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Guclu M, Aslan BB, Setayeshi T, Kiyici S. Could the presence of adrenal incidentaloma negatively affect COVID 19 outcomes? Endocrine 2023; 82:406-413. [PMID: 37488407 DOI: 10.1007/s12020-023-03454-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND AND OBJECTIVE Adrenal incidentalomas (AIs) are lesions larger than 1 cm that are incidentally detected in the adrenal glands. Chest computed tomography (CCT) is widely used in the first evaluation of patients with suspected coronavirus disease (COVID-19) that resulted in many incidental findings in the thorax and upper abdomen. In this study, we aimed to investigate the frequency of AI and their effects on the course and outcome of COVID-19 regardless of functional status. MATERIAL AND METHODS We included 2493 patients aged between 18 and 99 years and whose adrenal glands were clearly visible in CCT images. They were divided into two groups: those with AI (AI group) and without AI (Control group). RESULTS AI was detected in 148 (5.93%) patients and 80 (54.1%) of them were male. There was no difference in sex distribution between the groups, but the median age of patients with AI was significantly higher than those without AI [54.5 (20-94 years) vs. 42 (18-99 years); p < 0.001)]. In addition, in the AI group, both hospitalizations due to COVID-19-related conditions (30.4 vs. 21.2%, p = 0.008) and the mortality rate experienced during this time was significantly higher (14.7 vs. 7%, p < 0.001) diseases. The AI group had a significantly higher comorbidity rate than the control group (61.5 vs. 41.9%, p < 0.001). The most common comorbid diseases were hypertension, cardiovascular diseases, diabetes mellitus, respiratory system diseases, and hyperlipidaemia. Advanced age and male gender in terms of mortality, advanced age and covid 19 positivity in terms of hospitalization were determined as significant risk factors. CONCLUSIONS The presence of AI may increase the morbidity and mortality rates associated with COVID-19, regardless of their functional status. Therefore, patients subjected to CCT imaging for COVID-19-related lung diseases should also be evaluated for AI. Careful follow-up of patients with COVID-19 and AI is necessary to monitor the progression of COVID-19.
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Affiliation(s)
- Metin Guclu
- Bursa Faculty of Medicine, Yuksek Ihtisas Research Training and Hospital, Endocrinology and Metabolism Department, University of Health Sciences, Bursa, Turkey.
| | - Bilal Burcak Aslan
- Bursa Faculty of Medicine, Yuksek Ihtisas Research and Training Hospital, Department of Internal Medicine, University of Health Sciences, Bursa, Turkey
| | - Tirdad Setayeshi
- Bursa Faculty of Medicine, Yuksek Ihtisas Research and Training Hospital, Department of Radiology, University of Health Sciences, Bursa, Turkey
| | - Sinem Kiyici
- Bursa Faculty of Medicine, Yuksek Ihtisas Research Training and Hospital, Endocrinology and Metabolism Department, University of Health Sciences, Bursa, Turkey
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Huang D, Chang CPE, Newman M, Deshmukh V, Snyder J, Date A, Galvao C, Lloyd S, Henry NL, O'Neil B, Hashibe M. Adverse health outcomes among rural prostate cancer survivors: A population-based study. Cancer Epidemiol 2023; 86:102430. [PMID: 37473579 DOI: 10.1016/j.canep.2023.102430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/08/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Rural cancer survivors experience considerable health disparities compared to urban cancer survivors for cancer treatment and survival. The objective of our study was to investigate the risk of developing diseases for rural compared to urban prostate cancer survivors in Utah. METHODS We identified a cohort of 3575 rural prostate cancer survivors and 17,778 urban prostate cancer survivors from the Utah Cancer Registry. The Fine-Gray subdistribution hazards model was used to estimate hazard ratios and 95 % confidence intervals for diseases in major body systems among rural compared to urban prostate cancer survivors at > 1-5 years and > 5 years after prostate cancer diagnosis. RESULTS Rural residence was associated with an increased risk of diseases of the respiratory system at > 5 years (HR: 1.16, 95 % CI: 1.01-1.32) after cancer diagnosis compared to urban residence among prostate cancer survivors in Utah. Decreased risks were observed in infectious and parasitic diseases, diseases of the blood and blood-forming organs, diseases of the nervous system and sense organs, and diseases of the skin and subcutaneous tissue for rural prostate cancer survivors between 1 and 5 years after cancer diagnosis. CONCLUSIONS Rural prostate cancer survivors in Utah were somewhat healthier compared to urban prostate cancer survivors. Further studies are needed to confirm whether these associations are also supported for rural prostate cancer survivors in other regions of the U.S.
