Advances in Respiratory Medicine

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Open AccessReview

Role of Inhaled Corticosteroids in the Management of COPD

by Pneumonologia i Alergologia Polska Editorial Office

Adv. Respir. Med. 2009, 77(2), 186-191; https://doi.org/10.5603/ARM.27839 - 16 Mar 2011

Viewed by 239

Abstract

Role of inhaled corticosteroids in the management of COPD [...] Full article

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Open AccessLetter

Odpowiedź Autora na Komentarz do Pracy “Miejsce Ultrasonografii w Diagnostyce Pulmonologicznej”

by Grzegorz Mysiorski

Adv. Respir. Med. 2009, 77(2), 225-227; https://doi.org/10.5603/ARM.27835 - 16 Mar 2009

Viewed by 218

Abstract

Bardzo dziękuję Panu Doktorowi za wnikliwąi krytyczną lekturę artykułu [...] Full article

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Open AccessLetter

Ultrasonography in Respiratory Diseases. Commentary to the Article of Mysiorski G. et al.

by Pneumonologia i Alergologia Polska Editorial Office

Adv. Respir. Med. 2009, 77(2), 221-224; https://doi.org/10.5603/ARM.27834 - 16 Mar 2009

Viewed by 204

Abstract

Ultrasonography in Respiratory Diseases. Commentary to the Article of Mysiorski G. et al. [...] Full article

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Open AccessConference Report

Third Polish-French Pneumonological Conference, Warsaw, 24–25 October 2008

by Joanna Domagała-Kulawik and Tadeusz M. Zielonka

Adv. Respir. Med. 2009, 77(2), 211-220; https://doi.org/10.5603/ARM.27837 - 16 Mar 2009

Viewed by 234

Abstract

W dniach 24–25 października 2008 roku od-była się w Warszawie Trzecia Polsko-FrancuskaKonferencja Pneumonologów [...] Full article

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Open AccessCase Report

Combined Pulmonary Fibrosis and Emphysema: Case Report and Literature Review

by Monika Kosacka, Anna Brzecka, Renata Jankowska, Jerzy Lewczuk, Ewa Mroczek and Bożena Weryńska

Adv. Respir. Med. 2009, 77(2), 205-210; https://doi.org/10.5603/ARM.27830 - 16 Mar 2009

Viewed by 271

Abstract

We describe the case of a 61-year-old male patient, in which the search for the cause of chronic respiratory failure, severe pulmonary hypertension and secondary erythrocytosis resulted in a diagnosis of combined pulmonary fibrosis and emphysema (CPFE). This is a unique, recently characterised [...] Read more.

We describe the case of a 61-year-old male patient, in which the search for the cause of chronic respiratory failure, severe pulmonary hypertension and secondary erythrocytosis resulted in a diagnosis of combined pulmonary fibrosis and emphysema (CPFE). This is a unique, recently characterised syndrome with upper-lobe emphysema and pulmonary fibrosis of the lower lungs. The cause is unknown, but one of the main risk factor remains smoking. The patient was a heavy smoker (over 40 pack-years). He complained of dyspnoea on exertion and cough. Physical examination revealed basal crackles and cyanosis. The patient had severe reduction in diffusing capacity, out of proportion to his lung volumes (DLCO 27% of predicted value, FEV1 2.95 l (100%), FVC 4.41 l (118%), FEV1/FVC (66%). The blood gas showed hypoxemia (pO2 37 mm Hg), hypocapnia and respiratory alkalosis. Diagnosis was based on chest computer tomography, which revealed upper lobe emphysema and lower lobe ground glass changes and honeycombing. Severe pulmonary hypertension (SPAP 80 mm Hg) was confirmed by echocardiography and right cardiac catherisation. The patient received long-term oxygen therapy, inhaled corticosteroid and Ca-blocker. Full article

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Open AccessCase Report

Non-small Cell Lung Cancer in Patient with Visceral Total Inversion

by Michał Bielewicz, Małgorzata Wojtyś, Dominika Witkowska, Jacek Alchimowicz, Janusz Wójcik and Tomasz Grodzki

Adv. Respir. Med. 2009, 77(2), 200-204; https://doi.org/10.5603/ARM.27829 - 16 Mar 2009

Viewed by 318

Abstract

This article reports a case of non-small cell lung cancer in a 74-year-old man with visceral total inversion. The epidemiology and main anatomical differences present in this rare syndrome, as well as basic information on lung cancer, are explored. We present diagnostic procedures [...] Read more.

