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What is dependent edema?

Edema is the term used to describe the swelling that results from excess fluid that is trapped in the tissues of the body. Dependent edema is caused by the effects of gravity and occurs when fluid pools in the lower parts of the body, including the feet, legs, or hands.

This article discusses the causes and symptoms of dependent edema, as well as the available treatment options.

Fast facts on dependent edema: The main symptom of dependent edema is swelling of the lower body parts. Dependent edema happens when gravity pulls blood toward the feet. The treatment for dependent edema will vary, and it may not be curable.
Causes Pain in leg and foot caused by dependent edema, woman sitting on couch holding her calf in pain.
A problem in the veins may cause dependent edema, which is characterized by symptoms such as swollen and shiny skin.

Gravity pulls blood toward the parts of the body that are closest to the ground. For example, edema may occur in the feet, but people who are bedbound may experience edema in the buttocks.

Usually, the blood is pumped back from feet toward the heart by the veins and the motion of the muscles. When this system malfunctions, the lower body parts begin to fill up with excess fluid, causing the swelling and puffiness of edema.

According to the American Family Physician, one of the primary causes of dependent edema is a problem with the veins, although muscular issues may also contribute.

What are the symptoms? Signs and symptoms of this condition include: difficulty putting on shoes and socks due to swelling shiny skin stretched-looking skin To differentiate between dependent edema and one of the other types of edema, apply gentle pressure to the affected area. If dents appear on the skin, which is known as pitting, it suggests dependent edema. Thank you for supporting Medical News Today Warning signs to look out for Doctor in patient's home discussing report.
Those with dependent edema will need to monitor their skin health, and ensure they are aware of the warning signs. People with dependent edema should be vigilant when it comes to their skin health because they are at increased risk of skin infections. When the skin stretches and breaks, it becomes more vulnerable to infections such as cellulitis, which is a bacterial skin infection that can spread rapidly to other body parts. If anyone observes any signs of a serious skin issue, seek emergency medical attention. Symptoms include: a feeling that the skin is hot pus-like drainage redness slow-healing wounds swelling The risk of skin infection can be reduced by keeping the skin around the affected areas clean and moisturizing the skin regularly. What are the treatment options? If there is an underlying cause for the dependent edema, then treating the condition may resolve the edema. Sometimes, these conditions are not curable such as in the case of heart failure, so people may need to manage the edema to limit its symptoms and reduce the risk of complications. A person can implement some lifestyle changes to help manage dependent edema: Elevate the affected body parts Because gravity causes dependent edema, elevating the affected area to above heart level allows the excess fluid to drain toward the heart. If edema affects the feet, for example, lying down and propping up the legs with cushions can help. Use compression stockings or bandages If the feet or legs are affected, wearing compression socks or leg sleeves can stop the collection of fluid in the tissues. Compression bandages are also available to wrap other areas of the body. Manually move body parts People who cannot move their arms or legs should try manual mobility. This involves moving the immobile body part, perhaps with the hands or with the assistance of another person. This type of movement can encourage the muscles to pump blood and fluids more efficiently, which can prevent fluid buildup and reduce the edema. A doctor can advise on specific exercises that may further reduce swelling. Reduce salt intake A high-salt diet can increase water retention, which increases the likelihood of edema. Discuss salt intake with a doctor or dietitian. Massage Massage may move excess fluid out of the affected area. Using firm pressure, stroke the skin in the direction of the heart. Never use pressure that causes pain. Skin hygiene Keep the skin clean and moisturized to prevent cracks, scrapes, and cuts, which can lead to infection. Foot protection If edema occurs in the feet, wear suitable shoes that do not restrict blood flow but that protect the feet from injury and infection. What are the complications? Dependent edema can lead to some complications, such as: difficulty walking discolored, thick skin pain and stiffness reduced blood circulation stretched, itchy, or tender skin ulcers varicose veins Thank you for supporting Medical News Today Other types of edema periorbital edema image credit klaus d peter 2008 br
Periorbital edema is a type of edema that affects the eye.
Image credit: Klaus D Peter (2008) Dependent edema is just one type of edema. Others include: Cerebral edema: A severe condition that involves excess fluid in the brain. This type of edema is most commonly caused by trauma, a tumor, or a burst blood vessel. Lymphedema: A swelling in the arms and legs that is usually caused by damage to the lymph nodes. It may be as a result of cancer or cancer treatments. Macular edema: Caused by an increase of fluid in the macula of the eye. Pedal edema: This occurs when fluid builds up in the feet and legs. This typically affects older adults and pregnant women. Peripheral edema: This usually affects the legs, feet, and ankles. It can indicate a problem in the kidneys, lymph nodes, or circulatory system. Pulmonary edema: Characterized by excess fluid in the air sacs of the lungs. It can lead to breathing difficulties. Outlook Some causes of dependent edema are curable, and the edema may resolve once the underlying condition is treated. However, other causes have no cure. However, there are some steps that a person can take to reduce symptoms and the risk of complications. Using elevation, compression, movement, and keeping the skin clean can offer relief to many people with dependent edema. It is always important to discuss dependent edema and its symptoms with a doctor, who can best advise a person on the most effective treatment options for their condition.
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Gout drug could help treat heart failure

