How to recognize tuberculosis in a person. How to recognize tuberculosis at home

Main number of cases tuberculosis detected during the patient’s initial visit to doctors general practice. The patient, feeling unwell, does not immediately seek help from a doctor. A low-grade fever of up to 37.5 C appears and is maintained constantly. After some time, a dry cough develops, sometimes with sputum production ( heavy smokers most often do not pay attention to it, citing their bad habit ). That's when you should worry, it's time to see a doctor. Every doctor knows about the widespread prevalence of tuberculosis, therefore, when visiting a patient with characteristic symptoms, he must ask the patient Control questions, such as:

• Has the patient previously had tuberculosis?
• Did his relatives have tuberculosis?
• Has he been in contact with tuberculosis patients?
• Is the patient registered with a tuberculosis institution due to the presence of hypersensitivity for tuberculin
• Did you pass ( and when) patient fluorography of the lungs
• Whether the patient was in prison or in contact with people who were previously in prison
• Is he a migrant, homeless, living in unfavorable conditions, etc.

Tuberculin diagnostics

Mantoux test

Redness of the skin should not be confused with infiltration. To do this, it is necessary to compare the thickness of the skin fold of the forearm over the healthy area, and then at the site of needle insertion. The difference is that with redness the folds remain the same thickness, but with infiltration, the fold above the site of tuberculin injection thickens. After an external examination, the diameter of the reaction is measured using a transparent ruler.

There are three types of response to tuberculin:
1. Negative reaction – characterized complete absence skin redness and infiltration ( 0 – 1 mm).
2. Questionable reaction – redness of the skin of varying sizes or the presence of an infiltrate with a diameter of 2 – 4 mm/
3. Positive reaction – mandatory presence of infiltrate with a diameter of 5 mm or more.

In turn, positive reactions can also be divided into several types, depending on the diameter of the infiltrate:

• Weakly positive – 5 – 9 mm.
• Medium intensity – 10 – 14 mm.
• Pronounced – 15 – 16 mm.
• Hyperergic – in children and adolescents 17 mm or more, and in adults from 21 mm. Vesiculonecrotic reactions on the skin also fall into this category.
• Intensifying - a reaction accompanied by an increase in infiltrate by 6 mm or more compared to the previous sample.

Laboratory methods for detecting Mycobacterium tuberculosis

2. Sputum microscopy:
It is the fastest and cheapest method for detecting Mycobacterium tuberculosis. The method is based on the ability of mycobacteria to retain their color even after treatment with various acid solutions. So, they are detected using a microscope in stained sputum smears. Along with simple microscopy, fluorescence microscopy is also used, which is based on the use of ultraviolet rays to identify mycobacteria.

Molecular genetic methods for diagnosing Mycobacterium tuberculosis

1. Polymerase chain reaction: consists of deciphering the genetic material of Mycobacterium tuberculosis. Designed to detect pathogens in sputum and recognize types of bacteria. The method has particular sensitivity and specificity.

2. Definition drug resistance pathogen
Sensitive to any particular drug are those strains of Mycobacterium tuberculosis for which the drug is minimum concentration has a bacteriostatic or bactericidal effect.
Resistant or resistant to this drug are those strains of mycobacteria that are capable of multiplying when exposed to the drug in a minimum or increased concentration.

3. Serological methods diagnosis of tuberculosis
Serological methods for studying blood plasma components are based on the detection of numerous antigens related to tuberculosis, as well as a variety of immune responses caused by various forms of tuberculosis.

4. Blood analysis
Hemoglobin and red blood cells in most cases remain unchanged, except in cases accompanied by acute blood loss. An indicator indicating the presence of an active tuberculosis process is the erythrocyte sedimentation rate. Accelerated ESR is characteristic not only of fresh active tuberculosis, but also of exacerbation of a chronic process.
Other blood test parameters vary greatly depending on the nature of the lung damage.

5. Analysis of urine
In the urine analysis of a patient with pulmonary tuberculosis, there are no noticeable deviations from the norm. Changes only appear when tuberculosis infection kidneys and urinary tract.