This article reports a case of non-small cell lung cancer in a 74-year-old man with visceral total inversion. The epidemiology and main anatomical differences present in this rare syndrome, as well as basic information on lung cancer, are explored. We present diagnostic procedures and their results and describe the surgical technique of lung cancer treatment performed in this rare case. The perioperative period and the histopathological findings are analysed. Finally, references to similar cases found in worldwide literature are discussed. Full article

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Open AccessReview

Long-Term Oxygen Therapy: State of the Art

by Richard Casaburi

Adv. Respir. Med. 2009, 77(2), 196-199; https://doi.org/10.5603/ARM.27841 - 16 Mar 2009

Viewed by 208

Abstract

Long-term oxygen therapy is well establishedas an important part of our therapeutic options forsevere COPD [...] Full article

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Open AccessReview

Strategies to Reduce Dynamic Hyperinflation in Chronic Obstructive Pulmonary Disease

by Richard Casaburi

Adv. Respir. Med. 2009, 77(2), 192-195; https://doi.org/10.5603/ARM.27840 - 16 Mar 2009

Viewed by 229

Abstract

The chief complaint of many patients with chro-nic obstructive pulmonary disease (COPD) is thatthey are no longer able to carry out or maintain anactivity of which they were previously capable [...] [...] Read more.

The chief complaint of many patients with chro-nic obstructive pulmonary disease (COPD) is thatthey are no longer able to carry out or maintain anactivity of which they were previously capable [...] Full article

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Open AccessReview

Systemic Features in Chronic Obstructive Pulmonary Disease

by Halina Batura-Gabryel

Adv. Respir. Med. 2009, 77(2), 180-185; https://doi.org/10.5603/ARM.27838 - 16 Mar 2009

Cited by 1 | Viewed by 233

Abstract

Przewlekła obturacyjna choroba płuc (POChP)jest chorobą o dużym znaczeniu epidemiologicznym, zdrowotnym i społecznym [...] Full article

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Open AccessReview

End Stage Chronic Obstructive Pulmonary Disease

by Nicolino Ambrosino, Marco Gherardi and Nicoletta Carpenè

Adv. Respir. Med. 2009, 77(2), 173-179; https://doi.org/10.5603/ARM.27836 - 16 Mar 2009

Cited by 1 | Viewed by 320

Abstract

Many patients with chronic obstructive pulmonary disease (COPD) die each year as those with lung cancer but current guidelines make few recommendations on the care for the most severe patients i.e., those with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III [...] Read more.

Many patients with chronic obstructive pulmonary disease (COPD) die each year as those with lung cancer but current guidelines make few recommendations on the care for the most severe patients i.e., those with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure. Only smoking cessation and long term oxygen therapy (LTOT) improve survival in COPD. Although non invasive positive pressure ventilation (NPPV) may have an adjunctive role in the management of chronic respiratory insufficiency there is little evidence for its use in the routine management of stable hypercapnic COPD patients. At difference, several prospective, randomised, controlled studies, systematic reviews and meta-analyses show good level of evidence for clinical efficacy of NPPV in the treatment of acute on chronic respiratory failure due to acute exacerbations of COPD. NPPV is also alternative to invasive ventilation for symptom relief in end stage COPD. Surgical interventions for end stage COPD like bullectomy, different modalities of lung volume reduction surgery and lung transplantation are likely to be of value to only a small percentage of patients. Nevertheless, there are specific indications, which, when added to pulmonary rehabilitation will further advance exercise capacity and quality of life. As in other chronic diseases when severity of disease increases along the natural history, therapy aimed to prolong life becomes less and less important in comparison to palliative therapy aimed to relieve symptoms. The most effective treatments for dyspnoea are bronchodilators, although also opiates may improve dyspnoea. Supplemental oxygen reduce exertional breathlessness and improve exercise tolerance in hypoxaemic COPD patients. There are difficulties in treating with antidepressant the frail and elderly COPD patients. Good clinical care can prevent or alleviate suffering by assessing symptoms and providing psychological and social support to the patients and their families. Full article

