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Palones E, Plaza V, Gonzalez-Quereda L, Segarra-Casas A, Querol L, Bertoletti F, Rodriguez MJ, Gallano P, Crespo-Lessmann A. Chronic Cough and Cerebellar Ataxia With Neuropathy and Bilateral Vestibular Areflexia Syndrome (CANVAS): Screening for Mutations in Replication Factor C Subunit 1 (RFC1). Arch Bronconeumol 2024:S0300-2896(24)00141-8. [PMID: 38755058 DOI: 10.1016/j.arbres.2024.04.028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/05/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION A common complaint in patients is chronic cough (CC), which may be refractory (RCC) or unexplained (UCC). Recent studies point, as a possible cause of CC, to the hereditary cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome (CANVAS), with an estimated carrier prevalence of 1 in 20000. AIM In patients with CC, determine the prevalence of the biallelic (AAGGG)exp mutation in replication factor C subunit 1 (RFC1) responsible for CANVAS, test the usefulness of the Rydel-Seiffer fork test, and evaluate patient quality of life (QoL). METHODS Clinical and functional data were collected for the 33 included patients undergoing CC studies in our specialized unit. Performed were an etiological study of CC following European Respiratory Society recommendations, a genetic study of RFC1 mutations, and Rydel-Seiffer fork testing to detect possible peripheral vibratory sensitivity impairment. Administered to evaluate QoL were 4 questionnaires. RESULTS Prevalence of biallelic (AAGGG)exp in RFC1 was 6.1% (n=2) overall, increasing to 7.1% in the RCC subgroup, and to 33.3% in the Rydel-Seiffer fork altered results subgroup. Prevalence of monoallelic (AAGGG)exp in RFC1 was 18.2% (n=6) overall, rising to 50.0% (n=2) in the UCC subgroup. CONCLUSION Genetic screening for (AAGGG)exp in RFC1, and also use of the Rydel-Seiffer fork test, should be considered in specialized CC consultations for patients with RCC and UCC. Detecting possible CANVAS symptoms in CC studies would identify candidates for early genetic screening, of interest in reducing the disease burden for patients and health systems alike.
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Affiliation(s)
- Esther Palones
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Respiratory Medicine, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | - Vicente Plaza
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Respiratory Medicine, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lidia Gonzalez-Quereda
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain; Genetics Department, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alba Segarra-Casas
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain; Genetics Department, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Luis Querol
- Neuromuscular Disease Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Federico Bertoletti
- Department of Digestive Pathology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María José Rodriguez
- Genetics Department, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pía Gallano
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain; Genetics Department, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Networked Biomedical Research Centre for Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Astrid Crespo-Lessmann
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Respiratory Medicine, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Palones E, García-Rivero JL, Cisneros C, Almonacid-Sánchez C, Pérez-de Llano L, Plaza V, Crespo-Lessmann A. Methodology Employed to Develop the Airway Mucus Secretion Test (T-SEC): A Questionnaire to Evaluate Airway Mucus Hypersecretion in Patients With Asthma. Arch Bronconeumol 2024; 60:186-190. [PMID: 38290898 DOI: 10.1016/j.arbres.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/29/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024]
Affiliation(s)
- Esther Palones
- Department of Respiratory Medicine, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau & IIB Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Juan Luis García-Rivero
- Department of Respiratory Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Carolina Cisneros
- Department of Respiratory Medicine, Hospital Universitario de La Princesa, Madrid, Spain
| | - Carlos Almonacid-Sánchez
- Department of Respiratory Medicine, Hospital Universitario de Puerta del Hierro Majadahonda, Madrid, Spain
| | - Luis Pérez-de Llano
- Department of Respiratory Medicine, Hospital Universitario de Lucus Augusti, Lugo, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau & IIB Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Astrid Crespo-Lessmann
- Department of Respiratory Medicine, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau & IIB Sant Pau, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Palones E, Curto E, Plaza V, Gonzalez-Quereda L, Segarra-Casas A, Querol L, Bertoletti F, Rodriguez MJ, Gallano P, Crespo-Lessmann A. Clinical and functional characteristics, possible causes, and impact of chronic cough in patients with cerebellar ataxia, neuropathy, and bilateral vestibular areflexia syndrome (CANVAS). J Neurol 2024; 271:1204-1212. [PMID: 37917234 PMCID: PMC10896788 DOI: 10.1007/s00415-023-12001-9] [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: 08/07/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 11/04/2023]
Abstract
Cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome (CANVAS) is an hereditary autosomal recessive disease. Recent studies propose including chronic cough (CC) as a symptom of CANVAS. For 10 patients with CANVAS as genetically confirmed by biallelic expansion of the AAGG repeat motif (AAGGGexp) in intron 2 of replication factor C subunit 1 (RFC1), our aim was, as a multidisciplinary team, to describe clinical and functional characteristics and possible causes of CC following European Respiratory Society (ERS) recommendations, and to evaluate CC impact on quality of life (QoL) using self-administered questionnaires (Cough Severity Diary, Leicester Cough Questionnaire, Discrete Emotions Questionnaire, and EQ-5D-5L). In all 10 patients, the CC was a dry cough that developed several years prior to the neurological symptoms (mean 14.2 years); 7 patients had symptoms compatible with gastroesophageal reflux (GER), 5 with pathological GER diagnosed by 24-h esophageal pH testing, and 6 patients had impaired esophageal motility diagnosed by high-resolution esophageal manometry, most frequently ineffective peristalsis. Although further studies are required for confirmation, we conclude that CC may be a characteristic prodrome of CANVAS and may be related to GER and esophageal disorders. Furthermore, CC affects patients' QoL, especially in the psychosocial sphere.
