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Relationship Between Severity Of Periodontal Disease And Control Of Diabetes (glycated Hemoglobin) In Patients With Type 1 Diabetes Mellitus

Relationship Between Severity Of Periodontal Disease And Control Of Diabetes (glycated Hemoglobin) In Patients With Type 1 Diabetes Mellitus

Relationship between Severity of Periodontal Disease and Control of Diabetes (Glycated Hemoglobin) in Patients with Type 1 Diabetes Mellitus 1. 17 Periodontal disease and control of diabetes (HBA1c) in Type 1 diabetes mellitus … Jindal A et al Journal of International Oral Health 2015; 7(Suppl 2):17-20 Original ResearchReceived: 18th April 2015 Accepted: 10th July 2015 Conflicts of Interest: None Source of Support: Nil Relationship between Severity of Periodontal Disease and Control of Diabetes (Glycated Hemoglobin) in Patients with Type 1 Diabetes Mellitus Ankita Jindal1 , Anuj Singh Parihar2 , Meenakshi Sood3 , Pinojj Singh4 , Nandini Singh5 Contributors: 1 Senior Lecturer, Department of Periodontology, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India; 2 Post-graduate Student, Department of Periodontology, People’s College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India; 3 Post-graduate Student, Department of Oral Medicine and Radiology, People’s College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India; 4 MDS, Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Navi Mumbai, Maharashtra, India; 5 Private Practitioner, Lucknow, Uttar Pradesh, India. Correspondence: Dr. Parihar AS. Department of Periodontology, People’s College of Dental Sciences and Research Centre, Bhopal - 462 037, Madhya Pradesh, India. Phone: +91-8827047003. Email: [email protected] How to cite the article: Jindal A, Parihar AS, Sood M, Singh P, Singh N. Relationship between severity of periodontal disease and control of diabetes (glycated hemoglobin) in patients with Type 1 diabetes mellitus. J Int Oral Health 2015;7(Suppl 2):17-20. Abstract: Background: Both diabetes mellitus (DM) and periodontiti Continue reading >>

Prevention Strategies For

Prevention Strategies For

better living and a better life. University of Michigan E-Learning Program Economic Downturn Alternate economic consequences such as costly medical fees due to emergency room treatment and hospital fees occur when dental disease goes untreated. provide treatment/prevention strategies for oral infections and disease to those with special needs= overall health care costs dramatically reduced, quality of life of these individuals will improve, needless pain and suffering can be minimized.(Glassman, mod 1 readings) Educational Goal To increase staff and parents awareness of the importance and need for efficient oral hygiene care, good oral hygiene habits, and tooth friendly nutritional choices to decrease unnecessary pain and suffering and increase prevention strategies. While most Americans seek care from a dentist regularly, some individuals and families face challenges accessing dental care. These Americans, including racial and ethnic minorities, people with disabilities, and those whose families are economically disadvantaged, may also suffer a disproportionate share of dental disease. Access challenges include difficulty getting to a dental office, prioritizing dental care among other health crises, overcoming financial barriers, and navigating government assistance programs. These dental patients may need special financial arrangements, help accessing a dental office, or special oral hygiene instruction. Also, basic awareness of oral health issues for many Americans may be quite limited because of cultural or language barriers or problems with literacy. (ada.org) Goal Education = PREVENTION! Education to change parental attitudes and behaviors regarding oral health Sealants Fluoride Effective brushing/flossing technique Tooth friendly snack/food choices Oral vs. syst Continue reading >>

Diabetes And Periodontal Disease: What Should We Learn Next?

Diabetes And Periodontal Disease: What Should We Learn Next?