Drug repurposing is one of the fastest and most effective routes to new medical treatments. Researchers reveal how such a strategy may yield a new treatment for heart failure.
an illustration representing a heart problem
Researchers suggest that the gout drug probenecid may help to treat heart failure.

In a new study, the team found that probenecid — which is a drug commonly used to treat gout — improved heart function in a small number of individuals with heart failure.

First study author Nathan Robbins — from the University of Cincinnati College of Medicine in Ohio — and colleagues recently reported their findings in the Journal of the American Heart Association.

Heart failure is a condition that arises when the heart is unable to pump oxygen-rich blood well enough to support other organs.

It is estimated that heart failure affects around 5.7 million adults in the United States, and around 50 percent of people who have the condition die within 5 years of being diagnosed.

Though there is no cure for heart failure, treatments exist that help to manage the condition. Some of these treatments, such as a left ventricular assist device (LVAD), concentrate on improving the heart's function.

An LVAD is a battery-powered device surgically implanted into the patient's heart. It draws in blood from the left ventricle of the heart, before transporting it to the aorta, or the artery that distributes blood to the rest of the body.

In their new study, Robbins and team reveal how probenecid may offer a noninvasive alternative to such treatments, after finding that the gout drug improved the heart-pumping action of people with heart failure.

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'From bench to bedside'

The researchers tested probenecid on 20 people of an average age of 57 years, all of whom had heart failure.

As part of the double-blind, randomized, placebo-controlled study, all the participants either took probenecid or a placebo over 4-week periods between June 2013 and April 2015.

Subjects' ejection fraction, or the heart's ability to pump blood, was measured by echocardiogram. Other measures of heart function included an electrocardiogram and a 6-minute walk test.

Compared with the placebo, the researchers found that probenecid led to improvements in ejection fraction.

"This is the first time," states Robbins, "probenecid has been used in heart failure patients and we showed it increases the ejection fraction in patients with heart failure. It was exciting to be able to see this medicine work from the bench to the bedside."

"We were quite happily surprised it improved the two main ways in how the heart functions," adds study co-author Dr. Jack Rubinstein, of the Department of Internal Medicine at the University of Cincinnati. "It improves how the heart contracts and how it relaxes."

Importantly, the drug was found to cause no significant adverse effects in the subjects. "We know that it was very likely to be safe because the medicine had been taken by people of all ages for decades," says Dr. Rubinstein. "It has a very strong safety profile."

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'A new way of treating heart failure'

When the researchers tested the drug on heart cells taken from mice, they found that it improves the heart's use of calcium, which is a key player in heart muscle contraction.

While larger clinical trials are needed to determine the efficacy of probenecid for heart failure, the researchers believe that their results show promise.

"The repercussions are potentially significant — if we are able to confirm this experiment in larger studies with longer-term follow-up, this could present a new way of treating heart failure for which there are limited medical therapies available."

