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See detailSeasonal variations in vitamin D levels in melanoma patients: a single-centre prospective pilot comparative study
FAILLA, Valérie ULg; CAVALIER, Etienne ULg; EL HAYDERI, Lara ULg et al

in Journal of the European Academy of Dermatology & Venereology (2012), 26(5), 651-3

BACKGROUND: More than 90% of vitamin D synthesis is dependent on UV exposure. Photosensitive disorders such as lupus erythematosus, protoporphyria and xeroderma require strict sun avoidance, and vitamin D ... [more ▼]

BACKGROUND: More than 90% of vitamin D synthesis is dependent on UV exposure. Photosensitive disorders such as lupus erythematosus, protoporphyria and xeroderma require strict sun avoidance, and vitamin D deficiency has been demonstrated in these patients. Melanoma patients are also instructed to avoid sun exposure and may hence be expected to be vitamin D deficient. MATERIALS AND METHODS: Winter and summer vitamin D levels were compared in a group of melanoma patients (n =61) and age- and phototype-matched controls (n = 53) without photosensitive disorders. RESULTS: Oral supplementary vitamin D intake was reported in 32.7% of the melanoma patients and in 15.1% in the control group. Despite oral supplementation, only 25% of the melanoma patients and the controls presented with vitamin D levels of 30 ng/mL or higher. In non-supplemented subjects in the melanoma and control groups, respectively, mean winter vitamin D levels were below the recommended threshold at 12.6 ng/mL vs. 13.2 ng/mL, respectively, but not statistically different. These values increased significantly in both groups during the summer to 24.6 and 23.8 ng/mL respectively. CONCLUSION: Unexpected, significant increases in vitamin D levels were seen in melanoma patients during summer, suggesting non-adherence with photoprotective measures and reflecting a heliophilic behaviour. Vitamin D supplementation is recommended in melanoma patients during both winter and summer. [less ▲]

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See detailLa gestion des médicaments photosensibilisants
DEZFOULIAN, Bita ULg; LEBAS, Eglantine ULg; DE SCHAETZEN VAN BRIENEN, Virginie ULg et al

in Skin Inc (2012), 15(3), 16-21

L'arrivée de l'été nous confronte à nouveau aux réactions médicamenteuses photo-induites. Deux types de réactions photosensibles sont rencontrés : la photoallergie médicamenteuse, plutôt rare, et la ... [more ▼]

L'arrivée de l'été nous confronte à nouveau aux réactions médicamenteuses photo-induites. Deux types de réactions photosensibles sont rencontrés : la photoallergie médicamenteuse, plutôt rare, et la phototoxicité médicamenteuse, beaucoup plus fréquente. Ces réactions peuvent se produire aussi bien avec des médicaments topiques que systémiques. La liste des médicaments classiquement en cause est actuellement enrichie de nouveaux médicaments tels que le voriconazole, l'ipilimumab et le vémurafénib. Cette revue présente les pricipaux mécanismes en cause, une mise à jour de la liste des médicaments photosensibilisants et la gestion prophylactique et thérapeutique des patients. [less ▲]

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See detailLa photoprotection en 2012
LIBON, Florence ULg; DEZFOULIAN, Bita ULg; NIKKELS, Arjen ULg

in Skin Inc (2012)

La photoprotection est essentielle dans la prévention du processus de photovieillissement et de la carcinogenèse cutanée. Elle peut être comportementale, naturelle, induite, vestimentaire, topique et ... [more ▼]

La photoprotection est essentielle dans la prévention du processus de photovieillissement et de la carcinogenèse cutanée. Elle peut être comportementale, naturelle, induite, vestimentaire, topique et systémique. La photoprotection vestimentaire inclut le port de vêtements protecteurs, de lunettes solaires et de chapeau. La photoprotection externe topique repose sur l'utilisation de différents véhicules contenant siot des filtres minéraux, ayant pour but une réflexion de la radiation ultraviolette incidente, soit des agents chimiques qui absorbent une partie de la radiation incidente. La photoprotection systémique consiste en l'administration, par voie orale, de substances photoprotectrices. D'autres nouvelles voies de photoprotection sont les stimulations chimique ou hormonale de la mélanogenèse. Cet article revoit les dernières évolutions dans ce domaine. [less ▲]

