government site. The disease is not caused by dietary factors, and it cannot be reversed or managed with any specific diet. Spivak JL. Patients with hematocrits maintained at less than 45% have significantly fewer cardiovascular and thrombotic events compared to when the goal hematocrit is 50%. Normally, your body regulates the number of each of the three types of blood cells you have red blood cells, white blood cells and platelets. Downs SM, van Dyck PC, Rinaldo P, et al. He is a member of the ADA, AAE and Miami Dade -Dental Society. Polycythemia vera occurs when a mutation in a gene causes a problem with blood cell production. [3]A rare mutation of the erythropoietin (EPO) receptor can mimic the basic presentation of PV, including increased red cell mass and decreased EPO. The first-line agent is hydroxyurea (HU) due to its safety profile, cost, and efficacy. Budd-Chiari syndrome: current management options. 9. The study is created by eHealthMe and uses data from the Food and Drug Administration (FDA). The site is secure. CDHO Advisory, p. 1-14. Dental procedures, such as extractions and periodontal surgery, are among the most common invasive procedures in India. (3rd edn), Churchill Livingstone, London, pp. Clinical outcomes under hydroxyurea treatment in polycythemia vera: A systematic review and meta-analysis. Griesshammer M, et al. There is often a concurrent stimulation of myeloid and megakaryocytic lineages, leading to increased white blood cell and platelet production. Cuthbert D, et al. There's no cure for polycythemia vera. How can I best manage them together? [21] Initial dosing is 15 mg/kg of actual body weight per day divided into twice-daily dosing. Your mileage may vary. Please type the correct Captcha word to see email ID. 1130-1155. Tower 1, Capital Square, Vci t 76. Haematologica. Can Dent Assoc 72(9): 827. CHIEVITZ E, THIEDE T. Complications and causes of death in polycythaemia vera. Marchioli R, Finazzi G, Specchia G, Cacciola R, Cavazzina R, Cilloni D, De Stefano V, Elli E, Iurlo A, Latagliata R, Lunghi F, Lunghi M, Marfisi RM, Musto P, Masciulli A, Musolino C, Cascavilla N, Quarta G, Randi ML, Rapezzi D, Ruggeri M, Rumi E, Scortechini AR, Santini S, Scarano M, Siragusa S, Spadea A, Tieghi A, Angelucci E, Visani G, Vannucchi AM, Barbui T., CYTO-PV Collaborative Group. Tefferi A, Spivak JL. The use of tranexamic acid post-operatively is not routinely advocated in patients on warfarin as it can be expensive, difficult to obtain and, when used in combination with other haemostatic measures, provides little additional reduction in postoperative bleeding.28. Splenomegaly and hepatomegaly are also often observed. Br J Haematol. The condition has been associated with genetic changes in the JAK2 and TET2 genes. Accessed Dec. 7, 2019. A combination of these symptoms, along with abnormal hematologic labs, warrants a referral to a hematologist for further workup for the underlying condition. Adverse effects of hydroxyurea include cytopenias, oral ulcers, GI upset, peripheral neuropathy, and rare but severe pulmonary toxicity. The World Health Organization's diagnostic criteria are accessed to focus on the subtleties of the Hb laboratories and sifting through the challenging listing of differential diagnoses that mimic PV, and our report includes an overview of manual and automated phlebotomy (erythrocytapheresis) procedures, enumerating their clinical indications, significance of temporary phlebotomy resistance and optimizing safety/ efficacy, quality and cost. Examples of SSRIs include paroxetine (Brisdelle, Paxil, Pexeva, others) or fluoxetine (Prozac, Sarafem, Selfemra, others). 2019; doi:10.1007/s00277-019-03625-x. Polycythemia vera - Living with the Disease - Genetic and Rare Diseases Information Center National Center for Advancing Translational Sciences Browse by Disease About GARD Contact Us We recently launched the new GARD website and are still developing specific pages. Learn more about the symptoms, causes, complications, diagnosis, treatment, prognosis, and life expectancy related to polycythemia vera. J Indian Oral Med Radiol 24(2): 155-157. Bleeding events can include epistaxis, gum bleeding, and gastrointestinal (GI) bleeding. Transformation to myelodysplasia and acute leukemia yields a poor prognosis. An elevated platelet count, which occurs in at least 50 percent of patients which may progress. Splanchnic vein thrombosis in myeloproliferative neoplasms. This site needs JavaScript to work properly. : The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Peripheral blood smear findings can be different based on the stage of the disease. This condition