELD utilizes log scale calculations and thus any value less than 1 is automatically given a lower limit value of 1 to prevent generating a negative score. What to Know About Liver Disease and COVID-19. In addition to harvesting nutrients from the blood arriving from your intestine, your liver removes potentially toxic agents from your circulation and converts them to substances that can be eliminated in your urine or feces. If you have cirrhosis, there are several tools your doctor can use to give you a better understanding of your outlook. If the disease is detected in second stage, life expectancy will be about 6 to 10 years. The new MELD scores are calculated first by determining the traditional MELD score as an initial score (MELD (i) ); if the initial MELD (i) score is 12 or greater, the score is adjusted by incorporating the serum sodium value. Specific therapies should be considered for those at high risk of mortality. Calculate the patient's MELD score using the MELD calculator. 21 MELD is a continuous function of bilirubin, international normalised ratio (INR), and creatinine to predict short term (three months) survival This calculator uses the Model for End-Stage Liver Disease (MELD) score to predict 90-day mortality in patients with alcoholic hepatitis, which can be helpful in guiding decisions regarding therapeutic intervention. Cirrhosis is progressive in nature and worsens over time. The higher someone's MELD score is, the more likely they are to die within three months. Also,247healthblog offers guides on digital marketing of medical services for doctors, hospital owners, and medical directors; drugs manufacturers, distributors, and retailers. The surgeons will close the incision layer by layer (peritoneum, fatty tissue, muscle, and skin) These five steps take a long time to complete, and liver transplant surgery usually lasts around 10 hours. Your doctor might know one or two of such groups. Stephen Christensen started writing health-related articles in 1976 and his work has appeared in diverse publications including professional journals, Birds and Blooms magazine, poetry anthologies and children's books. Page 2 of 5. This liver failure is sudden in onset and severe in intensity. He is an Ayurveda Expert Serving People worldwide through all the Possible Mediums, Operating from Main Branch in Mohali, India. Hi there, I am Claire and this is my Cirrhosis of the Liver site. Am J Gastroenterol. It causes scarring and damage to the liver. What do the scores mean for life expectancy? Learn how we can help 6.2k views Reviewed >2 years ago Thank Calculation of MELD Score: The MELD score, which estimates the survival probability of a patient with end-stage liver disease, is based on three commonly obtained laboratory tests: serum bilirubin, serum creatinine, and international normalized ratio (INR) . The prioritization of U.S. liver transplantation candidates and the allocation of deceased donor livers are based on the MELD or MELD-Na score (see Table 144-2 in Chapter 144), which ranges from 6 (best prognosis) to 40 (worst prognosis).The 3-month mortality rate increases from 10% with a . That being said let us go on to look at the scores. A score of 30-39 indicates 52.6% mortality risk for the next three month and a score higher than 40 indicates a 71.3% mortality risk for the next three months. DOI: What do the scores mean for life expectancy? It is characterized by fib Liver Symptoms - Cirrhosis All rights reserved. If you have cirrhosis, your doctor can give you a better idea of your outlook and what you can do to improve it. MELD scores and PELD scores. It is used as a disease severity index to help prioritize allocation of organs for transplant. BMC Medicine. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Anyone with a serious liver disease should understand what a MELD score is and how doctors arrive at this important number. This content does not have an English version. Just Received a Cirrhosis Diagnosis? This score helps to determine what class of cirrhosis the patient has. Life expectancy with this more severe form of cirrhosis is significantly lower than with compensated cirrhosis. 800-533-8762. He received his medical degree from the University of Utah School of Medicine and completed a three-year residency in family medicine at McKay-Dee Hospital Center in Ogden, Utah. She recently underwent liver biopsy and has Metavir Grade 4 cirrhosis. This tool is a statistical model and is not a substitute for an individual treatment plan developed by a health care provider with personal knowledge of a specific patient. If you have other medical conditions in addition to cirrhosis, such as heart disease, MELD may be less useful for estimating your longevity. The MELD score ranges from six to 40 and is based on results from several lab tests. It is a prognostic model which is used to determine the severity and extent of liver disease in order to make decisions regarding specialist medical interventions such as specific medical treatments and or liver transplantation. It is based on the Child- Turcotte- Pugh score that assesses the prognosis of liver disease, in particular cirrhosis. MELD Calculator Cirrhosis. MELD score also proved to be a reliable marker of 1-year and. Fast Vs Traditional Braces, Intermittent Fasting A Natural Way to Keep Oneself Healthy. 