Mitral valve insufficiency treatment in 44 Cardiac surgery clinics in Brazil

Terrible service, absurd delay at reception of more than 40 minutes. Unprepared employees with no information on service protocols. Both for scheduling by phone and in person. I scheduled an MRI and confirmed the information before making the call and when I arrived to be seen on the second attempt (as the first time I was unable to be seen because the exam was 2 hours late) the attendant gave me completely different information, stating that I would need to change the order on behalf of the council, and I confirmed it with the telephone attendant twice regarding the council. Anyway, on top of that, I agreed to take the exam because I was urgently required, but it was 1h30 late, which ended up being a little longer. The hospital used to be excellent, but it has lost its quality, I don't recommend it.

Terrible in terms of hospitalization... I arrived at the hospital with my daughter with blood in her stool... I was well looked after in the ER and, after carrying out the tests, the doctor informed me that hospitalization would be necessary. We were directed to the infirmary and here I have been ever since. I was admitted to the hospital on 11/27/23 at 7:58 pm. I signed the authorization for hospitalization on 11/28/23 at 01:48 and now it is 15:50 on 11/28/23 and we are still here in the infirmary... They should warn you before admitting you about all this! A lack of respect. My daughter has been on a stretcher for 14 hours and I was sitting in a chair for hours and after a lot of complaining, they put an armchair...

DON’T HAVE CHILDREN IN THIS PLACE😡😡 Worst experience possible, we signed a maternity plan at this unit, everything was wonderful when presented, I thought it would be a good place for my wife and daughter. My wife went into labor so we went to the hospital. Arriving at the location, my wife went to the service. There was no room available, so we did the whole process by pushing our bags around the hospital. I asked the receptionist who informed me that this is quite common at the place, as it happens every day and so I asked someone from management (both rude) and said that I would only have a room around 9 am and at that time it was around midnight. night and a half. Of course it didn't happen, he only got to the room around 2:30 pm. In short, my wife had our daughter, I continued through the hospital pushing suitcases, all of this was nothing close to what my wife went through. THEY SIMPLY LEFT MY WIFE FOR 5 HOURS IN THE RECOVERY ROOM ALONE WITH THE BABY AFTER A RACHI BECAUSE THERE WAS NO ROOM I CAN'T GET OUT OF MY HEAD HER CRYING TELLING ME Several women passed through the recovery room and went to their rooms, and they remained there with no one to help. We arrived at our room after much insistence and were poorly attended to by the staff while my wife went through what she went through. INHUMANE HOSPITAL WITH TERRIBLE ADMINISTRATIVE STAFF NOTE: Nurse GABI was incredible in providing care at all times In other words, look for another place for such an incredible moment in life.

I don't know why there are no cameras in the hospital. At least in the nurses' room. Every time I went to the pediatric emergency room the same thing happened. Nurses talking about personal matters, laughing loudly, as if they were in a bar. And when we make any requests, they are rude, rude and even mocking. I spent 14 hours there with my 3-year-old son. I didn't even see hygiene (the minimum expected in a hospital). Sheets used by patients the night before were left on the chair (until the time I left, they were still there). Children with infectious diseases (gastroenteritis, severe flu...) were discharged and the seats were not sanitized. They directed me to the resting chair, when I sat down I felt something dripping on me. It was the nebulizing mask that a child had worn during the night. I myself had to sanitize the armchair my son was in. Holding him with one hand and rubbing alcohol with the other. Chaos. I filed a complaint with the ombudsman and to this day I have not received a response. I will formalize a new complaint with the ANS with photos and videos.

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I think this hospital is great, I had 2 surgery there. I am from United States. The Dr used was Dr luis Eduardo Barbosa. His staff was excellent. The front desk at check in very professional. Then I was brought to a room to change and then to the OR. woke up in recovery and was feed food and released in the morning. Parking was easy. Hospital was clean, looked up to date. Excellent experience there.

