55:370. Signs and symptoms. As such, it is a class or category of diseases rather than a single, specific entity. 23 (1):[Medline]. Other presentations of DGI include the following, which now occur in only 1-3% of cases However, it can develop at any age as a result of an injury or another joint-related condition. Identification of Neisseria gonorrhoeae as the causative agent in a case of culture-negative dermatitis-arthritis syndrome using real-time PCR. Septic arthritis form 2006. Arthritis Rheum. Gonococcal arthritis is the most common acute septic arthritis in young adults. Migratory arthralgias are the most common presenting symptom in persons with DGI and are usually polyarticular. See Mortality/Morbidity. Rarely, the lesions may resemble erythema nodosum or erythema multiforme. gonococcal arthritis triadhow to gonococcal arthritis triad for Foot problems caused by RA commonly occur in the forefoot (the ball of the foot, near the toes), although RA can also affect other areas of the foot and ankle. The center of the lesion may become necrotic or hemorrhagic. Diseases & Conditions, 2002 Intravenous drug abuse Joint symptoms begin within days to weeks of gonococcal infection. Although the pathogenesis of articular involvement is controversial, it is ultimately a consequence of disseminated gonococcal infection (DGI). It is the body's reaction to irritating crystal deposits in the joints. Neisseria gonorrhoeae paravertebral abscess. Gonococcal arthritis is caused by infection with the gram-negative diplococcus N gonorrhoeae. The time from initial infection to initial manifestations of DGI ranges from 1 day to 3 months. Belkacem A, Caumes E, Ouanich J, Jarlier V, Dellion S, Cazenave B, et al. Davis BT, Pasternack MS. Case records of the Massachusetts General Hospital. The clinical presentation of disseminated gonococcal infection (DGI) is typically divided into a bacteremic form and a septic arthritis form. Cutaneous manifestations of disseminated gonococcemia. Arthritis (the inflammation of one or more joints) is the leading cause of hand pain. Tenosynovitis of the fingers may result in dactylitis. Li R, Gossman WG. Arthritis-dermatitis syndrome includes the classic triad of dermatitis, tenosynovitis, and migratory polyarthritis. Michael P Keith, MD, FACP, FACR Chief of Rheumatology, Walter Reed National Military Medical Center; Associate Professor of Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine Low socioeconomic or educational status Victoria Fernandes Sullivan, MD Fellow in Rheumatology, Walter Reed National Military Medical CenterDisclosure: Nothing to disclose. 54 (6):844-848. [Medline]. Demographic risk factors include nonwhite ancestry, lower socioeconomic or educational status, urban residency, promiscuity or sexual activity at a young age, single marital status, homosexuality, previous history of gonorrhea infection, and intravenous drug abuse. [Full Text]. [Medline]. 2017 Jan 15. This website also contains material copyrighted by 3rd parties. 2005 Dec. 19(4):853-61. Dermatol Online J. Sexually Transmitted Infections (STIs). 1 Department of Oral and Maxillofacial Surgery, Derby Hospitals the 1 last update 2020/11/10 NHS Foundation Trust, Derby, UK 1 Department of Oral and Maxillofacial Surgery, Derby Hospitals NHS Foundation Trust, Derby, UK The rash associated with the bacteremic form of DGI may be overlooked by patients because it is painless and nonpruritic and consists of small papular, pustular, or vesicular lesions. [Medline]. This topic will discuss the epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatment of DGI. You have severe joint pain. Centers for Disease Control and Prevention. In the bacteremic form or arthritis-dermatitis syndrome, symptoms are typically present 3-5 days before diagnosis 25). 3 August 2016; Accessed: July 31, 2018. The arthralgias are typically asymmetric and tend to involve the upper extremities more than the lower extremities. Rarely, the lesions may resemble erythema nodosum or erythema multiforme. Sex, The disease is 3-4 times more common in females than in males, possibly because of the increased risk of asymptomatic infection in females. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. gonococcal arthritis triadhow to gonococcal arthritis triad for Just like RA, type 1 diabetes is an autoimmune disease — which occurs when your immune system mistakenly attacks your body. Sex Transm Infect. It causes joint pain and inflammation. Patients with gonococcal arthritis who develop joint destruction (rare) usually require hospitalization for antibiotic therapy to avoid other potentially serious complications of … Symmetric polyarthritis is less common but may occur in approximately 10% of patients. Diseases & Conditions, 2002 If you log out, you will be required to enter your username and password the next time you visit. Arthrocentesis and Synovial Fluid Analysis, Arthrocentesis, Arthroscopy, and Surgical Drainage, http://www.who.int/mediacentre/factsheets/fs110/en/index.html, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5614a3.htm, Association of Program Directors in Internal Medicine, American Association for the Advancement of Science. HIV infection The clinical presentation of disseminated gonococcal infection (DGI) is typically divided into a bacteremic form and a septic arthritis form. They tend to disappear within a few days after treatment is initiated. How Rheumatoid Arthritis Causes Hand Pain . Septic arthritis form 2018 Jun. Lesions are usually tiny maculopapular, pustular, or vesicular lesions on an erythematous base. triad for gonococcal arthritishow to triad for gonococcal arthritis for Alternatively, total ankle replacement is a relatively new procedure, the modern, accepted design having only come into widespread use in the late 1990s. Diagnosis in the emergency department (ED) must be suspected clinically, as confirmatory tests are often not available. 65 (7):1-19. 🔥+ gonococcal arthritis triad 11 Nov 2020 16 in Arthritis & Rheumatology. As a rule, complications of gonococcal arthritis are rare. Menses Extragenital infection Developing countries, however, continue to have a high incidence of disease, partly because of limited public health infrastructure and limited access to health care. MMWR Morb Mortal Wkly Rep. 2012 Aug 10. Bacteremic form (classic triad of migratory polyarthritis, tenosynovitis, and dermatitis) Rice PA. Gonococcal arthritis (disseminated gonococcal infection). Pregnancy Learn more about the ... joint is completely immobile. 64 (RR-03):1-137. Bacteremic form (arthritis-dermatitis syndrome) Infect Immun. Please confirm that you would like to log out of Medscape. 236299-overview [Guideline] Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. The arthralgias are typically asymmetric and tend to involve the upper extremities more than the lower extremities. How Rheumatoid Arthritis Causes Hand Pain . The foot of this patient is swollen due to gonococcal arthritis. Rheumatology. The syndrome most frequently follows genitourinary infection with Chlamydia trachomatis, but other organisms have also been implicated. MMWR Recomm Rep. 2015 Jun 5. triad for gonococcal arthritishow to triad for gonococcal arthritis for Like many joints in the body, the joints in the hand are synovial joints.These joints are flexible and the 1 last update 2020/11/09 surrounded … 2008 Nov. 29(1):81-5. It can occur anywhere in the body but is particularly common in the hands and wrist. Systemic lupus erythematosus However, rates vary by region. The tenosynovitis of DGI is asymmetric and most commonly occurs over the dorsum of the wrist and hand, as well as over the metacarpophalangeal joints, ankles, and knees. Symmetric polyarthritis is less common but may occur in approximately 10% of patients. United States. [Medline]. J Travel Med. 334286-overview Sex Transm Infect. In the western United States, rates increased from 57 cases per 100,000 persons in 2000 to 81.5 cases per 100,000 persons in 2005to. Atlanta: U.S. Department of Health and Human Services; 2017. There are more than 100 different types of arthritis, but the most common are osteoarthritis and rheumatoid arthritis. 2015 Mar 19. Sexually Transmitted Disease Surveillance 2016. Gonococcal arthritis manifests as either a bacteremic infection (arthritis-dermatitis syndrome) in 60% of cases or as a localized septic arthritis in the other 40%. Centers for Disease Control and Prevention (CDC). Gonococcal meningitis (very rare in the antibiotic era) Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital 2008 Sep-Oct. 15(5):369-71. 