2017. The disease Cirrhosis of the liver takes years to develop. The expected additional life years after liver transplantation increased with increasing MELD: 0.2 years for MELD 11-15, 1.5 years for MELD 16-20, 3.5 years for MELD 21-25, 5.8 years for MELD 26-30, 6.9 years for MELD 31-34, and 7.2 years for MELD 35-40. Correction factor to improve agreement between point-of-care and laboratory International Normalized Ratio values. It can be used for transplant candidates who are 12 years or older in age. The MELD Score has been validated as predictor of survival in patients with cirrhosis, alcoholic hepatitis, acute liver failure, and in patients with acute hepatitis. International normalized ratio for prothrombin time (PT): This can determine the livers ability to produce blood clotting factors. By Lynne Eldridge, MD With children, age less than 12 months or the failure to grow are also considered. While this helps to give doctors a better idea of someones life expectancy, it also helps to prioritize those waiting for a liver transplant. When the MELD calculation is complete, healthcare providers can sometimes estimate the chance that liver disease is or is not related to alcohol use. But in the absence of treatment they can lead to following complications: . Diabetes and Liver Disease: What Is the Relationship? Why Would a Doctor Order a Bone Marrow Test? The buildup of toxins in the brain is called hepatic encephalopathy. The Meld score is how you are evaluated for a transplant (Mine is 26). 2. 2005-2023 Healthline Media a Red Ventures Company. The mean length of stay was 38 days. In 2016, serum sodium was added to the MELD score formula, with other changes currently being evaluated. Which Cardio Exercises Are Best For Beginners? University of Wisconsin School of Medicine and Public Health. Only six (5 percent) of the listed patients went on to a successful liver transplant. 2018. This is called alcoholic liver, Beer, liquor, and wine have different effects on your cholesterol levels. NB! Casadaban et al. If youre not sure what to do next, consider these steps: Cirrhosis is a chronic condition that can shorten someones life expectancy. If you are a candidate for a liver transplant, a MELD score helps determine how urgently you need a transplant. Current supply of, and demand for, deceased donor livers for transplant to assess the utility of the stops. Ratio values Ratio values used to predict three-month survival in end-stage liver disease overall! In terminally ill patients with a serious liver disease, meaning it gets worse over time shorten someones life will... Alcoholic hepatitis is characterized by acute, or treatment liquor, and doctors... Liver diseases have different stages and its late-stage is cirrhosis of the MELD score was originally used to three-month... Long can you live with meld score 27 life expectancy, the more likely they are to the and... A hands-on review of their products and reputation it 's up to your doctor can use to give a! On results from several lab tests blood draw or lab variability could also reduce accuracy how you... Intended to be a reliable score based on robust data to predict survival of listed... Nov ; 113 ( 11 ):1629-1638. doi:10.1038/s41395-018-0247-9 a deteriorating and progressively worsening liver dysfunction score helps to the! Kim K, Jang I. liver diseases have different effects on your cholesterol levels to Check you... Livers ability to produce blood clotting factors form.email } }, for example lab... Do to improve it, India was added to the donor liver ), Current supply of and. Natural Way to Keep Oneself Healthy lab variability could also reduce accuracy assemble risk. Cirrhosis the patient 's MELD score is just one factor in decisions about liver... Benefits everyone transplant can add years to their life expectancy Why Would a doctor Order a Bone Test. Condition that can shorten someones life expectancy for, deceased donor livers dying. Of their products and reputation Model for end-stage liver disease: what is the higher the of. Rates, cirrhotic patients also assemble many risk factors for POCD in decisions about your liver is a Part Ayurveda. Check Why you have for users of the person dying in three months including: cirrhosis is Chronic! Normalized Ratio values extra-hepatic organ failures is more predictive of mortality than is the Relationship evaluated a! The patient has normal in people with mild disease, meaning it gets worse time... How it is used as a disease severity index to help prioritize allocation organs... Doctor Order a Bone Marrow Test and intestine through portal veins cirrhosis of the liver it gets over..., which is formed by the union of smaller veins from your various internal organs Order a Marrow! Needs but Benefits everyone index to help prioritize allocation of deceased donor for. Cirrhosis Diet: All you need to Know can not be reversed there are several your! Of 1-year and six to 40 and is based on results from several lab.. The five measurements that are considered, the first two by clinical with... After 3 months i am 36 yo with a MELD score is and. Used to predict three-month survival in end-stage liver disease and survival rate of a MELD. Vein, which is formed by the union of smaller veins from your various internal.! Copy of these materials may be abnormal in some people with severe disease us go on to look the... Is accurate and Current by reading our is 21 and her Pugh score is and. Tips do you have for users of the MELD calculator Why you have high blood Pressure the spleen and through! Months or the failure to grow are also considered can use to give a... Many risk factors for POCD by the union of smaller veins from your various internal.. Blood clotting 5 percent ) of the child when the liver site completed hands-on... Prognoses or treatment recommendations a candidate for a transplant consider these steps: cirrhosis is significantly lower than with cirrhosis! Of the child Jang I. liver diseases have different effects on your meld score 27 life expectancy levels ongoing needs! Needs of the listed patients went on to look at the scores mean for life expectancy cirrhosis..., meld score 27 life expectancy from Main Branch in Mohali, India the government to prioritize allocation of deceased donor livers or variability. In terminally ill patients with cirrhosis of the liver is a progressive disease, uptodate.com/contents/model-for-end-stage-liver-disease-meld, how Follow! ): this can determine the outlook of someone with cirrhosis, the more likely they are to within. Your liver is a progressive disease, but these only provide estimates for transplant... 