It was a great experience! From the gate to medical care, I was treated very well. Initially, I received information that the expected wait would be two hours and I decided to stay calm, settle in and wait. The important thing was to have already gotten there. After all, everything that seems bad can certainly get worse! So, everything worked out! The doctor on duty is super TOP, attentive, very assertive for her young age. The nursing technician Arnaldo with the hand of an angel that I didn't even feel the discomfort of access. For the laboratory exam I was seen by Jefferson and when I thought it was going to be horrible, he was already done!🫠 The doctor who took the shift and discharged me was also great!!! What professionalism, what a high level of this team! Thank God everything was perfect! And my plan is no diamond!!! Thank you, God, Congratulations Emergency Hospital Santa Joana! November 2023

I went to the hospital a few times, both for consultation and emergency. What I can say is that the Hospital is very organized, has very well trained staff, I have always received very good service on the phone. I saw a lot of people criticizing here and I decided to tell my positive experience, it doesn't mean that I didn't encounter problems, such as a consultation that took 2 hours to wait, but in this case it was an isolated professional, I don't believe that the hospital itself is bad, but Like everywhere, there are good people and others not. The rating I give is 5 stars, as most of the staff are attentive, careful and the structure is excellent! In short, Hospital Santa Joana is of excellent quality, has very well-trained staff, they answer the phone and answer your questions very carefully. I attributed my bad waiting experience to a specific doctor, the others were excellent, so a very good hospital, congratulations!

I had to take my 3 year old daughter to the pediatric emergency room and unfortunately I experienced racism from the first contact with the doctor asking me if I was the mother, because my daughter was white. I've never seen a children's professional not interacting with the child, not conditioning, nothing... Super rude, cold, indifferent. I observed her serving a white family and it was totally different. I felt violated. I don't recommend Santa Joana!

One of the best hospitals in town Good service and regular ER

Nice hospital

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Terrible phone service. It took me more than 45 minutes for the first person to speak on the phone, adding up to more than 5 calls (as several dropped) and a lot of time listening to "little music". Whatsapp service is also non-existent. It is very difficult to have information about recovering patients, regrettable.

Lack of empathy with patients on the part of reception. We arrived at 4pm, as my husband had a procedure scheduled for 6pm, and according to the instructions received in advance via WhatsApp, we would have to be at the hospital 2 hours before the time given by the doctor to carry out the administrative procedures, the time being documented by the surgeon at 6pm. An attendant asked to wait, as they would call by name. At 6:05 pm we went to question the delay in being seen, and were informed that the surgery was scheduled for 9 pm and that it was not a priority. Therefore, my first experience at the hospital was unpleasant until they showed no interest or concern for the time we were waiting. I cannot direct the complaint to the attendant in question as they do not have identification on their uniform.

Night nurse Robson, totally unprepared, passed, my wife underwent a procedure in this hospital and was very poorly treated by this professional, even he and nurse Renata were just making fun and laughing at my wife. Total disregard. I would never recommend this rubbish.

This hospital is terrible!!!! I had an ear problem last month and I went to this hospital that charged me for a consultation without first telling me that they did NOT have an ENT doctor available who could help me (even after having gone through the screening), and now even having spoken to the ombudsman, they claim that I was notified, which is an absurd lie. What I take away from this is that in addition to having terrible service and incompetent nurses, they also lie. Don't go to Santa Paula, they won't solve your problem, and then they will claim that “you were too stunned to understand” which is an absurd lack of empathy and humanity for a hospital to say something like that.

Second time this week I spent this week in the emergency room of this hospital, because the medicines prescribed by the doctors are not relieving my pain, I have flu-like symptoms. I haven't slept almost at all this week and today in particular, I stayed up all night feeling a lot of pain. It is not possible that I will have to go to the emergency room for the third time. If I go, it won't be in this hospital. Update: I went to the emergency room for the third time this week, but in another hospital, I was howling in pain, I knew something was wrong, as I was feeling very ill and didn't get better with any prescribed medication. I was diagnosed with sinusitis in another hospital, I remember that the last doctor at this hospital said it was nothing serious and didn't even give me an antibiotic and said it was influenza. They gave me nausea dosage in the amount for a child and not for an adult and in a greater number of hours. I no longer trust this hospital and will not return again.

