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Primary Care Physician Role In Type 1 Diabetes

Diabetes Specialist - Tampa, Fl & Wesley Chapel, Fl: Ronald Manalo, M.d.: Primary Care Physician : Florida Family Practice

Diabetes Specialist - Tampa, Fl & Wesley Chapel, Fl: Ronald Manalo, M.d.: Primary Care Physician : Florida Family Practice

Primary Care Physician located in Tampa, FL & Wesley Chapel, FL Careful management and monitoring of diabetes is critical for ongoing patient health and wellness. The caring team at Florida Family Practice in Tampa and Wesley Chapel, FL, are experienced in and dedicated to the successful management of diabetes in valued patients. Diabetes is a disease that affects the bodys ability to break down glucose, or sugar, to use for energy. In healthy patients, digestion releases sugars into the blood. In response, the pancreas releases insulin, which triggers the metabolism of the blood sugar, converting it into usable energy. In patients with diabetes, the pancreas either does not produce insulin (type 1 diabetes) or the body does not respond adequately to the insulin produced (type 2 diabetes). What is the difference between type 1 diabetes and type 2 diabetes? The primary difference between type 1 and type 2 diabetes is insulin production. In type 1 diabetes, which is also called insulin-dependent diabetes, the cells that produce insulin are attacked by the immune system and destroyed. As a result, no insulin is produced at all. In type 2 diabetes, which is often called adult-onset diabetes, the body becomes resistant to insulin and fails to use it appropriately, which can eventually lead to decreased insulin production. Type 1 diabetes cannot be prevented while type 2 diabetes can be prevented with simple lifestyle changes. Patients with type 2 diabetes may not experience any symptoms. Type 2 diabetes is often detected during a routine physical. The causes of type 1 diabetes are unknown, but genetic disposition may play a role. On the contrary, the causes of type 2 diabetes are known and include family history, obesity, a sedentary lifestyle, age, and poor diet. What comp Continue reading >>

Diabetes Doctors

Diabetes Doctors

A number of different healthcare professionals treat diabetes. A good first step is to talk to your primary care doctor about testing if you’re at risk for diabetes or if you begin experiencing symptoms associated with the disease. While you may work with your primary care doctor to manage your diabetes, it’s also possible to rely on another doctor or specialist to monitor your condition. Read on to learn about the different doctors and specialists who can assist in various aspects of diabetes diagnosis and care. Primary care physician Your primary care doctor can monitor you for diabetes at your regular checkups. Your doctor may perform blood tests to check for the disease, depending on your symptoms or risk factors. If you do have diabetes, your doctor may prescribe medication and manage your condition. They may also refer you to a specialist to help monitor your treatment. It’s likely that your primary care doctor will be part of a team of healthcare professionals who will work with you. Endocrinologist Diabetes is a disease of the pancreas gland, which is part of the endocrine system. An endocrinologist is a specialist who diagnoses, treats, and manages pancreatic diseases. People with type 1 diabetes are often under the care of an endocrinologist to help them manage their treatment plan. Sometimes, people with type 2 diabetes may also need an endocrinologist if they have trouble getting their blood glucose levels under control. Eye doctor Many people with diabetes experience complications with their eyes over time. These might include: You must regularly visit an eye doctor, such an optometrist or ophthalmologist, to check for these potentially serious conditions. According to guidelines from the American Diabetes Association, people with type 1 diabetes shou Continue reading >>

Acp: Ecp - A Population-based Approach To Diabetes Management...

Acp: Ecp - A Population-based Approach To Diabetes Management...