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Affiliation(s)
- Esther Palones
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | - Elena Curto
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Vicente Plaza
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lidia Gonzalez-Quereda
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alba Segarra-Casas
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Querol
- Neuromuscular Disease Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Federico Bertoletti
- Department of Digestive Pathology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María José Rodriguez
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pía Gallano
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Networked Biomedical Research Centre for Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Astrid Crespo-Lessmann
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Palones E, Curto E, Pelegrí A, Arilla M, Solanes I, Crespo-Lessmann A. Erratum to "Iatrogenic Adrenal Insufficiency Following Post COVID-19 Organizing Pneumonia" [Archivos de Bronconeumologia 59 (2023) 63-65]. Arch Bronconeumol 2024; 60:69. [PMID: 38040573 PMCID: PMC10838013 DOI: 10.1016/j.arbres.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Affiliation(s)
- Esther Palones
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Elena Curto
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Anna Pelegrí
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Marina Arilla
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Ingrid Solanes
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Astrid Crespo-Lessmann
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.
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Crespo-Lessmann A, Curto E, Mateus Medina EF, Palones E, Belda Soler A, Sánchez Maza S, Soto-Retes L, Plaza V. Erratum: Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma: Predictors of Bronchial Eosinophilia [Corrigendum]. J Asthma Allergy 2023; 16:1267-1268. [PMID: 38022752 PMCID: PMC10675634 DOI: 10.2147/jaa.s449238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
[This corrects the article DOI: 10.2147/JAA.S389402.].
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Crespo-Lessmann A, Curto E, Mateus Medina EF, Palones E, Belda Soler A, Sánchez Maza S, Soto-Retes L, Plaza V. Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma: Predictors of Bronchial Eosinophilia. J Asthma Allergy 2023; 16:95-103. [PMID: 36699564 PMCID: PMC9869783 DOI: 10.2147/jaa.s389402] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose The objectives of this study were, for patients attending a specialist asthma clinic at a tertiary care hospital, to determine, from sputum induction (SI), proportions of bronchial inflammatory phenotypes, demographic, clinical and functional characteristics of each phenotype, and the most accessible non-invasive inflammatory marker that best discriminates between phenotypes. Patients and Methods Included were 96 patients with asthma, attending a specialist asthma clinic at a tertiary care hospital, who underwent testing as follows: SI, spirometry, fractional exhaled nitric oxide (FeNO), blood eosinophilia, total immunoglobulin E (IgE), and a skin prick test. Results SI phenotypes were 46.9% eosinophilic, 33.3% paucigranulocytic, 15.6% neutrophilic, and 4.2% mixed. No significantly different clinical or functional characteristics were observed between the phenotypes. A positive correlation was observed between SI eosinophilia and both emergency visits in the last 12 months (p = 0.041; r = 0.214) and FeNO values (p = 0.000; r = 0.368). Blood eosinophilia correlated with SI eosinophilia (p = 0.001; r = 0.362) and was the best predictor of bronchial eosinophilia, followed by FeNO, and total blood IgE (area under the receiver operating characteristic curve (AUC-ROC) 72%, 65%, and 53%, respectively), although precision was only fair. Conclusion In consultations for severe asthma, the most frequent phenotype was eosinophilic. Peripheral blood eosinophilia is a reliable marker for discriminating between different bronchial inflammatory phenotypes, is useful in enabling doctors to select a suitable biologic treatment and so prevent asthma exacerbation, and is a better predictor of bronchial eosinophilia than FeNO and IgE values.
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Affiliation(s)
- Astrid Crespo-Lessmann
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Curto
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eder Freddy Mateus Medina
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Esther Palones
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alicia Belda Soler
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Soraya Sánchez Maza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lorena Soto-Retes
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vicente Plaza
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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Palones E, Curto E, Pelegrí A, Arilla M, Solanes I, Crespo-Lessmann A. Iatrogenic Adrenal Insufficiency Following Post COVID-19 Organizing Pneumonia. Arch Bronconeumol 2023; 59:63-65. [PMID: 35970652 PMCID: PMC9329133 DOI: 10.1016/j.arbres.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Esther Palones
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Elena Curto
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Anna Pelegrí
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Marina Arilla
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Ingrid Solanes
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Astrid Crespo-Lessmann
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Institut de Recerca IIB Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.
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Palones E, Pajares V, López L, Castillo D, Torrego A. Sarcoidosis following
SARS‐CoV
‐2 infection: Cause or consequence? Respirol Case Rep 2022; 10:e0955. [PMID: 35505665 PMCID: PMC9046551 DOI: 10.1002/rcr2.955] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 12/04/2022] Open
Abstract
The COVID‐19 pandemic has been a worldwide medical challenge. Despite rapid advancements, many questions regarding SARS‐CoV‐2 interaction with other pathologies and long‐term consequences remained unanswered. Sarcoidosis is a multi‐systemic granulomatous disease that develops in genetically predisposed individuals following their exposure to an environmental trigger. We present the case of a patient who was diagnosed with sarcoidosis following a SARS‐CoV‐2 infection.
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Affiliation(s)
- Esther Palones
- Pneumology Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Virginia Pajares
- Pneumology Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Laura López
- Pathological Anatomy Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Diego Castillo
- Pneumology Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Alfons Torrego
- Pneumology Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
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