Both diabetes and periodontal disease are highly prevalent worldwide, and the prevalence is higher in the aged population. Epidemiological studies have shown a link between periodontal disease and diabetes for nearly a century (Figure 1). In 1936, Sheppard[1] first noted a higher incidence of periodontitis in diabetic patients. It is now widely accepted that periodontal disease is one of the diabetic complications. In addition, many epidemiological studies have shown a bidirectional relationship between periodontal disease and diabetes. Bacterial biofilm (also known as dental plaque) forms on the surfaces of teeth, and chronic microbial stimulation induces local inflammation in the gingival tissues, which is termed gingivitis. Gingivitis is reversible by appropriate oral hygiene and mechanical disruption of the biofilm. However, long-term plaque accumulation induces sustained inflammation and the destruction of periodontal tissues, such as the formation of periodontal pockets, loss of connective tissue attachment and loss of alveolar bone, which is termed periodontitis. If periodontitis is left untreated, tooth loss can occur. Periodontal disease includes gingivitis and periodontitis. It is accepted that periodontal disease is more prevalent and more severe in persons with type 1 and type 2 diabetes than in non-diabetic persons. A German population-based longitudinal study showed that uncontrolled (glycated hemoglobin ≧7.0%) type 1 or type 2 diabetes is associated with the progression of periodontal disease[2]. Although the mechanisms by which hyperglycemia induces periodontal destruction have yet to be fully elucidated, the biological plausibility is based on diabetes-related features, such as inflammatory response abnormalities, vascular abnormalities, the uncoup Continue reading >>

Periodontal Disease Is An Infectious Disease Process That Involves Inflammation. Periodontal Diseases Involve The Structures Of The Periodontium.

Periodontal Disease Is An Infectious Disease Process That Involves Inflammation. Periodontal Diseases Involve The Structures Of The Periodontium.

Periodontal disease can cause a breakdown of the periodontium resulting in loss of tissue attachment and destruction of the alveolar bone. Prevalence of Periodontal Disease Periodontal diseases are the leading cause of tooth loss in adults. Almost 75% of American adults have some form of periodontal disease, and most are unaware of the condition. Almost all adults and many children have calculus on their teeth. Fortunately, with the early detection and treatment of periodontal disease, most people can keep their teeth for life. Systemic Conditions: Links to Periodontal Disease Certain systemic conditions increase the patient’s susceptibility to periodontal disease, and periodontal disease may actually increase a patient’s susceptibility to certain systemic conditions. Cardiovascular disease Preterm low birthweight Respiratory disease Fig. 14-1 Structures of the periodontium: junctional epithelium, gingival sulcus, periodontal ligaments, and cementum Periodontal Diseases Infectious diseases that are the leading cause of tooth loss in adults. Nearly 75% of American adults suffer from various forms of periodontal disease and most are unaware of it. Almost all adults have calculus on their teeth. With the early detection and treatment of periodontal disease, it is possible for most people to keep their teeth for a lifetime. Gingival Diseases Gingivitis is inflammation of the gingival tissue. Gingivitis is characterized by areas of redness and swelling, and there is a tendency for the gingiva to bleed easily. Gingivitis is limited to the epithelium and gingival connective tissues. It is important to note that there is no tissue recession or loss of connective tissue or bone. Other Types of Gingivitis Other types of gingivitis are associated with: Puberty Pregna Continue reading >>

Innovations And Resource Sharing In Graduate Periodontal Education

Innovations And Resource Sharing In Graduate Periodontal Education

Update on the Electronic Periodontal Literature Review Dr. Michael B. Goldberg, MSc DDS Assistant Professor University of Toronto Thank-you American Academy of Periodontology Education Committee Shana Berezin Faculty and Post-Graduate Students of the University of Toronto, Faculty of Dentistry, Division of Periodontics Faculty members of the University of Rochester and Indiana University Periodontal Literature Review— Update Electronic Paperless “Greenshift†Instant updating available Direct links to specific articles Presenting not Critiquing Content “Wikipediaâ€-type formatting Internal search engine Cross-chapter linking Periodontal Literature Review— Topics Examination Diagnosis Maintenance Epidemiology Risk Factors Microbiology Pharmacology Regenerative Therapy Mucogingival Therapy* Implantology* Periodontal Literature Review--Keywords Article Accumulation identifying keyword using PICO: P- patient, population I - intervention C- comparison O- outcomes Cardiovascular Disease Diabetes Smoking Specific Plaque Hypothesis Non-Specific Plaque hypothesis Supragingival plaque/calculus Subgingival plaque/calculus Infection Inflammation Bleeding suppuration Microbiology and…. Diagnosis Periodontitis Chronic Periodontitis Aggressive Periodontitis Gingivitis Periodontal Abscess Necrotizing Ulcerative Lesions AAP Literature Review Article Check-list Randomized Control Trials Citation: 1. The study addresses an appropriate and clearly focused question?(1) YES NO 2. The assignment of subjects to treatment groups is randomized?(1) YES NO 3. Subjects and investigators are kept “blind†about treatment allocation?(1) YES NO 4. The treatment and control groups are similar at the start of the trial?(1) YES NO 5. The only difference betw Continue reading >>

