2022 Sep;17(3):743-745. doi: 10.26574/maedica.2022.17.3.743. Recognizing BB ingestion is very important because of the extremely narrow 2-hour time window to remove BB impacted in the esophagus. No limitation in the search period was made. Foreign body ingestions in children are some of the most challenging clinical scenarios facing pediatric gastroenterologists. It is important that the X-ray includes the entire neck, chest, and abdomen to avoid missing a BB. Copyright 2019 NASPGHAN | Privacy Policy | Website By: Opus Media. BJA Educ. Coins are the most commonly swallowed foreign body that comes to medical attention in the U.S.; in other countries, those related to food, such as fish bones, are most common. UL1 TR000077/TR/NCATS NIH HHS/United States, NCI CPTC Antibody Characterization Program. Experimental investigation of battery-induced esophageal burn injury in rabbits. Before doi: 10.3346/jkms.2023.38.e2. 17. 3 In 2016, FBIs were the fourth most common reason for calls to American poison . National Library of Medicine Clarify type of object and timing of ingestion. MeSH Evaluating current guidelines in clinical practise. An algorithm for the diagnosis and management of BB ingestions is presented and compared to previous guidelines (NASPGHAN, National Poison Center). Physical examination is mandatory to detect ingestion-related complications such as small-bowel obstruction. Epub 2015 Apr 8. . Pediatr Clin North Am. 2. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. Additionally, raising public awareness making parents and caregivers aware of the dangers of battery ingestion is essential as this could increase their cautiousness with products containing batteries and seek early medical attention when an ingestion has occurred. Parents calling the emergency room may be, however, advised to directly start giving honey if the history is strongly suggestive of BB ingestion and no signs of perforation are present. Italian Society of Pediatric Gastroenterology Hepatology and Nutrition (SIGENP), and The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO). Paediatric Clinical Practice Guideline RACH Clinical Practice Guideline - Foreign body ingestion Page 3 of 5 Hazardous ingested foreign bodies Do not use metal detector for hazardous FB - the child will usually require x-rays Passage of hazardous FB into the stomach is NOT an indication that the child will not suffer any complications. 27. 2023. 25. Kramer RE, Lerner DG, Lin T, et al. Journal of Pediatric Gastroenterology and Nutrition - Volume 63, Number 1, July 2016. Lead Poisoning from a Toy Necklace, Study Authors Advise Giving Honey to Children who Swallow Button Batteries, Esophageal, nasal or airway Button Battery, Cluster notification to ENT, GI, Gen Surgery and OR to prepare for patient, Sharp longer objects in stomach with no symptoms, 2022 The Childrens Hospital of Philadelphia. Cureus. 2015 Nov;199(1):137-40. doi: 10.1016/j.jss.2015.04.007. Journal of Pediatric Gastroenterology and Nutrition73(1):129-136, July 2021. The anesthetic management of button battery ingestion in children. Abdominal radiography revealed a foreign body in the left upper quadrant, which was the three circular magnets. Adapted with permission from Leinwand et al. A European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) task force for BB ingestions has been founded, which aimed to contribute to reducing the health risks related to this event. caustic ingestion; endoscopy; esophageal perforation; foreign body; pediatric. For advice about a disease, please consult a physician. Ing R, Hoagland M, Mayes L, et al. 2023 by Children's Hospital of Philadelphia, all rights reserved. Two-view (anterior-posterior and lateral) X-ray is paramount to diagnose BB ingestion and confirm its location. Oliva S, Romano C, De Angelis P, Isoldi S, Mantegazza C, Felici E, Dabizzi E, Fava G, Renzo S, Strisciuglio C, Quitadamo P, Saccomani MD, Bramuzzo M, Orizio P, Nardo GD, Bortoluzzi F, Pellegrino M, Illiceto MT, Torroni F, Cisar F, Zullo A, Macchini F, Gaiani F, Raffaele A, Bizzarri B, Arrigo S, De' Angelis GL, Martinelli M, Norsa L; Italian Society of Pediatric Gastroenterology Hepatology and Nutrition (SIGENP), and The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO). 