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Open AccessReview

Dilemmas in the Curative Treatment of Lung Cancer in the Elderly Patients

by Lucyna Kępka

Adv. Respir. Med. 2009, 77(2), 166-172; https://doi.org/10.5603/ARM.27833 - 16 Mar 2009

Viewed by 225

Abstract

Patients aged 70 years and older accounted for 42% of all lung cancer deaths in Poland in 2005. Although the incidence of lung cancer in elderly people is growing in Poland, like in other developed countries, the standards of treatment for this subset [...] Read more.

Patients aged 70 years and older accounted for 42% of all lung cancer deaths in Poland in 2005. Although the incidence of lung cancer in elderly people is growing in Poland, like in other developed countries, the standards of treatment for this subset of population are not well established. Prospective elderly-specific trials concerning curative treatment are lacking. The results from prospective trials including elderly participants show similar effectiveness as in younger population at the expense of higher toxicity. Selection bias may limit the ability to generalize results of clinical trials to the entire population of elderly people. Methods of curative treatment (surgery, radiotherapy, chemotherapy as adjuvant for non-small cell lung cancer and basic treatment for limited-stage small cell lung cancer) are discussed. Some treatment options and modifications of standard strategies which are particularly promising in elderly patients, as VADS surgery, stereotactic radiotherapy or abbreviated treatment for SCLC, are presented. Full article

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Open AccessReview

Potential Role of Endothelin in Patients with Acute Pulmonary Embolism and Chronic Thromboembolic Pulmonary Hypertension

by Justyna Pedowska-Włoszek, Maciej Kostrubiec and Piotr Pruszczyk

Adv. Respir. Med. 2009, 77(2), 159-165; https://doi.org/10.5603/ARM.27832 - 16 Mar 2009

Viewed by 225

Abstract

Endothelins (ET), a family of three peptides of strong vasoconstrictive properties, participate in the regulation of vascular tone and blood flow. The synthesis and degradation of the ET predominantly take place in the pulmonary vasculature. Elevated plasma ET levels were reported in various [...] Read more.

Endothelins (ET), a family of three peptides of strong vasoconstrictive properties, participate in the regulation of vascular tone and blood flow. The synthesis and degradation of the ET predominantly take place in the pulmonary vasculature. Elevated plasma ET levels were reported in various forms of arterial pulmonary hypertension including chronic thromboembolic pulmonary hypertension (CTEPH). Moreover, clinical studies with nonselective ET receptor antagonist—bosentan reported improvement in functional class in patients with CTEPH. It has been suggested that endothelins may play an important role in acute pulmonary thromboembolism (APE). However, further studies are necessary to verify these observations. In the current paper we discuss a potential role of endothelins in CTEPH and APE. Full article

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Open AccessReview

Flow Cytometric Basophils Activation Test as a Method of Allergy Diagnosis

by Olga Potapińska, Urszula Demkow and Maria Wąsik

Adv. Respir. Med. 2009, 77(2), 152-158; https://doi.org/10.5603/ARM.27831 - 16 Mar 2009

Viewed by 226

Abstract

For several years the incidences of allergic diseases and anaphylactic reactions have been increasing dramatically. Classical method of allergy diagnosis—skin prick test in some situations can provoke life-threatening reactions. Detection of allergen-induced basophil activation by flow cytometry has been shown to be a [...] Read more.