Dr. Jack Rubinstein

"Left ventricular assist devices, pacemakers, heart transplants, and medications are available to treat heart failure patients, but outcomes for patients with heart failure are still worse than outcomes for the vast majority of cancer patients," Dr. Rubinstein adds.

"That's what we want to effectively change."

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What causes pain under my left breast?

Unexpected pain can occur under the left breast for reasons that range from problems with digestion through to heart conditions. Some can be treated at home, but some can be medically more serious.

There are some organs in the upper left region of the body that could be the source of the pain. These include the stomach, heart, lungs, ribs, colon, pancreas, and spleen.

Doctors often group the most common causes of pain under the left breast into two main categories: digestive and heart-related.

This article looks at the different causes of pain under the left breast, their symptoms, and the treatment options available.

Is pain under the left breast a heart attack? Man holding his chest with pain under left breast
The pain of a heart attack tends to occur in the center of the chest.

As the heart is situated slightly to the left of the midline in the upper body, pain under the left breast can sometimes indicate a heart problem.

According to the American Heart Association, when pain does occur during a heart attack, it commonly happens in the center of the chest, lasts longer than a few minutes, and can return after fading.

Heart attack pain can cause a very strong, uncomfortable, crushing pressure or squeezing sensation, or it may feel like very bad heartburn. Some people may not experience any or only mild chest pain; this is more common in women, older people, and those with diabetes.

Other symptoms include:

profuse sweating nausea or vomiting shortness of breath heavy, weak shoulders or arms severe pain traveling to the arm, jaw, neck, back, and elsewhere in the body dizziness a strong sense of anxiety or impending doom


If someone suspects a heart attack, they should call an ambulance immediately. While waiting, they should rest, and if they are not intolerant to aspirin, they should take an adult-dose tablet (300 milligrams) to help thin the blood.

Further treatment options will depend on when symptoms started and how soon the person having the attack can access the first stage of care.

If the cause of the attack is found to be a blocked coronary artery, the doctor may recommend a procedure called an angioplasty to open a blocked or severely narrowed coronary artery with a balloon and possibly place a stent.