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See detailLes effets cutanés indésirables des antagonistes du TNF alpha
FAILLA, Valérie ULg; SABATIELLO, Murielle ULg; LEBAS, Eglantine ULg et al

in Revue Médicale de Liège (2012)

The TNF alpha antagonists, including adalimumab, etanercept and infliximab, represent a class of anti-inflammatory and immunosuppressive drugs. Although cutaneous adverse effects are uncomon, they are ... [more ▼]

The TNF alpha antagonists, including adalimumab, etanercept and infliximab, represent a class of anti-inflammatory and immunosuppressive drugs. Although cutaneous adverse effects are uncomon, they are varied. There is no particular risk profile to develop cutaneous adverse effects. The principal acute side effects are injection site reactions and pruritus. The major long term cutaneous side effects are infectious and inflammatory conditions. Neoplastic skin diseases are exceptional. the association with other immunosuppressive agents can increase the risk of developing cutaneous adverse effects. Some adverse effects, such as lupus erythematosus, require immediate withdrawal of the biological treatment, while in other cases temporary withdrawal is sufficient. The majority of the other cutaneous adverse effects can be dealt without interrupting biologic treatment. Preclinical and clinical investigations revealed that the new biologics, aiming IL12/23, IL23 and IL17, present a similar profile of cutaneous adverse effects, although inflammatory skin reactions may be less often encountered compared to TNF alpha antagonists. [less ▲]

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See detailL'allergie au liquide séminal
DEZFOULIAN, Bita ULg; RATY, Laurent ULg; NIKKELS, Arjen ULg

in Skin Inc (2011), 14(N°5), 140

L'allergie au liquide séminal est une affection rare dont le diagnostic est difficile et souvent tardif. Divers degrés de sévérité clinique peuvent se rencontrer, allant d'une forme fruste, chronique et ... [more ▼]

L'allergie au liquide séminal est une affection rare dont le diagnostic est difficile et souvent tardif. Divers degrés de sévérité clinique peuvent se rencontrer, allant d'une forme fruste, chronique et localisée, à une symptomatologie aiguë pouvant conduire au choc anaphylactique. Des réactions croisées ont récemment été identifiées entre certains allergènes prostatiques humains et certains allergènes du chien. Ce phénomène pourrait expliquer l'apparition d'une réaction allergique au liquide séminal dès le premier rapport. Nous présentons ici le cas d'une jeune femme avec une allergie au liquide séminal, mise en évidence par un prick test positif à un extrait centrifugé et filtré à partir du sperme de son partenaire. [less ▲]

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See detailAllergologie cutanée
NIKKELS, Arjen ULg; DEZFOULIAN, Bita ULg

in Skin Inc (2011)

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See detailLes mastocytoses
AUSSEM, C.; BENOIT, A.; LOMBARD, Xavier ULg et al

in Derm'Actu (2011), 125

Les mastocytoses sont des entités rares qui peuvent se manifester sous une forme cutanée solitaire, disséminée ou comme atteinte systémique. Elle sont caractérisées par une prolifération des mastocytes ... [more ▼]

Les mastocytoses sont des entités rares qui peuvent se manifester sous une forme cutanée solitaire, disséminée ou comme atteinte systémique. Elle sont caractérisées par une prolifération des mastocytes, soit d'origine réactionnelle, liée à la sécrétion de certains facteurs de croissance, soit constitutionnelle, suite à diverses mutations. Les signes cliniques sont d'une part dus à la libération massive de médiateurs mastocytaire et d'autre part, à une éventuelle infiltration tumorale des tissus. Si la prise en charge d'une mastocytose relève principalement de la médecine spécialisée, cet article aura pour but de rappeler au praticien les principaux signes cliniques, les différentes répercussions ainsi que les méthodes diagnostiques. Il est également primordial de connaître les aliments riches en histamine et histamino-libérateurs ainsi que les méidcament histamino-libérateurs car ils peuvent être responsables de réactions sévères, pouvant aller jusqu'au choc de type anaphylactique. Les thérapeutiques font essentiellement appel aux antihistaminique de type anti-H1 de deuxième génération. [less ▲]