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Affiliation(s)
- Daren Huang
- Huntsman Cancer Institute, Salt Lake City, UT, United States; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Chun-Pin Esther Chang
- Huntsman Cancer Institute, Salt Lake City, UT, United States; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States.
| | - Michael Newman
- Department of Health Sciences, University of Utah, Salt Lake City, UT, United States
| | - Vikrant Deshmukh
- Department of Health Sciences, University of Utah, Salt Lake City, UT, United States
| | - John Snyder
- Intermountain Healthcare, Salt Lake City, UT, United States
| | - Ankita Date
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Carlos Galvao
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Shane Lloyd
- Department of Radiation Oncology, University of Utah, Salt Lake City, UT, United States
| | - N Lynn Henry
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Brock O'Neil
- Division of Urology, University of Utah, Salt Lake City, UT, United States
| | - Mia Hashibe
- Huntsman Cancer Institute, Salt Lake City, UT, United States; Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
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Khairy Y, Naghibi D, Moosavi A, Sardareh M, Azami-Aghdash S. Prevalence of hypertension and associated risks in hospitalized patients with COVID-19: a meta-analysis of meta-analyses with 1468 studies and 1,281,510 patients. Syst Rev 2022; 11:242. [PMID: 36397129 PMCID: PMC9672558 DOI: 10.1186/s13643-022-02111-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 10/30/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Since the COVID-19 outbreak, preliminary research has shown that some risk-associated conditions increase death and severe complications of the disease, hypertension being one of them. Thus, numerous meta-analyses have been conducted to explore this issue. Therefore, this umbrella review aims to perform a meta-analysis of the meta-analyses to estimate the prevalence and associated risks of hypertension in patients with COVID-19. METHODS PubMed, Scopus, Web of Knowledge, Embase, and Cochrane databases were searched for the published meta-analyses up to January 1, 2022. Google Scholar, citation check, reference check, and Grey literature were also manually searched. A random-effect model approach was used for analysis. RESULTS The overall death rate was estimated at 12%. Hypertension was present in 25% of the patients as a comorbid disease. The overall RR for death, disease severity, and the possibility of ICU admission were estimated at 1.79 [1.68-1.89 with 95% CI], 1.74 [1.66-1.83 with 95% CI], and 1.91 [1.48-2.34 with 95% CI], respectively. The meta-regression results showed that being "male" significantly increases the risk of disease severity and ICU admission. CONCLUSIONS The results indicated that hypertension is a common comorbid disease in hospitalized patients with COVID-19, which significantly increases mortality risk, the severity of the disease, and the probability of ICU admission. SYSTEMATIC REVIEW REGISTRATION This study has been registered in PROSPERO (CRD42021231844).
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Affiliation(s)
- Yousof Khairy
- Center for the Development of Interdisciplinary Research in Islamic Sciences and Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Deniz Naghibi
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Ahmad Moosavi
- Department of Health and Community Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Mehran Sardareh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Wibisono E, Hadi U, Bramantono, Arfijanto MV, Rusli M, Rahman BE, Asmarawati TP, Choirunnisa ML, Rahayu DRP. National early warning score (NEWS) 2 predicts hospital mortality from COVID-19 patients. Ann Med Surg (Lond) 2022; 76:103462. [PMID: 35284070 DOI: 10.1016/j.amsu.2022.103462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/22/2022] Open
Abstract
Background COVID-19 has a high risk of mortality, especially in patients with comorbid diseases such as cardiac disease, type 2 diabetes mellitus, chronic kidney disease, and hypertension. The National Early Warning Score (NEWS) is a tool that helps in identifying changes in patient conditions that require intensive treatment. Objective Analyzing NEWS-2 to identify the risk of death in COVID-19 patients. Methods This research was conducted from June to July 2020 by using quota sampling. The number of participants in this study was 112 participants (case group = 56 participants and control group = 56 participants). Participants were assessed for NEWS-2 and evaluated for their treatment outcomes. The analysis used in this study was the Chi-squared test and logistic regression with p < 0.05. Results 45 participants died of having NEWS-2 score >5, and as many as 50 participants showed an improvement in their condition by having NEWS-2 score 5 (OR = 34.091; p < 0.001). The accuracy of NEWS-2's assessment of mortality of COVID-19 patients had a sensitivity of 80.4% and a specificity of 89.3%. There were several comorbid diseases that had a significant relationship on mortality of COVID-19 patients such as cardiac disease (β = 5.907; 1.107-31.527 95% CI; p = 0.038), T2DM (β = 3.143; 1.269-7.783 95% CI; p = 0.013), CKD (β = 3.851; 1.195-12.416 95% CI; p = 0.024), and hypertension (β = 2.820; 1.075-7.399 95% CI; p = 0.035). Conclusion The NEWS-2 can be used to identify the risk of death of COVID-19 patients.
