Archives June 2024

The image shows a sign with "Pollen Season Ahead" to introduce steps you can take to prepare for seasonal allergies.

5 Steps You Can Take to Prepare for Seasonal Allergies

Allergies can affect people year-round, contributing to a series of negative symptoms and traits. You might be affected by the pollens that fly through the air during the spring. Or perhaps you are allergic to grass and deal with itching and irritation during the summertime. No matter what time of the year you deal with seasonal symptoms, you should invest in professional allergy services and take steps to prepare for seasonal allergies. 

If you feel allergy symptoms are starting to creep up on you, read on to learn steps you can take to prepare for seasonal allergies.

5 Steps You Can Take to Prepare for Seasonal Allergies

1. Learn Your Allergy Triggers

Different allergies stem from different triggers and allergens. It is important to recognize what exactly sparks your allergic reactions. For example, if you are allergic to flower pollens, stay indoors on particularly windy days. If you have multiple allergic reactions and cannot quite pinpoint the source, we encourage you to visit us for a comprehensive allergy test. 

2. Learn When Allergy Season Starts

Season allergies can occur every few months. Those with severe reactions might feel like they are always coming down with different allergy symptoms. Knowing when to expect seasonal flare-ups can help you prepare for the difficult times ahead. More importantly, knowing what to expect can help you avoid these problems altogether. 

Most people experience spring allergies, which can begin as early as February and last through the summer. Late summer and fall allergies exist as well, as the changing leaves and intense weather patterns take a toll on our bodies. Avoiding pollens, mold, dander, and other possible allergens during these peak times will keep your symptoms at bay. 

3. Equip Your Home with the Essentials

During particularly bad bouts of weather, you may want to stay indoors and avoid an allergic reaction—let alone a cold. If you are already struggling with an outbreak of allergies, these at-home essentials can help: 

  • Combine your air conditioner and dehumidifier to create a cool and dry environment, free of moisture in the air. 
  • Use designated filters and HEPA items to keep even the most microscopic of allergens out of the air in your home. 
  • Try to sweep and vacuum often to keep the area clean. 

If your allergies are very serious, you might also be prescribed medication like an inhaler or an EpiPen for use in an emergency.

4. List and Track Your Symptoms

If you are ready to get medical help for your seasonal allergy problems, you have come to the right place. When you reach out to our West Texas Health experts, we will ask you to describe the exact symptoms you are experiencing. Depending on the type of seasonal allergies you get, as well as how intense your symptoms are, there might be a specific type of treatment that works for you. 

Many allergy symptoms are similar to those of a common cold. Fever, sore throat, runny nose, congestion, coughing, watery eyes, itchiness, rash, and fatigue can all be signs that you are having an allergic reaction. 

5. Get Started with an Appropriate Treatment Plan

The longer you go without seeking appropriate care for seasonal allergies, the worse your symptoms can get. Instead of waiting for your health to deteriorate, you can get essential medical care in Abilene by reaching out to our friendly experts today. We can help you narrow down your allergy symptoms to pinpoint the exact trigger. With a combination of education and prescribed medication, you can set yourself up for an allergy-free future. Get started with us today to learn more! 

The image shows two surgeons operating on a patient and represents the most common types of reconstructive surgery.

Most Common Types of Reconstructive Surgery

At the office of Dr. Jennifer Murdock, we value the individuality of our patients from all across the world. There are so many reasons why you may be looking to get plastic surgery, and we can help you find a treatment to accommodate any of those needs. In some cases, people are looking to repair or reconstruct a part of their body that has been damaged over time. Today, your oculofacial plastic surgeon in Miami will take some time to highlight a few of the most common types of reconstructive surgery. You may find that you are an eligible candidate for one of these procedures. If any of them interest you, reach out to us to learn more about them. 

Reconstructive Breast Procedures

There are plenty of plastic surgery procedures that seek to improve the form and functionality of the breasts. Of the most common types of reconstructive surgery, breast reconstruction is possibly the most popular for both cosmetic and medical reasons. Breast reconstruction might entail a repair or a replacement of existing breast implants. Perhaps your saline implants started to leak, or an injury caused them to deform. 

You may also need to reduce the natural size of your breasts. A breast reduction is useful for anyone experiencing pain related to the size of their breasts. Sometimes, a small amount of breast tissue is removed in the process, though other patients may be looking for a more dramatic type of reconstruction. 