81(7):2358-70. The center may become necrotic or hemorrhagic. The pain can be … 61:590-4. [10]. Hematogenous spread of the mucosal infection (0.5-3% of cases) is caused by a delay in antibiotic treatment, physiologic changes in the host, host immune system failures, and particularly virulent strains of N gonorrhoeaeand can occur even in the absence of symptoms. Tenosynovitis is asymmetric, usually affecting the dorsum of wrists, hands, and ankles. Update to CDC’s Sexually Transmitted Diseases Treatment Guidelines 2006: Fluoroquinolones no longer recommended for treatment of gonococcal infections. Deighton C(1), O'Mahony R, Tosh J, Turner C, Rudolf M; Guideline Development Group. Reactive arthritis is a human leukocyte antigen B27 (HLA-B27)–associated condition that predominantly occurs in young men and has the clinical triad of urethritis, conjunctivitis, and arthritis. Infection may not cause symptoms and often affects genitourinary, rectal, or pharyngeal mucosal surfaces. Nature of osteoarthritis. gonococcal arthritis triad 🔥+ gonococcal arthritis triad 22 Oct 2020 Management of rheumatoid arthritis: summary of NICE guidance. Age, Persons younger than 30 years are at the greatest risk; however, older adults may be affected. Tenosynovitis of the fingers may result in dactylitis. Philadelphia, PA: Mosby Elsevier; 2015. Disseminated gonococcal infection (DGI) results from bacteremic spread of the sexually transmitted pathogen, Neisseria gonorrhoeae, which can lead to a variety of clinical symptoms and signs, such as arthritis or arthralgias, tenosynovitis, and multiple skin lesions. Although each form presents with its own symptom complex, the overlap can be considerable. Kimmitt PT, Kirby A, Perera N, Nicholson KG, Schober PC, Rajakumar K, et al. This is partly because spinal degeneration in later life is the main cause of facet joint arthritis. Approximately 60% of patients present with symptoms consistent with the bacteremic form, and the remaining 40% present with symptoms of more localized infection. Available at http://www.who.int/mediacentre/factsheets/fs110/en/index.html. There are more than 100 different types of arthritis, but the most common are osteoarthritis and rheumatoid arthritis. [1], The rash associated with the bacteremic form of DGI may be overlooked by patients because it is painless and nonpruritic and consists of small papular, pustular, or vesicular lesions. Fever rarely involves a temperature higher than 39°C. gonococcal arthritis triadhow to gonococcal arthritis triad for Rory C O’Connor. 1994 May. Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral Cephalosporins No Longer a Recommended Treatment for Gonococcal Infections. Fitz-Hugh and Curtis syndrome (gonococcal perihepatitis) 2013 Jul. [Medline]. Other presentations of DGI include the following: Pericarditis, endocarditis, meningitis, perihepatitis, pyomyositis, osteomyelitis, and glomerulonephritis have been reported but are now rare. Patients with DGI may present with dermatitis-arthritis syndrome or with a localized septic arthritis. Gonococcal arthritis manifests as either as a bacteremic infection (arthritis-dermatitis syndrome) or as a localized septic arthritis. Approximately 60% … INTRODUCTION. Symptoms resolve spontaneously in 30-40% of cases or evolve into a septic arthritis in 1 or several joints. Men: Homosexuality [1], In the bacteremic form (arthritis-dermatitis syndrome), symptoms are typically present 3-5 days before diagnosis. Share cases and questions with Physicians on Medscape consult. Both of these diseases can affect young women in their ... triad for gonococcal arthritis Other symptoms and signs associated with joint pain include swollen joints, joint redness, and stiffness. Clinical It most commonly involves the wrists, hands, knees, and elbows. The time from initial infection to initial manifestations of disease ranges from 1 day to 3 months. gonococcal arthritis triad 🔥+ gonococcal arthritis triad 14 Nov 2020 Some drugs used for rheumatoid arthritis can increase the risk of high blood pressure or diabetes for pregnant women. Septic arthritis is characterized by acute arthritis with signs of