A Population-Based Approach to Diabetes Management in a Primary Care Setting: Early Results and Lessons Learned David K. McCullough, MD, Martha J. Price, DNSc, Mike Hindmarsh, MA, Edward H. Wagner, MD, MPH OBJECTIVE. To determine the effect of a multifaceted program of support on the ability of primary care teams to deliver population-based diabetes care. DESIGN. Ongoing evaluation of a population-based intervention. SETTING/PARTICIPANTS. Group Health Cooperative of Puget Sound, a staff model HMO in which more than 200 primary care providers treat approximately 15 000 diabetic patients. INTERVENTION. A program of support to improve the ability of primary care teams to deliver population-based diabetes care was implemented. The elements of the program are based on an integrated model of well-validated components of delivery of effective care to chronically ill populations. These elements have been introduced since the beginning of 1995, and some aspects of the program were pilot-tested in a few practice sites before being implemented throughout the organization. The program elements include 1) a continually updated on-line registry of diabetic patients; 2) evidence-based guidelines on retinal screening, foot care, screening for microalbuminuria, and glycemic management; 3) improved support for patient self-management; 4) practice redesign to encourage group visits for diabetic patients in the primary care setting; and 5) decentralized expertise through a diabetes expert care team (a diabetologist and a nurse certified diabetes educator) seeing patients jointly with primary care teams. MAIN OUTCOME MEASURES. Patient and provider satisfaction through existing system-wide measurement processes; process measures, health outcomes, and costs are tracked continuously. RESULTS. Continue reading >>

Diabetes And The Primary Care Physician

Diabetes And The Primary Care Physician

The number of patients identified with diabetes is growing every year. For every patient diagnosed with type 2 diabetes, there are numerous people with type 1 diabetes and pre-diabetes who go undiagnosed. Early detection of the disease and initiation of treatment can make a huge difference the outcome for the patient. The primary care physician plays a key role in this step. The Primary Care Physician Detecting the signs of pre-diabetes or diabetes early can enable your primary care physician to work with you in slowing the progression of the disease. This can vastly lower your risk for diabetes related health complications. Primary care physicians identify patients at risk for diabetes based on family history and other factors. Member of certain racial ethnicities are more likely to present with the disease. Patients, who have a history of cardiovascular disease, are obese or overweight, and even those with a sedentary lifestyle are at a high risk for diabetes.[1] Pregnant women are screened for gestational diabetes. In addition, patients with certain symptoms will be screened for diabetes. Diagnosis by the Primary Care Physician The first step in treating a patient suspected of having diabetes is proper diagnosis. If your primary care physician suspects you have diabetes he or she will recommend a plasma glucose test. The most common tests are the two hour postprandial glucose test and the fasting plasma glucose test.[2] Once your doctor has the test results, the physician will meet with you. If the results are positive for diabetes, you will begin the journey of learning about the disease, how to manage the disease, and what lifestyle changes you will be making. Your primary care physician will guide you through this journey. During your initial ‘diagnosis meeting Continue reading >>

Type 2 Diabetes Mellitus: Practical Approaches For Primary Care Physicians | The Journal Of The American Osteopathic Association

Type 2 Diabetes Mellitus: Practical Approaches For Primary Care Physicians | The Journal Of The American Osteopathic Association

Type 2 Diabetes Mellitus: Practical Approaches for Primary Care Physicians James R. Gavin, III, MD, PhD ; Jeffrey S. Freeman, DO ; Jay H. Shubrook, Jr, DO ; Frank Lavernia, MD From Healing Our Village, Inc, in Lanham, Maryland, and Emory University School of Medicine in Atlanta, Georgia (Dr Gavin); from Philadelphia College of Osteopathic Medicine, in Pennsylvania (Dr Freeman); from Cornwell Center for Diabetes and Cardiovascular Care, in Athens, Georgia (Dr Shubrook); and from private practice in Coconut Creek, Florida (Dr Lavernia). Address correspondence to James R. Gavin III, MD, PhD, Healing Our Village, Inc, 10104 Senate Dr, Suite 210, Lanham, MD 20706-4393.E-mail: [email protected] Type 2 Diabetes Mellitus: Practical Approaches for Primary Care Physicians The Journal of the American Osteopathic Association, May 2011, Vol. 111, S3-S12. doi: The Journal of the American Osteopathic Association, May 2011, Vol. 111, S3-S12. doi: Gavin JR, Freeman JS, Shubrook JH, Lavernia F. Type 2 Diabetes Mellitus: Practical Approaches for Primary Care Physicians. J Am Osteopath Assoc 2011;111(5_suppl_4):S3S12. doi: . Type 2 Diabetes Mellitus: Practical Approaches for Primary Care Physicians You will receive an email whenever this article is corrected, updated, or cited in the literature. You can manage this and all other alerts in My Account The incidence and prevalence of type 2 diabetes mellitus (T2DM) have reached epidemic proportions in the United States. In addition to growing numbers of individuals in whom T2DM has been diagnosed, in numerous others T2DM or prediabetes remains undiagnosed or is likely to develop in the near future. Identification of individuals at risk for T2DM, as well as those who may already have the disease but in whom it has not yet been dia Continue reading >>