Facial Reconstruction

Facial reconstruction is available for people who have experienced trauma in or around the face. For example, tumor development on the face can cause leftover damage after it is removed. Facial reconstruction surgery removes damaged skin and rejuvenates the remaining skin to help you heal. 

Facial reconstruction can also strengthen the jaw, cheekbones, or mouth muscles. Your surgeon will utilize various techniques to ensure they meet your personal needs and aesthetic preferences. 

Reconstructive Hand Procedures

Reconstructive surgery offers resources to help with common hand problems, including osteoarthritis and carpal tunnel syndrome. Your hands contain many small and complex bones, which work together to complete motor functions. However, this also makes them more prone to damage and disrepair. Whether you have developed a painful condition over time or you have lost some flexibility due to an injury, you might be in the market for one of our reconstructive hand surgeries. 

Surgery to Repair Previous Surgical Results

One of the biggest reasons patients may look for reconstructive surgery with Dr. Murdock is to fix botched results from a previous reconstruction attempt. Many people find that their previous surgery results are no longer pleasing, especially as they age. Others might have dealt with injury or poor health that caused the results of their first surgery to become distorted. 

No matter what happened with your previous plastic surgery experiences, it is possible to go through much-needed repair. You deserve to be treated with a customized plan of care, covering all of your reconstruction needs on almost any part of the body. 

Why Reconstructive Surgery Matters

Many people tend to lump reconstructive surgery in with other cosmetic surgery options. A big difference that sets reconstructive surgery apart from other types of surgery is that there are medical reasons for proceeding with the procedure. While many reconstructive surgery treatments offer aesthetically pleasing results, that is not the main goal. 

Reconstruction is designed to help those dealing with physical defects, damage from diseases, or other problems with bodily development. Reconstructive surgery is also a viable option for individuals seeking gender-affirming care. Since reconstructive surgery can usually be classified into a medical category, you can work with a health insurance plan for better financial options. 

Contact Dr. Jennifer Murdock Today 

You deserve to feel good about your body, both inside and out. Reconstructive surgery comes in many forms and is readily available. Whether you have a minor issue such as wrinkling skin or sagging breasts or you need serious reconstructive repair to fix problems with arthritis, there is a surgical option available to you. The best way to get started is to contact our friendly team at Dr. Jennifer Murdock’s office and schedule a consultation. 

You can also look at our dynamic before-and-after photos to get an idea of how your reconstructive surgery results might turn out. You can read patient testimonials and see if Dr. Murdock would be a good match. Discuss your needs with us and find a long-lasting solution to repair your ailments for good!

concept for what to know ahead of your screening mammogram

What to Know Ahead of Your Screening Mammogram

Any healthcare physician will tell you about the importance of scheduling a screening mammogram regularly. This is an opportunity to assess the health of your breasts while checking for any abnormalities. These preventative measures can possibly save you from years of pain and expensive treatment. Below, we cover what to know ahead of your screening mammogram.

What to Know Ahead of Your Screening Mammogram

If you are getting a mammogram in Abilene for the first time or for the first time in a while, you are probably eager to learn more. In this article, we will discuss what to know ahead of your screening mammogram so you can be fully prepared for your appointment.

The Preparation Process

You do not need to do anything in particular before your appointment, such as fasting or taking a certain medication. But it is important that you are also mentally prepared. To help the process run more smoothly, make sure you wear clothing with a top that is easily removable. A mammogram requires you to remove all clothing above the waist.

You can bring lotion or deodorant with you to apply after the mammogram, which can provide some instant relief and comfort. However, make sure that you do not use these products before your screening. Certain products can show up as spots on mammogram results, but they will look indistinguishable from other spots, which could be a cause for concern.

During Your Appointment

If you have had a mammogram before, you should bring your records with you. This can help the doctor gauge whether or not there have been any changes since your last screening. Before you begin, you should let the doctor know whether you have implants or if you are breastfeeding. If you have trouble standing up straight and still, please let us know so we can provide you with the proper means of accessibility.

The Mammogram

You will be in a standing position during your mammogram screening. There will be two plates on which each breast will be put. Two upper plates will come down and compress your breast tissue slowly during the screening. It will feel like your breasts are being squished, which can cause some discomfort. You will feel the machine rotating a few times in order to capture images and X-rays of your breast tissue.

