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MELD score calculator without sodium

Calculates the MELD score to quantify end-stage liver disease for transplant planning. INSTRUCTIONS Note: This is the pre-2016 MELD which does not include serum sodium level, as non-US transplant societies are still using the original MELD formula The OPTN is operated under contract with the U.S. Dept. of Health and Human Services by the United Network for Organ Sharing (UNOS). This Web site provides data and educational information about organ donation, transplantation and the matching process MELD Calculator (Updated to include Serum Sodium) MELD score (Model for End stage Liver Disease) is a score used to calculate the 90 day survival chances for people suffering with ESLD.The MELD score is used as part of the criteria for a Liver Transplant

If sodium is less than 125 mmol/L then sodium level will be 125 mmol/L. If sodium is greater than 137 mmol/L then sodium level will be 137 mmol/L. MELD = (0.957 x ln (creatinine mg/dL) + 0.378 x ln (bilirubin mg/dL) + 1.120 x ln (INR) + 0.6431) * 10 Laboratory values less than 1.0 are set to 1.0 for the purposes of the MELD score calculation 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. The lower limit of Serum Sodium (Na) is capped at 125, and the upper limit is capped at 137 Adds sodium to the MELD model for liver cirrhosis. INSTRUCTIONS Note: The Organ Procurement and Transplantation Network recently incorporated sodium into their new MELD Score as of January 2016, using a different model than MELD-Na This calculator is intended for use by health care providers. The results of this tool should never be used alone to determine a patient's medical treatment. This tool is a statistical model and is not a substitute for an individual treatment plan developed by a doctor with personal knowledge of a specific patient

MELD Score (Original, Pre-2016, Model for End-Stage Liver

MELD Calculator (Model for End-Stage Liver Disease) For patients with liver disease MELD score determines how quickly he can undergo a liver transplant. The term MELD stands for model for end-stage liver disease. Typically a MELD calculator provides a score is a number that ranges between 6 and 40, based on lab tests Multiply the score by 10 and round to the nearest whole number. Laboratory values less than 1.0 are set to 1.0 for the purposes of the MELD score calculation. The revised MELD uses the MELD-Na score, which is as follows: MELD-Na = MELD + 1.32 x (137-Na) - [0.033 x MELD x (137-Na)] Sodium values less than 125 mmol/L will be set to 125, and. The original MELD calculator uses creatinine, bilirubin, and INR measurements; later, hyponatremia (Na concentration of 125-140 mEq/L) was found to be an independent predictor of mortality in patients with cirrhosis and Na levels were added to the MELD score calculatio

Anyone with a serious liver disease should understand what a MELD score is and how doctors arrive at this important number. If you are a candidate for a liver transplant, a MELD score helps determine how urgently you need a transplant.. The MELD score ranges from six to 40 and is based on results from several lab tests An electrolyte that is a marker for significant liver disease (Sodium) The MELD score ranges from 6 to 40, and is a measure of how severe a patient's liver disease is. MELD can fluctuate based on your current condition, with variations from a few points as lab values vary to a larger increase if you have an infection or an acute. Serum sodium level - the amount of sodium in blood The creatinine and bilirubin levels and the INR in liver disease patients are often elevated, while the serum sodium level is often low. MELD score is calculated from time to time depending on how high/low the score is, ranging from once a year to once every week

MELD Calculator - OPT

However, addition of hyponatremia or serum sodium to the MELD score increased the c‐statistic to 0.905 and 0.908, respectively. The accuracy of MELD score plus hyponatremia or plus serum sodium to predict waitlist mortality was significantly higher than MELD score alone (P = 0.006 and P = 0.026, respectively) A simple online MELD calculator to calculate the Meld Score Time and Interpretation for patients. It is abbreviated as Model For End-Stage Liver Disease. The MELD score calculator calculates the score for assessing the severity of chronic liver disease. It is useful in determining prognosis and prioritizing for receipt of a liver transplant