Ask The Doctors: It's Rare, But Type 1 Diabetes Can Be Diagnosed In Adulthood | Chicago Sun-times

Ask The Doctors: It's Rare, But Type 1 Diabetes Can Be Diagnosed In Adulthood | Chicago Sun-times

Dear Doctor: I always thought Type 1 diabetes developed when you were a child, or not at all. But now theyre saying it can happen as an adult, which is very alarming. How do I know if I develop it? Dear Reader: While there are several different types of diabetes and different pathways through which the disease develops, they all have one basic thing in common the body has lost the ability to adequately regulate the levels of glucose in the blood. When things are working properly, this glucose control is achieved by insulin, a hormone produced by the pancreas. Insulin makes it possible for the body to either use the glucose that enters the blood after digestion, or to store it for future use. Over time, people with chronic high blood glucose levels will face serious health problems like heart disease, kidney disease, nerve damage, eye problems, poor wound healing, foot problems and even stroke. In Type 2 diabetes, which can develop at any age, the body has either stopped responding to insulin, or no longer produces enough to properly regulate blood sugar and keep it within optimal levels. In Type 1 diabetes, often referred to as juvenile diabetes, the bodys immune system goes haywire and attacks the insulin-producing cells of the pancreas. Genetics is believed to play a role in Type 1 diabetes, and recent research has shown that viruses may also be involved. Because Type 1 diabetes is an autoimmune disease, the attack on the insulin-producing cells, known as the islets of Langerhans, is a sustained one. Unlike in Type 2 diabetes, which can sometimes be managed through diet and lifestyle changes, there is no middle ground in Type 1 diabetes. The insulin-producing cells of the pancreas are destroyed and in order to keep blood glucose within a safe range, insulin must be i Continue reading >>

Your Diabetes Care Team

Your Diabetes Care Team

Your health care team helps you manage your diabetes and maintain your good health. According to the American Diabetes Association, your diabetes care team should include: You: You are the most important member of your diabetes care team! Only you know how you feel. Your diabetes care team will depend on you to talk to them honestly and supply information about your body. Monitoring your blood sugar tells your doctors whether your current treatment is controlling your diabetes well. By checking your blood sugar levels, you can also prevent or reduce the episodes of hypoglycemia (low blood sugar) you have. Primary doctor: Your primary care doctor is who you see for general checkups and when you get sick. This person is usually an internist or family medicine doctor who has experience treating people with diabetes, too. Because your primary care doctor is your main source of care, he or she will most likely head up your diabetes care team. Endocrinologist: An endocrinologist is a doctor who has special training and experience in treating people with diabetes. You should see yours regularly. Dietitian: A registered dietitian (RD) is trained in the field of nutrition. Food is a key part of your diabetes treatment, so yours will help you figure out your food needs based on your weight, lifestyle, medication, and other health goals (like lowering blood fat levels or blood pressure). Nurse educator: A diabetes educator or diabetes nurse practitioner is a registered nurse (RN) with special training and background in caring for and teaching people with diabetes. Nurse educators often help you with the day-to-day aspects of living with diabetes. Eye doctor: Either an ophthalmologist (a doctor who can treat eye problems both medically and surgically) or an optometrist (someone who Continue reading >>

Diabetes Specialist - Austin, Tx & Cedar Park, Tx: Austin Primary Care Physicians: Internist

Diabetes Specialist - Austin, Tx & Cedar Park, Tx: Austin Primary Care Physicians: Internist