Thank you for supporting Medical News Today Other heart-related causes 1. Angina When the heart muscle does not receive enough oxygen in the coronary artery blood supply, the resulting pain under the left breast or in the center of the chest is known as angina. Associated symptoms include an uncomfortable feeling in the shoulders, arms, neck, jaw, or back. Angina pain can also feel like indigestion, and a person may also experience sweating, light-headedness, nausea, or shortness of breath. Treatment Angina is a possible symptom of severe underlying heart disease, so anyone experiencing symptoms of angina should seek medical attention immediately. A doctor may prescribe medication, such as beta-blockers, ACE-inhibitors, statins, or aspirin. 2. Pericarditis The heart is surrounded and protected by a thin, layered, fluid-filled membrane called the pericardium. It can become inflamed due to infection or a disorder where the body's immune system attacks itself. Symptoms of acute pericarditis include: sharp, stabbing pain under the left breast or in the chest pain in one or both shoulders pain worsening when taking a deep breath or lying down on the back feeling hot, sweaty, feverish, light-headed, and short of breath Treatment Immediate treatment for pericarditis may include an OTC anti-inflammatory medication, such as ibuprofen and rest until feverish symptoms decrease. If a person experiences severe pain, a doctor may prescribe a steroid, such as prednisone. If the condition is severe, the person may need to say in the hospital for monitoring. Prevention While acute pericarditis typically cannot be prevented, getting treated quickly and following a prescribed treatment plan will reduce the chance of the acute pericarditis recurring or becoming a long-term condition. Digestive causes 3. Gastritis When the stomach's lining becomes inflamed, this is known as gastritis. Not everyone will experience symptoms, but a sharp, stabbing or burning pain under the left breast is a potential clue that gastritis may be present. The pain can also be accompanied by heartburn, feeling sick, vomiting, and bloating. Treatment For mild symptoms, changing the diet and lifestyle can ease pain under the left breast. Over-the-counter (OTC) medications, such as antacids, can help reduce stomach acid. Home remedy options include: reducing alcohol intake eating smaller portions more often, as opposed to one big meal cutting out dairy, spicy, fried, or acidic foods, and caffeinated drinks cutting down or giving up tobacco smoking reducing high intake of OTC non-steroidal anti-inflammatory drugs (NSAIDs) eating foods high in fiber and plant nutrients If the pain is caused by or related to the presence of the bacterium called Helicobacter pylori, the doctor may prescribe a course of antibiotics and medicine that reduces the production of stomach acid. 4. Pancreatitis Pancreatitis is inflammation of the pancreas. Acute pancreatitis has symptoms that include: sudden, severe pain under the left breast and in the upper center part of the abdomen nausea and vomiting rapid pulse fever Chronic pancreatitis, where the condition worsens over time, has symptoms including: frequent or prolonged episodes of pain under the left breast that can spread to the back nausea and vomiting oily, pale-looking stools diarrhea Treatment Treatment for chronic pancreatitis ranges from pain management, using increasing strengths of medication, to surgery if pain under the left breast is still severe. For acute pancreatitis, immediate treatment includes: intravenous fluids to aid in hydration and ensure the body's other organs have good blood flow no eating for 24-48 hours, then following a high-calorie diet to support healing giving intravenous pain medication or antinausea medication 5. Heartburn Man suffering from heartburn which may cause pain under left breast
Heartburn may cause a pain under the left breast. When stomach acid travels back up the food pipe, it causes a burning sensation in the mid-chest and throat, and sometimes pain under the left breast. Heartburn can be a symptom of indigestion and stomach acid issues. Symptoms include: a tight, burning sensation in the upper chest or throat that sometimes travels under the left breast and the jaw a bitter taste in the mouth pain under the left breast or in the chest while lying down or just after eating Treatment Self-help treatment options for mild heartburn include not eating big meals, not lying down to sleep right after eating, and raising one's pillow, so the head is higher than the waist when sleeping. This may help prevent stomach acid from traveling up the food pipe. OTC medications such as antacids are a first medical option to try. Thank you for supporting Medical News Today Other causes 6. Pleurisy The lungs are surrounded by a layered membrane called the pleura. If the pleura surrounding the left lung become inflamed due to infection or another cause, the resulting pain will develop under the left breast. More severe causes of pleurisy include rheumatoid arthritis and lung cancer. The most common symptom of pleurisy is a sharp chest pain when taking a deep breath, but it can also be accompanied by: pain in the shoulder a dry cough shortness of breath The pain can get worse when the person walks around, coughs, or sneezes. Treatment Rest is highly recommended. Lying on the side of the pain can help relieve pain symptoms. If a person experiences particularly severe chest pain, they should seek immediate treatment from a doctor, who may prescribe NSAIDs or other pain-relieving medication. A doctor may also carry out further tests, such as blood tests, a chest X-ray, a chest CT scan. They may also take a small sample of pleural lung tissue for biopsy. Pleurisy caused by a viral infection often gets better after a few days, but a bacterial infection will require antibiotic therapy. Prevention The best way to prevent severe cases of pleurisy is early intervention. 7. Spleen The spleen can cause pain under the left breast if it is enlarged or if it bursts following an injury. Symptoms of an enlarged spleen include: tenderness and pain under the left breast feeling uncomfortable when eating even just a small meal anemia and extreme tiredness bleeding easily A burst spleen typically will cause: pain under the left breast or ribs, and tenderness when touched bleeding dizziness and fast heart rate Treatment If a person suspects a burst spleen, they should go immediately to the emergency room. Bleeding can be life-threatening if left untreated. A doctor will check for an enlarged spleen by feeling the abdomen and may recommend further testing through blood testing or imaging, such as an abdominal ultrasound, CT scan, or MRI scan. Underlying conditions, such as chronic liver disease and subsequent cirrhosis, can affect and interact with the spleen. A doctor will prescribe medication when medical therapy is possible to treat splenic or liver disease. Surgery is only required if underlying causes cannot be diagnosed clearly, or if complications arise from the enlarged or damaged organ. Prevention People should aim to keep the spleen safe when playing sport by wearing protective sporting equipment. Always wearing the seatbelt when in the car is also advised. As cirrhosis can be caused by excessive or long-term high alcohol intake, cutting down is recommended. 8. During pregnancy pregnant lady holding her stomach with pain under left breast
As the uterus grows it may cause pain under the left breast. Soreness and pain experienced under the left breast during pregnancy are often caused by pressure from the top of the uterus as it grows, or if the baby is kicking or punching the expectant mother. The pain can be worse when leaning forward. Muscles and other tissues will stretch as the baby grows, and this can also cause pain under the breasts. The expectant mother's body is changing during pregnancy, and the internal organs will be pushed and moved as the baby grows. The mother's body chemistry may also change, and other causes of pain under the left breast during pregnancy can include: heartburn with stomach acid reflux the rib cage changing position to allow space for the baby in the abdomen When to see a doctor Some conditions can be treated at home with rest and OTC medication, but people should seek medical attention straight away if: the chest is injured the pain under the left breast is unexpected symptoms of pain and tightness do not get better with rest shortness of breath, feeling sick, or profuse sweating accompanies the pain Thank you for supporting Medical News Today Outlook Pain under the left breast is often frightening to experience. As there are several organs in this area of the body, the earlier the cause of the pain can be diagnosed, the more likely that treatment and recovery will be successful. A heart attack is not the most common reason for pain under the left breast, but it is always better to have the symptoms checked out, especially if other symptoms of a heart attack are present. Many causes of pain under the left breast can be prevented through making changes to several everyday lifestyle choices. Following a healthful diet, getting regular exercise, lowering or cutting out tobacco smoking, reducing alcohol intake, keeping weight down, and reducing stress can all help.
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Stroke risk may depend on your height as a child