joint effusion, warmth, tenderness, decreased range of motion, and marked erythema. Liebling MR, Arkfeld DG, Michelini GA, Nishio MJ, Eng BJ, Jin T, et al. gonococcal arthritis triadhow to gonococcal arthritis triad for facebook Carol Eustice is a writer covering arthritis and chronic illness, who the 1 last update 2020/11/26 herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis. J Emerg Med. gonococcal arthritis triad 🔥+ gonococcal arthritis triad 23 Oct 2020 Facet joint arthritis develops slowly over a long period of time. Pain may also be due to tenosynovitis. Dermatitis occurs in 40-70% of patients and typically involves the extremities. Physical Arthritis in more unusual joints (eg, sternoclavicular, hip) in patients with HIV may be more aggressive than typical cases in the general population. About 70% of patients have 1-3 joints with clear inflammatory signs after just a few days. Race, In the United States, the disease is more prevalent among African American, Hispanic, and Native American populations. Innate recognition by neutrophil granulocytes differs between Neisseria gonorrhoeae strains causing local or disseminating infections. Despite their appearance, they are painless and nonpruritic. Chronic arthritis with joint destruction is rare when appropriate antibiotic therapy is provided. Chronic arthritis with joint destruction is rare with appropriate antibiotic therapy. 🔥+ gonococcal arthritis triad 26 Oct 2020 It's easy to see inflammatory arthritis: it causes joint swelling, warmth, redness, and pain. Despite their appearance, these lesions are painless and nonpruritic. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5614a3.htm. Pain may also be due to tenosynovitis. Although decreasing or stable in the 1990s, the national incidence of gonococcal infection increased in 2005 to 115 cases per 100,000 persons. The cause of osteoarthritis is not fully understood. Changing patterns of disseminated gonococcal infection in France: cross-sectional data 2009-2011. Learn about the symptoms, causes and treatment. Immunoglobulin A (IgA) proteases (protection from mucosal surface defenses) 37(5):702-9. An HLA-B27 genotype is a predisposing factor in over two thirds of patients with reactive arthritis. It differs from spondylopathy, which is a disease of the vertebra itself. This patient presented with cutaneous foot lesions that were diagnosed as a disseminated gonococcal infection. The wrist, elbows, ankles, and knees are most commonly affected. Arthritis-dermatitis syndrome includes the classic triad of dermatitis, tenosynovitis, and migratory polyarthritis. The timing of when drugs ... gonococcal arthritis triad Psoriatic arthritis. As such, it is a class or category of diseases rather than a single, specific entity. Disseminated gonococcal infection in a homosexual man diagnosed by nucleic acid amplification testing from a skin lesion swab. The presence of pili [9]. Although each form presents with its own symptom complex, the overlap can be considerable. Lawrence H Brent, MD Associate Professor of Medicine, Jefferson Medical College of Thomas Jefferson University; Chair, Program Director, Department of Medicine, Division of Rheumatology, Albert Einstein Medical Center, Lawrence H Brent, MD is a member of the following medical societies: American Association for the Advancement of Science, American Association of Immunologists, American College of Physicians, and American College of Rheumatology, Disclosure: Genentech Honoraria Speaking and teaching; Genentech Grant/research funds Other; Amgen Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching; Abbott Immunology Honoraria Speaking and teaching; Takeda Honoraria Speaking and teaching; UCB Speaking and teaching; Omnicare Consulting fee Consulting; Centocor Consulting fee Consulting, Timothy M Straight, MD Instructor, Department of Medicine, Uniformed Services University School of Medicine, Timothy M Straight, MD is a member of the following medical societies: American College of Physicians, Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference. Rachel Robbins, MD, FACP Assistant Professor of Medicine, Uniformed Services University of the Health Sciences; Staff Rheumatologist, Walter Reed National Military Medical Center [Medline]. 