Your appointment will last around 45 minutes or less, but the time you will spend with your breasts in the mammogram machine is much shorter. Most screenings take just a few minutes! The machine spends about 15 seconds taking each image, and the doctor will likely take a few images of each breast.

Do Mammograms Hurt?

Some people experience pain during the mammogram screening. Most experience discomfort. A lot of people have avoided their necessary mammogram screenings in the past because they worry about the painful process.

While mammograms can be a bit painful, the sensation only lasts a few seconds at a time. We need to compress your breast tissue to get an accurate and detailed reading of your chest area, as well as to prevent radiation from reaching other parts of your body. You can take Advil or Tylenol prior to your appointment to help ease any feelings of pain.

Assessing Your Results

Once the radiologist receives your mammogram images, testing will begin. The doctor will look for any signs of abnormality, including solid masses that may or may not be cancer. Mammograms are also helpful to measure things such as breast density, fibrous tissue, calcifications, and more.

In some cases, you will receive your results on the very same day that you had your mammogram screening. You may have to wait until the next business day. However, you can usually find your results pretty fast. If you are called back for a second mammogram, do not panic – this is common and can mean a lot of different things. Your doctor may want to simply give you another screening to establish a record of your breast health.

Get in touch with your trusted Abilene gynecologists to schedule your mammogram screening today.

The image shows a gloved hand drawing correction lines on man's stomach. The image serves to represent what plastic surgery is right for men.

What Plastic Surgery is Right for Men?

Plastic surgery is most often associated with women. However, many men will choose to undergo various procedures in their lifetime. Certain procedures are more commonly selected by men when they choose to go under the knife.

Knowing which procedures are most beneficial for men rather than women can help those of the masculine persuasion pick the best ones to enhance their lifestyle and appearance. If you are a man and are thinking of undergoing plastic surgery, take a look at this guide that describes the most popular plastic surgery for men.

What Plastic Surgery is Right for Men?

Liposuction

Liposuction is a beneficial procedure for both men and women. During liposuction, a physician modifies the shape of the patient’s body through a series of body-sculpting procedures. A successful liposuction procedure has the potential to totally reformat a patient’s physique and give them a sleeker-looking appearance.

For men, liposuction can help remove stubborn pockets of fat that resist the usual diet and exercise efforts to remove body fat. It can also help adjust the overall appearance of a patient’s midsection and other areas of the body.

Liposuction can be successfully performed on several different areas of the body. The most common areas where it is performed include the following target zones:

  • Back
  • Bust
  • Arms
  • Neck
  • Abdomen
  • Beneath the chin
  • Buttocks

Eyelid Surgery

Eyelid surgery is another type of plastic surgery that has become popular with men. There are many different types of eyelid surgery, each of which has different results.

Eyelid surgery has the potential to drastically improve the appearance of the area surrounding the eyelids and the other sections of the face that are impacted by adjusting the skin surrounding the eyelids.

Eyelid surgery can also be performed for medical reasons, such as to prevent skin from drooping over the eyes. This condition is known as ptosis and can interfere heavily with a patient’s ability to perform day-to-day activities. A successful eyelid surgery can eliminate ptosis and restore vision.

Nose Surgery

Nose surgery, also known as rhinoplasty, is also a popular type of plastic surgery for men. Rhinoplasty can adjust the appearance of one’s nose, which is generally considered the central feature of a person’s facial appearance.

Rhinoplasties are also performed quite frequently for medical reasons, such as to rectify a deviated septum. Occasionally, rhinoplasty is performed for both aesthetic and medical reasons.

Male Breast Reduction

Studies have shown that male breast enlargement is a phenomenon on the rise among men worldwide. Given this fact, male breast reduction has become a considerably more popular procedure in the past few decades.

Some medical professionals suspect that this rise in male breast size has come in conjunction with the rise in obesity in the last few years. The likelihood of a man seeking this procedure increases as he ages, with many of the patients who come seeking this treatment being middle-aged or elderly.

Male breast reduction has the potential to improve one’s appearance and increase self-confidence. You can discuss with your doctor whether this type of procedure would benefit you and your overall physique.