6. X-ray methods diagnostics
The most commonly used methods for diagnosing pulmonary tuberculosis are:

• Radiography
• X-ray
• 
  Fluorography
• Tomography

• Tracheobronchoscopy
• Bronchoscopic lavage
• Thoracoscopy ( pleuroscopy)
• Transbronchial biopsy
• Transthoracic needle biopsy
• Pleural puncture and puncture biopsy of the pleura

Timely and late detected tuberculosis

Tuberculosis is a disease that affects both children and adults. Call him dangerous bacteria, which is called Koch's wand.

The symptoms of the disease are very diverse and first of all, it is necessary to determine the form of tuberculosis, and what the immune system in humans.

In the early stages, they do not always have a clear manifestation in men and women. And in children they can be mild, which makes diagnosis difficult.

When the signs become more noticeable, the disease is much more difficult to cure. Therefore, it is important to know how to identify tuberculosis at home.

The tuberculosis bacillus can be acquired at any age. Infection most often occurs by airborne droplets when an infected person coughs, laughs or just talks.

This type of lung pathology can be caught through a kiss, through dishes or other objects used by the patient. There is another way for the infection to spread - placental. Thus, a pregnant woman can infect her unborn baby.

The sources of the disease can be not only people, but also meat or milk from tuberculous animals. It is important to remember that even if the symptoms of tuberculosis are mild, it is still contagious. It's all about the duration of contact.

Weakened immunity, poor lifestyle, alcohol and drug use are the main reasons for the spread of infection.

In the absence of normal social and living conditions, infection is also possible. Often children are not protected from this disease due to their lifestyle. Therefore, early disability in children is possible.

Classification of the disease

Clinical forms of tuberculosis are divided into three main groups:

1. The first group includes tuberculosis intoxication in young children and adolescents.
2. The second group includes tuberculosis of the lungs and other respiratory organs.
3. The third group includes tuberculosis infection Bladder, intestines, prostate, bones and other organs.

Tuberculosis is considered one of the most dangerous diseases. But it is possible to cure it if this disease is detected in a person in the early stages of development.

Therefore, it is important to respond to the changes that occur in the body. The first signs of pulmonary tuberculosis are:

These are the main symptoms of how tuberculosis manifests itself. Any of them lasts more than three weeks and is not explained by other reasons. If several symptoms appear simultaneously, you should immediately contact a medical facility and undergo examination.

Considering modern conditions When a child is heavily loaded with lessons, it is very difficult to recognize the first symptoms. Therefore, you need to pay attention to the condition of children and take into account every sign.

It is better to worry once again or consult a doctor than to miss the moment when tuberculosis is just beginning to develop.

Symptoms of the disease are often confused with ARVI. If the temperature persists for a long time and the cough does not stop, you should definitely undergo x-ray examination. This makes it possible to determine whether tuberculosis is developing in the lungs.

Usually the first stage can be cured complex therapy, which consists of drug treatment, special physical activity, sufficient quantity fresh air and proper diet.

Tuberculosis. A disease that doesn't go away

The primary form of tuberculosis often occurs in children. There is no obvious localization of the disease and this makes its timely detection very difficult.

Symptoms of tuberculosis on early stage such:

• irritability, sleep disturbance, increased excitability, inattention, headache;
• cough with sputum for more than 3 days;
• hemoptysis;
• loss of appetite;
• in children with a lack of weight, an enlarged liver and spleen is diagnosed;
• Allergy occurs on the front of the lower leg, it is different from others similar manifestations- these are hot red swellings that do not have clear boundaries;
• positive reaction after the Mantoux test.

Each of the criteria is non-specific and develops slowly; how to understand that you have tuberculosis is very difficult. Therefore, any suspicions should alert a person.

If you do not seek help in time, there is a risk of developing serious complications:

• cavity formation;
• fibrous-cavernous tuberculosis;
• cancerous transformation of the affected tissue.

Tuberculosis in women and men has the same symptoms. This disease can also affect other organs:

Tuberculosis refers to social diseases, which can affect any category of the population. Therefore, it is necessary to know how long after infection tuberculosis appears.

The development time depends on several factors:

• level of immunity;
• transmission route;
• age;
• virulence, infectiousness of this particular bacterium;
• the number of rods that entered the body.

Children and older people are more likely to get tuberculosis because their bodies are more weakened.. In some cases, the pathogen enters the body, resides in it, but does not cause the development of the disease. This can continue until the immune system weakens significantly.

During a year human body may encounter such bacteria several times. Immunity against tuberculosis is not developed. If contact is repeated, the person may become ill again and the infection recurs.