For several years the incidences of allergic diseases and anaphylactic reactions have been increasing dramatically. Classical method of allergy diagnosis—skin prick test in some situations can provoke life-threatening reactions. Detection of allergen-induced basophil activation by flow cytometry has been shown to be a useful tool for allergy diagnosis in those patients. CD 63 and CD203c have recently been demonstrated as a specific activation markers of basophils that are rapidly up-regulated after allergen challenge in sensitized patients. Although flow-cytometry methods are quite sophisticated and expensive, it could be a good alternative in patients at risk of severe anaphylactic reactions or with contradictory test results. Full article

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Open AccessArticle

The Epidemiology of Atopic Dermatitis in the General Population of the Lodz Province’s Citizens

by Izabela Kupryś-Lipińska, Anna Elgalal and Piotr Kuna

Adv. Respir. Med. 2009, 77(2), 145-151; https://doi.org/10.5603/ARM.27828 - 16 Mar 2009

Cited by 1 | Viewed by 258

Abstract

Introduction: It is estimated that 12–26% of the European population is suffering from atopic dermatitis. The aim of the study was to determine the prevalence of atopic dermatitis in the general population of the Łódź province in Poland and to attempt to [...] Read more.

Introduction: It is estimated that 12–26% of the European population is suffering from atopic dermatitis. The aim of the study was to determine the prevalence of atopic dermatitis in the general population of the Łódź province in Poland and to attempt to identify the risk factors for this disease. Material and Methods: We investigated a randomly selected group of 1522 inhabitants of the Łódź province aged between 3 and 80 years. The demographic and anamnestic data were collected by means of standardised questionnaires. Skin prick testing was performed with 10 aeroallergens commonly occurring in Poland. Results: We analysed complete data sets from 1340 (283 children and 1057 adults). The prevalence of atopic dermatitis was estimated at 9.2% in children and 0.9% in adults. Family history of atopy and exposure to tobacco smoke were found to be strong risk factors of atopic dermatitis (OR 3.69 and 3.40, respectively). The difference in the prevalence of atopic dermatitis between inhabitants of the city centre and inhabitants of rural areas was observed only in adults, while children inhabiting both types of area were characterised by the same high prevalence rate. We found that 38% of the children and 10% of the adults had not been correctly diagnosed with atopic dermatitis prior to this epidemiological study. Conclusions: The results of our epidemiological study show that atopic dermatitis has become a significant health, social and economic problem. The equalisation of the prevalence rates of atopic dermatitis in inhabitants of rural and urban areas may reflect an increase in the prevalence of other atopic diseases in this population and the disappearance of differences between rural and urban areas. Full article

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Open AccessArticle

The Usefulness of CD203c Expression Measurement on Basophils after Activation with Grass Pollen and Dermatophagoides pteronyssinus Antigens. Preliminary Study

by Olga Potapińska, Elżbieta Górska, Anna Zawadzka-Krajewska, Marek Kulus, Maria Wąsik and Urszula Demkow

Adv. Respir. Med. 2009, 77(2), 138-144; https://doi.org/10.5603/ARM.27827 - 16 Mar 2009

Cited by 3 | Viewed by 263

Abstract

Introduction: 'Gold standard' in the diagnosis of atopic disease are skin prick tests and specific IgE evaluation. Well-established in vitro tests, such as the histamine release test, the leukotriens release test and the flow cytometric basophil activation test can be very helpful [...] Read more.

