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1.
Journal of the National Medical Association ; 93(7): 238-242, Aug. 2001. tab
Artigo em Inglês | MedCarib | ID: med-17768

RESUMO

Among 1470 elderly hospitalized and nonhospitalized people, 566 cases of bacteriuria were identified. There were 663 men (41.5% with bacteriuria) and 807 women (36.0% with bacteriuria). The overall prevalence of bacteriuria was 38.5%. More than 90% of the isolates were gram-negative organisms with Proteus species being the predominant pathogen among men, with 68.1% seen among inpatients. Escherichia coli was the main pathogen in women, with 62.0% recovered from inpatients. Catheterization was seen most commonly among non-hospitalized males with outflow obstruction. Catheter care in this population is often performed at home by these men who either refuse prostate surgery, are not fit for surgery, or are awaiting surgery. Polymicrobic bacteriuria was identified more frequently (approximately 60%) among the catheterized group. Of the 440 gram-negative bacilli recovered as single organisms, 352 (80.0%) were resistant to ampicillin, cephalothin, and tetracycline, whereas 229 (52.0%) were resistant to co-trimoxazole. The most effective antibiotics (in increasing order of sensitivity; 80% - 100%) were augmentin, nalidixic acid, cefuroxime, gentomicin, and ciprofloxacin. No mortality due to bacteremia complicated by bacteriuria was observed during the study period.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Feminino , Bacteriúria/tratamento farmacológico , Bacteriúria/epidemiologia , Bacteriúria/microbiologia , Bacteriúria/prevenção & controle , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Resistência Microbiana a Medicamentos , Prevalência , Fatores de Risco , Distribuição por Sexo , Trinidad e Tobago/epidemiologia
2.
Cent Afr J Med ; 44(11): 283-6, Nov. 1998.
Artigo em Inglês | MedCarib | ID: med-1335

RESUMO

OBJECTIVE: To compare microbial prevalence (mixed versus pure), define microbial combination in mixed urine cultures among inpatients and outpatients to identify factors that might allow a more objective interpretation of polymicrobic urine cultures. DESIGN: Case series. SETTING: The study involved inpatients (hospitalized) and outpatients (those attending outpatient clinics and the accident and emergency department) of the San Fernando General Hospital in southern Trinidad. MAIN OUTCOME MEASURES: Prevalence rates of bacterial isolates in mixed and pure cultures of urine specimens were determined using standard techniques and Kirby-Bauer disc diffusion methodology. RESULTS: The results showed that of 5,089 urine specimens, 1,491 (29.3 percent) yielded positive cultures. Of these positive cultures, 524 (35.1 percent) revealed significant polymicrobic bacteriuria. Eighty five percent yielded two organisms 13.2 percent had three organisms and 1.8 percent had four organisms. Repeat cultures 157 patients revealed the same organisms in only 57.3 percent of them. Almost all of the repeat cultures were from patients with in-dwelling Foley catheters. E. coli was the most common single isolate (42.8 percent), while Klebsiella, Enterobacter and Proteus organisms were most often encountered in mixed cultures. All isolates were relatively sensitive to routinely used antibiotics for urinary pathogens. CONCLUSION: The prevalence rate of polymicrobic bacteriuria at our institution was 10.2 percent. More than 65 percent of positive cultures were from patients with Foley catheters on open drainage (inpatients) and closed drainage (outpatients). Most were men with out-flow obstruction who either refused surgery, were unfit for surgery, or had to wait long periods to be booked for surgery. No cases developed bacteremia secondary to bacteriuria. All urinary isolates were susceptible to routinely used antimicrobial agents.(Au)


Assuntos
Feminino , Humanos , Masculino , Estudo Comparativo , Bacteriúria/microbiologia , Pacientes Internados/estatística & dados numéricos , Pacientes Ambulatoriais/estatística & dados numéricos , Bacteriúria/etiologia , Bacteriúria/urina , Hospitais Gerais , Hospitais de Ensino , Controle de Infecções , Testes de Sensibilidade Microbiana , Prevalência , Estudos Prospectivos , Fatores de Risco , Trinidad e Tobago , Cateterismo Urinário/efeitos adversos
3.
West Indian med. j ; 44(1): 28-31, Mar. 1995.
Artigo em Inglês | MedCarib | ID: med-7230