Internists & Podiatrists located in Austin, TX & Cedar Park, TX The 29 million Americans diagnosed with diabetes know its more than a medical condition; its a disease that can wreak havoc on their lives and bodies if left unmanaged. Sadly, an estimated 8 million Americans with diabetes are undiagnosed today. Establishing a relationship with the expert physicians at Austin Primary Care Physicians can ensure patients in Austin, Texas, are diagnosed and treated early and effectively. Diabetes is an endocrine disorder in which the body doesn't make enough (or any) insulin to break down sugars in the blood or in which the body becomes less reactive to sugar levels in the blood. What are the signs and symptoms of diabetes? Not all patients notice signs and symptoms before being diagnosed with diabetes but those who do, report the following symptoms (which generally apply for both type 1 and type 2 diabetes): What are the complications associated with diabetes? Proper management of diabetes is critical in decreasing risk of complications. Long-term complications include heart disease, nerve damage, foot/toe amputations, blindness, hearing impairment, kidney damage, and Alzheimers disease. In very severe cases, diabetics can develop diabetic ketoacidosis (DKA), a life-threatening emergency related to high blood sugar. DKA requires emergency intervention. Successful diabetes treatment always requires physician involvement. The treatment of diabetes is dependent on a comprehensive diabetes treatment plan, which includes close monitoring of blood sugar levels, medications (especially insulin), diet, exercise, and periodic evaluation from a team of specialists. The diabetics care team might include their primary care practitioner, a podiatrist (foot doctor), nutritionist, endocrin Continue reading >>

Primary Care Physician Perspectives On Basal Insulin Initiation And Maintenance In Patients With Type 2 Diabetes Mellitus - Sciencedirect

Primary Care Physician Perspectives On Basal Insulin Initiation And Maintenance In Patients With Type 2 Diabetes Mellitus - Sciencedirect

Volume 12, Issue 2 , April 2018, Pages 155-162 Primary care physician perspectives on basal insulin initiation and maintenance in patients with type 2 diabetes mellitus Author links open overlay panel SamanehKaliraia 85% of 100 surveyed US-based PCPs made the decision to start patients on insulin. Challenges reflect patients lack of confidence and perception of personal failure. Opportunities include more frequent contact and referrals to patient support groups. To describe primary care physicians (PCPs) perceptions of patient reactions and concerns about insulin initiation and identify opportunities for increased support. Cross-sectional, online survey of PCPs prescribing basal insulin to adults with type 2 diabetes mellitus (T2DM). PCPs were identified from administrative claims of a large commercial health plan and descriptive results of PCP responses were reported. PCPs (N=100) treated an average of 17 patients receiving insulin during a typical week. More than 85% of insulin initiation recommendations originated with PCPs. Most offered glucose monitoring instructions (96%) and advice on diet, exercise, and diabetes management (96%); 35% provided insulin titration algorithms; 93% reported that patients often or always took their insulin daily within 3 months of initiation; 31% of PCPs reported monthly office contacts with patients for the first 3 months; 16% reported no outreach efforts; fewer than 20% connected patients with support groups. When starting basal insulin, PCPs reported patients feeling personal failure regarding their diabetes treatment (33% often/always) and lacking confidence in their ability to manage insulin therapy (38% often/always). Study results identify additional opportunities for assisting patients in making the transition to insulin, incl Continue reading >>

Role Of Patient, Physician And Systemic Factors In The Management Of Type 2 Diabetes Mellitus | Family Practice | Oxford Academic

Role Of Patient, Physician And Systemic Factors In The Management Of Type 2 Diabetes Mellitus | Family Practice | Oxford Academic

Background. Few studies have explored the contextual dimensions and subsequent interactions that contribute to a lack of adherence in the application of guidelines for diabetes management. Objective. The purpose of this qualitative study was to explore family physicians' issues and perceptions regarding the barriers to and facilitators of the management of patients with type 2 diabetes mellitus (DM). Methods. Four focus groups composed of family physicians (n= 30) explored the participants' experiences in the management of patients with type 2 DM. A semi-structured interview guide began with questions on family physicians' experience of providing care and included specific probes to stimulate discussion about the various barriers to and facilitators of the management of type 2 DM in family practice. Results. Participants clearly identified type 2 DM as a chronic disease most often managed by family physicians. The findings revealed distinct barriers and facilitators in managing patients with type 2 DM which fell into three domains: patient factors; physician factors; and systemic factors. There was a dynamic interplay among the three factors. The important role of education was common to each. Conclusions. The interactions of patient, physician and systemic factors have implications for the implementation of a diabetes management model. The care of patients with type 2 DM exemplifies the ongoing challenges of caring for patients with a chronic disease in family practice. The findings, while specific to the management of type 2 DM, have potential transferability to other chronic illnesses managed by family physicians. Brown JB, Harris SB, Webster-Bogaert S, Wetmore S, Faulds C and Stewart M. The role of patient, physician and systemic factors in the management of type 2 Continue reading >>

