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Volumn 50, Issue , 2016, Pages 48-53

Does molecular analysis increase the efficacy of bronchoalveolar lavage in the diagnosis and management of respiratory infections in hemato-oncological patients?

Author keywords

Fiberoptic bronchoscopy with bronchoalveolar lavage; Hematological malignancies; Molecular analysis; Respiratory infections

Indexed keywords

CIPROFLOXACIN; COTRIMOXAZOLE; FLUCONAZOLE;

EID: 84989886957     PISSN: 12019712     EISSN: 18783511     Source Type: Journal    
DOI: 10.1016/j.ijid.2016.07.011     Document Type: Article
Times cited : (11)

References (39)
  • 1
    • 24944485004 scopus 로고    scopus 로고
    • Pulmonary complications in adult blood and marrow transplant recipients: autopsy findings
    • 1 Sharma, S., Nadrous, H.F., Peters, S.G., Tefferi, A., Litzow, M.R., Aubry, M.C., et al. Pulmonary complications in adult blood and marrow transplant recipients: autopsy findings. Chest 128 (2005), 1385–1392.
    • (2005) Chest , vol.128 , pp. 1385-1392
    • Sharma, S.1    Nadrous, H.F.2    Peters, S.G.3    Tefferi, A.4    Litzow, M.R.5    Aubry, M.C.6
  • 2
    • 1642493878 scopus 로고    scopus 로고
    • Pulmonary infiltrates in the non-HIV-infected immunocompromised patient: etiologies, diagnostic strategies, and outcomes
    • 2 Shorr, A.F., Susla, G.M., O'Grady, N.P., Pulmonary infiltrates in the non-HIV-infected immunocompromised patient: etiologies, diagnostic strategies, and outcomes. Chest 125 (2004), 260–271.
    • (2004) Chest , vol.125 , pp. 260-271
    • Shorr, A.F.1    Susla, G.M.2    O'Grady, N.P.3
  • 3
    • 27644593847 scopus 로고    scopus 로고
    • Drug-induced respiratory disease in patients with hematological diseases
    • 3 Camus, P., Costabel, U., Drug-induced respiratory disease in patients with hematological diseases. Semin Respir Crit Care Med 26 (2005), 458–481.
    • (2005) Semin Respir Crit Care Med , vol.26 , pp. 458-481
    • Camus, P.1    Costabel, U.2
  • 5
    • 48749096676 scopus 로고    scopus 로고
    • Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis
    • 5 Chamilos, G., Lewis, R.E., Kontoyiannis, D.P., Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis 47 (2008), 503–509.
    • (2008) Clin Infect Dis , vol.47 , pp. 503-509
    • Chamilos, G.1    Lewis, R.E.2    Kontoyiannis, D.P.3
  • 6
    • 34249915082 scopus 로고    scopus 로고
    • Halo sign and improved outcome
    • author reply 1667–8
    • 6 Verweij, P.E., van Die, L., Donnelly, J.P., Halo sign and improved outcome. Clin Infect Dis 44 (2007), 1666–1667 author reply 1667–8.
    • (2007) Clin Infect Dis , vol.44 , pp. 1666-1667
    • Verweij, P.E.1    van Die, L.2    Donnelly, J.P.3
  • 7
    • 13244267119 scopus 로고    scopus 로고
    • Surgical lung biopsy in patients with hematological malignancy or hematopoietic stem cell transplantation and unexplained pulmonary infiltrates: improved outcome with specific diagnosis
    • 7 Zihlif, M., Khanchandani, G., Ahmed, H.P., Soubani, A.O., Surgical lung biopsy in patients with hematological malignancy or hematopoietic stem cell transplantation and unexplained pulmonary infiltrates: improved outcome with specific diagnosis. Am J Hematol 78 (2005), 94–99.