Things to Consider About Plastic Surgery

All cosmetic surgeries have the potential to be very taxing on the body. Following this, it is beneficial to keep realistic expectations and consider your overall health profile before you pursue treatment. The following elements should be taken into consideration before proceeding with plastic surgery.

  • Understand the risks involved with your procedure.
  • Be realistic about the outcome of your surgery.
  • Cease drinking and smoking for a few weeks prior to surgery.
  • Practice good physical habits ahead of your surgery.
  • Seek advice about your elective surgery risks if you consider yourself at risk.
  • Discuss with your doctor if you’re taking medication, are obese, or have serious chronic health conditions.

You and your doctor can discuss whether you meet the criteria for surgical treatment.

The Best Surgeon in Beverly Hills

Beverly Hills Plastic Surgery, Inc. is one of the best resources available for those looking to improve their quality of life and appearance through plastic surgery. If you are wondering what plastic surgery is right for you or the men in your life, contact L.A.’s leading plastic surgeon today to set up an appointment.

The image shows a woman preparing for rhinoplasty and begs the question "what nose shape is right for me?"

What Nose Shape is Right for Me?

A nose job, or a rhinoplasty as it is known in the medical community, is a popular plastic surgery procedure that can alter the appearance of one’s nose. This type of procedure is performed for both aesthetic and medical reasons and in both cases, the right nose shape can have a major impact on one’s overall quality of life.

However, many patients are unaware that there are many different options for rhinoplasty and many different shapes to choose from for interested patients. Knowing the types of shapes can help a patient be more satisfied with their results.

If you are interested in undergoing rhinoplasty, this guide to choosing the right shape for your procedure will help.

What Occurs During a Rhinoplasty?

A rhinoplasty is a type of surgery designed to alter the appearance of one’s nose. Sometimes, this procedure is performed with explicit medical intent, such as rectifying a patient’s deviated septum.

A rhinoplasty can also help patients with various obstructive breathing problems, which have the potential to very significantly impact one’s quality of life. In these situations, rhinoplasty is considered a medical asset.

However, many individuals choose to get rhinoplasty for aesthetic reasons. Since the nose is a central feature of the face, it can have a large impact on how an individual is perceived and, in turn, how they feel about themselves.

The Different Types of Rhinoplasty

There are several types of rhinoplasty, each one designed to address a specific set of issues. Knowing the difference between these procedures can help you select the right one for your situation.

Closed Rhinoplasty

This type of rhinoplasty is considered to be less invasive than the other versions of this procedure. Its non-invasive quality may be helpful to those who struggle with invasive surgery.

Open Rhinoplasty

In this type of rhinoplasty, the surgeon makes incisions in the skin between the nostrils. The skin is then gently lifted away to give the physician access to the bone and cartilage underneath. This is the most commonly requested type of rhinoplasty.

Revision Rhinoplasty

This type of rhinoplasty is utilized when a patient is unsatisfied with the results of an already completed rhinoplasty. If this is the case with your results, you can consult with your physician to discuss whether or not you would benefit from a revision procedure of some kind.

Filler Rhinoplasty

A filler rhinoplasty utilizes injectable fillers instead of invasive surgery techniques. Similarly to closed rhinoplasty, this procedure is considered less invasive, but the trade-off is that the results can be less permanent. If you proceed with filler rhinoplasty, you may need to return to the doctor’s office to receive repeat treatments.

Recovering From a Rhinoplasty

After a rhinoplasty, you will need to take some time to recover fully from the procedure. The most common side effect is swelling. The general recovery time frame for rhinoplasty patients is as follows.

Four to Six Weeks After Surgery

Swelling is expected during this time. Your nose will look and feel larger than usual. The skin surrounding the nose will experience bruising and possible color changes while it heals.

Three Months After Surgery

Swelling decreases over time, and about three months after their initial procedure, most patients find that their nasal swelling has disappeared.

One Year After Surgery

Most patients are able to experience the full benefits of their procedure. At this stage of the recovery process, some may experience very mild residual side effects.

If you still experience discomfort between six months and one year after your procedure, consider discussing this with your physician. Checking in can help rule out the possibility that you are experiencing abnormal side effects. You may be referred to receive revision treatment to amend your results.

The Right Surgeon for Beverly Hills

Beverly Hills Plastic Surgery, Inc., is one of the most highly regarded surgeons in Los Angeles. Contact our plastic surgery center today to chat with a qualified surgeon about a planned rhinoplasty and determine which nose shape is right for you.