Primary Care Physicians Practice Regarding Diabetes Mellitus Diagnosis, Evaluation And Management In The West Region Of Cameroon

Primary Care Physicians Practice Regarding Diabetes Mellitus Diagnosis, Evaluation And Management In The West Region Of Cameroon

Primary care physicians practice regarding diabetes mellitus diagnosis, evaluation and management in the West region of Cameroon JeanJacquesNNoubiap 3 , 4 Email author Jingi et al.; licensee BioMed Central.2015 Primary care physicians (PCPs) are the main providers of diabetes care especially in resource-limited countries which experience extreme shortage of specialists. The present study aimed to evaluate PCPs approach towards diabetes mellitus (DM) diagnosis, evaluation and management in Cameroon. We carried-out a cross-sectional survey in February 2012 in the West Region of Cameroon. Using a structured pretested questionnaire, we interviewed all PCPs working in the region who were present at their working place when the investigators visited, and volunteered to be enrolled in the study. Sixty-six PCPs were interviewed. Their ages ranged from 24 to 56years (mean 38.3, standard deviation 9.2years). The levels of knowledge of PCPs regarding DM diagnosis were: 72.7%, 37.9%, 19.7% and 32.8% respectively obtained when using fasting plasma glucose, post-prandial glycemia, random glycemia and glycated hemoglobin as diagnostic tools. Only 6 PCPs (9.9%) prescribed the correct minimal work-up to evaluate diabetes patients at diagnosis. PCPs advised lifestyle modifications in 92.4% of cases, and thirty nine (53.1%) PCPs used to prescribe both generic and specialty oral anti-diabetic drugs in case of uncomplicated type 2 DM management. The two main classes of anti-diabetic drugs prescribed were biguanides (77.3%) and sulfonamides (60.6%). Nearly all PCPs (97%) used to give frequent follow-up appointments to their patients. Ninety eight point five percent of participants were willing to receive any further continuous training on DM management. PCPs knowledge and practices towards Continue reading >>

Type 1 Diabetes Mellitustreatment & Management

Type 1 Diabetes Mellitustreatment & Management

Type 1 Diabetes MellitusTreatment & Management Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... Patients with type 1 diabetes mellitus (DM) require lifelong insulin therapy. Most require 2 or more injections of insulin daily, with doses adjusted on the basis of self-monitoring of blood glucose levels. Long-term management requires a multidisciplinary approach that includes physicians, nurses, dietitians, and selected specialists. In some patients, the onset of type 1 DM is marked by an episode of diabetic ketoacidosis (DKA) but is followed by a symptom-free honeymoon period in which the symptoms remit and the patient requires little or no insulin. This remission is caused by a partial return of endogenous insulin secretion, and it may last for several weeks or months (sometimes for as long as 1-2 years). Ultimately, however, the disease recurs, and patients require insulin therapy. Often, the patient with new-onset type 1 DM who presents with mild manifestations and who is judged to be compliant can begin insulin therapy as an outpatient. However, this approach requires close follow-up and the ability to provide immediate and thorough education about the use of insulin; the signs, symptoms, and treatment of hypoglycemia; and the need to self-monitor blood glucose levels. The American Diabetes Association (ADA) recommends using patient age as one consideration in the establishment of glycemic goals , with targets for preprandial, bedtime/overnight, and hemoglobin A1c (HbA1c) levels. [ 5 ] In 2014, the ADA released a position statement on the diagnosis and management of type 1 diabetes in all age groups. The statement includes a new pediatric glycemic control target of HbA1c of less than 7.5% across all pediatric age groups, replacing e Continue reading >>