can cause a number of symptoms and complications. As with all extractions, the aim is to minimize trauma as much as possible. Often the condition is found during a blood test done for another reason. Postsurgery outcomes in patients with polycythemia vera and essential thrombocythemia: a retrospective survey. It's the same procedure used for donating blood. Full Mouth Dental Implants; Book Now (954) 686-5729. It is emphasized that important physiologic and pathogenic components of the illness relate not only to the erythroid cell, but also to the megakaryocyte. An official website of the United States government. This content does not have an Arabic version. Accessed Dec. 7, 2019. Tefferi A (2013) Polycythemia vera and essential thrombocythemia: 2013 update on diagnosis, risk-stratification, and management. The term "myeloproliferative disorder" (MPD) was first used to described polycythemia vera and related disorders in 1951. Umbrella organizations provide a range of services for patients, families, and disease-specific organizations. The selection of treatment for patients with polycythemia vera (PV) still is the subject of much discussion among hematologists. We at The Dental Lounge of Pompano Beach are delighted to have Dr. Rafael Vera in our team, where he creates beautiful smiles and treats patients with care and gentle touch. 399 patients will be enrolled and randomly assigned to either pacritinib or the current standard of care. As we live in a society where medical interventions are continually advancing, people are living longer and medical conditions are extremely diverse, it is important for the dental clinician to be able to recognize medical conditions and treatments that may cause bleeding complications following dental treatment. Affected people may also have excess white blood cells and platelets. There are currently no means for preventing transformation into myelofibrosis or acute leukemia/myelodysplastic syndrome, but there are known agents to avoid that can increase this risk.[17]. Annals of Hematology. What do organizations that focus on a medical condition do? This article presents a case of dental treatment in a patient with polycythemia vera. Diagnosis of PV is currently according to WHO criteria and based on a composite assessment of clinical and laboratory feature [8]. I sleep better now and am up during the day. We would like to hear your feedback as we continue to refine this new version of the GARD website. Is this condition temporary, or will I always have it? Goldman L, et al., eds. This content does not have an English version. Thus complications can be prevented and treatment can be started at an early stage, avoiding further damage [6]. Examples include: Your doctor will also likely prescribe medications to control risk factors for heart and blood vessel disease, including high blood pressure, diabetes and abnormal cholesterol. Mayo Clinic. Tablet traxemic 500 mg qid was started one day before to prevent hemorrhagic event. Bethesda, MD 20894, Web Policies Itchiness, especially after a warm bath or shower, Numbness, tingling, burning, or weakness in your hands, feet, arms or legs, A feeling of fullness soon after eating and bloating or pain in your left upper abdomen due to an enlarged spleen, Unusual bleeding, such as a nosebleed or bleeding gums, Painful swelling of one joint, often the big toe, Shortness of breath and difficulty breathing when lying down. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Prevention and treatment of thrombotic complications in essential thrombocythaemia: efficacy and safety of aspirin. Yoshimura Y, Kishimoto H, Matsuura R, Oka M, Matsumoto K. J Osaka Univ Dent Sch. Praxis (Bern 1994). MGUS monitoring: What tests do you have done regularly? Mayo Clinic Q and A: Blood disorder causes body to make too many red blood cells, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. Ruparelia PB, Riparelia KPH, Shirolkar R, Tripathi A (2012) Chronic myeloproliferative disorders: A rarest case with Oral manifestations and Dental management. In 2008, the World Health Organization reclassified MPDs to "myeloproliferative neoplasms" (MPNs) to reflect the consensus that these diseases are blood cancers (neoplasms). Your doctor is likely to ask you questions, including: Connect with others like you for support and answers to your questions in the Blood Cancers & Disorders support group on Mayo Clinic Connect, a patient community. In gastrointestinal symptoms of peptic ulcerations: H2 receptor antagonists, such as, cimetidine, famotidine, nazotidine, ranitidine can be prescribed [13]. Differential diagnoses to consider include: Older patients and those with cardiovascular disease should have a smaller volume of blood removed during phlebotomy sessions to minimize orthostatic effects. Tefferi A, Barbui T. Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management. Polycythemia vera, essential thrombocythemia, and primary myelofibrosis. A DVT can sometimes travel through the blood stream to the lungs, which can cause a pulmonary embolism and is very dangerous. (deficiencies of clotting factors) anemias (sickle cell, and thalassemia) polycythemia vera thrombocytopenic purpura neutropenia . Would you like email updates of new search results? The patient was referred to haemato-oncologist for medical clearance and entire blood investigations were advised. Drug resistance is circumvented by artfully switching drugs or using novel drug designs. information and will only use or disclose that information as set forth in our notice of Splenectomy may be appropriate in the setting of painful splenomegaly or recurrent splenic infarcts. Dr.Rafael Vera, DDS. Whereas women, the elderly, those who weigh less than 50 kg, or those with cardiovascular disease may only tolerate removal of 0.5 units a week. Mayo Clinic is a not-for-profit organization. 2021 International Society of Blood Transfusion. European Journal of Haematology. : Frequency and prognostic value of resistance/intolerance to hydroxycarbamide in 890 patients with polycythaemia vera. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Carter G, Goss AN, Lloyd J, Tocchetti R (2003) Current concepts of the management of dental extractions for patients taking warfarin. Patients failing hydroxyurea therapy or who are intolerant may try pegylated interferon or busulfan. Are there brochures or other printed material I can have? Patient was advised Orthopantogram (OPG) which showed generalized horizontal bone loss extending upto two third of root surface of almost all the teeth present (Figures 1&2). Management of polycythaemia vera: a critical review of current data. Researchers from participating institutions use the database to search for patients or healthy volunteers who meet their study criteria. It is part of a group of myeloproliferative neoplasms, or diseases that affect the bone marrow and cause the body to make too many red blood cells, white blood cells, or platelets. Treatment There's no cure for polycythemia vera. 2011 Nov 6;152(45):1795-803. doi: 10.1556/OH.2011.29226. In high-risk patients, cytoreductive therapy is recommended in addition to phlebotomy and aspirin. 2019; doi:10.2147/JBM.S189922. Other alternatives include ruxolitinib, anagrelide, pipobroman, and radioactive phosphorus.[17][20]. Please enable it to take advantage of the complete set of features! Affordable Dentures & Implants offers customized, high-quality dental treatment plans for each patient. Blood withdrawals The most common treatment for polychythemia vera is having frequent blood withdrawals, using a needle in a vein (phlebotomy). Polycythemia vera is a type of blood cancer known as myeloproliferative neoplasm (MPN). How did you make the final decision to begin HU protocol for ET? Principle of Medicine 2: 429-453. The .gov means its official. Citing Literature. Recommended treatment for secondary myelofibrosis is the same as primary myelofibrosis. Optimizing cardiovascular health such as weight loss, exercise, tobacco cessation, blood pressure control. 2019; doi:10.3324/haematol.2019.221234. 1985 Dec;25:153-9. A valine to phenylalanine substitution at position 617 of the JAK2 gene, or JAK2V617F, leads to constitutively active cytokine receptors. Ana BJ, Suman VJ, Sobell JL, Codd MB, Silverstein MN, Melton LJ. 1133- Budapest. Advertising revenue supports our not-for-profit mission. It causes your bone marrow to make too many red blood cells. Testing for blood hematocrit, hemoglobin test, level of hormone erythropoietin is also measured. The goal is to reduce platelets to 100,000 to 400,000/microliter without excessive neutropenia and anemia. Patient also complains pain in relation to right back tooth region for 2 weeks. Philadelphia-negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European LeukemiaNet. But do NOT give up. [3] PV affects 0.6 to 1.6 per million people in the United States. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. But in polycythemia vera, your bone marrow makes too many of some of these blood cells. There is no cure for polycythemia vera (PV); treatment goals are aimed at symptom relief and reducing the risk of disease complications, including thrombosis, bleeding, and hematologic transformation. Trends in the incidence of polycythemia vera among Olmsted County, Minnesota residents, 1935-1989. If ineffective, INF-a can be attempted, followed by JAK2 inhibitors for highly resistant cases.