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Zhao XC, Zhao L, Sun XY, Xu ZS, Ju B, Meng FJ, Zhao HG. Excellent response of severe aplastic anemia to treatment of gut inflammation: A case report and review of the literature. World J Clin Cases 2020; 8:425-435. [PMID: 32047795 PMCID: PMC7000934 DOI: 10.12998/wjcc.v8.i2.425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/02/2019] [Accepted: 12/22/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cumulative evidence suggests that the aberrant immune responses in acquired aplastic anemia (AA) are sustained by active chronic infections in genetically susceptible individuals. Recently, the constant source to trigger and sustain the pathophysiology has been proposed to come from the altered gut microbiota and chronic intestinal inflammation. In this case, our serendipitous finding provides convincing evidence that the persistently dysregulated autoimmunity may be generated, at least in a significant proposition of AA patients, by the altered gut microbiota and compromised intestinal epithelium.
CASE SUMMARY A 30-year-old Chinese male patient with refractory severe AA experienced a 3-month-long febrile episode, and his fever was refractory to many kinds of injected broad-spectrum antibiotics. When presenting with abdominal cramps, he was prescribed oral mannitol and gentamycin to get rid of the gut infection. This treatment resulted in a quick resolution of the fever. Unanticipatedly, it also produced an excellent hematological response. He had undergone three episodes of recurrence within the one-year treatment, with each recurrence occurring 7-8 wk from the gastrointestinal inflammation eliminating preparations. However, subsequent treatments were able to produce subsequent remissions and consecutive treatments were successful in achieving durative hematological improvements, strongly indicating an etiological association between chronic gut inflammation and the development of AA. Interestingly, comorbid diseases superimposed on this patient (namely, psychiatric disorders, hypertension, insulin resistance, and renal dysfunction) were ameliorated together with the hematological improvements.
CONCLUSION Chronic gut inflammation may be responsible for AA pathogenesis. The comorbidities and AA may share a common etiological association.
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Affiliation(s)
- Xi-Chen Zhao
- Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Li Zhao
- Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Xiao-Yun Sun
- Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Zeng-Shan Xu
- Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Bo Ju
- Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
| | - Fan-Jun Meng
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Hong-Guo Zhao
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
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de Pascale S, Belotti D, Celotti A, Minerva EM, Quagliuolo V, Rosati R, Romario UF. Prognostic factors for short-term and long-term outcomes of gastric cancer surgery for elderly patients: 10 years of experience at a single tertiary care center. Updates Surg 2018; 70:265-71. [PMID: 29961192 DOI: 10.1007/s13304-018-0548-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
Abstract
This retrospective study aimed to verify the short-term and long-term outcomes of elderly patients who underwent gastric resection for gastric cancer and to compare the results between younger and elderly patients. 222 Patients, who underwent gastrectomy between January 2005 and December 2014, were divided into 2 groups: ≤ 75 years old (group A) and > 75 years (group B). The groups were homogeneous except for more advanced pathological stage (p = 0.011) and higher number of comorbidities in group B (p < 0.001) and a higher rate of neoadjuvant or adjuvant complementary therapy in group A (p = 0.029 and p < 0.001). Perioperative morbidity rates were 38.7 and 65.5% (p = 0.001), and mortality rates were 2.5 and 7.9% (p = ns), respectively. The independent negative prognostic factors for morbidity were age older than 75 years [odds ratio (OR) 2.7], multiple organ resection (OR 2.4), and male gender (OR 1.8). The 36-month survival rates were 76.1% and 42.1% (p = 0.002) and disease-free survival rates were 85% and 76.3% (p = 0.017), respectively. Surgical indications should not be limited by age.