No need to press a calculate button, just enter your values and the result will be shown. Units of measure can be switched between mcmol/L and mg/dL by tapping the unit of measure buttons. If you.. During these times, Vicki's MELD score ranged from a low of 14 to a high of 26. For the first year the range was 14 to 18. Later in 2013, especially after complications from dangerously low Sodium levels, her MELD score fluctuated from 22 to 26; the low Sodium scores provided some bonus points The MELD score is calculated using the lab tests creatinine, international normalized ratio (INR), bilirubin, and sodium. While a good tool, the MELD score is a statistical measure and does not take into account several factors that might affect your individual prognosis. Therefore the test should always be interpreted along with clinical findings The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease.It was initially developed to predict mortality within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure, and was subsequently found to be useful in determining prognosis and prioritizing for receipt of a. Hepatologist put me on a low sodium diet and diuretics. Won't this result in a lower sodium serum score and therefore a higher MELD score? I was inputting different sodium scores on the MELD calculator on the OPTN website and saw that the lower the sodium serum value the higher the MELD score was

MELD Calculator Livers With Lif

  1. Meld Score Calculator - @candaceincanada - Liver disease - 20140203. candaceincanada (Inactive) So someone with HE gets priority over someone without. People who are on a ventilator get priority over folks just in the ICU. sodium serum 106! My point is if my MELD would drop a few more points and hold for a while, I'd be happy. Not.
  2. MELD calculator. For ages 12 and older. The Model for End-Stage Liver Disease (MELD) calculator provides a 'score' (number) based on how urgently someone needs a liver transplant in the next three months. MELD calculator. PELD calculator. For ages 11 and under
  3. MELD Score (age 12 and older) Equation: MELD Score = 10 x (0.957 x Ln(serum creatinine mg/dL) + 0.378 x Ln(serum bilirubin mg/dL) + 1.120 x Ln(INR) + 0.643 ) MELD scores are reported as whole numbers, so the result of the equation above is rounded
  4. In January 2016, OPTN changed Policy 9.1 in regard to the calculation of the MELD score to include serum sodium. Therefore, the new formula where original MELD score is MELD(i) is: MELD Score (2016) = MELD(i) + 1.32 x (137-Na) - [0.033 x MELD(i) x (137-Na)] Please note the calculator also accounts for the following adjustments
  5. predictive models Model for End stage Liver Disease with and without serum sodium (MELD and MELD-Na) using objective laboratory elements that includes bilirubin, INR, creatinine, and serum sodium. (1) There are however, several limitations of current models based on urgency. The MELD and MELD-Na are excellent predictors of WL mortality
  6. ABIC Score: Predictor of 90 day mortality: ≤6.71; low risk 6.71-9.0; intermediate risk ≥9.0; high risk PT used = seconds Prognosis From Maddrey and Glasgow scores From ABIC (steroid treated) 90 day survival by MELD % From Lille Other liver scores MELD-Na: UKELD: Child-Pugh Grade(score)

UNOS has made the following modifications to the original MELD score: If the patient has been dialyzed twice within the last 7 days, then serum creatinine should be assigned a value of 4.0 Any value less than one should be converted to 1.0 (e.g. if bilirubin is 0.9, a value of 1.0 is used) The Model for End-stage Liver Disease (MELD) is a scoring system for prioritizing patients for liver transplantation. The MELD score is an objective model that predicts a patient's 90-day mortality while waiting for a liver transplant. It is a better predictor of perioperative mortality than the Child's scoring system and therefore has replaced it MELD score is used to assess 3-month mortality: <9 = 1.9%; 10-19 = 6%; 20-29 = 19.6%; 30-39 = 52.6%; 40 and above = 71.3% mortality As you can see, the MELD score relies heavily on INR , and there is concern that because the INR is based on thromboplastin ISI values computed from vitamin K antagonist ( VKA ) cilabrators, it may vary by. In most studies, the median difference in the MELD score between the highest and lowest scoring laboratory is around 3-5 MELD points, but individual differences of up to 11 or 12 MELD points have been reported (1-5), which has obvious implications in prioritization for liver transplantation. By proposing a series of possible solutions, their. • MELD score less than or equal to 10; Labs needed every year. No one on the transplant team can determine or predict when a liver from a reputable donor will be available for any patient. It is a common policy not to discuss or inform a patient when they are on the list