What Is a Nuclear Stress Test?

Trips to medical clinics, especially when it involves undergoing tests, cause a lot of stress and anxiety to many patients. Not only are they anxious about the results of the tests, but they are also worried about how much pain and discomfort are involved. A nuclear stress test is a common medical procedure that may intimidate patients. However, understanding what it is and what to expect during the procedure can help ease worries and lessen stress. So, does a nuclear stress test hurt? This is one of the common questions cardiology doctors may get from patients when they are told to have one.

What Is a Nuclear Stress Test?

A nuclear stress test is a type of stress test that uses imaging to see how the blood flows from the heart into the heart muscle while the patient is at rest and during exercise. It is usually ordered by a cardiologist and done by a doctor or radiology technologist.  A small amount of radioactive material called a tracer will be injected into the patient’s bloodstream. This will make the blood vessels and heart muscle more visible when a special camera takes pictures of the blood flow in and around the patient’s heart.

Doctors usually use this test to diagnose coronary artery disease. But there are also other things it can do. It can:

  • assess how well the heart muscle is pumping
  • identify any blocked arteries
  • determine if the heart has any damage
  • check if a person has had a heart attack
  • determine if a person’s heart is capable of managing physical activities
  • determine the reason for chest pain 

Does a Nuclear Stress Test Hurt?

Concerns about pain and discomfort are normal, and knowing that the procedure does not cause any significant amount of pain aside from the prick of the needle when the tracer is injected into the bloodstream is a great relief to many patients.

One might experience muscle fatigue, breathlessness, chest discomfort, dizziness, and shortness of breath during the exercise part of the test. Patients should inform the healthcare provider at once if they start experiencing any of these.

If your doctor has ordered a nuclear stress test for you, feel free to tell him how you feel. Knowing what to expect and discussing your anxieties with your doctor will do a lot of good in calming your nerves.

What to Expect on the Day of the Procedure

  1. A health provider will insert an IV into your arm, and the tracer will be injected into the bloodstream. If you feel cold at first, that is normal.
  2. Electrodes will be placed on your chest, arms, and legs.
  3. These electrodes will be connected to an EKG machine.
  4. Your blood pressure will also be monitored.
  5. You will be asked to stay still as you lie on a table and then exercise on a treadmill or stationary bike after that. You will have to continue exercising with increasing intensity until your heart has reached a target rate. However, this should not be a cause for worry because you can stop anytime you feel uncomfortable or when you experience bothersome symptoms.

How to Prepare for the Procedure

  1. Your doctor may tell you not to eat, drink, or smoke before the test. You may also be required to avoid caffeine the day before and on the day itself.
  2. Since some medicines may affect test results, it would be wise to inform your doctor of the medications you are presently taking just in case there is a need to stop taking some of them temporarily. However, do not stop taking any medications without your doctor’s consent or advice.
  3. If you have asthma, make sure to bring your inhaler to the clinic with you.
  4. Wear comfortable clothes and walking shoes. Refrain from applying lotion, oil, or anything on your skin on the day of the nuclear stress test.

Post-Test Information

You may be asked to rest for a while after the test as the clinic continues to monitor your heartbeat and breathing. You can go back to your regular activities afterward unless your healthcare provider tells you otherwise. 

Remember to drink a lot of water to help get the tracer out of your system.

Common Concerns 

Radiation exposure

A nuclear stress test usually takes two to four hours, and the amount of radiation patients are exposed to is usually low and safe. Besides, the benefits of accurate diagnosis that the stress test can give far outweigh the minimal risks associated with radiation.

Driving after the test

Most patients can drive themselves home, but if you are unsure, ask a family member or a trusted friend to take you to the clinic and bring you home afterward.

Take the Nuclear Stress Test as Your First Step to Better Health

It is normal to feel stressed, worried, and anxious if your cardiologist orders a nuclear stress test. But your new knowledge about what it is, what to expect, the fact that it does not hurt, and its many benefits will hopefully empower you to make the right decision to put your fears aside and schedule your much-needed nuclear stress test today. 

concept for how ultrasound technology tightens skin

How Ultrasound Technology Tightens Skin

In the constant quest for ageless beauty, scientific advancements, and technological innovations have seen great improvements over the years and now offer a variety of both invasive and non-invasive solutions to men and women alike. One such innovation is ultrasound technology.  Popular for its role in diagnostics, ultrasound technology now has a big role to play in aesthetics. Has your skin started to sag?  That is no problem. All you need to do is call a reputable cosmetic dermatology specialist and ask them about their ultrasound skin tightening treatment or their non-surgical arm lift (if that is what you need). If you are wondering how ultrasound technology tightens skin, continue reading.