RESUMO

The prevalence and socio-biological relations of bacteriuria was found to be 16.7 percent and it was more common in the 30-39 age group, among parous women, among negroes, and in patients with a low family income and overcrowded living conditions. Symptoms were present in 19 percent of bacteriuric patients and almost one-third gave a past history of urinary tract infection. Only 10 percent had been previously exposed to sexually transmitted diseases such as syphilis, gonorrhoea and herpetic genital infections. Because of the serious consequences to mother and foetus, we advocate quantitative urine cultures for all antenatal patients, especially those from disadvantaged socio-economic conditions (AU)


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Bacteriúria/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Trinidad e Tobago/epidemiologia , Fatores Socioeconômicos , Fatores de Risco , Urina , Bacteriúria/complicações , Cuidado Pré-Natal , Estudos Prospectivos
4.
Kingston; [Unpublished]; 1994. 70 p. tab.
Tese em Inglês | MedCarib | ID: med-7703

RESUMO

Significant bacteriuria in pregnancy, particularly when asymptomatic remains a major problem due to the many complications that have been associated with this condition. In this study, 457 samples of midstream urine from pregnant women attending the UWI-ANC and the CHC-ANC and 164 from non-pregnant women attending the Freezone clinic were collected between March 18 and April 11, 1994. Laboratory investigations to determine significant bacteriuria, the distribution of isolates and their antimicrobial susceptibility were performed. Population characteristics such as age, parity, socio-economic status and gestational age as well as the presence of symptoms consistent with urinary tract infection and choice of treatment were ascertained via the use of a questionnaire. The level of contamination among the samples was compared with that found in the Microbiology Laboratory UWI within the same period. While the prevalence of significant bacteriuria in pregnancy was 19.6 percent, that of asymptomatic bacteriuria was 13.3 percent compared with 7.3 percent among non-pregnant women. This difference was of statistical significance (p < 0.01). Statistical significant association existed between bacteriuria and the presence of symptoms, pyuria, gestational age. None was found with age, parity and socio-economic status. The three most common isolates were Streptococcus group B, Streptococcus faecalis and Staphylococcus aureus. Resistance to Ampicillin was high (37.8 percent) while resistance to Bactrim was low (3.3 percent). The level of contamination of samples from pregnant women was 4.2 percent compared to 11.5 percent found in the laboratory. This study highlighhts the problem of asymptomatic bacteriuria and suggests the need for further studies using larger samples to confirm these interesting findings (AU)


Assuntos
Gravidez , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , FENALE , Bacteriúria/epidemiologia , Bacteriúria/terapia , Urina/microbiologia
5.
West Indian med. j ; 40(suppl. 1): 34, April 1991.
Artigo em Inglês | MedCarib | ID: med-5577

RESUMO

This study was designed to compare the prevalence of asymptomatic bacteriuria in diabetic and non-diabetic adult females. Sixty stable, asymptomatic female diabetics (mean age 50 years) attending diabetics out-patients clinic and 66 non-diabetic hypertensives (mean age 51 years) attending diabetic, hypertensive out-patient clinic at the Queen Elizabeth Hospital were studied. Mid-stream urines were examined microscopically, tested by dipstick for glucose, protein and nitrite and cultured on the same day, using standardized techniques. Significant bacteriuria (>10 to fifth power cfu/ml) was detected in 7 diabetic patients (11.7 percent) and in 3 control patients (4.5 percent), (xý = 2.18. 0.5 1.0). Pyuria (<5 cells/hpf) was found in 14 diabetics (23 percent) and only 6 (9 percent) patients in the control group (Xý = 4.77, 0.05>p>0.01). Four diabetics had both significant bacteriuria and pyuria, and none of the controls. Three of the diabetics were hospitalized during the past twelve months for UTIs, including one with pyelonephritis, and none of the controls. Treatment of asymptomatic bacteriuria in diabetics may help prevent morbidity, especially of the upper urinary tract (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Bacteriúria , Diabetes Mellitus/microbiologia
6.
West Indian med. j ; 38(Suppl. 1): 26, April 1989.
Artigo em Inglês | MedCarib | ID: med-5695