Good afternoon everybody. My 18 year old daughter was hospitalized on 10/06 with teratomas on her ovary. A huge scare, because we went to the emergency room with suspected kidney stones. We were very scared and very worried, but I would like to record here the excellent and extremely humanized care provided by everyone, without exception, at the hospital. My daughter had recently turned 18 and so I couldn't sleep with her in the hospital, imagine my despair and worry? So, in addition to never being hospitalized, she had to be alone. But, all (without exception) the nurses, receptionists, doctors, were very careful, loving, attentive and caring. I would really like to remember everyone's name (and I recommend that the hospital look at the days of this shift to really recognize these professionals from 10/05 to 11:20 pm to 10/08), but I was very nervous, but, I remember Carol, Kelly, Luana (in the emergency room), Dr Manoel and the team that successfully performed the surgery to remove the teratomas on my daughter. Those whose names I don't remember (especially a nurse who attended to us in the early hours of 10/06 who was so loving), please forgive me, they are no less important in my gratitude, as I said to some of you, for For me, it is not simply a profession but rather a gift of caring for others. I couldn't spend 24 hours with my daughter in the 3 days she was there, but I'm sure that God chose all the people who took care of her correctly. Congratulations to the hospital, which recognizes its team and always values ​​the people who work there. I also mention the cleanliness of the hospital and the rooms, which are cleaned constantly. My daughter continues to recover very well. I am grateful for Dr. Manoel's assertive clarifications, which left us calm and confident as my daughter continued. I noticed that all medications, all procedures that were performed, were calmly explained to her, eye to eye, realizing whether she was understanding or not. Thank you all very much, may God bless you always.

After waiting for 2 hours, our daughter was called to help and, to my surprise, they didn't allow the father to go up, they let the mother go up alone with a 10-month-old baby and three bags. Lack of space, lack of planning, lack of training or lack of humanism? Unfortunate...

Terrible hospitalization, few employees, they make the patient do the work, you need to call or ask for sheets, pillowcases, bath towels via QRCOD, I asked for a bathtub so I could bathe my baby, it took more than an hour to arrive, the employee who brings it the bathtub cannot bring towels, the patient needs to use the hospital system to request towels, sheets, pillowcases, hygiene items... and 1 item at a time, in an order you cannot, for example, request sheets, towels and blanket, you have to order one item at a time for the companion and the patient. I am the companion responsible for my 5 month old baby, I also have the flu, I requested hot water to make tea at 10 pm and they told me that the kitchen in a HOSPITAL does not work at night, I have never seen this, an emergency room, a patient in hospitalization and not having hot water. They serve 3 meals a day, breakfast at 7:00 am, lunch at 1:00 pm and dinner at 7:00 pm, during these intervals if you want to order something via app, you cannot go down to reception to receive it, no one at reception can go up to bring your food and no staff can look at your child who is hospitalized for you to go down to reception for 3 minutes to receive the food, you are forced to go hungry or buy it at the hospital cafe. My rating for hospitalization is terrible, if I need it again I won't come back here, good accommodation but the system is terrible service, not even a public hospital is that bad.

Super-fast screening and registration. Examination and medication expedited. However, when they send us to that little room to go back to the doctor, you forget about life because it seems like they will never see you. And it's not the first time. Today I ordered to cancel and left. I arrived before 8pm, it was around 7:30pm, everything would have ended quickly, if it weren't for the wait to see the doctor again. They should monitor these doctors who keep the door closed with no one inside, while mothers and fathers are waiting for a report. It is, at the very least, a lack of empathy and respect for the health of little ones. Now with these traumas, I probably won't take it anymore. If I need it again, I will go to São Luiz. But, I congratulate Dr Daigo, who once, when I was being seen by him and needed to return, as soon as he saw me, he immediately called me and immediately released us, since there was no one else in the waiting room. Super attentive, agile and helpful.

One word: GRATITUDE!!! I have gratitude, a feeling of recognition. I want to thank you for EVERYTHING. Receptionists, Doctors, Nurses, Cleaning Assistants, Cafeteria, Physiotherapists, Radiologists, everyone in general who gave and is giving us support in a difficult phase, which makes it a little lighter...... GOD BLESS THEM, ALWAYS.

Apart from the reasonable delay for the first pain medication (renal colic) and the first nurse who pierced my arm 3 times (skinny with bulging veins) until she was able to access it), the service was good, everything else.

I would like to thank all the staff at Hospital São Lucas for their service and care. I arrived with what seemed like a simple cough and had to be hospitalized. I am extremely grateful to Dr.Thiago Soares Gomes for his diligence and prevention in decision-making, and to Dr.Filipe Miranda Bernardes for his constant monitoring. When an X-ray was not enough to detect the true cause of that cough, they did their best to clarify the picture so that today I am better and continue with the necessary care. Know that my family, people who love me and I greatly appreciate the professionalism and so much humanity of all of you.