The Effects Of Periodontal Treatment On Diabetes

The Effects Of Periodontal Treatment On Diabetes

ABSTRACT Background Diabetes mellitus and periodontal diseases are common chronic diseases in the United States. Periodontal infection may adversely affect glycemic control in people with diabetes. This article reviews the evidence regarding how treatment of periodontal diseases affects glycemic control. Types of Studies Reviewed The review consisted of a MEDLINE literature search to identify primary research reports on the relationship between periodontal therapy and changes in glycemic control. The review identified three randomized clinical trials and nine nonrandomized clinical follow-up studies. Results The strength, quantity and breadth of evidence are varied, precluding clear-cut guidance for determining whether treating periodontal infection has a beneficial effect on glycemic control. Despite the variation and limitations in the literature, evidence supports the concept that periodontal diseases can contribute to poorer glycemic control in people with diabetes. Although the evidence is not unequivocal, it provides sufficient support for additional investigations of the effect of preventing and treating periodontal infections on managing glycemic control. Clinical Implications Sufficient evidence exists to incorporate oral examinations and periodontal care in management regimens for people with diabetes. It is prudent to assess patients' glycemic control status and communicate the importance of referring patients with diabetes for thorough oral health evaluations and necessary care. Continue reading >>

Periodontal Medicine

Periodontal Medicine

1. PERIODONTAL MEDICINE BY M.BHARATH REDDY 2. OBJECTIVES  Introduction  Era of focal infection  Periodontal and coronory heart disease/Atherosclerosis  Periodontal disease & Diabetes mellitus  Role of periodontitis in pregnancy out come  Periodontal disease & COPD  Periodontal disease & Acute Respiratory Infection  Periodontal Medicine In Clinical Practice 3. INTRODUCTION     Advances in the science & technology over the last centuary have greatly expanded our knowledge of pathogenesis of periodontal disease. Certain systemic conditions may affect the initiation & progression of gingivitis & periodontitis. The effect of oral health on the rest of the human body was proposed by assyrians in the 7th centuary. In the 18th centuary a pennsylvanian physician named Benjamin Rush quoted that arthritis could be treated in some people after they get extracted the infected teeth. 4. ERA OF FOCAL INFECTION  WD MILLER & WILLIAM HUNTER given a concept that oral bacteria & infection were likely to cause most of the person’s systemic illness.  This  This concept became very popular. era,which came to be known as “THE ERA OF FOCAL INFECTION” 5. However by 1940 medicine & dentistry were realising that there was much more to explain a patients general condition than bacteria in his/her mouth. o They realised that1.extarcting a person teeth donot make their disease go away. 2.people with very healthy mouths also develop systemic disease. 3.people with no teeth & thus no apparent oral infection still develop systemic disease. FOCAL INFECTION as a primary cause of systemic infection finally came to an end. o 6. Periodontal and coronory heart disease/Atherosclerosis 7. Periodontal and coronory heart disease CHD and CHD RELATED diseases aare Continue reading >>