RESUMO

The culture of mid-stream specimen of urines for significant bacteriuria forms the bulk of the workload of the microbiological laboratory. Any screening test which can effectively reduce this load will be most useful. This study evaluated the LN strip in 942 urine samples, using 10 (to the 4th power) Colony Forming Units/ml of one or two species as the criterion for signiifcant bacteriuria. The prevalence rate of infection was 32.1 percent. The sensitivity of the LN test was 82.5 percent, the specificity was 38.5 percent and the negative predictive value was 81.9 percent. These results have demonstrated that the LN test in this study was not cost-effective. Further study in more selected populations with a lower prevalence rate of infection may yet prove the LN strip to be cost-effective (AU)


Assuntos
Humanos , Bacteriúria/diagnóstico , Urina/microbiologia
7.
West Indian med. j ; 37(Suppl. 2): 18-19, Nov. 1988.
Artigo em Inglês | MedCarib | ID: med-5845

RESUMO

Infection is a contributing or initiating factor in children with inadequate food intake who develop malnutrition, and malnutrition by virtue of immunosuppression leads to further episodes of infection. In this prospective study, 206 community acquired and 73 nosocomial infections occurring in 50 hospitalised severely malnourished children were investigated. This represented an average of 5.6 episodes of infection per child. Predominant community acquired infections in the 50 children included gastroenteritis (68 percent), otitis media (60 percent), rhinopharyngitis (60 percent), oral candidiasis (46 percent), skin infections (40 percent), pneumonia (28 percent), bacteraemia (24 percent), and bacteriuria (18 percent). The most frequent nosocomial infections were rhinopharyngitis (34 percent), lower respiratory tract infections (24 percent) and septicaemia (18 percent). In those infections where an aetiological agent was identified, Giardia lamblia was the commonest enteric pathogen and Klebsiella sp. were recovered from the majority of urines. Coagulase Negative Staphylococcus was the most frequent aetiological agent of bacteraemia, 12 of the 13 episodes were associated with fever +/- leucocytosis and in six episodes this organism was recovered from two or more blood culture sets. The lack of clinical signs and symptoms, and the atypical presentation in some of the infected malnourished children were attributed to impairment of the acute inflammatory response. Nasal, throat and axillary swabs taken on admission revealed significant colonisation with coliforms and pneumococcus; however, these swabs were not useful as indicators of potentially infective organisms. Two of the four deaths were attributed to infection. The role of Cryptosporidium, an enteric pathogen which is prevalent in immunocompromised hosts, was further investigated. Cryptosporidium was isolated from the stools of 19.5 percent (15/77) malnourished children compared to 2.4 percent (10/436) well-nourished children, who were more likely to present with fever, vomiting, prolonged diarrhoea and dehydration. Community acquired non-bacterial respiratory tract infections were further investigated from paired sera in 83 moderately malnourished children. In 60 percent of the children with a history of respiratory tract disease and 25 percent of those without reported disease, a specific non-bacterial infection was diagnosed. Multiple aetiological agents were identified in 6 of the 42 chidren with respiratory disease. The most common micro-organisms observed were: Para-influenza 1,2 or 3 (in 15 children), Influenza H1N1, H2N3 or "B" in 12, Adenovirus in 10, Respiratory Syncitial Virus in 7 and Mycoplasma Pneumoniae in 6 children. These three studies report a high prevalence of common and unusual infections, especially Cryptosporidium enteritis and Coagulase Negative Staphylococcus bacteraemia, occurring in these immunocompromised children. Diagnosis of infection requires a high index of suspicion and a comprehensive screening system (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Infecção Hospitalar/etiologia , Infecções Comunitárias Adquiridas , Distúrbios Nutricionais/sangue , Jamaica/epidemiologia , Bacteriúria , Candidíase Bucal , Nasofaringe , Gastroenterite , Giardia lamblia/patogenicidade
8.
West Indian med. j ; 33(3): 180-4, Sept. 1984.
Artigo em Inglês | MedCarib | ID: med-11470