The average time for signs of pathology to appear is from 3 weeks to 3 months. But if the body does not succumb to stress, it does not suffer from exacerbation chronic pathologies, then the incubation period can stretch up to a year.

1. Until significant discomfort appears, there are no signs of pathology.
2. Until the first signs begin to appear, the stick is not released into the environment, the patient is not contagious.
3. For incubation period The Mantoux test will be negative.

Determining the disease at an early stage has great importance, as it makes it possible to avoid complications and recover completely. Infection can be prevented if it is known in advance that the patient is infected.

It is very important to know the symptoms of tuberculosis in order to identify it at home and contact a specialist in a timely manner.

What is tuberculosis

Tuberculosis (TB) is an airborne infection that primarily affects the lungs.

Who is at risk

Although tuberculosis is now less common, some children are at greater risk of contracting it than others.

At risk are:

• children living in a family where there is an adult with open form tuberculosis or having high risk TB infection due to low immunity;
• children infected with HIV or suffering from other diseases that significantly weaken the immune system;
• children born in a country where TB is widespread;
• children who have visited countries where tuberculosis is endemic or have had prolonged contact with people who live permanently in such countries;
• children from places where medical care is poor;
• children living in a boarding school or in a family, one of whose members previously served a sentence in prison.

Ways of spreading tuberculosis

The usual way this infection spreads is through the air: a sick adult coughs and the bacteria become airborne. The child inhales them along with the air and thus becomes infected. Children under ten years of age with pulmonary tuberculosis rarely infect other people because they usually have very little bacteria in their mucus and relatively nonproductive cough.

Fortunately, most children who have been exposed to tuberculosis pathogens do not become ill. When bacteria reach a child's lungs, the body's immune system destroys the "enemy" and prevents further spread of infection. These children develop asymptomatic infection, which is detected only by a positive reaction to a skin test. However, children with asymptomatic forms of tuberculosis should still be treated to prevent further development diseases.

Symptoms

From time to time, in a small number of children left without proper treatment, the infection begins to actively develop, causing fever, fatigue, irritability, persistent cough, weakness, heavy and/or rapid breathing, night sweats, inflammation of the lymph nodes, weight loss and growth retardation.

In some children (mostly under four years of age), TB germs can spread through the bloodstream, affecting almost any organ. In this case, the disease will require much more complex treatment, and the sooner it is started, the better the result will be. In such children with high degree chances of developing tuberculous meningitis - most dangerous form this disease that affects the brain and central nervous system.

Diagnostics

Children who are constantly at risk of contracting TB should undergo regular TB skin testing.

Your child may need a skin test if your answer is yes. at least to one of the questions:

• Did any family members or people your child came into contact with have tuberculosis?
• Has anyone in the family had a positive tuberculin skin test?
• Was your child born in a country with high level risk for tuberculosis (all countries except the USA, Canada, Australia, New Zealand and countries Western Europe)?
• Has your child visited a high-risk country for TB for more than one week and had contact with local residents?

The test is carried out in the pediatrician's office (or in the manipulation room of the clinic) by injecting tuberculin (a mixture of organic matter varying degrees complexity obtained from Mycobacterium tuberculosis) into the skin of the forearm. If there is an infection, your child's skin will become swollen and red at the injection site. Your pediatrician will check the injection site within 48 to 72 hours after the test and measure the diameter of the redness and swelling. This skin test will show whether there has been a bacterial infection, even if the child has no symptoms and has successfully fought off the disease.

Treatment

• If your baby's skin test is positive, an x-ray will be needed chest to determine the presence/absence of an active or past infection in the lungs. If an X-ray of the lungs indicates a possible active infection, your child's pediatrician will order testing to look for Mycobacterium tuberculosis in cough or stomach secretions. This is done in order to determine further treatment.
• If your child's skin test is positive but he has no symptoms or signs of an active TB infection, he is still infected and needs treatment. To prevent the process from becoming active, your pediatrician will prescribe isoniazid (INH). This medication should be taken orally - one tablet per day, every day for at least nine months.
• For an active TB infection, your pediatrician will prescribe three or four medications. You will need to give them to your baby for 6 to 12 months. Sometimes the child is hospitalized during the initial stage of treatment, although in fact most treatment can be carried out at home.