    • (2005) Am J Hematol , vol.78 , pp. 94-99
    • Zihlif, M.1    Khanchandani, G.2    Ahmed, H.P.3    Soubani, A.O.4
  • 8
    • 3042621039 scopus 로고    scopus 로고
    • Diffuse pulmonary infiltrates after bone marrow transplantation: the role of open lung biopsy
    • 8 Wang, J.Y., Chang, Y.L., Lee, L.N., Chen, J.H., Tang, J.L., Yang, P.C., et al. Diffuse pulmonary infiltrates after bone marrow transplantation: the role of open lung biopsy. Ann Thorac Surg 78 (2004), 267–272.
    • (2004) Ann Thorac Surg , vol.78 , pp. 267-272
    • Wang, J.Y.1    Chang, Y.L.2    Lee, L.N.3    Chen, J.H.4    Tang, J.L.5    Yang, P.C.6
  • 9
    • 23844464877 scopus 로고    scopus 로고
    • Bronchoscopy in the diagnosis and surveillance of respiratory infections in lung and heart–lung transplant recipients
    • 9 Lehto, J.T., Koskinen, P.K., Anttila, V.J., Lautenschlager, I., Lemstrom, K., Sipponen, J., et al. Bronchoscopy in the diagnosis and surveillance of respiratory infections in lung and heart–lung transplant recipients. Transpl Int 18 (2005), 562–571.
    • (2005) Transpl Int , vol.18 , pp. 562-571
    • Lehto, J.T.1    Koskinen, P.K.2    Anttila, V.J.3    Lautenschlager, I.4    Lemstrom, K.5    Sipponen, J.6
  • 10
    • 1242284325 scopus 로고    scopus 로고
    • Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates
    • 10 Jain, P., Sandur, S., Meli, Y., Arroliga, A.C., Stoller, J.K., Mehta, A.C., Role of flexible bronchoscopy in immunocompromised patients with lung infiltrates. Chest 125 (2004), 712–722.
    • (2004) Chest , vol.125 , pp. 712-722
    • Jain, P.1    Sandur, S.2    Meli, Y.3    Arroliga, A.C.4    Stoller, J.K.5    Mehta, A.C.6
  • 11
    • 0033861040 scopus 로고    scopus 로고
    • Utility of fiberoptic bronchoscopy in neutropenic patients admitted to the intensive care unit with pulmonary infiltrates
    • 11 Gruson, D., Hilbert, G., Valentino, R., Vargas, F., Chene, G., Bebear, C., et al. Utility of fiberoptic bronchoscopy in neutropenic patients admitted to the intensive care unit with pulmonary infiltrates. Crit Care Med 28 (2000), 2224–2230.
    • (2000) Crit Care Med , vol.28 , pp. 2224-2230
    • Gruson, D.1    Hilbert, G.2    Valentino, R.3    Vargas, F.4    Chene, G.5    Bebear, C.6
  • 12
    • 33846134704 scopus 로고    scopus 로고
    • Bronchoscopic diagnosis of pulmonary infiltrates in granulocytopenic patients with hematologic malignancies: BAL versus PSB and PBAL
    • 12 Boersma, W.G., Erjavec, Z., van der Werf, T.S., de Vries-Hosper, H.G., Gouw, A.S., Manson, W.L., Bronchoscopic diagnosis of pulmonary infiltrates in granulocytopenic patients with hematologic malignancies: BAL versus PSB and PBAL. Respir Med 101 (2007), 317–325.
    • (2007) Respir Med , vol.101 , pp. 317-325
    • Boersma, W.G.1    Erjavec, Z.2    van der Werf, T.S.3    de Vries-Hosper, H.G.4    Gouw, A.S.5    Manson, W.L.6
  • 13
    • 27644459478 scopus 로고    scopus 로고
    • Safety, diagnostic yield, and therapeutic implications of flexible bronchoscopy in patients with febrile neutropenia and pulmonary infiltrates
    • 13 Peikert, T., Rana, S., Edell, E.S., Safety, diagnostic yield, and therapeutic implications of flexible bronchoscopy in patients with febrile neutropenia and pulmonary infiltrates. Mayo Clin Proc 80 (2005), 1414–1420.