Diabetes & Perio

Diabetes & Perio

1. DIABETES  Introduction  Classification  Pathophysiology  Clinical symptoms  Diagnostic criteria  Classic complications  Oral manifestations  Diabetes and periodontal disease  Pathogenesis  Mechanism of diabetic influence on periodontium  Effects of Periodontal Diseases on the Diabetic State  Mechanism of  Conclusion Introduction Definition : Diabetes mellitus is a clinically and genetically heterogeneous group of metabolic disorders manifested by abnormally high levels of glucose in the blood. The hyperglycemia is the result of a deficiency of insulin secretion caused by pancreatic β-cell dysfunction or of resistance to the action of insulin in liver and muscle, or a combination of these. Frequently this metabolic disarrangement is associated with alterations in adipocyte metabolism. Diabetes is a syndrome and it is now recognized that chronic hyperglycemia leads to long-term damage to different organs including the heart, eyes, kidneys, nerves, and vascular system.A Diabetes mellitus includes a number of diseases resulting from the malfunction of insulin- dependent glucose homeostasis. Classically, they present as a triad of symptoms including polydypsia, polyuria, and polyphagia. These symptoms are the direct result of hyperglycemia and the resultant osmotic imbalance B CLASSIFICATION OF DIABETES MELLITUS C In 1997, the American Diabetes Association provided the current classification 2.  Type 1 diabetes (formerly, insulin-dependent diabetes)  Type 2 diabetes (formerly, non-insulin-dependent diabetes)  Gestational diabetes  Other types of diabetes - Genetic defects in β cell function - Genetic defects in insulin action - Pancreatic diseases or injuries Pancreatitis, neoplasia, cystic fibrosis, trauma, pancreatect Continue reading >>

"influence Of Systemic Factors(conditions) On Periodontium"

1. GOOD MORNING 2. INFLUENCE OF SYSTEMIC CONDITIONS ON THE PERIODONTIUM 3. CONTENTS • Endocrine Disorders and hormonal changes • Hematologic disorders and immune deficiencies • Genetic disorders • Stress and psychosomatic disorders • Nutritional influences • Medications • Other Systemic Conditions. 4. ENDOCRINE DISORDERS AND HORMONAL CHANGES. DIABETES MELLITUS • Diabetes mellitus is a clinically and genetically heterogeneous group of metabolic disorders manifested by abnormally high levels of glucose in the blood. • The hyperglycemia is the result of a deficiency of insulin secretion caused by pancreatic Beta cell dysfunction or of resistance to the action of insulin in liver and muscle or a combination of these. (Brian L Mealey 2007) 5. CLINICAL SIGNS & SYMPTOMS AND DIABETIC COMPLICATIONS • Polyuria (excessive urination) • Polydipsia ( excessive thirst) • Polyphagia (excessive hunger) • Unexplained weight loss • Changes in vision • Fatigue, weakness • Irritability • Nausea • Dry mouth 6. COMPLICATIONS Retinopathy Nephropathy Neuropathy Macrovascular disease Altered wound healing Periodontal disease( Loe H. Periodontal disease is the sixth complication of diabetes mellitus. Diabetes Care,1993). Ketoacidosis (usually associated with severe hyperglycemia in Type I diabetes) Hyperglycemic hyperosmolar state Hypoglycemia 7. ORAL MANIFESTATIONS OF DIABETES • Xerostomia • Greater susceptibility of oral tissues to trauma • More opportunistic infections (e.g., Candidiasis) • Greater accumulation of plaque, greater risk of caries • Greater susceptibility to periodontal disease • Greater risk of developing periodontal abscesses when periodontitis is present • Delayed healing • Oral paraesthesia, includ Continue reading >>

Hiv Oral Health And Systemic Health

Hiv Oral Health And Systemic Health

Over the last several years, some intriguing associations between oral and systemic disease have been reported. If oral conditions really impact the risk for systemic disease, such findings have important implications for the prevention of these systemic diseases. Furthermore, the existence of such associations supports biomedical research on the microinfection theory of cardiovascular disease (CVD) and raises other pathophysiologic questions. Additionally, a causal link between oral conditions and morbidity and mortality would establish the medical model for management of dental caries and periodontal disease. Recent reports have also shown associations between poor oral health, mainly periodontal disease and tooth loss, and increased risk of CVD, pulmonary disease, diabetes, pregnancy outcomes and osteoporosis. A recent review2 lists about 200 possible associations between systemic conditions and oral symptoms or oral manifestations, although for most of these associations, the oral conditions are a consequence rather than a risk factor for the systemic condition. The original focal infection theory, suggested during the 19th century, postulated a causal relationship between infectious diseases and inflammatory changes at distant body sites. Associations between dental diseases and systemic outcomes are potentially important because of the high occurrence of dental diseases. Among the elderly in the United States, about 33% have experienced severe periodontal disease, nearly 40% have lost all of their teeth,6,7 and the prevalence of gingivitis is 48%.8 If this extremely common source of chronic infection (dental disease) leads to an increased mortality rate, the public health impact of oral disease on the health of millions of Americans would be subs Continue reading >>