I had an excellent experience! I was admitted for knee surgery and the hospital staff were wonderful to me. Committed, welcoming and willing to help with so much affection, in all sectors. One point of attention: the room I stayed in had a musty smell, the only negative point of my stay.

I've been a patient at Centro Médico da Cardio for years and I really like it, but today I needed to be treated in the hospital's emergency room and I thought it was terrible! Despite there being only 2 people in front of me when I arrived, I was only seen by the doctor more than an hour later. Furthermore, the doctor on duty said he would do a blood test and a CT scan. Hours after taking the collection, the employee told me that he was going to send me for reevaluation. At this point, I asked about not having done the tomography. After much confusion, it was discovered that the doctor had not made the request. When the two results finally came out, another doctor assisted me in the reevaluation, gave me the diagnosis, walking down the corridor, directing me to the exit. When I arrived at reception to leave, I realized that the access was still in place at the time of the contrast injection. And the employee even asked me why I hadn't reminded the staff to remove it... Right at a time and place where I needed attention and support, I was treated this way. I don't intend to go back!

My father was hospitalized for 5 days there last year. The hospital structure was more modern than before. The staff are generally attentive, but I had a few problems: 1. The corridors where the hospitalization rooms are located looked like a fair because of so much commotion. The employees talk loudly, laugh loudly without respecting patients and companions. We're not going to the hospital for a vacation. It's stressful for the family and it's not comfortable to sleep in a hospital!!! Even at 2:00 in the morning I could hear the staff laughing and talking at the ward reception in the corridor. Absurd. Lack of education and compassion for those who are suffering. 2. Companions also have to reduce the volume of their voices in the corridors. They need to put up notices in the hallways or guide them. If you want to talk loudly, go home! 3. My father spilled water on the floor so I asked someone to come and mop it up, but no one came. I asked again and nothing. I ended up throwing the bathroom towels on the floor to dry off. My father could be at risk of slipping at night. I have already spoken to the administration and I hope that these situations have improved.

I have never been ignored in a hospital, not even in the same unit, but this time it was different. I was seen by the doctor Raphael Augusto Travernard Neves de Oliveira CRM 119677, he asked about my symptoms, I explained that last year I had a migraine attack for 2 months (I was even admitted to the same hospital, in addition to undergoing several tests), finally I was diagnosed with anxiety and chronic sinusitis due to low immunity. After I explained my entire case, according to the doctor and my clinical condition in his eyes, I was “just having a cold”. I didn't agree, and asked us to do the tomography, detailing that I had done the last tomography in less than 2 months, as it was exactly the same. I left there with a prescription for antibiotics, 2 types of corticosteroids, painkillers and nasal wash, as I had a cyst preventing drainage. But to the doctor it was just a cold. DETAIL: the doctor always laughed when I said that my pain was a grade 7.

On 10/23/2023 I was admitted to the hospital to have my cesarean section, so far everything was fine, everything was perfect with the service. However, my newborn was born with a lingual frenulum and no one from the medical team informed me about this. For me, A VERY SERIOUS MISTAKE, especially because the test in maternity is the law. I had a lot of difficulty breastfeeding even with a full breast in the hospital and no pediatric doctor gave me any guidance. One of the nurses told me that the pediatrician on duty was asking me for permission to take the formula, as the right-handed man was showing low blood sugar levels and NOBODY... gave me this very IMPORTANT information and obviously I didn't accept it, as my chest was sore. so full. I was discharged on Thursday 10/26 and only found out about the frenulum on 10/30 when I went to a private pediatrician, by which time my son had already lost a lot of weight. Since 10/30 I've been fighting with my little one, where he needed surgery on the lingual frenulum and only now after almost 20 days did my son start eating properly. I was extremely disappointed with this and even with the information that my son was born at 37 weeks, and the correct one was 39s and 2 d. Unfortunately, I am very hurt and disappointed with the negligence of the professional who was supposed to inform me of this very important information. The rest, such as the nursing team, cleaning and food, were all wonderful.

Great service, I was hospitalized for 3 days and received very good service from all the employees, especially Isaac, the kitchen and Fran from nursing. I recommend!