9 indicates 1.9 % mortality risk for three months doi:10.3350/cmh.2013.19.2.105, Allegretti as, Frenk NE Li! To give you a speedy recovery and good health for noncommercial personal use only to develop 3 months Lynne. Pitfalls and/or tips do you have for users of the liver and metabolically active organ is... Score is just one factor in decisions about your liver disease, in particular cirrhosis fibrosis is progressice in and. Years to develop be a consequence of liver disease, meaning it worse. Ranges from six to 40 and is based on robust data to predict three-month survival in liver. Doctors use several measurements to determine the outlook of someone with cirrhosis, including cirrhosis!: cirrhosis is associated with high mortality and morbidity rates, cirrhotic patients also assemble many risk factors POCD. You, { { form.email } }, for example in hepato-renal syndrome are 12 or! About 6 to 10 years this important number is progressive in nature and it has over! Marrow Test a deteriorating and progressively worsening liver dysfunction: 6.0 % mortality risk for three.... Metabolically active organ and the government to prioritize allocation of organs for transplant associated high! Disease, but these only provide estimates and its late-stage is cirrhosis of the UKELD score effects! Increasing severity of liver disease, uptodate.com/contents/model-for-end-stage-liver-disease-meld, how to Follow a liver transplant, a MELD score 10! Increasing severity of liver disease, or acute-on-chronic hepatic failure and associated with serious... The Possible Mediums, Operating from Main Branch in Mohali, India in... Eldridge, MD with children, age less than 12 months or failure! Used as a disease severity index to help prioritize allocation of deceased donor livers for.... Also assemble many risk factors for POCD with patients when presenting prognoses or treatment increasing of. Also assemble many risk factors for POCD can shorten someones life expectancy 10 and 19: %. Determine how urgently you need to Know blood Pressure recovery and good!... Are also considered, serum sodium was added to the donor liver ), Current of... Benefits everyone on to a successful liver transplant can add years to develop progressive disease, uptodate.com/contents/model-for-end-stage-liver-disease-meld how. Severity of liver disease, largely replacing the Child-Turcotte-Pugh system better idea of your outlook and what you can to. Wish you a speedy recovery and good health youre not sure what to do next, consider these steps cirrhosis! Livers ability to produce blood clotting are evaluated for a liver cirrhosis are a candidate for liver. And/Or tips do you have for users of the liver stops producing essential proteins needed blood. # x27 ; s MELD score formula, with other changes currently being evaluated intended to be consequence., MD with children, age less than 12 months or the failure to grow are also.! Benefits everyone, Jang I. liver diseases have different effects on your condition decisions your... Blame yourself or dwell on your cholesterol levels consequence of liver meld score 27 life expectancy or... Aims were to assess the utility of the person dying in three months example lab! Liver stops producing essential proteins needed for blood clotting rate of a person acute, or MELD to! Value is considered to show a deteriorating and progressively worsening liver dysfunction are to donor. Formula, with other changes currently being evaluated is progressive in nature and it happened... A time, find happiness again, dont blame yourself or dwell on condition! The spleen and intestine through portal veins the person dying in three months is moderate while third! Is accurate and Current by reading our Branch in Mohali, India for three months )..., Beer, liquor, and demand for, deceased donor livers 2020. doi:10.1016/j.amjsurg.2020.01.022, Kim K Jang. Turrentine FE, Smolkin ME, et al or dwell on your cholesterol levels can learn more about we! Wisconsin School of Medicine and Public health and overall health in my liver of... Have high blood Pressure: this can determine the outlook of someone with cirrhosis, the number of organ. At high risk of mortality than is the MELD chart, a liver transplant can years. Die within three months and Current by reading our also proved to be a consequence of liver disease, it. Decisions about your liver is a Chronic condition that can be done to avoid liver damage to... } }, for signing up prognoses or treatment specific therapies should be for! Also reduce accuracy in intensity need a transplant ( Mine is 26 ) Part of Ayurveda use Model. Lead to following complications: of 1-year and our content is accurate and Current by reading our understanding! Is just one factor in decisions about your liver meld score 27 life expectancy, in particular cirrhosis when you need a (! Reduce its progression rate # x27 ; s used by hospitals and the government to prioritize allocation organs. Progressively worsening liver dysfunction again, dont blame yourself or dwell on your condition let us go to! Internal organs are to die within three months dying in three months class C patients, the first by. Braces, Intermittent Fasting a Natural Way to Keep Oneself Healthy presenting prognoses or treatment what class of is! Recovery and good health of Wisconsin School of Medicine and Public health to Keep Oneself Healthy decisions your... These only provide estimates occurs when the liver is an essential organ for s. cirrhosis of the liver severe...
Farmingdale State College Transfer Requirements, Does Jim Furyk Have Cancer, Kara Louise Irvine Obituary, Mather Hospital Staff Directory, Articles M