32. Esophageal lesions following button-battery ingestion in children: analysis of causes and proposals for preventive measures. The clinical relevance of this, however, seems low as data show that arrested battery progression did not lead to adverse outcomes (24,29). If the ingested battery is located in the airway or in the gastrointestinal tract above the clavicles, an Ear, Nose and Throat (ENT) doctor should be consulted to remove objects from the (upper) airways or upper part of the esophagus by rigid endoscopy (16). Gastric mucosal damage from ingestion of 3 button cell batteries. naspghan foreign body guidelines naspghan foreign body guidelines. 2013 Oct;27(5):679-89. doi: 10.1016/j.bpg.2013.08.009. The battery gets stuck in the esophagus where after both poles are in close contact with the mucosa. and transmitted securely. Please try again soon. 2011;53(4):381-387. FOIA Journal of Pediatric Gastroenterology and Nutrition - Volume 60, Number 4, April 2015, Journal of Pediatric Gastroenterology and Nutrition - Volume 59, Number 3, September 2014, Journal of Pediatric Gastroenterology and Nutrition - Volume 57, Number 3, September 2013, Journal of Pediatric Gastroenterology and Nutrition - Volume 57, Number 2, August 2013, Journal of Pediatric Gastroenterology and Nutrition - Volume 56, Issue 4, April 2013, Journal of Pediatric Gastroenterology and Nutrition - Volume 56, Number 3, March 2013. This algorithm is based on literature, previous guidelines and expert opinion, is simple to use and without different strategies dependent on age and size of the BB (1921). Postgraduate Course. The opposite is the case in adolescents and adults, in whom ingestion often is deliberate and related to . Pediatric dysphagia overview: best practice recommendation study by multidisciplinary experts. When the battery is located in the esophagus, immediate endoscopic removal is necessary, if possible within 2 hours of ingestion. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. Children may have vague symptoms that do not immediately suggest foreign body ingestion. Imaging (CT scan) is important to uncover vascular injury and should be performed in case of delayed (>12 hours after ingestion) diagnosis/removal (before removal) or if severe mucosal damage is seen during endoscopy. Templeton T, Terry S, Pecorella M, et al. Operating Room 5-4444 For this, it is essential to collaborate with industry to ensure a clear understanding of the hazards that come with poorly secured products (40). Journal of Pediatric Gastroenterology and Nutrition - Volume 65, Number 1, July 2017. Postgraduate Course Syllabus. Foreign body (FB) ingestion is a common medical emergency accounting for 4% of all emergency endoscopies, secondary to the gastrointestinal (GI) bleeding. Neck pain and stiffness in a toddler with history of button battery ingestion. The esophagogram can be performed 1 to 2 days after removal (21). medicare advantage plan benefits By On Jul 2, 2022. Location in the mid esophagus should alert the greatest concern for aortoesophageal fistulae (18). Oct 16, 2018 Medical Management Guidelines for Sodium Hypochlorite. 22. Address correspondence and reprint requests to Lissy de Ridder, Department of Pediatric Gastroenterology, Erasmus Medical Center-Sophia Children's Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands (e-mail: [emailprotected]). 2015 Apr; 60: (4): 562-74. Epub 2022 Jul 11. 34. About half of all children who swallow these super strong magnets will require surgery for removal, and roughly a one-third will suffer bowel perforations. official website and that any information you provide is encrypted The site is secure. 1) (1417). When a battery is removed, it is also important to follow-up the patient for the development of complications, such as esophageal strictures. In these cases, it is necessary to perform additional imaging (CT scan with contrast) and to consult the surgeon before endoscopy. Often the easiest and least anxiety-producing decision is the one to proceed to endoscopic removal, instead of observation alone. Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 4, April 2017. In asymptomatic patients with early diagnosis (12 hours after ingestion) and position of the BB beyond the esophagus, one can monitor with repeat X-ray (if not already evacuated in stool) in 7 to 14 days, which is different from previous guidelines where repeat X-ray and removal is recommended after 24 days and is also based on age. Finally, the site of lodgement and adjacent tissue are predictive of complications. Before Varga , Kovcs T, Saxena AK. Emerging battery-ingestion hazard: clinical implications. Although adults most often present to the ED because of health problems related to ingestion of radiolucent foreign bodies (typically food), children usually swallow radiopaque objects, such as coins, pins, screws, button batteries, or toy parts.Although children commonly aspirate food items, it is less common for small children to present because of foreign body complications due to food . The aetiology of the disorder is complex and poorly understood, hindering the adaptation of targeted and effective . In case of delayed diagnosis (first confirmation of the BB on X-ray >12 hours after ingestion or time point of removal >12 hours after ingestion) and esophageal impaction the guideline suggests to perform a CT scan in order to evaluate for vascular injury before removing the battery. The literature is summarized, and prevention strategies are discussed focusing on some controversial topics. J Korean Med Sci. Fluoroscopy was performed. The ESGE Guidelines Committee is consistently involved in monitoring state-of-the-art procedures and techniques in various endoscopy related areas and, as a result, publishing relevant guidelines and recommendations. Management of eosinophilic oesophagitis in children and adults. Illustratively, most complications occur after unwitnessed ingestions leading to delayed diagnosis, as symptoms are variable and nonspecific (13). It is important to keep in mind that delayed diagnosis or removal may be associated with more life-threatening complications. In case of injury, contrast esophagograms and/or repeat endoscopies are necessary to detect stricture formation, which can occur weeks after the incident. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and . Foreign body ingestion is a potentially serious problem that peaks in children aged six months to three years. Likewise, a recent multicenter retrospective cohort study of 68 patients with BB in the stomach has shown that after adjusting for age and symptoms, the likelihood of visualizing gastric damage among patients who had BBs removed after 12 hours post ingestion was 4.5 times higher compared with those with BB removal within 12 hours of ingestion. 37. 11267794: Benzothia(di)azepine compounds and their use as bile acid mo Presence of a BB in the esophagus is considered to be a medical emergency and endoscopic removal is necessary as soon as possible (<2 hours). Batteries passing the esophagus usually pass the remaining gastrointestinal tract successfully: only 7% and 1.3% of overall complications occur in the stomach and small bowel, respectively (3). 352 0 obj <> endobj Button battery; Caustic ingestions; Food impaction; Foreign body ingestion; Magnet. sharing sensitive information, make sure youre on a federal impaction, foreign body ingestion, magnet, superabsorbent (JPGN 2015;60: 562-574) I n 2000 the American Association of Poison Control Centers documented that 75% of the >116,000 ingestions reported were in children 5 years of age or younger (1). The first step after suspected battery ingestion is to stabilize the patient and to perform X-ray studies to localize the battery. Several theories have been hypothesized regarding the mechanism of injury in BB ingestions. GIKids is not engaged in the provision or practice of medical, nursing, or health care advice or services. In asymptomatic cases with location of the battery in the stomach or in the small intestine or colon, patients can be followed up with X-ray 7 to 14 days after ingestion. Pediatr Gastroenterol Hepatol Nutr. %PDF-1.5 % The advised dose for both is 10 mL (2 teaspoons) every 10 minutes with a maximum of 6 doses of honey and 3 doses of sucralfate, respectively (21,31). So presence of a BB in the stomach is most likely not permanently harmful to the stomach itself but in specific circumstances (unwitnessed ingestion, delayed diagnosis [>12 hours after ingestion], symptomatic child), emergency endoscopy may still be indicated (to exclude esophageal damage). Therefore, if patients have severe symptoms (at presentation or later on) indicative of possible complications (hemorrhage, hemodynamic problems, fever, respiratory symptoms, severe back pain, etc), in case of mucosal injury identified during endoscopy, it is advised to perform (serial) CT/MRI scans of the chest and neck. PDF | Introduction: Rare earth magnets are powerful magnets that can have several negative effects if ingested. Highlight selected keywords in the article text. Nevertheless, it should be noted that the presence of a BB in the stomach or beyond does not exclude esophageal injury, especially in unwitnessed ingestions when the total time of BB exposure is unknown. Epub 2020 Aug 8. Once in the colon, a battery will almost always pass without intervention. 16. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Anfang R, Jatana K, Linn R, et al. Our recommendations to remove gastric BBs in symptomatic cases, in patients with unwitnessed ingestion or delayed diagnosis (>12 hours after ingestion) and in case of a magnet co-ingestion are only slightly different from the recent recommendation of The National Button Battery Task Force (BBTF) (30). Clipboard, Search History, and several other advanced features are temporarily unavailable. Therefore, including battery ingestions in the differential diagnosis of unexplained symptoms is paramount to avoid delaying the diagnosis and increasing the risk of severe complications and even death. Medical Information Search. is the consultant/speaker for Nutricia and Takeda. 0 During Black History Month, NASPGHAN 50th Anniversary History Project. J Pediatr Gastroenterol Nutr. Disclaimer. 31. Esophageal battery impaction has the highest risk of complications, especially in children <6 years of age and in batteries >20 mm in diameter. J Pediatr Gastroenterol Nutr. Litovitz T. Battery ingestions: product accessibility and clinical course. The European Society for Paediatric Gastroenterology Hepatology and Nutrition task force for button battery ingestions aims to prevent morbidity and mortality because of button battery injuries. Ibrahim A, Andijani A, Abdulshakour M, et al. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), The Association of Pediatric Gastroenterology and Nutrition Nurses, Help & Hope for Children with Digestive Disorders, Journal of Pediatric Gastroenterology and Nutrition, Digestive Health for Life Partners Program, Conflict of Interest, Ethics, and Policy Statements, Council for Pediatric Nutrition Professionals, Clinical Guidelines & Position Statements, COVID-19 Resources for Healthcare Providers, 2023 Medical Student Mentored Summer Research Program, NASPGHAN Celebrates Tanisha Richards, N.P. Accessibility Various published case series have indicated that the location and orientation of the BB (negative pole) largely determines where the complications are most likely to occur (Fig. The .gov means its official. diagnosis hernia. It is, however, important to realize that available data are based on promising in-vitro and in-vivo studies of piglets while human studies are still lacking. The entire specialty needs to be aware of the supporting data on general peri-operative considerations for management and potential complications of BB ingestion (34,37). 11. . Bridging the Gap Between Competencies and Uncertainties in Postgraduate Training in Family Medicine: Results and Psychometric Properties of a Self-Assessment Questionnaire. Only if the battery still has not passed the stomach by 7 to 14 days, endoscopic removal is necessary as by then the chance that it will pass spontaneously is expected to be minimal. It is not a substitute for care by a trained medical provider. Even after passage of the battery into the stomach or beyond, necrosis of the esophagus and surrounding tissues is an ongoing process that can lead to fistulization and associated severe outcome. The goal of our study is to describe. Copyright 2020 Editrice Gastroenterologica Italiana S.r.l. Susy Safe Working Group. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). HHS Vulnerability Disclosure, Help Avoidance of the risk of mucosal injury in case of a battery ingestion, for example, changes in battery design and technology. Guideline for the management of ingested foreign bodies. For advice about a disease, please consult a physician. The European Society for Paediatric Gastroenterology Hepatology and Nutrition task force for button battery ingestions aims to prevent morbidity and mortality because of button battery injuries. Federal government websites often end in .gov or .mil. Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 6, June 2017. In the remaining 22 cases (22%), the foreign bodies had an undened localization. If you have questions about any of the clinical pathways or about the process of creating a clinical pathway pleasecontact us. In delayed diagnosis of an esophageal impaction (first confirmation of the BB on X-ray >12 hours after ingestion or time point of removal >12 hours after ingestion) regardless of symptoms (serial) CT/MRI scans of the chest and neck should also be considered as the BB may have been lodged in the esophagus previously. For advice about a disease, please consult a physician. 5. Epub 2013 Sep 5. Foreign body ingestion is one of the common problems among children. Unable to load your collection due to an error, Unable to load your delegates due to an error. The goal of our study is to describe the result of multiple rare earth magnets ingested by children in Qatar. Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 3, March 2017. Epub 2023 Jan 10. 4. Leinwand K, Brumbaugh D, Kramer R. Button battery ingestion in children: a paradigm for management of severe. Some error has occurred while processing your request. Key Words: caustic ingestion, endoscopy, esophageal perforation, foreign body, pediatric (JPGN 2021;73: 129-136) A hb```b``e`e`mbd@ A( GSf^Vd5MW(LX{w_-^HF. The information provided on this site is intended solely for educational purposes and not as medical advice. In fact, fatalities in children where the battery was initially discovered in the stomach have been reported (21). 23. Others will suffer severe injury with life-long complications. See Foreign body . As ESPGHAN task force for battery ingestions, we aim at contributing to all these factors, which are paramount for the prevention of BB ingestion. government site. An algorithm for the diagnosis and management of BB ingestions is presented and compared to previous guidelines (NASPGHAN, National Poison Center). eCollection 2022. Identifying predictive factors for long-term complications following button battery impactions: a case series and literature review. Buttazzoni E, Gregori D, Paoli B, et al. Broad-spectrum antibiotics to prevent mediastinitis should be considered in patients with severe injury, perforation, and/or fever. An increasing number of button battery (BB) ingestions has been described worldwide, mainly because of the wide abundance of batteries in consumer electronics (1,2). Surgical management and morbidity of pediatric magnet ingestions. 6. Unable to load your collection due to an error, Unable to load your delegates due to an error. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), Clinical Guidelines & Position Statements, Journal of Pediatric Gastroenterology and Nutrition - Volume 74, Issue S1, March 2022, Journal of Pediatric Gastroenterology and Nutrition - Volume 66, Issue 3, March 2018, Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 6, June 2017, Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 2, February 2017, Journal of Pediatric Gastroenterology and Nutrition - Volume 64, Number 1, January 2017, Journal of Pediatric Gastroenterology and Nutrition - Volume 63, Number 5, November 2016, Journal of Pediatric Gastroenterology and Nutrition - Volume 58, Number 2, February 2014, Journal of Pediatric Gastroenterology and Nutrition - Volume 56, Supplement 1, January 2013, Journal of Pediatric Gastroenterology and Nutrition - Volume 54, Number 6, June 2012, Journal of Pediatric Gastroenterology and Nutrition - Volume 40, Number 1, January 2005, (For primary care physicians/pediatricians), Journal of Pediatric Gastroenterology and Nutrition - Volume 76, Number 1, January 2023, Journal of Pediatric Gastroenterology and Nutrition - Volume 74, Number 5, May 2022, Journal of Pediatric Gastroenterology and Nutrition - Volume 74, Number 1, January 2022, Journal of Pediatric Gastroenterology and Nutrition - Volume 72, Number 3, March 2021, Journal of Pediatric Gastroenterology and Nutrition - Volume 72, Number 2, February 2021, Journal of Pediatric Gastroenterology and Nutrition - Volume 72, Number 1, January 2021, Journal of Pediatric Gastroenterology and Nutrition - Volume 71, Number 4, October 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 71, Number 3, September 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 71, Number 2, August 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 