shown by several investigators that incorporating sodium into the MELD score increases its predictive accuracy,10 especially for patients with ascites.8 Specifically, it was shown that 7% of waiting-list deaths could be averted using MELD-Na score over standard MELD score.9 Sup-ported by these findings, the OPTN committee propose For example, a patient with a MELD score of 10 and a serum sodium concentration of 125 mmol per liter would have a MELDNa score of 21 (i.e., 11 points added to the MELD score), because the risk of. This is an indicator of kidney malfunction that is also used by our MELD calculator. Normal levels of creatinine in blood are approximately 0.6 to 1.2 mg/dL in adult males and 0.5 to 1.1 mg/dL in adult females. Sodium: the serum sodium test, also referred to as Na+ test, tells you the level of sodium in your blood Cirrhosis Support Group. Cirrhosis is a consequence of chronic liver disease, most commonly caused by alcoholism and hepatitis C. Ascites is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infections, and a poor long term outcome

Model for End-Stage Liver Disease (MELD) for ages 12 and

Calculators MELD score. Use MELD-XI in patients with anticoagulation with vitamin K antagonists (Heuman et al, Liver transplantation. 2007;13L30-37 I was wondering what causes meld score fluctuations. For the first half of this year my inr was stable at 1.4 and my bilirubin bounced between. 3-4 making my meld 15-16. Last Thursday, I had blood drawn at my transplant center rather than my local Quest. My meld jumped to 18. My inr went up to 1.6 and my bilirubin went up to 5.9 Corrected Sodium in Hyperglycemia. As used in the new MELD score, to correct Na in the setting of hyperglycemia. The global unit selector only affects unanswered questions. Si US. 1. No part of this service may be reproduced in any way without express written consent of QxMD. This information should not be used for the diagnosis or.

MELDNa/MELD-Na Score for Liver Cirrhosis - MDCal

  1. MELD score greater than 14 at baseline; Prior Liver Transplantation; Presence of Portal Hypertension (varices, ascites, encephalopathy, splenomegaly, or platelets less than 150 x 10^9/L) at baseline; Subjects less than 18 years of ag
  2. In January 2016, the model for end-stage liver disease (MELD) score was refined to take into account serum sodium level, creating the MELD-Na score. This change was implemented because patients with cirrhosis and hyponatremia have significantly higher mortality rates compared with those with normal serum sodium levels
  3. The prognosis in patients with AOCH who had a MELD score over 26 was poor using the MELD scoring system; 80. Feb 28, 1998 · Grade Inflation Is Often Cover for Bad Teaching; Include a Relative Score. Organ allocation is prioritized for the sickest patients based on Model for End Stage Liver Disease (MELD) score
  4. Background In 2009, chronic liver disease and cirrhosis resulted in approximately 30,000 deaths, making it the twelfth leading cause of death in the United States. Patients with compensated chronic liver failure (without ascites, variceal bleeding, encephalopathy, or jaundice) have a median survival of 12 years. After decompensation, median survival drops to ~ 2 years. This Fast [

MELD Model - Medical Professionals - Mayo Clini

  1. I used this for the last 3 MELD labs to see how the sodium impacted his MELD. In one case, Na increased his MELD score by 1 pt over MELD without Na. In the other two MELD score values, it did not change the MELD at all. It would be interesting to see how others old numbers look with and without Na
  2. tients without cirrhosis undergoing liver resection. 62. In. Addition of serum sodium into the MELD score predicts waiting list. Although the two scores are simple to calculate and
  3. Meld score go up and down just like every blood level does and people feel sicker of less ill at different times with early cirrhosis. In order to be put on the waiting list for transplant at most US transplant centers, a person needs a MELD score of 15 to get listed
  4. al surgery (see the MELD Score calculator). In one study, a preoperative MELD score of greater than 14 was a better predictor of postoperative death than Child Class C status
  5. The MELD-Na, a modification including sodium levels into the score, has received much attention. Fisher et al. [ 7 ] report in their prospective trial that including exceptional points for persistent serum sodium <130 mEq/L improved organ allocation to hyponatremic cirrhotics, a high risk subset
  6. MediMath is the only medical calculator to take full advantage of the iPhone rather than feeling like a port of an old Palm application. I recently took advantage of specials to try Mediquations and Medical Calculator as well, so that comparison isn't just a guess from screenshots