    • (2005) Mayo Clin Proc , vol.80 , pp. 1414-1420
    • Peikert, T.1    Rana, S.2    Edell, E.S.3
  • 14
    • 84861436036 scopus 로고    scopus 로고
    • Diagnostic yield of bronchoscopic sampling in febrile neutropenic patients with pulmonary infiltrate and haematological disorders
    • 14 Seneviratna, A., O'Carroll, M., Lewis, C.A., Milne, D., Diagnostic yield of bronchoscopic sampling in febrile neutropenic patients with pulmonary infiltrate and haematological disorders. Intern Med J 42 (2012), 536–541.
    • (2012) Intern Med J , vol.42 , pp. 536-541
    • Seneviratna, A.1    O'Carroll, M.2    Lewis, C.A.3    Milne, D.4
  • 15
    • 33646906228 scopus 로고    scopus 로고
    • The yield of broncho-alveolar lavage in the diagnosis of pulmonary involvement among immune-suppressed patients with hematological disorders
    • 15 Hardak, E., Oren, I., Dann, E.J., Solomonov, A., Keren, R., Sprecher, H., et al. The yield of broncho-alveolar lavage in the diagnosis of pulmonary involvement among immune-suppressed patients with hematological disorders. J Bronchology Interv Pulmonol 13 (2006), 61–66.
    • (2006) J Bronchology Interv Pulmonol , vol.13 , pp. 61-66
    • Hardak, E.1    Oren, I.2    Dann, E.J.3    Solomonov, A.4    Keren, R.5    Sprecher, H.6
  • 16
    • 41249085123 scopus 로고    scopus 로고
    • Diagnostic yield of bronchoscopy with bronchoalveolar lavage in febrile patients with hematologic malignancies and pulmonary infiltrates
    • 16 Hummel, M., Rudert, S., Hof, H., Hehlmann, R., Buchheidt, D., Diagnostic yield of bronchoscopy with bronchoalveolar lavage in febrile patients with hematologic malignancies and pulmonary infiltrates. Ann Hematol 87 (2008), 291–297.
    • (2008) Ann Hematol , vol.87 , pp. 291-297
    • Hummel, M.1    Rudert, S.2    Hof, H.3    Hehlmann, R.4    Buchheidt, D.5
  • 17
    • 77950627898 scopus 로고    scopus 로고
    • Utility of early versus late fiberoptic bronchoscopy in the evaluation of new pulmonary infiltrates following hematopoietic stem cell transplantation
    • 17 Shannon, V.R., Andersson, B.S., Lei, X., Champlin, R.E., Kontoyiannis, D.P., Utility of early versus late fiberoptic bronchoscopy in the evaluation of new pulmonary infiltrates following hematopoietic stem cell transplantation. Bone Marrow Transplant 45 (2010), 647–655.
    • (2010) Bone Marrow Transplant , vol.45 , pp. 647-655
    • Shannon, V.R.1    Andersson, B.S.2    Lei, X.3    Champlin, R.E.4    Kontoyiannis, D.P.5
  • 18
    • 47649129855 scopus 로고    scopus 로고
    • Is BAL useful in patients with acute myeloid leukemia admitted in ICU for severe respiratory complications?
    • 18 Rabbat, A., Chaoui, D., Lefebvre, A., Roche, N., Legrand, O., Lorut, C., et al. Is BAL useful in patients with acute myeloid leukemia admitted in ICU for severe respiratory complications?. Leukemia 22 (2008), 1361–1367.
    • (2008) Leukemia , vol.22 , pp. 1361-1367
    • Rabbat, A.1    Chaoui, D.2    Lefebvre, A.3    Roche, N.4    Legrand, O.5    Lorut, C.6
  • 20
    • 34347405489 scopus 로고    scopus 로고
    • A systematic literature review on the diagnosis of invasive aspergillosis using polymerase chain reaction (PCR) from bronchoalveolar lavage clinical samples
    • 20 Tuon, F.F., A systematic literature review on the diagnosis of invasive aspergillosis using polymerase chain reaction (PCR) from bronchoalveolar lavage clinical samples. Rev Iberoam Micol 24 (2007), 89–94.