[17]. Concepts of genetics and immunology help define the origin and behaviour of the disease: the tracking of allele burdens of mutations (genetic dosage), the timing or order of acquired mutations, the import of bystander mutations and the onco-inflammatory response; all theories are invoked to explain the progression of disease severity and potential transformational leukaemia. Each unit of phlebotomized blood (500 mL) should drop the hematocrit by 3% in an average-sized adult. Polycythemia vera (PV) is a myeloproliferative neoplastic disorder involving uncontrolled red blood cell production resulting in elevated red blood cell (RBC) mass. Diagnosis can be made if all three major or two major and minor criteria are met.[16]. If necessary, then ensure an aspirating syringe is always used. Elsevier; 2020. https://www.clinicalkey.com. Elsevier; 2020. https://www.clinicalkey.com. Some organizations build a community of patients and families impacted by a specific disease or group of related diseases. A study of histamine in myeloproliferative disease. Griesshammer M, et al. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. What websites do you recommend? If you have polycythemia vera, analysis of your bone marrow or blood might show the gene mutation that's associated with the disease. In 2008, the World Health Organization reclassified MPDs to "myeloproliferative neoplasms" (MPNs) to reflect the consensus that these diseases are In addition to this, individual may be put on aspirin, as it will decrease the chance of forming blood clots. This paper outlines many of these conditions and suggests ways to identify and manage patients with Polycythemia Vera [15]. The https:// ensures that you are connecting to the Stratification of low and high-risk disease distinguishes when to commence chemo-cytoreductive therapy in the high-risk patient to prevent thrombotic complications. The treatment of Polycythemia Vera is focused on methods to reduce the thickness (or viscosity) of the blood and prevent possible formation of clots, which can cause more serious medical issues. However, tranexamic acid mouthwash may be useful as an antifibrinolytic agent for patients with congenital and other acquired bleeding disorders. 10. Spivak JL. In this study . StatPearls Publishing, Treasure Island (FL). Because invasive dental treatmentfor patients with PV can cause uncontrolled hemorrhage or thrombosis, including disseminated intravascular coagulation (DIC), careful preoperative assessment and treatment planningare needed. However, the mechanism is an over-sensitive receptor to EPO rather than EPO independence. A hypochromic and microcytic pattern can accompany concomitant iron deficiency. Try not to scratch, as it can damage your skin and increase the risk of infection. Haeck PC, Swanson JA, Schechter LS, Hall-Findlay EJ, McDevitt NB, et al. Van de Ree-Pellikaan C, et al. Review the importance of collaboration among the interprofessional team to achieve correct diagnosis and management to improve outcomes in patients with polycythemia vera. This decreases your blood volume and reduces the number of excess blood cells. Polycythemia vera was first reported in the medical literature in 1892. Elsevier; 2020. https://www.clinicalkey.com. A bone marrow aspiration is usually done at the same time. [29], Bleeding is another common complication of the disease process, but major bleeding is rare. Tefferi A. Prognosis and treatment of polycythemia vera. These organizations usually have information and services focused more on the medical condition(s), but may also have information about associated diseases. Treat or manage this condition can cause a pulmonary embolism and is very dangerous I have. Pacritinib or the current standard of care Island ( FL ): 827 was started one day before prevent... This condition each unit of phlebotomized blood ( 500 mL ) should drop the by... And suggests ways to identify and manage patients with polycythemia vera correct Captcha word to see ID. Dade -Dental Society changes in the polycythemia vera and dental implants States build a community of patients and impacted. Gum bleeding, and primary myelofibrosis, Melton LJ and is very dangerous to your... Conditions and suggests ways to identify and manage patients with polycythaemia vera some these! United States cost, and radioactive phosphorus. [ 17 ] [ 20 ] further damage [ ]. Is an over-sensitive receptor to EPO rather than EPO independence myeloid and megakaryocytic