How Ultrasound Technology Tightens Skin

Unlike invasive procedures that involve incisions and the use of anesthesia, ultrasound offers patients a non-invasive option that has no downtime and will not leave them with surgical scars. 

Collagen is a protein that the body naturally produces. Working with another protein, elastin, it keeps young skin supple, firm, and elastic. 

The production of collagen naturally decreases as people age, and the collagen in the body loses its strength. As the body gives in to gravity, the skin begins to sag and is pulled downwards as time passes.  

Ultrasound penetrates 5 millimeters deep into the layers of the skin. It can reach the second layer of muscles under the facial muscles, where collagen production takes place. The ultrasound stimulates the dermis layer, causing new collagen to be produced.

Advantages of Ultrasound Treatment

  • Smoothes fine lines and wrinkles
  • Improves skin elasticity
  • 80% improvement in face and neck skin
  • Firms up and reduces jowls
  • Lifts up drooping eyelids
  • Tightens neckline and cleavage area
  • Stimulates collagen production
  • Firms up arms
  • Continuous skin improvement long after having the treatment
  • Non-invasive
  • Does not leave scars
  • Minimal to no downtime
  • No risk of side effects from anesthesia
  • The device used is more helpful than lasers

Side Effects

Ultrasound skin tightening treatments, although relatively safe, may come with some recorded side effects.

  • marks on the skin
  • redness that may last for more than a day
  • skin tenderness for a month or more
  • swelling
  • skin bleeding under the dermis

These treatments need to be done by a trained and qualified practitioner. That is the only way you can ensure that the treatment is as safe as possible. 

Other Considerations

Adverse reactions are likely

While rare, the potential for adverse reactions is still likely. Some of these are temporary blistering and burns. Although they are usually mild, they emphasize why it is crucial to undergo the treatment with a qualified professional.

Results are variable

Ultrasound treatment results depend on different factors, such as the patient’s skin type, age, and skin condition. Many patients may observe noticeable improvements, while some patients may get less dramatic transformations. There may also be a need to undergo the treatment more than once. The good thing is that improvements will continue as weeks go by, and those with less dramatic effects may be able to appreciate more in the future months. Your specialist will be able to better explain to you what results you can expect based on the given variables.  

Cost Considerations

Ultrasound treatments may be costly, especially if a patient has to undergo more than one treatment. The expense may be justifiable for some but may turn other patients off. 

Patients should look into the factors that affect the cost. Location, extent of treatment, extent of treatment, and the expertise of the specialist.  If the budget is tight, you may ask your specialist about payment options.

Candidates for Ultrasound Skin Tightening

This treatment is good for patients who are:

  • In their 30s or older who have noticed sagging skin or surgical patients who want to keep their results for longer
  • Generally healthy
  • Have enough skin elasticity
  • Concerned with mild or moderate signs of skin aging
  • Have realistic expectations

How to Prepare for Ultrasound Tightening Treatment

Have an initial consultation with your specialist.

Make sure that you consult with your specialist so you can talk about your concerns, and confirm that this is the best treatment for you.

Avoid direct sunlight

It is important to avoid direct sunlight for at least five days before your treatment. If you suffer a sunburn, your specialist will not let you undergo the treatment.

Protect your skin from UV rays by wearing sunscreen with the maximum amount of protection.

Eat good food

Fill your stomach with good nutritious foods. Tropical fruits and dark green leafy vegetables are good for preparing your skin.

Drink a lot of water

Ensure that you drink a lot of water for at least five days before your treatment. Your body needs water to produce collagen.

Avoid some skin care products.

Ask your specialist beforehand which skin care products you have to avoid temporarily. 

Transform Your Skin Today

If you have been struggling with loose or sagging skin, do not let your age or your concern with invasive procedures deter you from achieving firmer, younger-looking skin. Visit our clinic today and begin your journey towards beautiful skin transformation.