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Erdogan T, Karakaya G, Kalyoncu AF. Comorbid diseases in aspirin-exacerbated respiratory disease, and asthma. Allergol Immunopathol (Madr) 2015; 43:442-8. [PMID: 25547458 DOI: 10.1016/j.aller.2014.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 07/22/2014] [Accepted: 07/31/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Asthma, persistent rhinosinusitis, and/or nasal polyposis accompanying non-steroidal anti-inflammatory drug (NSAID) intolerance is defined as aspirin-exacerbated respiratory disease (AERD). Although the literature includes considerable data on comorbidities in asthma, data on comorbidities in AERD have not been previously published. OBJECTIVE This study aimed to determine the prevalence of comorbidities in AERD and compare the findings to those in asthmatic patients. MATERIALS AND METHODS The records for 330 AERD patients that presented to our allergy clinic were reviewed. Patients with urticaria/angio-oedema type reactions to NSAIDs were included in the pseudo Samter's group (n=83) and 338 randomly selected NSAID-tolerant asthma patients constituted the control group. RESULTS Gender, age at presentation, age at onset of asthma, and follow-up periods were similar in all groups. Hypertension (P=0.035), diabetes mellitus (P=0.323), gastro-oesophageal reflux (P<0.001), psychological disorders (P=0.099), obesity (P=0.003), and hyperlipidaemia (P=0.002) were significantly more prevalent in the asthma group. Interestingly, coronary artery disease (CAD) and congestive heart failure (CHF) were more common in the AERD group (P=0.178); CAD/CHF was associated with AERD (OR: 4.5; 95% CI: 1.206-16.93). CONCLUSION AERD and asthma are associated with several comorbidities. Even though systemic steroid dependency and severe asthma were significantly more common in the AERD group, comorbidities occurred more frequently in the asthma group. Additional longitudinal studies are needed to more clearly discern if the risk of CAD/CHF is increased in AERD.
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Hsiao KCW, Wann JG, Lin CS, Wu CC, Jao SW, Yang MH. Colonic diverticulitis with comorbid diseases may require elective colectomy. World J Gastroenterol 2013; 19:6613-6617. [PMID: 24151389 PMCID: PMC3801376 DOI: 10.3748/wjg.v19.i39.6613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 08/25/2013] [Accepted: 09/17/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.
METHODS: A retrospective chart review of 246 patients with colonic diverticulitis admitted between 2000 and 2008 was conducted, and 19 patients received emergent operation were identified and analyzed. Data were collected with regard to age, sex, albumin level on admission, left or right inflammation site, the history of recurrent diverticulitis, preoperative comorbidity, smoking habits, medication, treatment policy, morbidity, and mortality. Preoperative comorbid diseases included cardiovascular disease, diabetes, pulmonary disease, peptic ulcer disease, gouty arthritis, and uremia. Medications in use included non-steroidal anti-inflammatory drugs, acetylsalicylic acid (Aspirin), and corticosteroids. Univariate and multivariate logistic regression analyses were performed to identify the relevant risk factors correlating to colectomy.
RESULTS: The mean age of the 246 patients was 69.5 years (range, 24-94 years). Most diverticulitis could be managed with conservative treatment (n = 227, 92.3%), and urgent colectomy was performed in 19 patients (7.7%). There were three deaths in the surgical group and four deaths in the nonsurgical group. The overall mortality rate in the study was 1.7% among patients with conservative treatment and 15.7% among patients undergoing urgent colectomy. Multiple logistic regression analysis indicated that comorbidities were risk factors for urgent colectomy for diverticulitis.
CONCLUSION: To avoid high mortality and morbidity related to urgent colectomy, we suggest that patients with colonic diverticulitis and comorbid diseases may require elective colectomy.
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Kim BJ, Chang TH, Kim JJ, Min BH, Lee JH, Son HJ, Rhee PL, Rhee JC, Kim KM, Park CK. Efficacy and safety of endoscopic submucosal dissection for early gastric cancer in patients with comorbid diseases. Gut Liver 2010; 4:186-91. [PMID: 20559520 DOI: 10.5009/gnl.2010.4.2.186] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 11/19/2009] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS Endoscopic submucosal dissection (ESD), a new and potentially curative method for treating gastrointestinal neoplasms, may have longer procedure time and the risk of complications when compared to conventional endoscopic mucosal resection. This study evaluated the efficacy and safety of ESD in patients with comorbid diseases. METHODS The outcomes of 337 patients who underwent ESD for early gastric cancer at Samsung Medical Center from April 2003 to December 2006 were analyzed retrospectively. The Charlson comorbidity scale was used to divide the patients into low-risk (no risk factor) and high-risk (at least one risk factor) groups. The outcomes and complications were compared between the high- and low-risk groups. RESULTS The low- and high-risk groups comprised 240 and 97 patients with mean ages of 61.1 and 64.7 years, respectively (p=0.002). Tumor location, tumor size, depth of invasion, procedure duration, and rates of en bloc resection, complete resection, complication, and recurrence did not differ significantly between the two groups (p>0.05). CONCLUSIONS ESD may be a safe and effective treatment for early gastric cancer in patients with comorbid diseases.
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Affiliation(s)
- Beom Jin Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
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