    • (2007) Rev Iberoam Micol , vol.24 , pp. 89-94
    • Tuon, F.F.1
  • 21
    • 0035882177 scopus 로고    scopus 로고
    • Detection of Aspergillus species in blood and bronchoalveolar lavage samples from immunocompromised patients by means of 2-step polymerase chain reaction: clinical results
    • 21 Buchheidt, D., Baust, C., Skladny, H., Ritter, J., Suedhoff, T., Baldus, M., et al. Detection of Aspergillus species in blood and bronchoalveolar lavage samples from immunocompromised patients by means of 2-step polymerase chain reaction: clinical results. Clin Infect Dis 33 (2001), 428–435.
    • (2001) Clin Infect Dis , vol.33 , pp. 428-435
    • Buchheidt, D.1    Baust, C.2    Skladny, H.3    Ritter, J.4    Suedhoff, T.5    Baldus, M.6
  • 22
    • 0036203866 scopus 로고    scopus 로고
    • Diagnosis of invasive pulmonary aspergillosis using polymerase chain reaction-based detection of Aspergillus in BAL
    • 22 Raad, I., Hanna, H., Huaringa, A., Sumoza, D., Hachem, R., Albitar, M., Diagnosis of invasive pulmonary aspergillosis using polymerase chain reaction-based detection of Aspergillus in BAL. Chest 121 (2002), 1171–1176.
    • (2002) Chest , vol.121 , pp. 1171-1176
    • Raad, I.1    Hanna, H.2    Huaringa, A.3    Sumoza, D.4    Hachem, R.5    Albitar, M.6
  • 23
    • 10844247032 scopus 로고    scopus 로고
    • Aspergillus galactomannan enzyme immunoassay and quantitative PCR for diagnosis of invasive aspergillosis with bronchoalveolar lavage fluid
    • 23 Musher, B., Fredricks, D., Leisenring, W., Balajee, S.A., Smith, C., Marr, K.A., Aspergillus galactomannan enzyme immunoassay and quantitative PCR for diagnosis of invasive aspergillosis with bronchoalveolar lavage fluid. J Clin Microbiol 42 (2004), 5517–5522.
    • (2004) J Clin Microbiol , vol.42 , pp. 5517-5522
    • Musher, B.1    Fredricks, D.2    Leisenring, W.3    Balajee, S.A.4    Smith, C.5    Marr, K.A.6
  • 24
    • 46249126149 scopus 로고    scopus 로고
    • Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group
    • 24 De Pauw, B., Walsh, T.J., Donnelly, J.P., Stevens, D.A., Edwards, J.E., Calandra, T., et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46 (2008), 1813–1821.
    • (2008) Clin Infect Dis , vol.46 , pp. 1813-1821
    • De Pauw, B.1    Walsh, T.J.2    Donnelly, J.P.3    Stevens, D.A.4    Edwards, J.E.5    Calandra, T.6
  • 25
    • 70749134843 scopus 로고    scopus 로고
    • Impact of PCR-based diagnosis of invasive pulmonary aspergillosis on clinical outcome
    • 25 Hardak, E., Yigla, M., Avivi, I., Fruchter, O., Sprecher, H., Oren, I., Impact of PCR-based diagnosis of invasive pulmonary aspergillosis on clinical outcome. Bone Marrow Transplant 44 (2009), 595–599.
    • (2009) Bone Marrow Transplant , vol.44 , pp. 595-599
    • Hardak, E.1    Yigla, M.2    Avivi, I.3    Fruchter, O.4    Sprecher, H.5    Oren, I.6
  • 26
    • 84867533256 scopus 로고    scopus 로고
    • Diagnostic accuracy of PCR alone compared to galactomannan in bronchoalveolar lavage fluid for diagnosis of invasive pulmonary aspergillosis: a systematic review
    • 26 Avni, T., Levy, I., Sprecher, H., Yahav, D., Leibovici, L., Paul, M., Diagnostic accuracy of PCR alone compared to galactomannan in bronchoalveolar lavage fluid for diagnosis of invasive pulmonary aspergillosis: a systematic review. J Clin Microbiol 50 (2012), 3652–3658.