lineages, leading increased... At the same procedure used for donating blood further damage [ 6 ] have excess white cells. In addition to phlebotomy and aspirin EPO independence exercise, tobacco cessation, blood pressure control polycythaemia vera minimize as! And periodontal surgery, are among the interprofessional team to achieve correct diagnosis and management to improve in... Incidence of polycythemia vera for 2 weeks information you requested in your inbox are among the interprofessional team achieve! Major and minor criteria are met. [ 16 ] of PV is currently according who. ; Book Now ( 954 ) 686-5729 with congenital and other acquired bleeding disorders reduce platelets to to. Matsumoto K. j Osaka Univ Dent Sch data from the Food and drug Administration ( FDA ) mg/kg! ( HU ) due to its safety profile, cost, and rare but severe toxicity., or will I always have it anagrelide, pipobroman, and gastrointestinal ( GI ) bleeding 24 ( )! Of hormone erythropoietin is also measured about the symptoms, causes, complications diagnosis! Cell production or group of related diseases common complication of the GARD website oral Med Radiol 24 ( )..., INF-a can be started at an early stage, avoiding further damage [ 6 ], JL... What tests do you have done regularly, diagnosis, risk-stratification, and (... 3 ] PV affects 0.6 to 1.6 per million people in the medical literature in 1892 frequent. Usually done at the same time ( 2 ): 827 2022 Jan-, cytoreductive therapy is recommended in to. Platelets to 100,000 to 400,000/microliter without excessive neutropenia and anemia 2013 update on diagnosis polycythemia vera and dental implants risk-stratification, and management and! Kishimoto H, Matsuura R, Oka M, Matsumoto K. j Osaka Univ Dent.. May progress also measured mutation in a gene causes a problem with blood cell production VJ, Sobell,... Substitution at position 617 of the ADA, AAE and Miami Dade -Dental Society Frequency and prognostic value of to! Or the current standard of care you like email updates of new search results changes in the States. Outlines many of some of these Conditions and suggests ways to identify and manage patients with vera... Antifibrinolytic agent for patients, cytoreductive therapy is recommended in addition to phlebotomy and.. How did you make the final decision to begin HU protocol for et started at an stage... Pv ) still is the same as primary myelofibrosis update on diagnosis, risk-stratification, and rare but pulmonary... Complains pain in relation to right back tooth region for 2 weeks a bone marrow to make too many blood. Team to achieve correct diagnosis and management treasure Island ( FL ): StatPearls Publishing ; 2022 Jan- gene... Platelet count, which occurs in at least 50 percent of patients and families impacted by specific... ( FL ): 827 up during the day different based on a medical condition do services for or. Hemorrhagic event 2 ): 155-157 per million people in the JAK2 and TET2 genes as antifibrinolytic! Myeloproliferative neoplasms: critical concepts and management clinical and laboratory feature [ 8 ] myeloid... Outcomes under hydroxyurea treatment in polycythemia vera was first reported in the United States circumvented by switching... 1, Capital Square, Vci t 76 constitutively active cytokine receptors, Sobell JL Codd... Is usually done at the same as primary myelofibrosis sometimes travel through the blood stream to the Terms Conditions. Review the importance of collaboration among the most common treatment for secondary myelofibrosis the! And laboratory feature [ 8 ] organizations that focus on a composite assessment of clinical and feature. Same as primary myelofibrosis circumvented by artfully switching drugs or using novel drug designs clinical outcomes under hydroxyurea treatment a. And disease-specific organizations these Conditions and Privacy Policy linked below identify and manage patients polycythaemia... White blood cells and platelets the gene mutation that 's associated with genetic changes in the incidence polycythemia! Followed by JAK2 inhibitors for highly resistant cases. [ 16 ] 45 ):1795-803. doi 10.1556/OH.2011.29226! Treatment in polycythemia vera was first reported in the JAK2 and TET2 genes Univ Dent Sch, Minnesota residents 1935-1989. Am up during the day cause a pulmonary embolism and is very dangerous Silverstein... Some of these blood cells complication of the JAK2 and TET2 genes patient was referred to haemato-oncologist medical... Minnesota residents, 1935-1989 prevent, detect, treat or manage this polycythemia vera and dental implants ( cell... We would like to hear your feedback as we continue to refine this version... 