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See detailCOMPLICATIONS DERMATOLOGIQUES DES TATOUAGES DEFINITIFS ET TEMPORAIRES
CAUCANAS, MARIE; EL HAYDERI, Lara ULg; LEBAS, Eglantine ULg et al

in Annales de Dermatologie et de Vénéréologie (2011)

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See detailAlitrétinoïne : une nouvelle arme dans l'eczéma chronique des mains
DEZFOULIAN, Bita ULg; FAILLA, Valérie ULg; RATY, Laurent ULg et al

in Skin Inc (2011)

L'eczéma chronique des mains représente une difficulté thérapeutique majeure en dermatologie, et en particulier, quand l'exploration allergologique ne permet pas d'identifier l'agent responsable de l ... [more ▼]

L'eczéma chronique des mains représente une difficulté thérapeutique majeure en dermatologie, et en particulier, quand l'exploration allergologique ne permet pas d'identifier l'agent responsable de l'affection ou que l'éviction de celui-ci est difficile à obtenir pour raisons professionnelles. La première approche thérapeutique consiste en l'application de dermocorticoïdes. Cependant, leur utilisation chronique n'est pas recommandée en raison de leurs effets secondaires tels que l'atrophie cutanée. L'application topique des inhibiteurs de la calcineurine, comme le tacrolimus ou le pimecrolimus peut être envisagée comme traitement complémentaire. La photothérapie par UVB ou par PUVA est un traitement de deuxième ligne. Le méthotrexate et la ciclosporine sont des médicaments à réserver aux cas graves et multirésistants. L'alitrétinoïne, rétinoïde endogène et agoniste des récepteurs aux rétinoïdes, est une nouvelle thérapeutique contre l'eczéma chronique des mains qui ne répond plus aux dermocorticoïdes et est réfractaire aux autres options thérapeutiques. Plusieurs études randomisées, multicentriques et contrôlées contre placebo ont montré l'efficacité et l'innocuité de l'alitrétinoïne dans l'eczéma chronique des mains résistant aux traitements classiques. [less ▲]

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See detailSeasonal variations in vitamin D levels in melanoma patients : a single-centre prospective pilot comparative study
FAILLA, Valérie ULg; CAVALIER, Etienne ULg; EL HAYDERI, Lara ULg et al

in Journal of the European Academy of Dermatology & Venereology (2011)

Background: More than 90% of vitamin D synthesis is dependent on UV exposure. Photosensitive disorders such as lupus erythematosus, protoporphyria and xeroderma require strict sun avoidance, and vitamin D ... [more ▼]

Background: More than 90% of vitamin D synthesis is dependent on UV exposure. Photosensitive disorders such as lupus erythematosus, protoporphyria and xeroderma require strict sun avoidance, and vitamin D deficiency has been demonstrated in these patients. Melanoma patients are also instructed to avoid sun exposure and may hence be expected to be vitamin D deficient. Materials and method : Winter and summer vitamin D levels were compared in a group of melanoma patients (n=61) and age- and phototype-matched controls (n=53) without photosensitive disorders. Results : Oral supplementary vitamin D intake was reported in 32.7% of the melanoma patients and in 15.1 % in the control group. Despite oral supplementation, only 25% of the melanoma patients and the controls presented with vitamin D levels of 30 ng/mL or higher. In non-supplemented subjects in the melanoma and control groups, respectively, mean winter vitamin D levels were below the recommended threshold at 12,6 ng/mL vs 13.2 ng/mL, respectively, but not statistically different. These values increased significantly in both groups during the summer to 24.6 and 23.8 ng/mL respectively. Conclusion: Unexpected, significant increases in vitamin D levels were seen in melanoma patients during summer, suggesting non-adherence with photoprotective measures and reflecting a heliophilic behaviour. Vitamin D supplementation is recommended in melanoma patients during both winter and summer. [less ▲]