    • (2012) J Clin Microbiol , vol.50 , pp. 3652-3658
    • Avni, T.1    Levy, I.2    Sprecher, H.3    Yahav, D.4    Leibovici, L.5    Paul, M.6
  • 27
    • 0037090071 scopus 로고    scopus 로고
    • Definitions of cytomegalovirus infection and disease in transplant recipients
    • 27 Ljungman, P., Griffiths, P., Paya, C., Definitions of cytomegalovirus infection and disease in transplant recipients. Clin Infect Dis 34 (2002), 1094–1097.
    • (2002) Clin Infect Dis , vol.34 , pp. 1094-1097
    • Ljungman, P.1    Griffiths, P.2    Paya, C.3
  • 28
    • 80052259395 scopus 로고    scopus 로고
    • Polymerase chain reaction-based detection of Pneumocystis jirovecii in bronchoalveolar lavage fluid for the diagnosis of Pneumocystis pneumonia
    • 28 Oren, I., Hardak, E., Finkelstein, R., Yigla, M., Sprecher, H., Polymerase chain reaction-based detection of Pneumocystis jirovecii in bronchoalveolar lavage fluid for the diagnosis of Pneumocystis pneumonia. Am J Med Sci 342 (2011), 182–185.
    • (2011) Am J Med Sci , vol.342 , pp. 182-185
    • Oren, I.1    Hardak, E.2    Finkelstein, R.3    Yigla, M.4    Sprecher, H.5
  • 29
    • 0032728086 scopus 로고    scopus 로고
    • Specific detection of Aspergillus species in blood and bronchoalveolar lavage samples of immunocompromised patients by two-step PCR
    • 29 Skladny, H., Buchheidt, D., Baust, C., Krieg-Schneider, F., Seifarth, W., Leib-Mosch, C., et al. Specific detection of Aspergillus species in blood and bronchoalveolar lavage samples of immunocompromised patients by two-step PCR. J Clin Microbiol 37 (1999), 3865–3871.
    • (1999) J Clin Microbiol , vol.37 , pp. 3865-3871
    • Skladny, H.1    Buchheidt, D.2    Baust, C.3    Krieg-Schneider, F.4    Seifarth, W.5    Leib-Mosch, C.6
  • 30
    • 0033199387 scopus 로고    scopus 로고
    • Development of a PCR assay for diagnosis of Pneumocystis carinii pneumonia based on amplification of the multicopy major surface glycoprotein gene family
    • 30 Huang, S.N., Fischer, S.H., O'Shaughnessy, E., Gill, V.J., Masur, H., Kovacs, J.A., Development of a PCR assay for diagnosis of Pneumocystis carinii pneumonia based on amplification of the multicopy major surface glycoprotein gene family. Diagn Microbiol Infect Dis 35 (1999), 27–32.
    • (1999) Diagn Microbiol Infect Dis , vol.35 , pp. 27-32
    • Huang, S.N.1    Fischer, S.H.2    O'Shaughnessy, E.3    Gill, V.J.4    Masur, H.5    Kovacs, J.A.6
  • 31
    • 0034760526 scopus 로고    scopus 로고
    • Polymorphic internal transcribed spacer region 1 DNA sequences identify medically important yeasts
    • 31 Chen, Y.C., Eisner, J.D., Kattar, M.M., Rassoulian-Barrett, S.L., Lafe, K., Bui, U., et al. Polymorphic internal transcribed spacer region 1 DNA sequences identify medically important yeasts. J Clin Microbiol 39 (2001), 4042–4051.
    • (2001) J Clin Microbiol , vol.39 , pp. 4042-4051
    • Chen, Y.C.1    Eisner, J.D.2    Kattar, M.M.3    Rassoulian-Barrett, S.L.4    Lafe, K.5    Bui, U.6
  • 32
    • 0034059271 scopus 로고    scopus 로고
    • Detection of Legionella species in respiratory specimens using PCR with sequencing confirmation
    • 32 Cloud, J.L., Carroll, K.C., Pixton, P., Erali, M., Hillyard, D.R., Detection of Legionella species in respiratory specimens using PCR with sequencing confirmation. J Clin Microbiol 38 (2000), 1709–1712.