The aim of this study was to identify the utility of MELD-Na to predict patient outcomes, with and without liver disease, after elective colon cancer surgery. METHODS: A review of the American College of Surgeons National Surgical Quality Improvement Program database (2005 to 2010) was conducted to calculate risk-adjusted 30-day outcomes using. As I mentioned before your MELD score is critical to determining how far progressed your disease is and in how you are prioritized for a transplant. It's generally as scale of 0-40 with 40 being the sickest meaning likely to die in a few days without a transplant. In my book, any score over 30 requires urgency and hopefully a transplant within. Several variations of the original MELD score, involving the addition of serum sodium or looking at the change in MELD over time, have been examined, and these may slightly improve its accuracy MELD Na Score Calculator. Oct 27, 2018 · MELD score interpretation. ' Aug 28, 2020 · Madden 21. They told me that you get on the list with 20, when you hit 28-30, then it could take 6-12 months. 23-27 Although early studies showed progressively lower patient survival benefits with rising MELD scores, 28,29 recent studies have validated no.

Calculating and Interpreting MELD Score - Referral for

According to one study in the United States that analyzed 2,175 patients in the pre-MELD era (before 2002) using a large multicenter LT database, of which 31% had hyponatremia (Na <135mEq/L) before transplant, the investigators found no change in 90-day post-LT survival in this group of patients as compared to recipients with normal sodium. ABSTRACT The Model for End Stage Liver (MELD) score is validated to predict pretransplant mortality.However, as a predictor of postoperative outcomes, its utility has proven inconsistent. Recently developed MELD-Lactate models better predict 30-day survival as compared with the MELD and MELD-Sodium scores.We compared the MELD-Lactate, original MELD, and MELD-Sodium formulae and the initial.

Zaman MB, Hoti E, Qasim A, et al. MELD score as a prognostic model for listing acute liver failure patients for liver transplantation. Transplant Proc 2006; 38:2097. Schmidt LE, Larsen FS. MELD score as a predictor of liver failure and death in patients with acetaminophen-induced liver injury. Hepatology 2007; 45:789. Nyberg SL, Misra SP The 2016 MELD score formula is the following: MELD Score (2016) = MELD(i) + 1.32*(137-Na) - [0.033*MELD(i)*(137-Na)] Where MELD(i) is the original MELD score without serum sodium. With Serum Sodium between 125 and 137 mEq/L. Adjustments to the method: This log scales calculations therefore any value that is less than 1 is automatically. This MELD calculator caps the levels of sodium with the lower limit of 125 and upper limit of 137 mEq/L or mmol/L. MELD score formula There are actually two formulas for estimating the MELD score

Assessment of Prognosis of Cirrhosis

Notes. The Model of End-stage Liver Disease, or MELD score is used to estimate relative disease severity and likely survival of patients awaiting liver transplantation.; The MELDNa score system adds a Serum Na parameter, so the added risk of significant hyponatremia may be taken into account.; Children under the age of 12 should be assessed by the PELD score MELD-sodium score: optimal timing for first referral is MELD ≥10, and definitely by MELD ≥15 First development of any decompensation event: ascites, variceal bleeding, or hepatic encephalopathy HCC without metastasis or macrovascular invasion; patients with HCC and cirrhosis (either compensated or decompensated) should be referred for.

The model is used by the United Network for Organ Sharing (UNOS) and is addressed to children below the age of 12, while the adult equivalents of the score are MELD and MELD-Na. Transpl Int. Calculating and Interpreting MELD Score Bilirubin = 1.8 mg/dL International normalized ratio = 1.5 Creatinine = 1.4 mg/dL Sodium = 133 mmol/L Glucose = 94. Data were dichotomized according to (A) Model for End-Stage Liver Dysfunction (MELD); (B) MELD serum sodium score (MELDNa); and (C) MELD without international normalized ratio score (MELD-XI) by using the average cutoff value derived from the receiver-operating characteristic analysis for 1-year death/heart transplantation (HTx)/ventricular. MELD uses the patient's values for serum bilirubin, serum creatinine, and the international normalized ratio for prothrombin time (INR) to predict survival. So 18 or less, we will consider proceeding with a TIPS evaluation. The MELD Na Score adds the sodium determination to the variables of the original Model of End Stage Liver Disease Serum sodium based modification of the MELD does not improve prediction of outcome in acute liver failure. Christoph Jochum. Ali Canbay. Fuat Saner. Christoph Jochum. Ali Canbay. Fuat Saner. Related Papers. Cytokeratin 18-based modification of the MELD score improves prediction of spontaneous survival after acute liver injury Although MELD and CP scores are commonly used to determine the survival of patients with liver cirrhosis, MELD score is difficult to calculate without a personal digital assistant, whereas five parameters are required to interpret and calculate the CP score