Fighting the spread of tuberculosis

If your child has been infected with TB (whether they develop symptoms or not), it is very important to try to find out who they might have been infected with. To do this, you should find out if anyone who has been in close contact with the sick child has symptoms of TB. It is necessary to conduct a skin test for TB and examine all family members, nannies, housekeepers, and employees of preschool and school institutions. The most common symptom of tuberculosis in adults is a persistent cough, especially one that is accompanied by hemoptysis. Anyone with a positive skin test should be seen by a doctor and thoroughly examined, including a chest x-ray, sputum examination, etc. If necessary, the person should be treated with certain medications.

With an active infection found in adult, he will be isolated to the maximum extent possible (especially from young children) until the end of full course treatment.

All family members who were in contact with this person, as a rule, also undergo preventive therapeutic measures- take isoniazid regardless of the results of their own skin tests. Anyone who is sick or has characteristic changes on a chest x-ray should be considered a carrier of active tuberculosis.

Tuberculosis is very common among antisocial populations who are more susceptible to disease due to poor living conditions, poor nutrition and lack of proper medical care. People with AIDS are also at greater risk of contracting tuberculosis due to their body's reduced resistance various infections.

Without treatment tuberculosis pathogens in a child’s body can remain dormant for many years and will begin to become active only during special periods - in adolescence, during pregnancy or during periods of stress during adult life.

The main danger of tuberculosis is that a person not only becomes seriously ill, but can also spread the infection to others. This is why it is important that your child is promptly tested for TB if he or she is in close contact with any adult who tests positive. skin test or a survivor of tuberculosis, even if he received timely and adequate treatment.

She takes into account shapes of this disease and him clinical manifestations. Timely diagnosis tuberculosis is very important, as it greatly facilitates the fight against infection and can even save the patient’s life.

Diagnosis of tuberculosis: how to identify tuberculosis?

Diagnosis of tuberculosis is carried out in various medical institutions. As a rule, if this disease is suspected, patients turn to either the local doctor or family doctor. It is he who prescribes the initial examination and, if necessary, refers the patient to institutions providing treatment and diagnosis of tuberculosis. There are several main stages in identifying tuberculosis.

It is a diagnosis of symptoms of the disease, such as prolonged fever, hemoptysis, prolonged cough, night sweats. In addition, at this stage, the attending physician finds out whether the patient has contacts with people who are carriers of tuberculosis and the nature of changes in the patient’s well-being during Lately.

Consists of examining the patient in a clinical setting. When diagnosing tuberculosis, the doctor primarily pays attention to the abnormal movement of the chest during breathing, the size lymph nodes and the patient's weight.

If, after carrying out the first two steps of diagnosis, there is an assumption that the person is still sick with tuberculosis, then the third stage of diagnosing tuberculosis is carried out. In this case, the patient is sent to a medical clinic that specializes in treating and identifying various forms tuberculosis. To confirm the presence of tuberculosis infection in the patient's body, a person's sputum is examined under a microscope for the presence of acid-fast mycobacteria. These microorganisms cause tuberculosis. In addition, chest X-ray is used to diagnose tuberculosis. At positive result(inflammation was detected in the lungs, and tuberculosis pathogens are present in the sputum), obtained during both studies, the patient is sent for a second course of examination. At secondary diagnosis In addition to the final confirmation of the presence of the disease in the patient, the specifics of the disease are determined. If the fears are confirmed, then treatment is prescribed.

When signs of pneumonia are present in the lungs, and acid-fast mycobacteria are not detected in the sputum, the patient is sent for a 2-week course of treatment. If the effect of treatment is observed after 14 days, then the diagnosis of tuberculosis is refuted, otherwise, the patient is sent for further examination.

Diagnosis of tuberculosis: stages of disease research

Tuberculosis is a complex and quite common disease, its difficulty lies in the fact that it is not always possible to recognize it at first, but you should consult a doctor precisely when initial stages. After all, if you hesitate in this matter, then this disease is quite aggressive and progresses very quickly, and the longer you do not take action, the more difficult it will be to recover later. In order to prevent such situations, we will give several signs of the disease:

sputum culture

determination of antibody titer to tuberculosis;

smear examination;

X-ray examination of the lungs in the diagnosis of tuberculosis;

polymerase method chain reaction;

Mantoux test.