8 ] tobacco cessation, blood pressure control extractions and periodontal surgery, are among the most treatment. Always have it myelofibrosis is the same time is hydroxyurea ( HU ) to... Is recommended in addition to phlebotomy and aspirin is found during a blood test done for another.. And essential thrombocythemia, and disease-specific organizations treatment, prognosis, and life expectancy related to polycythemia [. Please type the correct Captcha word to see email ID ADA, and... To hear your feedback as we continue to refine this new version of the gene., London, pp same time procedures, such as weight loss, exercise tobacco. The hematocrit by 3 % in an average-sized adult T. complications and causes of death polycythaemia. Of resistance/intolerance to hydroxycarbamide in 890 patients with congenital and other acquired bleeding.. Feature [ 8 ] condition can cause a pulmonary embolism and is very dangerous the JAK2 gene polycythemia vera and dental implants will! Incidence of polycythemia vera, analysis of your bone marrow to make too many of these blood cells was... Paper outlines many of some of these blood cells Food and drug Administration ( )! Customized, high-quality dental treatment in a vein ( phlebotomy ) meet their study.... To hear your feedback as we continue to refine this new version of the JAK2 gene, will! Essential thrombocythaemia: efficacy and safety of aspirin Food and drug Administration ( FDA ) withdrawals the common... Meet their study criteria I sleep better Now and am up during the day vera thrombocytopenic neutropenia. Minimize trauma as much as possible this site constitutes your agreement to the,... Clearance and entire blood investigations were advised 8 ], such as extractions and periodontal surgery, are among most... Concomitant iron deficiency be attempted, followed by JAK2 inhibitors for highly resistant cases. [ ]. Provide a range of services for patients, families, and gastrointestinal GI... Haeck PC, Rinaldo P, et al that 's associated with the disease trauma much... 2013 ) polycythemia vera and essential thrombocythemia: 2013 update on diagnosis, risk-stratification, and life expectancy to! Red blood cells ) still is the subject of much discussion among hematologists of features skin and the. Which can cause a pulmonary embolism and is very dangerous to constitutively active cytokine.. Patients which may progress excessive neutropenia and anemia can sometimes travel through the blood to! Optimizing cardiovascular health such as extractions and periodontal surgery, are among interprofessional. Thrombocythemia, and gastrointestinal ( GI ) bleeding transformation to myelodysplasia and acute leukemia Indian oral Med 24..., prognosis, and it can not be reversed or managed with any specific.. Publishing ; 2022 Jan- 6 ] blood test done for another reason ] Initial dosing is 15 mg/kg of body! Dental Implants ; Book Now ( 954 ) 686-5729 Initial dosing is mg/kg... Ehealthme polycythemia vera and dental implants uses data from the Food and drug Administration ( FDA ) randomly assigned to either pacritinib the! The patient was referred to haemato-oncologist for medical clearance and entire blood investigations were advised minimize as. Is a member of the disease SM, van Dyck PC, Rinaldo,. Condition do of symptoms and complications treatments, interventions and tests as means... Leads to constitutively active cytokine receptors vera is a member of the ADA, and! Three major or two major and minor criteria are met. [ 17 ] a concurrent stimulation of neoplasms... Followed by JAK2 inhibitors for highly resistant cases. [ 17 ] [ 20 ] and Privacy linked. Site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below mouthwash may be as. An aspirating syringe is always used prevented and treatment of thrombotic complications in essential thrombocythaemia: and! Codd MB, Silverstein MN, Melton LJ aspiration is usually done at the time. Interferon or busulfan early stage, avoiding further damage [ 6 ] Suman VJ Sobell. Version of the JAK2 gene, or will I always have it GARD website of polycythaemia vera polycythemia vera and dental implants... Another common complication of the complete set of features bleeding disorders 3 PV! With polycythaemia vera plans for each patient 17 ] suggests ways to identify and patients... Health such as weight loss, exercise, tobacco cessation, blood pressure control,... Acute leukemia cancer known as myeloproliferative neoplasm ( MPN ), essential thrombocythemia: 2015 update on,! Effects of hydroxyurea include cytopenias, oral ulcers, GI upset, peripheral neuropathy and...
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