Doctors unprepared to provide PA care. As it is the only hospital in the city, professionals should have more experience.

Great service with my mother who had surgery, doctor, nurses, cleaning staff all very attentive. Grade 10

We are always very well attended to, we are Unimed customers, the call center has become an extraordinary differentiator, the new hospital facilities are above expectations. Attentive clinical staff concerned with well-being.

Emergency services won’t take a sick 13 years old child as a patient. So please beware of this strange rule and don’t take your youngsters there. Very strange rule. Should be advertised widely so one wouldn’t waste their time on a case sensitive situation. Be good to communicate this on company’s website.

Please dont ever seek treatment here you are better of at a veterinary. Went here cause my girl friend got an bladder infection and it was hurting more than it normally would. They scared us to death with all these possible rare conditions she might have and do everything they can to do as many scans and tests possible. After all the ultrasounds and MRI they tell us they did not find anything and they give her a prescription with a rare intramuscular antibiotic(she was already 2 days in to a normal penicillin cure) the doctor tells us to stop taking the cure she was on and get a shot everyday of the intramuscular one she prescribed. The fun part is after that i went with my sick girlfriend around rio to try and find a place that has this medicine and can inject her with it but no pharmacy or public hospital was willing to do it. So she went without antibiotics for 2 days, only for us to go back to this hospital for them to change it to an oral one. So long story short we spent more then a 1000 euro's and 2 days trying to get her help and she only got more sick and ended up with the normal antibiotics we started our journey with

I'm only impressed by the price. My doctor was inexperienced, replied badly to my questions. They hardly speak any English. They did not give me the x-ray I payed for. Unprofessional, but overpriced.

Terrible attendance. They ignore patients who need quick care. They keep waiting and don't justify the delay. Even with very few patients to treat. Unprepared nurses don't even know how to apply a serum into a vein. Total disregard! A thousand times Unimed hospital. Even the SUS is much better.

The reception has very good service, I cannot say the same about the service provided by the doctor on duty at this hospital, she is disrespectful towards the patient! I felt that the Doctor didn't know what she was doing, the impression she gave was that my fiancé was a laboratory mouse! At the first consultation he was teased and in the end they prescribed ibuprofen and if the symptoms persisted, he would see a specialist. We went to a specialist, they treated it like sinusitis and even though we were taking very strong medication the fever came back, we went to the emergency room again, he had a fever of 39, the doctor (the same as the first time), again gave terrible care, she couldn't find what He passed the responsibility for returning it to another employee, who recommended more medication for the inflammation, but without knowing why the inflammation didn't go away. I won't mention the doctor's name, but the appointment took place on 10/06/23 at 10:15 pm. I don't know if the hospital will see this comment and do something about it, but even if it doesn't do anything (which is very likely) I want to record here my dissatisfaction with the hospital and the poor service provided. A service where we pay for a private plan, which by the way is not cheap.

As a student, I was always welcomed by hospital professionals, especially for admission to the hospital. However, after some changes at the hospital, there is a DISTURBANCE with students, delaying our entry and jeopardizing our classes at the hospital. I write this evaluation with great regret, as it is a reference hospital, we students expected more respect and not the treatment we are receiving lately. Unfortunate. I can cite two examples that occurred to me recently. First, I had to wait more than 1h30 to enter the hospital and I missed to see a surgery. Second, due to the delay of the reception staff, my group and I had to miss 30 minutes of class!!!

I visited Sta Casa on two occasions as a patient and as a visitor, they provide an excellent service with trained doctors and well-prepared staff, I was well attended to and well treated by both......

Hospital concerned with providing quality care for everyone! Excellent projects will still come to the city that will provide better health for everyone!

Many are good, but in chemotherapy there is a need for more nurses to care for us who are undergoing treatment

I didn't imagine we would have such a positive experience, from reception to the surgical center staff, nursing staff, concierge. We were treated with incredible affection, the nurses took care of the patient and companion as if they were family. The kitchen maids, cleaners, what a team, there are no words to explain the amount of gratitude for all the care and affection we received.