Diabetes Mellitus & Its Oral Manifestations

Diabetes Mellitus & Its Oral Manifestations

1. Oral Manifestations Of Diabetes Mellitus By: Md Khateeb Khan 2. Introduction

  • Diabetes mellitus is a metabolic disorder characterized by relative or absolute insufficiency of insulin and resultant disturbances of carbohydrate metabolism .
  • The major function of insulin is to counter the concerted action of a number of hyperglycemia-generating hormones and to maintain low blood glucose levels .
3. Epidemiology
  • Almost 20% of adult older than 65 year old have DM.
  • A dental practice serving an adult population of 2,000 can expect to encounter 40-80 persons with diabetes, about half of whom will be unaware of their condition.
4. Etiologic classification of DM
  • There are two types of Diabetes Mellitus:
    • Type 1, insulin-dependent or juvenile-onset diabetes (IDDM)
    • Type 2, non-insulin-dependent or adult-onset diabetes (NIDDM)
    • Other specific types
5. Type 1 (IDDM)
  • Autoimmune destruction of the insulin-producing beta cells of pancreas.
  • 5-10% of DM cases.
  • Commonly occurs in childhood and adolescence.
  • Absolute insulin deficiency.
  • High incidence of severe complications.
  • Prone to autoimmune diseases (Grave’s, Addison, Hashimoto’s thyroiditis).
6. Pathogenesis of Type I DM Environment ? Viral infection ? Genetic HLA-DR3/DR4 Severe Insulin deficiency ß cell Destruction Type I DM Autoimmune Insulitis 7. Type 2 (NIDDM)
  • Result from impaired insulin function (insulin resistance).
  • Constitutes 90-95% of DM cases.
  • Specific causes of this form are unknown.
    Continue reading >>

013.systemic Diseases In The Etiology Of Periodontal Disease

013.systemic Diseases In The Etiology Of Periodontal Disease

013.systemic diseases in the etiology of periodontal disease 1. Dr Jaffar Raza Page 1 Systemic Diseases in the etiology of PDD primary etiological agent in periodontal disease is bacterial plaque. systemic factors that can alter the response of the tissue to plaque. certain systemic disorders can have a direct effect on the periodontal tissues and these represent the periodontal manifestations of systemic diseases. 2. Dr Jaffar Raza Page 2 DIETARY AND NUTRITIONAL ASPECTS OF PERIODONTAL DISEASE The Consistency of Diet Firm and fibrous diet  beneficial Softer diet  greater deposits and increase in plaque A coarse diet, requires vigorous mastication 3. Dr Jaffar Raza Page 3 Protein Deficiency and Periodontal Disease The integrity of the periodontal ligament is also dependent upon proteins Deprivation of protien  marked degeneration of periodontal support Vitamins and Periodontal Disease Vitamin C Its deficiency in humans results in scurvy, a disease characterized by hemorrhagic susceptability and retardation of wound healing. 4. Dr Jaffar Raza Page 4 Clinical Manifestations 1. Increased susceptibility to infections. 2. Impaired wound healing. 3. Bleeding and swollen gums. 4. Mobile teeth. 5. Dr Jaffar Raza Page 5 Periodontal Features of Scurvy chronic gingivitis which can involve the free gingiva, attached gingiva and alveolar mucosa gingiva becomes brilliant-red, tender and swollen The spongy tissues are extremely hyperemic and bleed spontaneously. the tissues attain a dark blue or purple hue. Alveolar bone resorption with increased tooth mobility. 6. Dr Jaffar Raza Page 6 Vitamin D Deficiency Vitamin D is essential for the absorption of calcium from the gastrointestinal tract and the maintenance of calciumphosphorus balance. Radiographically, there is a generali Continue reading >>