People who were very short as children may have to pay closer attention to their cerebrovascular health. A new study suggests that it is these people who are more at risk of having a stroke in adulthood.
stroke written in red lettering on wooden blocks
Could we look to childhood height to predict stroke risk in adulthood?

Stroke is an event that occurs when the blood supply to the brain is obstructed or otherwise impaired, so that the brain does not receive enough oxygen for it to function correctly.

There are two main types of stroke. These are ischemic, which is caused by a blood clot or an otherwise blocked artery, or hemorrhagic, which is characterized by blood leaks in the brain.

The Centers for Disease Control and Prevention (CDC) estimate that around 6.5 million adults in the United States have had a stroke. It is the currently fifth most common cause of death nationwide.

Known risk factors for stroke include age, hypertension, heart disease, diabetes, obesity, habitual drinking and smoking, and a family history of stroke or cardiovascular disease.

New research from the Bispebjerg and Frederiksberg Hospital and the University of Copenhagen, both in Denmark, may have uncovered a new and surprising risk factor: an individual's height during childhood.

Senior study author Jennifer L. Baker — who is affiliated with both of the institutions named above — and colleagues worked out that adults who had a shorter-than-average height as children were more likely to experience a stroke as adults.

The researchers' findings have now been published in the journal Stroke.

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We should focus on modifiable factors

Baker and team conducted a prospective study in which they analized the relevant data — sourced from the Copenhagen School Health Records Register — of 372,636 children from Denmark. They were all born between 1930 and 1989 and were evaluated once every 3 years — at age 7, 10, and 13.

The researchers found that both boys and girls who were 2–3 inches (roughly 5–7 centimeters) shorter than the average height considered normal for their age were more likely to have a stroke later in life than their peers.

More specifically, both boys and girls were more at risk of ischemic stroke in adulthood, and boys in particular had a heightened risk of hemorrhagic stroke later on.

Baker and colleagues explain that there are many reasons why some children may not reach the average height, as expected.

One cause may be genetic factors, but equally important to a child's development is the mother's diet during the course of her pregnancy, and the child's diet throughout their years of growth.

Other reasons behind stunted growth include infection and being exposed to psychological stress. Fortunately, the researchers point out, most of these factors can be prevented, which could also help to reduce a person's risk of experiencing stroke.

"[I]n addition to being genetically determined," write the study authors, "adult height is a marker of exposures affecting childhood growth [...], of which many are modifiable and all are thought to affect the risk of stroke."

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Shared fundamental mechanisms?