Diagnosis of tuberculosis: methods

A sputum analysis is performed to determine the content of tuberculosis viruses. This method cannot guarantee the accuracy of the results, since there may be no bacteria in the sputum.

More exact method definition, it determines the presence of tuberculosis with an accuracy of approximately 75%. It is carried out, as a rule, in specialized clinics, where the titer of antibodies to tuberculosis is applied. It allows you to determine whether there is immunity to the Koch bacillus, and also allows you to find out the effectiveness of vaccination.

This method for diagnosing tuberculosis cannot provide high accuracy, since Koch's Mycobacterium can be easily confused with other bacteria.

The X-ray diagnostic method of tuberculosis can be used in situations where there is nothing more suitable, but this method allows you to see more accurate results.

The polymerase chain reaction method in diagnosing tuberculosis is the most accurate; it allows you to detect the disease with very high accuracy, approximately 95-100% accurate. This method is carried out through DNA diagnostics, when the sputum of a sick person is examined. The results of the study are ready in 3 days.

The Mantoux reaction method has very low accuracy. The results of the study become known after 72 hours.

Useful to know about tuberculosis

Ultraviolet is deadly to Koch's wand, it deals with it very quickly, in about two or three minutes it destroys it. Solar bright light is able to cope with the destruction of Koch's wand in half an hour. But still, the microbe is very adaptable and tenacious; it can develop and multiply for up to three months even in the dried sputum of a sick person. Therefore, at the first signs of tuberculosis, it is necessary to urgently take action.

Tuberculosis is a disease transmitted through the air, personal contact, and household objects (i.e., by airborne droplets). In each country, the situation with the incidence of Koch's bacillus is carefully monitored. According to experts, including the rather famous Dr. Komarovsky, this situation is far from rosy.

Therefore, it was important for human health and the preservation of his life to find ways to identify tuberculosis. For example, the Mantoux test, fluorography, or x-ray of the lungs, familiar to everyone since childhood. The methods do not end there: a new generation drug has been developed - Diaskintest.

Must be remembered : early detection tuberculosis can prevent its further development, which can result in death.

Mantoux test

Mantoux is often called a graft, although in fact it is a test. The difference between these definitions is that vaccination provokes the emergence of antibodies that can resist pulmonary tuberculosis; in short, it is a vaccine, and with the help of a test you can only find out whether a person is sick or not.

The Mantoux test consists of tuberculin, an extract of tuberculosis bacteria that does not contain live/dead Koch bacilli. From here - this remedy is completely safe for children. Two units of tuberculin are taken for the sample.

Mantoux is mainly made for children. The age limit is sixteen years, sometimes up to eighteen years. To detect pulmonary tuberculosis in adults, fluorography is performed, a blood test is taken, and, if necessary, an x-ray or tomogram is taken. Based on the images obtained and the result of the analysis, it is determined whether the person has pulmonary tuberculosis.

Usually the procedure is done annually, and if the result is positive, it is repeated a few days after the first. How many times a year can a test be done? Their number cannot exceed three times. If such a need arises, the sick person is sent to phthisiology for diagnosis.

Peculiarities

As a rule, parents have many questions regarding how to behave before and after the test, what can be done and what cannot be done.

1. Diet. There is no need to comply with any special diet, although you still shouldn't try anything new before the test as it may cause an allergic reaction.
2. Sweet. Whether the child ate sweets or not will not affect the Mantoux result in any way. Of course, there is a possibility of itching due to sharp jump blood glucose level, but for this you will need to eat a lot of sweets.
3. Runny nose. If the runny nose is caused by an infectious disease, the test should be done at another time. But it happens that the body only reacts to the environment (with too dry/cold/humid air).
4. ORZ. There is no strictly established answer. Sometimes the procedure is canceled, sometimes the test is done when elevated temperature. But to get a more accurate result, it would be best to reschedule it.
5. Vaccination schedule. The drug is administered according to national calendar vaccinations. Therefore, there should be no overlap when administering other vaccinations. If the test is nevertheless postponed, a break between vaccinations should be taken for several weeks.
6. Disease. After the child has recovered from any illness, it is necessary to wait about two weeks before the test.
7. The injection site should not be scratched.
8. It is not forbidden to walk; it is even better to increase the number of walks.
9. You can, but you can’t rub it with anything. Then the redness and increase in the mark will not be surprising.