Risk Factors Of Periodontal Disease: Review Of The Literature

Risk Factors Of Periodontal Disease: Review Of The Literature

International Journal of Dentistry Volume 2014 (2014), Article ID 182513, 9 pages Dental Health Department, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia Academic Editor: Jagan Kumar Baskaradoss Copyright © 2014 Yousef A. AlJehani. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Objectives. This paper aims to review the evidence on the potential roles of modifiable and nonmodifiable risk factors associated with periodontal disease. Data. Original articles that reported on the risk factors for periodontal disease were included. Sources. MEDLINE (1980 to Jan 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: “periodontal disease,” “periodontitis,” “risk factors,” and “causal.” This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. It is important to understand the etiological factors and the pathogenesis of periodontal disease to recognize and appreciate the associated risk factors. As periodontal disease is multifactorial, effective disease management requires a clear understanding of all the associated risk factors. 1. Introduction Periodontitis is one of the most ubiquitous diseases and is characterized by the destruction of connective tissue and dental bone support following an inflammatory host response secondary to infection by periodontal bacteria [1, 2]. Severe periodontitis, which may result in tooth loss, is found in 5–20% of most adult populations worldwide [ Continue reading >>

Periodontics And Diabetes

Periodontics And Diabetes

1. The Correlation Between Diabetes and Dental Health dr shabeel pn 2. Abstract

  • Diabetes is a disease that has been associated with an increased risk for a number of serious, sometimes life-threatening complications. Some of those risks include, poor dental health. Studies have shown that people with diabetes are more likely to have periodontal disease than people without diabetes, probably because diabetics are more susceptible to contracting infections. This study will show the correlation between diabetes and periodontal disease.
  • [American Academy of Periodontology]
3. Who is at risk?
  • Diabetes has a strong prevalence in minority and ethnic groups
    • Native Americans
    • Blacks/ African Americans
    • Hispanics
    • Cubans
4. What is Diabetes?
  • A condition characterized by hyperglycemia resulting from the body’s inability to use blood glucose for energy.
    • Type 1
    • Type 2
    • Gestational Diabetes.
  • Diabetes is a preventable disease
  • National Diabetes Information Clearinghouse (NDIC)
5. Current Statistics
  • 24 Million individuals have diabetes in USA
  • Increase of 3 million people in 2yrs
  • 57 Million people are estimated to have pre diabetes
  • Decrease in the number of people that did not know they had the disease: 30% -25%
6. Its Effect on the Body
  • Stroke
  • Oral Health
  • Heart
  • Lungs
  • Stomach
  • Kidneys
  • Reproductive health and Pr Continue reading >>

Diabetes And Periodontal Disease ,at Two Way Relationship

Diabetes And Periodontal Disease ,at Two Way Relationship

1. Diabetes and Periodontal disease A two way relationship 2. Contents • Diabetes overview • Periodontal disease overview • Relation between Diabetes and Periodontal disease • effect of diabetes on periodontal disease and its mechanism • Effect of periodontal disease on diabetes and its mechanism • references 3. Introduction • Its widely thought that any diseases associated with each other , then one caused the other . • But many of these diseases interrelationship mechanisms is obscure ! • A better understanding of this relationship provides more appropriate treatment for these patients. • So in this seminar we will figure out the relation between diabetes and periodontal disease and its bidirectional mechanisms. 4. Diabetes Among many systemic diseases , diabetes ,have been a nightmare to researches ,doctors and patients , due to its difficult control and diverse complications 5. Classification according to its patho- physiology DM Type I IDDM due to destruction of beta cells of pancreas Type II NIDDM due to insulin resistance Gestational temporary condition occurs during pregnancy others Drug- or chemical- induced Diseases of the exocrine pancreas Genetic defects in *β-cell function, *insulin action 6. • Actually to understand diabetes its as simple as just increase in glucose in blood , whether its due to insulin deficiency or resistance. • But what will result from this increase ? Why is it dangerous then ? 7. • Deficiency of insulin secretion or insulin resistance , results in : Inability to transport glucose into cells Glucose retained in the blood stream Hyperglycemia Complications 8. • microangiopathy • nephropathy • neuropathy, • macro vascular disease • delayed wound healing. - All the forms of DM are associated with hyper Continue reading >>

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