Finding The Right Doctor

Finding The Right Doctor

How to pick a great physicianand get the most out of your visit No one goes to the doctor for fun. There's always a wait. The examination rooms are cold and bare. The flimsy paper gowns are mortifying. When you add wrestling with insurance to the mix, a simple office visit can seem like an ordeal. All that, and the typical appointment lasts only 10 minutes, which can feel like hardly enough time to even begin to discuss your health. Fed up yet? Well, the doctors are, too: Cramming dozens of appointments into a single day is frustrating enough, but when your doc isn't rushing between exam rooms, he or she is on the phone with insurance companies to make sure patients get the tests and medications they need. While some of the things that make doctors' visits frantic are out of your hands, others are up to you. We've tapped experts from across the country to help you choose a doctor, plan for a visit, and make sure all of your health questions get answered. Picking a doctor isn't as easy, of course, as opening the phone book and calling the first office you see. "This is a person you have to get along with," says Ruthann Russo, PhD, JD, MPH, RHIT, author of 7 Steps to Your Best Possible Healthcare: The Essential Guide for Crafting Your Personal Healthcare Plan. "The relationship between you and the physician, whether you think you can trust them, is really important." By doing some research before booking an appointment, you can increase your chances of finding The One. For starters, all doctors should be board certified. You can find one who has received certification by visiting the American Board of Medical Specialties' website, www.abms.org. Next, make sure your primary care physician has special training in diabetes. "Be sure that the physician [you're] going to see Continue reading >>

Managing Diabetes In Primary Care: 2016 Recommendations From Ada

Managing Diabetes In Primary Care: 2016 Recommendations From Ada

Managing diabetes in primary care: 2016 recommendations from ADA Managing diabetes in primary care: 2016 recommendations from ADA The American Diabetes Association (ADA) has released a summary of its 2016 recommendations that focus on managing patients with diabetes inprimary care, as published March 1 in the Annals of Internal Medicine. A synopsis of the 2016 Standards of Medical Care in Diabetes highlights 8 key areas for primary care providers: diagnosis, glycemic targets, medical management, hypoglycemia, cardiovascular risk factor management, microvascular disease screening and management, and inpatient diabetes management. To create the 2016 Standards, the ADA Professional Practice Committee (PPC) searched on MEDLINE to find and grade new evidence from January 1, 2015, through December 7, 2015. Recommendations are assigned an A, B, or C rating based on evidence quality. Some expert opinions are given an E rating to indicate that there is no evidence from clinical trials, clinical trials may be impractical, or existing evidence is conflicting. The 2016 ADA Standards diagnostic criteria for prediabetes and diabetes are outlined in Table 1. Table 1. Criteria for the diagnosis of prediabetes and diabetes1 * 2-h plasma glucose level after a 75-g oral glucose tolerance test ** In the absence of unequivocal hyperglycemia, results should be confirmed by repeated testing. *** Only diagnostic in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis. Distinguishing whether a patient has type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) is important, as their diagnosis affects management. T1DM is characterized by the presence of 1 or more autoimmune markers. Pregnant women with no history of diabetes should be screened for gestational diab Continue reading >>

10 Medical Professionals Who Can Help You Manage Type 2 Diabetes | Everyday Health

10 Medical Professionals Who Can Help You Manage Type 2 Diabetes | Everyday Health

You have figured out by now that taking control of your diabetes means managing the level of glucose in your blood. Making that happen involves creating a diet, exercise, medication, and glucose-monitoring plan and enlisting the help and support of a battery of professionals to show you how to get on track and help you stay there. Heres a list of the healthcare providers you will need to have on your team as you take up the challenge of type 2 diabetes. Your primary-care physician or a certified diabetes educator (CDE) can help you make sure that all these professionals are coordinating your care effectively. Each member of your team will be counting on you to be open and honest about how you feel and how successfully you are following your diet, exercise, and medication routines. Primary-care physician: Your family doctor will monitor your general health and help coordinate your care as you take responsibility for your type 2 diabetes. Endocrinologist: This doctor treats diabetes and other diseases of the endocrine glands, which produce the hormones that control physical functions and which the insulin-producing pancreas is part of. This specialist can help you learn to monitor your blood-glucose levels and can prescribe and monitor medications to control them. Nutritionist or registered dietitian: These experts in nutrition will help you understand the relationship between food and diabetes and help you create an eating plan that works for you and your particular lifestyle while taking into account how physically active you are. Pharmacist: This professional can help you understand your medications and how they work and will make sure that you are not taking other medications that can interfere with your diabetes treatment. Certified diabetes educator (CDE): This cer Continue reading >>

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