Reaction

• Negative. There is no red “button”; there is only a small red dot at the injection site. This indicates the absence of infection.
• Doubtful. It is difficult to determine whether a person is sick because the area of ​​redness is of ambiguous size and there is no “button”. Then a decision is made to repeat the procedure.
• Positive. The diameter of the papule is about fifteen millimeters. This means that the child had contact with an infected person, he is sent to doctors, after tuberculin diagnostics The test is done again within a year.
• Hyperergic. The size of the papule is more than fifteen millimeters - the child is definitely sick.

Diaskintest

How to identify tuberculosis differently? Not long ago, a new generation drug of synthetic origin called Diaskintest was invented. Some parents are asking the pressing question, what kind of vaccine is this? Just like Mantoux, the test is not an anti-tuberculosis vaccine. Using the drug, the patient is diagnosed for infection with Koch's bacillus. Diaskintest contains proteins that are present exclusively in mycobacteria.

Diaskintest for tuberculosis contains tuberculin allergens (antigens CFP10, ESAT6). Based on the body's reaction to the administered drug, it will be possible to judge the presence of the disease. Due to this composition of the drug, the safety of the person being tested is guaranteed: there is no way to get infected through this test, it only causes an allergic reaction.

It should be noted that such a test is much more accurate than Mantoux: the first has about ninety percent accuracy, the second has fifty to seventy percent accuracy.

Goals

1. Diagnosis of tuberculosis.
2. At active form disease determination of its degree.
3. Differential testing of the body with other diseases.
4. Determining what the body reacts to: BCG vaccination or on harmful Koch sticks.
5. Monitoring the effectiveness of disease treatment.

Video

Video - dangerous symptoms tuberculosis

Passage Frequency

• Children are much more likely to get pulmonary tuberculosis, so they are diagnosed annually. If Manta is done twice a year, then Diaskin is done once (from 8 to 17 years old).
• Upon receipt negative result The test can be repeated only after two months.
• Having received any mandatory vaccine, the Diaskin test is allowed to be done only thirty days after it.
• Having recovered after infectious disease After a difficult period, a test for tuberculosis is performed after thirty days.
• If the patient is registered at a tuberculosis dispensary, checks occur every three to six months.
• Having received positive reaction to test Mantoux, you can do Diaskintest from one year onwards.
• Diaskintest in adults is usually done only if the person is a member of an anti-tuberculosis dispensary or has had contact with a person suffering from tuberculosis.

Contraindications

• Acute respiratory viral infection, acute respiratory disease, sore throats, colds.
• Any disease in the acute stage.
• Allergy condition.
• Skin diseases with abscesses, rashes.
• After receiving the vaccine, a month must pass before the test.

Rules

• Do not scratch or rub the injection site.
• Do not apply anything to the injection site ( neither cosmetics nor medicines).
• Do not wrap the injection site with anything or put a bandage there.
• Try to keep water away from the injection site.

Evaluation of results

The results of this test can be obtained after seventy-two hours. They will be assessed better to the doctor, since he has the necessary and sufficient knowledge.

After carrying out it may be different:

• Negative reaction. Absolute absence of skin redness and papules.
• Doubtful. The injection site is red, but there is no papule.
• Positive. The appearance of papules of any diameter.
• Weakly expressed. There is a papule whose diameter does not exceed five millimeters.
• Moderately expressed. The diameter of the papule is five to nine millimeters.
• Expressed. The diameter of the papule is ten to fourteen millimeters.
• Hyperergic. The diameter of the papule is more than fifteen millimeters

A negative reaction occurs in people who do not have tuberculosis; who received the infection earlier, but now it is inactive; recovered from the disease.

Side effects

• Mild headache.
• Fever.
• General painful condition.
• Hematoma at the injection site.

Basically negative consequences it should not be, it is extremely rare that intolerance to the drug occurs, then it will be necessary to do a hemotest.

Additional Information

It is important to remember when buying Diaskintest, instructions for use are always included with the package. There is no need to worry about the manufacturer of the test, because there is only one Diaskintest manufacturer - Generium. The price of the drug is not the lowest - more than one and a half thousand rubles. And despite the fact that the test can be purchased at pharmacies, it is not recommended to do it yourself. It's best to leave this to the experts.

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