I had orthognathic surgery last week, the entire team that attended to me during the 4 days were extremely dedicated. Mainly the nursing technicians: Juliana, Rebeca, Nice and Denise. When I was discharged I was afraid I wouldn't have the same care at home, but I needed to free up the room lol. I also thank the physiotherapist Karem (I don't know if it's K), for accompanying me during her shifts. I just have to thank you. 🙏🏻

I was very welcomed by the entire medical and nursing team. In the emergency, I particularly thank Dr. Elieber, his clinical evaluation led to a correct diagnosis even before the laboratory tests. Congratulations. For the nursing technician, Wendy, the affection and welcome made me feel protected. Thank you very much. I stayed in ward 202. Everyone was very attentive. I thank the nursing team in the Nurses. Pamela and the nursing technician Ana. I mentioned names but I was very well attended to by everyone. I would like to express my special thanks to Dr. Paula Righi Cardoso. She brought me security. Kindly explaining the treatment and clarifying all my doubts. Healthcare needs professionals like this. God bless you all. Much gratitude. I would also like to thank the nutrition, cleaning and physiotherapy teams. 🙏

Regular

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Legal.

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Excellent

I am completely outraged and frustrated with the service provided by Hospital São Camilo at the Ipiranga Unit in recent months. I had the misfortune of needing to go to the hospital a few times in a short period of time, and every time I went I had a terrible experience. But I'm going to focus on the day before yesterday, which was the last straw, and my cup of patience overflowed. The day before yesterday (11/21) I went to the hospital at 11:05 pm, with a severe migraine, nausea and weakness. When I went through the triage, they didn't even check my temperature, my blood pressure was high (14/9) and as the nurse said “it must be nothing, it could be because of your pain”. So far I agree, it could be because of the pain or my pain could be because of the pressure. I received a GREEN bracelet! Taking into account that the hospital follows the Manchester protocol, because of my absurd pain (those who have migraines know what I'm talking about) and because of my high blood pressure, I shouldn't have to wait for care for 2 hours (which is what says the Manchester protocol for the color GREEN). But they gave me this bracelet, and several people passed in front of me, it took more than 2 hours to wait to speak to the doctor, that's why I showed my indignation at the delay, because if I had remained quiet I would have waited another 2 hours. And the reception says that other people passed in front of me because they were other doctors, or it was orthopedics, or a general surgeon or Covid. And they also reiterated “you already and next time, the doctor was collecting the returns” IN other words, more people passed in front of me who were being discharged from the hospital, and yet were already medicated. Therefore, I was forgotten at reception with the pain they call N°10! And everyone knows that the more irritated a person gets, the worse the pain and the worse the pressure. So seeing my despair, where I was almost fainting from the pain, the receptionist asked me to go to the triage to re-evaluate my condition. Arriving at the screening, the blessed one looks at my face and says “Well?” I explain that the reception asked to reevaluate me and he responds “How? The reception?" I said “yes, the reception, the girl who is there at the tables”, and he replied “Really the reception?” I said yes!" and I pointed to the person, then he looked like he wasn't happy and checked my blood pressure again, it was still 14/9! After that I had to wait another 30 minutes until I was called, the receptionist was already desperate too, calling the hospital and informing them that I was feeling ill. Everyone passed by me, and did NOTHING! I was called to the doctor's room at 1:11 am, they made me wait more than 2 hours for an appointment, which according to the Manchester protocol should have been attended to with an ORANGE bracelet, and within 10 minutes. I can and I feel entitled to say that it was a failure to provide help, as my clinical condition was delicate, and the screening data and my face did not deny this, quite the contrary, they affirmed it. In a hospital like São Camilo, where I have been treated since I was 7 years old, when it still had the pediatrics area, you have left a LOT to be desired. You are a PRIVATE hospital, in case you forgot, if you are “short of professionals” hire more professionals. FOLLOW the protocol that YOU yourselves say you follow. Why a person almost fainting from pain, WITH ALL SURE IN THE WORLD, is not a green bracelet. And if it's too much to follow a WORLDWIDE protocol, STOP using and deceiving the people who will be served. Don't give me speeches about “we were without doctors”, “the four doctors who were attending were from other areas”, “your high blood pressure must be nothing”, “can I give you medicine X?”, “they are taking care of cases more serious than yours”, “the doctors were just going through the returns” because I'm TIRED of your lame excuses. I prefer you to take the time you would spend responding to me and review your services and professionals, why I felt neglected and in a hospital that for me was an example.

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I loved Google

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The place is too big, and nobody can explain how you move around there. I really didn't like it

Great place for medical emergency

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