RESUMO

The sensitivity patterns of gram-negative organism were recorded over a six-month period from August 1982 to January 1983, and percentage sensitivities were calculated for urine and non-urine isolates. Sensitivity patterns did not differ substancially from those previously reported. However, urine isolates were shown to be significantly more resistant to antimicobials when compared with non-urine isolates. Multiresistant strains of Serratia marcesens demonstrated considerable resistance to all anibiotics except amikacin. Analysis of data on a monthly basis revealed significant changes in the antibiograms of E. coli and Acinetobacter sp. Antimicrobials on restricted usage maintained a high level of activity with the exception of tobramycin. (AU)


Assuntos
Humanos , Antibacterianos/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bacteriúria/microbiologia , Resistência Microbiana a Medicamentos , Bactérias Gram-Negativas/isolamento & purificação , Jamaica
10.
Lancet ; 2(7989): 784-6, Oct. 1976.
Artigo em Inglês | MedCarib | ID: med-13169

RESUMO

An epidemiological survey of adults aged 35-64 years living in a rural area of Jamaica was started in 1962-63 and continued until 1975. Information was available on 856 subjects with AA and 119 subjects with AS h‘moglobin genotypes. The mortality-rates over 12 or 13 years and the number of clinic attendances in 10 years did not differ significantly between subjects with AA and those with AS h‘moglobin. The patterns of disease as well as the life expectancy of the two groups appeared to be the same.(Summary)


Assuntos
Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Anemia Falciforme/mortalidade , Morbidade , Mortalidade , Anemia Falciforme/complicações , Anemia Falciforme/genética , Bacteriúria/epidemiologia , Bacteriúria/mortalidade , Estudo Comparativo , Seguimentos , Genótipo , Jamaica , Expectativa de Vida , Saúde da População Rural , Razão de Masculinidade , Fatores de Tempo
12.
West Indian med. j;19(2): 71-7, June 1970.
em Inglês | MedCarib | ID: med-10969

RESUMO

The "Uroscreen" as a screening test for significant bacteriuria has been assessed and shown to have an accuracy of 88.3 percent: there is a false positive rate of 56.6 percent of positive tests, or 14.4 percent of all tests, when compared with single plate cultures. All cases of significant bacteriuria associated with E.coli were detected by the "Uroscreen". It is recommended that the routine described be used. A urine screening test for significant bacteriuria has for the second time been assessed against the standard of significant bacteriuria; which in this series has been shown to have a confidence of 96 percent. It has been confirmed that routine screening for significant bacteriuria post partum is necessary, and appears most important in the primigravida. Post partum infection offers an explanation for the increase in prevalence of significant bacteriuria with parity. The figures confirm those of the University of the West Indies and indicate the prevalence of significant bacteriuria in the general pregnant population of Jamaica and the Caribbean may be similar to or higher than that found in series from other countries (AU)


Assuntos
Feminino , Humanos , Bactérias/isolamento & purificação , Bacteriúria/diagnóstico , Programas de Rastreamento , Complicações Infecciosas na Gravidez/diagnóstico , Urina/microbiologia , Derivados de Benzeno , Cloretos , Gravidez , Jamaica
13.
Am J Epidemiol ; 90(3): 236-43, Sept. 1969.
Artigo em Inglês | MedCarib | ID: med-12452

RESUMO

In surveys of representative samples of Jamaicans aged 35-64 years living in rural and suburan communities, no significant differences in heights, weights, hematological indices, cardiothoracic ratios, blood pressures, glycosuria, proteinuria, parity or electrocardiographic abnormalaties were apparent between 167 subjects with the sickle cell trait, AS, and 1,282 subjects with normal hemoglobin, AA. Older women with the trait had a significantly higher prevalence of bacteriuria without other evidence of urinary tract pathalogy. The findings suggest that the trait is not appreciably associated with chronic disease. (AU)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Anemia Falciforme , Anemia/sangue , Anemia/complicações , Anemia/epidemiologia , Anemia/fisiopatologia , Bacteriúria/complicações , Bacteriúria/epidemiologia , Pressão Arterial , Estatura , Peso Corporal , Eletrocardiografia , Métodos Epidemiológicos , Glicosúria/complicações , Glicosúria/epidemiologia , Cardiopatias/complicações , Jamaica , Paridade , Proteinúria/complicações , Proteinúria/epidemiologia , Amostragem
14.
J Med Assoc Jamaica ; 3(1): 3,5, Apr. 1968.
Artigo em Inglês | MedCarib | ID: med-15534