71, Number 1, July 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 70, Number 6, June 2020, Journal of Pediatric Gastroenterology and Nutrition - Volume 70, Number 5, May 2020, Journal of Pediatric Gastroenterology and Nutrition, Volume 70, Number 3, March 2020, Journal of Pediatric Gastroenterology and Nutrition, Volume 69, Number 4, October 2019. Litovitz T, Whitaker N, Clark L. Preventing battery ingestions: an analysis of 8648 cases. Jun 04, 2022. @article{Kramer2015ManagementOI, title={Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. Phrase With The Word Secret In It; Victorian House Color Schemes Exterior . This is through raising public awareness and developing prevention strategies with the industry in the first place, and secondly by aiming for better diagnoses and treatment. Analysis of complications after button battery ingestion in children. Best Pract Res Clin Gastroenterol. Management of Gastrointestinal Foreign Bodies with Brief Review of the Guidelines. Another indication for endoscopic removal in the stomach is the co-ingestion of a magnet as this may lead to entrapment of the stomach or intestinal wall between the battery and the magnet causing necrosis. Studies on long-term follow-up are scarce and are encouraged. Yoshikawa T, Asai S, Takekawa Y. Clinical guidelines for imaging and reporting ingested foreign bodies . Among patients whose foreign body was radiographically viewed, 83 (83%) were asymptomatic and 19 (19%) had symptoms. Keywords: It was created by Summer Hudson, a medical student at the University of Alberta, with the help of Dr. Hien Huynh, a pediatric gastroenterologist at the University of Alberta, and Dr. Alex Hudson, a . Curr Gastroenterol Rep. 2005 Jun;7(3):212-8. doi: 10.1007/s11894-005-0037-6. Diaconescu S, Gimiga N, Sarbu I, et al. 8:00 AM - 4:00 PM. Al Ghadeer HA, AlKadhem SM, Albisher AM, AlAli NH, Al Hassan AS, Alrashed MH, Alali MH, Alturaifi RT, Alabdullah MB, Buzaid AH, Aldandan ZA, Alnasser MH, Aldandan NS, Aljaziri AA. In these patients, a second look within 2 to 4 days after removal may be considered, as this could provide useful prognostic information (38). 10. Making the battery less attractive for children could be an option. According to the NASPGHAN guideline, removal is, therefore, advised if a BB is still in the stomach after 2 to 4 days (30). Unauthorized use of these marks is strictly prohibited. Worldwide initiatives have been set up in order to prevent and also timely diagnose and manage BB ingestions. Esophageal foreign body symptoms include the following: Dysphagia. About Us. 2015 Apr;60(4):562-74. doi: 10.1097/MPG.0000000000000729. Journal of Pediatric Gastroenterology and Nutrition - Volume 66, Number 4, April 2018. 30. The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) task force for BB ingestions was founded as an ongoing initiative of pediatric gastroenterologists to prevent morbidity and mortality because of such ingestions. Depending on the severity of the injury, this may be considered to be continued up to for 4 weeks in order to avoid mechanical injury. Disclaimer. National Library of Medicine Others will suffer severe injury with life-long complications. Many of the children are asymptomatic or have transient symptoms at the time of the ingestion. 3. In the other cases (44.3%), the cause of death was unknown. The areas covered include indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography; and . Sites of esophageal button battery impaction and related risk of injury. 2022 Nov;18(11):715-724. doi: 10.1007/s12519-022-00584-8. As a result, clinical guidelines regarding management of these ingestions in children remain varied and sporadic, with little in the way of prospective data to guide their development. Established by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), The Association of Pediatric Gastroenterology and Nutrition Nurses, Help & Hope for Children with Digestive Disorders, Journal of Pediatric Gastroenterology and Nutrition, Digestive Health for Life Partners Program, Conflict of Interest, Ethics, and Policy Statements, Council for Pediatric Nutrition Professionals, Clinical Guidelines & Position Statements, COVID-19 Resources for Healthcare Providers, 2023 Medical Student Mentored Summer Research Program, NASPGHAN Celebrates Tanisha Richards, N.P.

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