🔥+ triad for gonococcal arthritis 27 Nov 2020 Spotlight on lupus-systemic lupus erythematosus or "SLE" Lupus is the name given to a group of chronic immune diseases. It is sometimes the first manifestation of human immunodeficiency virus infection. Dermatitis occurs in 40-70% of patients and typically involves the extremities. Lack of protein II (transparent colonies [associated with DGI]) and protein III (blocking antibodies that reduce serum bactericidal activity) Promiscuity Gonococcal Tenosynovitis Diagnosed with the Aid of Emergency Department Bedside Ultrasound. Tuttle CS, Van Dantzig T, Brady S, Ward J, Maguire G. The epidemiology of gonococcal arthritis in an Indigenous Australian population. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzMzNjEyLWNsaW5pY2Fs. Other cutaneous lesions of DGI that have been reported are abscesses, cellulitis, petechiae, purpuric macules, necrotizing fasciitis, and vasculitis. Treatment with doxycycline or its analogs sometimes shortens the course or abor… Centers for Disease Control and Prevention. Both sides and any combination of elbows, hips, knees, feet, etc. [Medline]. 🔥+ gonococcal arthritis triad 27 Nov 2020 Rheumatoid arthritis of the hand is most common in the wrist and the finger knuckles (the MP and PIP joints (see Figure 1). [Medline]. Your email address will not be published. The wrist, elbows, ankles, and knees are most commonly affected. The risk of dissemination following mucosal infection depends on both the ability of the patient’s immune system to control the infection and the virulence of the organism. Executive Summary. N Engl J Med. Michael Doherty, Martin Pattrick, Richard Powell. The clinical presentation of disseminated gonococcal infection (DGI) is typically divided into a bacteremic form and a septic arthritis form. Sex Transm Infect. gonococcal arthritis triadhow to gonococcal arthritis triad for Spondyloarthropathy or spondyloarthrosis refers to any joint disease of the vertebral column. gonococcal arthritis triad 🔥+ gonococcal arthritis triad 12 Nov 2020 The causes include trauma, inflammatory arthropathy, and idiopathic arthritis. Sepsis with Waterhouse-Friderichsen syndrome (rare) Symptoms resolve spontaneously in 30-40% of cases or evolve into a septic arthritis in one or several joints. Rheumatol Int. Joint symptoms begin within days to weeks of gonococcal infection. triad for gonococcal arthritishow to triad for gonococcal arthritis for Like many joints in the body, the joints in the hand are synovial joints.These joints are flexible and the 1 last update 2020/11/09 surrounded by a thin, pliable membrane called synovium. Puerperium triad for gonococcal arthritis 🔥+ triad for gonococcal arthritis 08 Nov 2020 Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are no exception. It differs from spondylopathy, which is a disease of the vertebra itself. gonococcal arthritis triad 🔥+ gonococcal arthritis triad 28 Nov 2020 Gout is actually a form of arthritis. It is caused by the gram-negative diplococcus Neisseria gonorrhoeae. Mortality/Morbidity Dr. Baak's Arthritis Center specializes in the diagnosis and treatment of auto-immune and inflammatory diseases including rheumatoid arthritis, psoriatic arthritis… Patients may experience pain, redness, and swelling in usually one or sometimes multiple joints. gonococcal arthritis triadhow to gonococcal arthritis triad for Spondyloarthropathy or spondyloarthrosis refers to any joint disease of the vertebral column. Low SY, Ong CW, Hsueh PR, Tambyah PA, Yeo TT. Arthritis, Gonococcal. Acute septic arthritis: remember gonorrhea. Osteoarthritis, on the other hand, does not cause much joint inflammation and ... symptom in patients that have non-inflammatory causes of joint pain. The lesion on this patient's heel was due to the systemic dissemination of the N gonorrhoeae bacteria. [Medline]. Nonspecific constitutional symptoms may include myalgias, fever, and malaise. Reactive arthritis, also called Reiter's syndrome, is the most common type of inflammatory polyarthritis in young men. Nutritional requirements such as arginine, hypoxanthine, and uracil (associated with lack of protein II) Rachel Robbins, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, Association of Program Directors in Internal MedicineDisclosure: Nothing to disclose. Case 19-2007 - a 19-year-old college student with fever and joint pain. [Full Text]. 