RESUMO

A series is described in which 500 mid stream specimens of urine were collected from 265 women in the antenatal and postnatal period, and the results of the "Uroscreen" test and plate culture were correlated. Analysis of the results showed only a 50 percent correlation. In the 249 antenatal women there was a 10.9 percent incidence of significant bacteriuria by plate culture, and the "Uroscreen" correlated in 72.8 percent of these cases. There was only a 66.6 percent, instead of an expected 80 percent, confirmation of the first plate culture; and this is felt to reflect the fact that the urines were not examined when freshly voided. Of those found to have significant bacteriuria, 22.7 percent were found to have renal abnormality, on radiological examination. From this small series and an examination of the literature, it is concluded that for consistent results two consecutive, freshly voided, mid stream, early morning specimens of urine, which has been in the bladder for at least two hours must be examined. A delay of more than an hour or two, or refrigeration at 4§C for 24 hours or more before examination may yield unreliable information. It is urged that as significant bacteriuria was found for the first time in the puerperium. It is felt that the presence of significant bacteriuria in mothers might indicate those infants who could profitably have urine examination. A current investigation is being undertaken to test "Uroscreen" against a standard of an expected 95 percent accuracy. (AU)


Assuntos
Humanos , Feminino , Gravidez , Bacteriúria/urina , Jamaica
15.
West Indian med. j ; 16(3): 178, Sept. 1967.
Artigo em Inglês | MedCarib | ID: med-7308

RESUMO

A screening programme involving approximately 6,000 pregnant negro females has revealed the incidence of bacteriuria to be three per cent in Jamaica. Asymptomatic bacteriuria was shown to be associated with a higher incidence of pyelonephritis, prematurity, pre-eclamptic toxaemia and other hypertensive disorders of pregnancy (Stuart et al, 1965, Brit. Med. J., 1, 554). Present study was undertaken, in order to eradicate bacteriuria and study the results of this. One hundred and fifty bacteriurics were treated with nitro-furantoin (100 mg. twice daily) and a matching placebo on a double blind basis. In distinction to long-term therapy (Kincaid-Smith, P., 1965, International symposium on Progress in Pyelonephritis, Ed. by E. H. Kass, p. 11, Davis, Philadelphia a short three-week course was found sufficient to keep approximately 80 per cent patients bacteria-free for the rest of the pregnancy. All relapses except one cleared on a repeat course. Approximately 60 per cent of subjects on placebo therapy remained positive to delivery. Clinical pyelonephritis occurred in 30 per cent of untreated or unsuccessfully treated bacteriurics. Early foetal loss, prematurity and relatively small size of babies were twice as common in persistent bacteriurics as compared with successfully treated group. The offspring of the treated and persistent bacteriurics were studied for rates of growth in the first four months of life. No clearcut difference has emerged as yet. Twenty treated and untreated patients have been subjected to renal function tests. The tests include urinalysis, blood urea, electrolytes, dehydrated osmolaity, water concentration test, creatinine clearance test and intravenous pyelogram by the infusion technique. No gross abnormality has been demonstrated although the results in successfully treated groups seem to be superior to those in untreated groups (AU)


Assuntos
Gravidez , Adulto , Humanos , Feminino , Bacteriúria/terapia , Complicações Infecciosas na Gravidez , Jamaica
16.
West Indian med. j ; 14(2): 138, June 1965.
Artigo em Inglês | MedCarib | ID: med-7356

RESUMO

In all age and parity groups the occurrence of prematurity and the hypertensive disorders of pregnancy was higher in bacteriurics than in non-bacteriurics. Prevalence rates for the emergence of the hypertensive disorders of pregnancy rose particularly rapidly with increasing age and parity in bacteriuric subjects. The predictive values of bacteriuria as an index of subsequent clinical pyelonephritis was confirmed. Some of the perinatal mortality and morbidity associated with hypertension and prematurity may be preventable (AU)