Introduction: 'Gold standard' in the diagnosis of atopic disease are skin prick tests and specific IgE evaluation. Well-established in vitro tests, such as the histamine release test, the leukotriens release test and the flow cytometric basophil activation test can be very helpful in diagnostics, especially when the skin prick test is contraindicated. The aim of this study was to evaluate the usefulness of antigen CD203c expression, as a marker of basophil activation by grass pollen or D. pteronyssinus antigens. Material and Methods: Peripheral blood from 13 allergic patients and nine healthy volunteers was analysed. Basophils activation was measured by the breakdown of antigen CD203c expression with Allergenicity Kit (Beckman Coulter), using Cytomics FC 500 flow cytometer (Beckman Coulter). Results: The sensitivity was 92,3% and specificity of test was 100%. 50.95 ± 15.7% of basophils (median 49.7%, 1.91–72.42%) were activated after grass pollen stimulation in atopic patients sensitised to this allergen, in comparison to 1.91% (0.00–7.96%) in control patients (p = 0.002). The percentage of activated basophils after D. pteronyssinus antigens stimulation was 40.6 ± 25.2% in allergic patients, compared to only 2.51 ± 1 96% of basophils from non-atopic controls (p = 0.0003). Basophils from 21 patients responded after anti-IgE stimulation (44.1 ± 18.9%), and none of the analysed samples was activated after PBS stimulation (2.03 ± 1.19%, p < 0.0001). Conclusions: These results demonstrate that basophil activation test based on antigen CD203c expression is very accurate in the diagnosis of atopic diseases. Full article

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Open AccessArticle

Expression of p53, bcl-2 and nm23 Proteins in Squamous Cell Lung Cancer

by Irena Porębska, Monika Kosacka, Ewa Wyrodek and Renata Jankowska

Adv. Respir. Med. 2009, 77(2), 131-137; https://doi.org/10.5603/ARM.27826 - 16 Mar 2009

Cited by 2 | Viewed by 244

Abstract

Introduction: The evaluation of lung cancer molecular profiles is an essential element of the therapeutic process in that type of neoplasm. The analysis of apoptotic and metastasis-linked proteins is an important goal because of the key role of those processes in carcinogenesis. [...] Read more.

Introduction: The evaluation of lung cancer molecular profiles is an essential element of the therapeutic process in that type of neoplasm. The analysis of apoptotic and metastasis-linked proteins is an important goal because of the key role of those processes in carcinogenesis. The aim of this study was to evaluate the expression of apoptosis regulatory proteins p53 and bcl-2 as well as antimetastatic marker nm23 in squamous cell lung cancer, taking into account the clinical and pathological data. Material and Methods: Thirty tissue specimens from patients undergoing therapeutic or diagnostic thoracic surgery were included in the study. All markers were assessed with immunohistochemistry method on paraffin-embedded tissue. Results: Nm23 expression was observed less frequently in specimens with cancer cell emboli in blood vessels or lymph node metastasis. In cancers with lymph node metastasis, the coexpression of p53 and bcl-2 was found statistically more often than in lymph node negative cases. There was no correlation between p53, bcl-2 and nm23 expression and 2-years survival time. Conclusions: Our study indicates a marked heterogeneity of p53, bcl-2 and nm23 expression in squamous cell lung cancer and the potentially unfavorable influence of p53 and bcl-2 coexpression. Less frequent nm23 expression seems to be connected with morphological signs of metastatic process. Full article

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Open AccessArticle

Evaluation of TH1/TH2 Lymphocyte Balance and Lypopolysaccharide Receptor Expression in Asthma Patients

by Jan Siwiec, Tomasz Zaborowski, Olga Jankowska, Kamila Wojas-Krawczyk, Paweł Krawczyk and Janusz Milanowski

Adv. Respir. Med. 2009, 77(2), 123-130; https://doi.org/10.5603/ARM.27825 - 16 Mar 2009

Cited by 4 | Viewed by 250

Abstract

Introduction: An increase in the number of asthma patients which has recently been observed depends on their place of residence and their occupation. This suggests that both external factors and genetic predispositions affect the development of the disease. The contact with bacterial [...] Read more.