333612-overview Incidence rates declined in the northeast, south, and Midwest regions over the same period. General Arthritis-dermatitis syndrome includes the classic triad of dermatitis, tenosynovitis, and migratory polyarthritis. [Medline]. History. [Full Text]. The tenosynovitis of DGI is asymmetric and most commonly occurs over the dorsum of the wrist and hand, as well as over the metacarpophalangeal joints, ankles, and knees. It can occur anywhere in the body but is particularly common in the hands and wrist. Chronic asymptomatic endocervical infection The risk of infection from a single contact is estimated at 60-90% among women and 20-50% among men. Neisseria gonorrhoeae Antimicrobial Susceptibility Surveillance - The Gonococcal Isolate Surveillance Project, 27 Sites, United States, 2014. Lesions are usually tiny maculopapular, pustular, or vesicular lesions on an erythematous base. [Medline]. [Full Text]. Septic arthritis is characterized by acute arthritis with signs of joint effusion, warmth, tenderness, decreased range of motion, and marked erythema. 2002 Lipo-oligosaccharide ([LOS] endotoxic activity and possible reduced serum bactericidal activity) Infect Dis Clin North Am. The timing of when drugs ... gonococcal arthritis triad Psoriatic arthritis. Approximately 60% of patients present with symptoms consistent with the bacteremic form, and the remaining 40% present with symptoms of more localized infection. 🔥+ triad for gonococcal arthritis 24 Oct 2020 Nodal generalised osteoarthritis is an autoimmune disease. Forgoing the fusion process, this procedure instead relies on replacement of the arthritic surfaces with a man-made implant that is composed of two or three … 6th ed. Frequency The lesions tend to disappear within a few days after treatment is initiated. 2018 Jan. 5 (2):211-23. 17(1):93-7. [Medline]. Notice to readers: discontinuation of spectinomycin. Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH. [9] Patients may experience pain, redness, and swelling in 1 joint (or sometimes multiple joints), most commonly in a knee, wrist, ankle, or elbow. 2012 Jul. Diffuse involvement of fingers can result in dactylitis. Two hundred million cases of N gonorrhoeae infection occur worldwide each year. gonococcal arthritis triad 🔥+ gonococcal arthritis triad 19 Nov 2020 Joint pain refers to discomfort, aches, and soreness in any of the body's joints. Protein IA on the outer membrane (inhibits neutrophil exocytosis and promotes organism endocytosis by epithelial cells) Seventy percent of patients have 1-3 joints with clear inflammatory signs after just a few days. Gonococcal endocarditis (rare in the antibiotic era) Identification of Neisseria gonorrhoeae in synovial fluid using the polymerase chain reaction. 🔥+ triad for gonococcal arthritis 26 Oct 2020 Visit Boulet Physical Therapy & Wellness Institute to get PT treatments by our certified physical therapists to relieve arthritis pain in Lafayette, LA. Inherited: Patients with an inherited terminal complement deficiency (C5-C9) are susceptible to recurrent gonococcal infections, especially DGI with meningitis. The bacteremic form of gonococcal arthritis comprises the classic triad of migratory polyarthritis, tenosynovitis, and dermatitis. Published: June 1, 2018. Migratory arthralgias are the most common presenting symptom in persons with DGI and are usually polyarticular. Michael P Keith, MD, FACP, FACR is a member of the following medical societies: American College of Physicians, American College of Rheumatology, Clinical Immunology SocietyDisclosure: Nothing to disclose. Usually, 4-50 lesions are reported. Beatrous SV, Grisoli SB, Riahi RR, Matherne RJ, Matherne RJ. Symptoms are present 3-5 days before diagnosis. Host factors for disseminated infection include the following: [Medline]. Disseminated gonococcal infection (DGI) consists of gonococcal infection plus one or more of the triad of arthritis, tenosynovitis, and dermatitis. Read P, Abbott R, Pantelidis P, Peters BS, White JA.

gonococcal arthritis triad

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