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See detailA propos de la réticence à l’immunothérapie spécifique chez les personnes allergiques : les nouvelles données de la littérature
Dezfoulian, Bita ULg; Caucanas, Marie ULg; Wauters, Odile ULg et al

in Revue Médicale de Liège (2010)

The increasing number of allergic subjects and the alteration of their quality of life are major concerns of public health. Symptomatic treatments of allergic diseases are not always able to improve the ... [more ▼]

The increasing number of allergic subjects and the alteration of their quality of life are major concerns of public health. Symptomatic treatments of allergic diseases are not always able to improve the patient’s complaints. Allergic exploration aims to identify IgE-dependant mechanisms and subsequently to prove the responsibility of the detected allergen in the allergic disease. The efficacy of the specific immunotherapy (SIT ) using allergens in either subcutaneous or sublingual forms has been proven in rhinitis, conjunctivitis, asthma and IgE-induced reactions to hymenoptera venom. The lack of training in allergology is an important reticence of general practitioners and specialists to prescribe SIT . Furthermore, the duration of the treatment and its important cost in Belgium (where, only venom SIT is reimbursed by the Social Security) interfere significantly with the compliance of the patients. [less ▲]

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See detailTHE CLINICAL RELEVANCE OF OFF-LABEL PHOTODYNAMIC THERAPY IN ONCO-DERMATOLOGY
WAUTERS, Odile ULg; CAUCANAS, Marie; RICHERT, Bertrand et al

in American Journal of Clinical Dermatology (2010)

Background : Besides actinic keratosis, Bowen's disease, as well as superficial and small nodular basal cell carcinoma, aminolevulinic acid and methylaminolevulinic acid photodynamic therapy (ALA-PDT, MAL ... [more ▼]

Background : Besides actinic keratosis, Bowen's disease, as well as superficial and small nodular basal cell carcinoma, aminolevulinic acid and methylaminolevulinic acid photodynamic therapy (ALA-PDT, MAL-PDT) present a broad potential of experimental indications in oncologic skin conditions. AIM : To present the various off-label indications with their respective PDT protocols, treatment results, level of evidence (A, B, C, D levels), and potential clinical interest. MATERIAL AND METHODS : A Pubmed search matched PDT with actinic cheilitis, anal, vulvar, and penile intraepithelial neoplasia (AIN, VIN, PIN), verrucous carcinoma, Paget disease, extramammary Paget disease, cutaneous B-cell lymphoma (CBCL), cutaneous T-cell lymphoma (CTCL), and cutaneous metastases of breast carcinoma. RESULTS : All indications presented interesting complete and partial cures, even in cases faling on previous standard treatments. All publications score C and D levels of evidence. The best PDT outcomes and the lowest recurrence rates concerned unifocal oncologic skin conditions with limited extension. Direct comparison of treatment data was difficult, as PDT protocols were highly variable. Comparative therapeutic trials vs standard care were rarely available. CONCLUSION : PDT represents a valuable treatment alternative in selected off-label oncologic skin conditions. However, literature data are too limited to support a hierarchic treatment position for PDT or a preferential protocol in these specific indications. There is a clear need for clinical trials evaluationg PDT vs standard treatments. In contrast to the approved PDT indications, where clinical evaluation accurately matches histologica evaluation, histology is required in these off- label indications to ensure treatment efficacy. Off-label use of PDT should be measured against the advantages and inconveniencies of standar treatment procedures. [less ▲]

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See detailLE CREMAGE A DU PLOMB DANS L'AILE
FAILLA, Valérie ULg; WAUTERS, Odile ULg; RATY, Laurent ULg et al

in Revue Médicale de Liège (2010)