MELD Na Score Calculato

average meld score for liver transplant. A 53-year-old member asked: what does someone's meld score have to be in order to qualify for a liver transplant? Dr. Rodrigo Vianna answered. 27 years experience Transplant Surgery. Above 15: Usually to be included on the list it has to be above 15. Depending on the area the score has to be a lot more. In patients with cirrhosis, the Model for End-Stage Liver Disease Sodium (MELD-Na) score is a validated predictor of outcomes after transplant and non-transplant surgical procedures. This study investigates the association of MELD-Na score with complications following elective ventral hernia repair in non-cirrhotic patients. The ACS NSQIP database was queried (2005-2016) for all elective. Disease score (MELD), and serum sodium based modifications like the MELD-Na score and the United Kingdom criminate those patients who will survive without LTx remains a major challenge [7,8]. The model of end-stage liver disease (MELD), initially order to calculate the individual MELD score we used the formula as published by Kamath et. But, with MELD score of 8, I can't say the liver disease is severe that it normal function can't be reverted back. Hope this answered your question. Request to click on the positive rating, on the top right corner of the chat box, so that I'm compensated for the answer. Wish you a speedy recovery and good health The CP score (range 5-15) was calculated for every patient included in the study and each patient was classified according to the suggestion by Pugh et al. into grade A (up to 6), grade B (7-9) and grade C (> 9). 6 MELD score which ranged from 6-40 was calculated according to the formula proposed by Kamath et al. 9 i.e. [9.57 x Log creatinine.

MELD-Na Score (Model For End-Stage Liver Disease

  1. MELD Score wiki. From Wikipedia, the free encyclopedia MELD-Plus is a risk score to assess severity of chronic liver disease. The score includes nine variables as effective predictors for 90-day mortality after a discharge from a cirrhosis-related admission MELD Score; MELD-Plus; History.The surgeon and portal hypertension expert Charles Gardner Child (1908-1991) (with Turcotte) of the.
  2. Sodium(Na) Correction Rate in Hypernatremia (Adrogue Formula) Sodium(Na) Correction Rate in Hyponatremia SOFA (Sepsis-related Organ Failure Assessment) score TIMI Risk Score (for ACS, unstable angina, NSTEMI) TIMI Risk Score (for STEMI) Transtubular K Gradient (TTKG) Trauma and Injury Severity Score(TRISS) Wells' Criteria for deep vein.
  3. meld score chart. Bejegyzés szerzője Szerző: Bejegyzés dátuma 2021. március 13. szombat.
  4. NAFLD Fibrosis Score Reduce the need for liver biopsy by identifying patients with non-alcoholic fatty liver disease likely or unlikely to have advanced fibrosis MELD Score - Age above 12 years Scoring system used to rank prioritize candidates for liver transplantation, including MELD-Na used in the OPTN match system Alcohol Relapse Risk after.
  5. In interpreting the MELD score in hospitalized patients, Wiesner et al. had reported that the 3-month mortality was more than 19.6% in patients with MELD score ≥ 20. In contrast, the current study on patients with VNSSTIs revealed that the case-fatality rate was as high as 66.7% for patients with MELD score ≥ 20 on admission, whereas for.
  6. FIB-4 score was a superior predictor of hepatocellular carcinoma than CP and MELD scores. All 3 scores were poor predictors of mortality. Our study found that FIB-4 score performed significantly better than MELD score and CP class for predicting incident hepatic decompensation and hepatocellular carcinoma events over 5 years