Assuntos
Humanos , Gravidez , Recém-Nascido , Feminino , Complicações na Gravidez , Bacteriúria/prevenção & controle , Trabalho de Parto Prematuro
17.
Br Med J ; 1(5434): 554-6, Feb. 27, 1965.
Artigo em Inglês | MedCarib | ID: med-9606

RESUMO

The occurrance of prematurity and the hypertensive disorders of pregnancy in bacteriuric and in non-bacteriuric women has been compared. In all age and parity groups the occurrance of prematurity and the hypertensive disorders of pregnancy was higher in bacteriurics than in non-bacteriurics. Prevalence rates for the emergence of the hypertensive disorders of pregnancy rose particularly rapidly with increasing age parity in bacteriuric subjects. The predictive value of bacteriuria as an index of subsequent clinical pyelonephritis has been confirmed. The possible implications of these observations are discussed. It is suggested that some of the perinatal mortality and morbidity associated with hypertension and prematurity may be preventable. (Summary)


Assuntos
Humanos , Gravidez , Feminino , Complicações na Gravidez , Bacteriúria/prevenção & controle , Trabalho de Parto Prematuro , Paridade , Fatores Etários , Grupos Controle , Hipertensão , Urina/análise , Jamaica
18.
Br Med J ; 2(5303): 497-506, Aug. 1962.
Artigo em Inglês | MedCarib | ID: med-14565

RESUMO

Representative rural and urban populations in Jamaica were defined geographically, enumerated by private census, and visited at home by two physicians who carried out indirect arterial blood-pressure measurements. These readings have been related to a number of personal and environmental factors,and this analysis shows the following facts. 1. There was a considerable difference in the prevalence of hypertension, particularly among women, between neighbouring rural and urban negro populations, with relative higher prevalence in the women from the rural area. This was not attributable to differences in survey technique, weight, or pulse rate, nor to differnces in the prevalence of hypertension secondary to renal disease as detected by proteinuria. 2. Bacteriuria (the presence of Gram-negative rods in a concentration of 10E5 or more bacteria per ml. in repeated specimens of clean-voided urine), which was usually asymptomatic, was a common finding among women (4.4 percent of women investigated), was significantly more common in the rural area, was related to hypertension, and was found in 15 percent of females with diastolic pressures exceeding 110 mm Hg in these surveys. Bacteriuria was found in only 0.5 percent of males. 3. The relationship between bacteriuria, as detected in one prevalence study, and hypertension was not sufficient to account for the differences in the prevalence of hypertension between these two female populations. 4. Mean arterial pressures as found in these Jamaican populations were lower than those reported in other surveys of Western Negro populations. 5. Pregnant women in Jamaica had significantly lower systolic and diastolic pressures than those who were not pregnant. The prevalence of diastolic hypertension (100 mm Hg or more) was higher in nulliparous than in parous women, and was least in those with moderate sized families of two to five children. The prevalence of hypertension increased again in those with very large families, as did the presence of bacteriuria. 6. Body build, as measured by the ponderal index, had a small but consistent influence on arterial pressure as measured indirectly, in Jamaican subjects under age 55. The absence of this relationship in the elderly may be due to increased mortality among obese hypertensives. 7. The use of a qualitative method for determining the genetic factor in arterial pressure suggests that its inheritance is graded, the resemblance in pressure between close relatives being independent of the range of pressure considered, and closely similar to the genetic factor in blood-pressure found in the Welsh. 8. The pressures of middle-aged siblings of middle-age hypertensives showed no bimodality in their distribution (Summary)


Assuntos
Humanos , Gravidez , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Pressão Arterial , População Rural , População Urbana , Fatores Etários , Negro ou Afro-Americano , Proteinúria , Urina/análise , Bacteriúria , Nefropatias , Jamaica/epidemiologia , Gravidez/sangue , Pressão Arterial/genética , Paridade , Somatotipos
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