Moreover, the researchers saw that in high-income countries, the rates of stroke cases and stroke-related mortality were dwindling where the higher adult height rates were on the rise. This was especially true for female populations.

Baker and colleagues surmise that this may be because physical growth and the development of stroke conditions may be determined by overlapping underlying biological mechanisms.

The researchers clarify that these findings are important less in terms of determining risk factors for stroke, and more in terms of understanding some of the root causes of this adverse health event.

That being the case, they suggested that further research should be dedicated to identifying the exact reasons why childhood height is associated with a heightened risk for stroke in later life.

"Our study suggests that short height in children is a possible marker of stroke risk and suggests these children should pay extra attention to changing or treating modifiable risk factors for stroke throughout life to reduce the chances of having this disease."

Jennifer L. Baker

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Cholesterol-removing gene may prevent heart disease

Heart disease is the leading cause of death for men and women in the United States, which highlights the urgent need for new strategies to prevent the condition. Researchers may be one step closer to meeting this need, after locating a gene that assists in the clearance of excess cholesterol from blood vessels.
a human heart and DNA strands
Researchers reveal how a gene called MeXis helps to clear cholesterol from blood vessels.

The gene — known as MeXis — was previously believed to sit under the umbrella of "selfish" genes, or those thought to be functionless because they fail to produce proteins.

But the new study shows that MeXis does not need to produce proteins to be useful. Instead, it makes molecules known as long-coding RNAs (IncRNAs).

These IncRNAs regulate the expression of a protein that removes cholesterol from the arteries.

High cholesterol is a major risk factor for heart disease.

Lead study author Dr. Tamer Sallam, the co-director of the Center for Cholesterol Management at the University of California, Los Angeles (UCLA), and his colleagues recently reported their new findings in the journal Nature Medicine.

According to the Centers for Disease Control and Prevention (CDC), around 610,000 people in the United States die from heart disease every year.

Coronary artery disease (CAD), which is also called coronary heart disease, is the most common form of heart disease, accounting for around 370,000 deaths annually. CAD is caused by the accumulation of plaque in the arteries.

Over time, plaque buildup can block the arteries and reduce the flow of blood to the heart, which is a process known as atherosclerosis. This can lead to chest pain, or angina, irregular heartbeat, heart attack, and heart failure.

High cholesterol — more specifically, high low-density lipoprotein (LDL) cholesterol — is a major risk factor for heart disease. When we consume too much cholesterol from our diet, it can accumulate in the arteries.

In the new study, Dr. Sallam and colleagues discovered how the MeXis gene helps to remove excess cholesterol from the arteries, potentially opening the door to a new strategy for heart disease prevention.

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With their new study — which was conducted using mice — the researchers sought to learn more about the molecular events that play a role in atherosclerosis.

They identified MeXis as a key player; plaque accumulation in the blood vessels of rodents without the gene was almost double that of mice with normal levels of MeXis.

Upon further investigation, the team found that MeXis activates the expression of a protein called Abca1 through the production of IncRNAs. The role of Abca1 is to remove excess cholesterol from the blood vessels.

It was found that increasing MeXis levels in the rodents led to an increase in the removal of cholesterol from blood vessels, which makes MeXis a potential candidate for heart disease prevention and treatment.

What is more, the findings may open the door to other genes that play a role in heart health.

"What this study tells us is that lncRNAs are important for the inner workings of cells involved in the development of heart disease," says senior study author Dr. Peter Tontonoz, of the David Geffen School of Medicine at UCLA.

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"Considering many genes like MeXis have completely unknown functions," he explains, "our study suggests that further exploring how other long non-coding RNAs act will lead to exciting insights into both normal physiology and disease."

In future research, the team plans to find out more about the mechanisms of MeXis, how its activity can be modified, and whether it could hold up as a target for heart disease prevention.

"The idea that lncRNAs are directly involved in very common ailments such as plaque buildup within arteries offers new ways of thinking about how to treat and diagnose heart disease."

Dr. Tamer Sallam

"There is likely a good reason why genes that make RNAs rather than proteins exist," Dr. Sallam continues. "A key question for us moving forward is how they may be involved in health and disease."

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