Topical treatment is the cornerstone of therapy for patients suffering from psoriasis. Its efficacy and safety have been demonstrated in a large number of publications. Howerver, in daily life, the ... [more ▼]

Topical treatment is the cornerstone of therapy for patients suffering from psoriasis. Its efficacy and safety have been demonstrated in a large number of publications. Howerver, in daily life, the treatment outcome is often less satisfactory that the results published in the literature. This phenomenon is clearly linked to non-adherence. Indeed, patients with psoriasis frequently consider the topical therapies frequently as a heavy burden. The succesful management of psoriasis with topical agents requires a perfect understanding between the patient and the practionner, which provides regular renewal of the patients motivation. [less ▲]

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See detailScedosporium apiospermum septicemia following a wedge excision of an ingrown toenail.
Vanhooteghem, Olivier ULg; Gillard, Patricia ULg; Dezfoulian, Bita ULg et al

in International Journal of Dermatology (2009), 48(10), 1137-1139

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See detailLes allergies aux plantes d'intérieur
Wauters, Odile ULg; Dezfoulian, Bita ULg; Failla, Valérie ULg et al

in Revue Médicale de Liège (2009)

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See detailRespiratory and skin hypersensitivity reactions caused by a peptide coupling reagent.
Vandenplas, O.; Hereng, M.-P.; Heymans, J. et al

in Occupational and Environmental Medicine (2008), 65(10), 715-716

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See detailLa comparaison des taux de sensibilisation IgE-dépendante aux moisissures, aux dermatophytes et aux levures dans les maladies allergiques générales et les dermatoses inflammatoires
Dezfoulian, Bita ULg; de LA BRASSINNE, Michel ULg

in Revue Française d'Allergologie et d'Immunologie Clinique (2006), 46

We aimed to determine IgE-dependant skin sensitization rates to moulds, dermatophytes and yeasts in patients with typical allergic diseases in comparison to those with inflammatory dermatitis seen over ... [more ▼]

We aimed to determine IgE-dependant skin sensitization rates to moulds, dermatophytes and yeasts in patients with typical allergic diseases in comparison to those with inflammatory dermatitis seen over the course of one year. Skin prick tests were done in 267 patients (172 women and 95 men; median age 38 years, range 25–50 years). We allocated them into 8 groups: 64 with head and neck atopic dermatitis; 11 with seborrheic dermatitis; 52 with eczema and not atopic dermatitis other than on the head and neck; 64 with rhinitis, conjunctivitis and asthma; 28 with urticaria; 10 with food allergy; and 12 healthy controls. Skin tests were done with the following aqueous standardized commercial extracts: Alternaria, Penicillium, Aspergillus, Cladosporium, Mucor, Trichophyton, Epidermophyton, Candida albicans, Malassezia and Saccharomyces cerevisiæ. Globally, positive skin test reactions occurred most frequently with the yeast extracts, less to the dermatophytes and even less to the moulds. The results were homogenous among members of each group. The relevance of our tests was reinforced by the fact that the moulds that gave positive skin tests most frequently were those most often isolated in the Belgian environment. In patients with atopic dermatitis of the head and neck, positive tests were most frequent with four moulds and three yeasts; compared to this group, positive tests were less frequent in patients with atopic dermatitis localized to other sites. In inflammatory dermatitis of the head and neck, the study of immediate hypersensitivity to yeasts seems to be important. [less ▲]

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See detailComment je traite ... les varicosités par sclérothérapie
Mostinckx, S.; Dezfoulian, Bita ULg; Richert, Bertrand ULg et al

in Revue Médicale de Liège (2005), 60(2), 77-80

Sclerotherapy is a technique for the treatment of varicosities, vascular ectasia, and sometimes, leg varicose veins. This method is aesthetic and in some cases therapeutics and uses sclerosing agents ... [more ▼]