The ReFit MELDNa model provides a modest yet significant increase in the c-statistic in the prediction of death when compared to MELD, SRTR MELD (both p = 0.0001), and MELDNa, (p=0.040). The ReFit MELD, without the serum sodium variable, also demonstrates improved discrimination compared to the existing MELD (p=0.020) and SRTR MELD (p=0.0001) Currently, patients are ranked by means of a score made up of 3 (+/- sodium) blood values (Model for End Stage Liver Disease or MELD score). However, over the past few years, significant. Serum Sodium Level: A measurement of sodium in the blood. Patients are rated on a scale of 6 (least severe) to 40 (most severe). The MELD score is then paired with additional factors, such as the patient's distance from the donor hospital and chance of survival, to determine their priority

MELD Score (2016) = MELD(i) + 1.32*(137-Na) - [0.033*MELD(i)*(137-Na)] Where MELD(i) is the original MELD score without serum sodium. With Serum Sodium between 125 and 137 mEq/L. Adjustments to the method: This log scales calculations therefore any value that is less than 1 is automatically adjusted to the lower limit value of 1 to prevent. Hyponatremia—defined as a serum sodium concentration of less than 135 mEq/L—is a common and important electrolyte imbalance that can be seen in isolation or, as most often is the case, as a complication of other medical illnesses (eg, heart failure, liver failure, renal failure, pneumonia). [] The normal serum sodium concentration is 135-145 mEq/L. Joint European guidelines classify.

The MELD score is calculated from the results of 3 blood tests: PT/INR, bilirubin and creatinine, which is a measure of kidney function. MELD scores range from 6 to 40, with higher scores indicating more serious illness. MELD scores correlate with short-term prognosis and are used to assess a patient's need for a liver transplant The M-MELD, D-MELD, and integrated MELD had a good discriminative performance in predicting 3-month mortality after LDLT with AUCs > 0.7, while the M-MELD was the only score that showed a good discriminative performance in predicting 6-month and 1-year mortality after LDLT with AUCs > 0.7 Eighteen patients had a Model for End-stage Liver Disease (MELD) score of ≤9 and twenty had MELD >9. Serum sodium was found to differ significantly between Child-Pugh stage A and B cirrhotics (mean 142.8±2.0 mmol/L vs. 140.5±3.3 mmol/L, p<0.05). Serum sodium was als

Sodium - measures the body's fluid balance; If you want to enter your lab values to know your MELD-Na score, you can use this MELD-Na calculator While you are waiting for your transplant, your lab work will be done and MELD -Na score calculated weekly to monthly as determined by UNOS requirements A calculated Meld greater than 11.12 Much of the excess mortality risk related to ascites is similar to portal hypertension and hepatorenal syndrome and will be accurately reflected in the lab values used to calculate the Meld score, specifically the serum creatinine and serum sodium

MELD Na Score Calculator - MDAp

How does this MELD Na score calculator work? This health tool assesses the outcome in patients who need transplant or suffer from a serious liver condition such as cirrhosis and adds the serum sodium determination to the precedent equation in the Model of End Stage Liver Disease.. This MELD-Na score calculator differs from the standard MELD. A variation of the MELD score that incorporates serum sodium measurement (MELD-Na) more accurately predicts mortality in cirrhotic patients than the conventional MELD score, and is now used by the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation Network (OPTN) to prioritize patients on the liver transplant waiting list It can take months or years to deteriorate from a MELD score of 24 to a score of 30, yet in most west coast cities the average MELD score at transplant is 30. Move east to Phoenix and it's 24. For many such differences make the difference between life and death as shown in studies of mortality risk

MELD Score and 90-Day Mortality Rate for Alcoholic

Meaning it cannot be used while the iPad is docked. The app also does not take advantage of the iPad OS's multitasking features like split-view or slide-over, a huge detriment when I am charting on my virtual desktop app and looking to have MDCalc slide-over to briefly calculate a MELD score for example compared with patients with low scores (p < 0.001). Similarly, a high MELD-XI score was also predictive of early and late mortality (p < 0.001) after risk adjustment. There was, however, no difference in 5-year survival between the high score and low score cohorts after ac-counting for 1-year deaths. Subanalysis of patient Validation in an external prospective cohort showed that this score was significantly more accurate than Child-Pugh score, Model for End-Stage Liver Disease (MELD) score, and MELD with serum sodium score in predicting 28-day mortality in ACLF . CLIF-C ACLF score predicted short-term mortality 25% better than all listed scores

Liver Failure Support Group - webpage
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