Introduction: An increase in the number of asthma patients which has recently been observed depends on their place of residence and their occupation. This suggests that both external factors and genetic predispositions affect the development of the disease. The contact with bacterial lypopolysaccharide (LPS) may suppress the development of asthma among rural inhabitants. The mechanism of LPS effect most probably consists in the activation of macrophages and granulocytes by TLR4 and CD14 receptors for the production of cytokines, which affect Th1/Th2 balance. The objective of the study was the evaluation of CD14 and TLR4 expression on mononuclear cells and the analysis of Th1/Th2 balance in peripheral blood among asthma patients. Material and Methods: The study group covered 22 patients with bronchial asthma (mean age 45 ± 15), and was conducted by the method of flow cytometry with the use of fluorochrome-labelled monoclonal antibodies. CD14 and TLR expression was assessed in peripheral blood monocytes. Th1/Th2 balance was determined by the measurement of intracellular IL-2, IFN-γ, IL-4 and IL-10 expression in T-helper cells after culture with the stimulation of cytokine production. Results: A negative correlation was noted between TLR4 expression and the percentage of Th2 lymphocytes, while a positive correlation was observed between expression of TLR4 and percentage of Th1 cells. No relationship was found between CD14 expression on monocytes and the percentage of Th1 and Th2 lymphocytes. Conclusions: An increased percentage of lymphocytes with TLR4 expression is associated with the change in Th1/Th2 balance in favour of Th1 lymphocytes in asthma patients. Full article

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Open AccessArticle

Application of Western Blotting for the Eetection of Uncoupling Protein-2 (UCP-2) in Mitochondria from Smokers and Non-Smokers

by Kinga I. Stańczak-Mrozek, Paweł Grieb and Monika Kolanowska

Adv. Respir. Med. 2009, 77(2), 118-122; https://doi.org/10.5603/ARM.27824 - 16 Mar 2009

Cited by 1 | Viewed by 242

Abstract

Introduction: Uncoupling proteins (UCPs) are a family of transmembrane anion transporters present in the inner mitochondrial membrane. UCP-2, which exhibits the widest distribution in various tissues, plays an important role in many physiological processes. Human UCP-2 studies have been hampered by the [...] Read more.

Introduction: Uncoupling proteins (UCPs) are a family of transmembrane anion transporters present in the inner mitochondrial membrane. UCP-2, which exhibits the widest distribution in various tissues, plays an important role in many physiological processes. Human UCP-2 studies have been hampered by the lack of a method for measuring this protein in an easily accessible human tissue, e.g., blood. The aim of this study was to develop such a method and test its utility by comparing UCP-2 levels in smokers and non-smokers. Material and Methods: Venous blood samples from 10 smoking and seven non-smoking volunteers were used for the study; lymphocytes were isolated employing Lymphoprep. UCP-2 levels were measured by Western blotting combined with chemoluminescence detection. Results: Total lymphocyte homogenates were found useless for measuring UCP-2 levels, but it was possible to measure UCP-2 in homogenates of purified lymphocyte mitochondria. There was a significant, though moderate, linear correlation between UCP-2 level and daily cigarette use. UCP-2 level in peripheral blood lymphocytes from smokers was higher than that in non-smokers. Conclusion: The method for measuring UCP-2 in peripheral blood lymphocytes opens the possibility of UCP-2 screening studies in humans and thus may be useful for studying the role of the protein in human physiology and pathology. Full article

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Open AccessEditorial

Współistnienie samoistnego włóknienia płuc i rozedmy

by Jan Kuś

Adv. Respir. Med. 2009, 77(2), 115-117; https://doi.org/10.5603/ARM.27823 - 16 Mar 2009

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Abstract

Samoistne (idiopatyczne) włóknienie płuc(SWP) jest bardzo dobrze scharakteryzowane podwzględem zaburzeń czynnościowych, zmianw obrazie radiologicznym płuc, w badaniu mikrosko-powym wycinków miąższu płuca, objawów, prze-biegu i rokowania [...] Full article

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Adv. Respir. Med., Volume 77, Issue 2 (March 2009) – 19 articles , Pages 115-227

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