Sclerotherapy is a technique for the treatment of varicosities, vascular ectasia, and sometimes, leg varicose veins. This method is aesthetic and in some cases therapeutics and uses sclerosing agents, electrocoagulation and exceptionally LASER. These relatively simple methods are safe and efficient if they are applied with a rigorous procedure by well trained physicians. [less ▲]

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See detailÉtude comparative des « prick » et « patch » tests aux moisissures, aux dermatophytes et aux levures dans la dermatite atopique de la tête et du cou, la dermatite séborrhéique et le sébopsoriasis
Dezfoulian, Bita ULg; de LA BRASSINNE, Michel ULg

in Revue Française d'Allergologie et d'Immunologie Clinique (2005), 45

Aim of the study. – The capacity of fungi to induce eczema in head and neck dermatitis has already been studied. Malassezia has often been implicated in two other dermatitis of the cephalic region ... [more ▼]

Aim of the study. – The capacity of fungi to induce eczema in head and neck dermatitis has already been studied. Malassezia has often been implicated in two other dermatitis of the cephalic region (seborrhoeic dermatitis and sebopsoriasis).We have explored the cellular and IgE dependant reactions to different groups of fungi in these three dermatitis using “patch” and “prick” tests. Tested allergens were: Alternaria, Penicillium, Aspergillus, Cladosporium, Trichophyton, Epidermophyton, Candida albicans, Malassezia, Saccharomyces cerevisiae. Material and methods. – Seventy persons including 42 females (60%) and 28 males (40%) aged 40 years old in average were distributed in four groups: Head and neck dermatitis (24 patients), seborrheic dermatitis of the face (21 patients) and sebopsoriasis of the face (10 patients) compared to 15 controls without these dermatoses. Results and conclusions. – Globally, in “prick” and “patch” tests, yeasts had the highest number of positivity comparing to the two other groups. Malassezia was the leader in “prick tests”. In “patch tests”, the global results showed a positivity rate, which was clearly lower than those in “prick tests”. Detailed analysis of the results revealed that in the head and neck dermatitis the highest number of positive “patch tests” for all of these allergens is found. For the three other groups, no significant difference for these two techniques for any of these allergens has been detected. [less ▲]

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See detailContact and photocontact allergy to ketoprofen. The Belgian experience.
Matthieu, L.; Meuleman, L.; Van Hecke, E. et al

in Contact Dermatitis (2004), 50(4), 238-241

Topical ketoprofen (KP) is widely used because of its anti-inflammatory effect. However, photocontact dermatitis is a side-effect. Between May 2001 and June 2002, the Belgian Contact & Environmental ... [more ▼]

Topical ketoprofen (KP) is widely used because of its anti-inflammatory effect. However, photocontact dermatitis is a side-effect. Between May 2001 and June 2002, the Belgian Contact & Environmental Dermatitis Group conducted a prospective, open patch and photopatch test study in 20 patients suspected of KP dermatitis. Severe skin symptoms requiring systemic corticotherapy occurred in 47%. 5 patients were hospitalized. 1 patient showed prolonged photosensitivity. All patients were tested with KP and the other constituents of KP gel. Attribution to KP was demonstrated in all cases. Patch and photopatch tests with KP 2% in petrolatum showed contact photoallergy in 17 patients, contact allergy in 1 patient and photoaggravated contact allergy in 2 patients. 5 patients also reacted to the fragrance components lavender (Lavandula augustifolia) oil and/or neroli (Citrus aurantium dulcis) oil 5% in alcohol. However, in 4 of these, irritant reactions to the ethanolic dilutions could not be ruled out. Additional tests with 3 non-steroidal anti-inflammatory drugs without benzophenone structure ibuprofen, naproxen and diclofenac identified only 1 contact allergic reaction to diclofenac. Cross-reactivity to the substituted benzophenones, oxybenzone and sulisobenzone occurred only to the first in less than 30% of the patients. A high frequency (69%) of contact allergy to fragrance mix was found. Dermatologists should be aware of the severity of photoallergic reactions to KP and the risk of cross-sensitization. [less ▲]

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