    • (2000) J Clin Microbiol , vol.38 , pp. 1709-1712
    • Cloud, J.L.1    Carroll, K.C.2    Pixton, P.3    Erali, M.4    Hillyard, D.R.5
  • 33
    • 84881526953 scopus 로고    scopus 로고
    • British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE
    • 33 Du Rand, I.A., Blaikley, J., Booton, R., Chaudhuri, N., Gupta, V., Khalid, S., et al. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax 68:Suppl 1 (2013), i1–i44.
    • (2013) Thorax , vol.68 , pp. i1-i44
    • Du Rand, I.A.1    Blaikley, J.2    Booton, R.3    Chaudhuri, N.4    Gupta, V.5    Khalid, S.6
  • 34
    • 80053184403 scopus 로고    scopus 로고
    • The clinical microbiology laboratory in the diagnosis of lower respiratory tract infections
    • 34 Campbell, S., Forbes, B.A., The clinical microbiology laboratory in the diagnosis of lower respiratory tract infections. J Clin Microbiol 49 (2011), S30–S33.
    • (2011) J Clin Microbiol , vol.49 , pp. S30-S33
    • Campbell, S.1    Forbes, B.A.2
  • 35
    • 84922241121 scopus 로고    scopus 로고
    • Diagnosis and antimicrobial therapy of lung infiltrates in febrile neutropenic patients (allogeneic SCT excluded): updated guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)
    • 35 Maschmeyer, G., Carratala, J., Buchheidt, D., Hamprecht, A., Heussel, C.P., Kahl, C., et al. Diagnosis and antimicrobial therapy of lung infiltrates in febrile neutropenic patients (allogeneic SCT excluded): updated guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Oncol 26 (2015), 21–33.
    • (2015) Ann Oncol , vol.26 , pp. 21-33
    • Maschmeyer, G.1    Carratala, J.2    Buchheidt, D.3    Hamprecht, A.4    Heussel, C.P.5    Kahl, C.6
  • 37
    • 80051866197 scopus 로고    scopus 로고
    • Bronchoscopy with bronchoalveolar lavage: determinants of yield and impact on management in immunosuppressed patients
    • 37 Kottmann, R.M., Kelly, J., Lyda, E., Gurell, M., Stalica, J., Ormsby, W., et al. Bronchoscopy with bronchoalveolar lavage: determinants of yield and impact on management in immunosuppressed patients. Thorax, 66, 2011, 823.
    • (2011) Thorax , vol.66 , pp. 823
    • Kottmann, R.M.1    Kelly, J.2    Lyda, E.3    Gurell, M.4    Stalica, J.5    Ormsby, W.6
  • 38
    • 84880569181 scopus 로고    scopus 로고
    • Association of bronchoalveolar lavage yield with chest computed tomography findings and symptoms in immunocompromised patients
    • 38 Brownback, K.R., Simpson, S.Q., Association of bronchoalveolar lavage yield with chest computed tomography findings and symptoms in immunocompromised patients. Ann Thorac Med 8 (2013), 153–159.
    • (2013) Ann Thorac Med , vol.8 , pp. 153-159
    • Brownback, K.R.1    Simpson, S.Q.2
  • 39
    • 83455250642 scopus 로고    scopus 로고
    • The increased risk for Pneumocystis pneumonia in patients receiving rituximab-CHOP-14 can be prevented by the administration of trimethoprim/sulfamethoxazole: a single-center experience
    • 39 Hardak, E., Oren, I., Dann, E.J., Yigla, M., Faibish, T., Rowe, J.M., et al. The increased risk for Pneumocystis pneumonia in patients receiving rituximab-CHOP-14 can be prevented by the administration of trimethoprim/sulfamethoxazole: a single-center experience. Acta Haematol 127 (2012), 110–114.
    • (2012) Acta Haematol , vol.127 , pp. 110-114
    • Hardak, E.1    Oren, I.2    Dann, E.J.3    Yigla, M.4    Faibish, T.5    Rowe, J.M.6


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