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PPPs now manage three-quarters 47 ; of all identified neglected disease drug development projects. Nearly one-third of these projects 13 ; are at the clinical trial stage, including six drugs now in Phase III trials. A further two products are in the registration stage rectal artesunate by WHO TDR, and paromomycin by iOWH ; . Based on standard attrition rates, this combined portfolio would be expected to yield six to seven new neglected disease drugs within five years. Association between posttreatment PSA doubling time PSA-DT ; and prostate cancerspecific mortality in 8, 669 patients treated with surgery or radiotherapy and found a significant association with disease-specific and overall survival. Men with a posttreatment PSA-DT of up to 3 months were particularly likely to develop distant metastasis and die of prostate cancer. The authors propose that post-treatment PSADT may be an acceptable surrogate end point for prostate cancer-specific mortality in future clinical trial designs D'Amico AV, Moul JW, Carroll PR, et al: J Natl Cancer Inst 95: 1376-1383, 2003, for instance, ketoconazole drug interactions. I would not say that the future is necessarily less predictable than the past. I think the past was not predictable when it started.

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CROFT et al: DRUG DEVELOPMENT 62. Franck X, Fournet A, Prina E, Mahieux R, Hocquemiller R, Figadere B. Biological evaluation of substituted quinolines. Bioorg Med Chem Lett 2004; 14 : 3635-8. 63. Chakrabarti G, Basu A, Manna PP, Mahato SB, Mandal NB, Bandyopadhyay S. Indolylquinoline derivatives are cytotoxic to Leishmania donovani promastigotes and amastigotes in vitro and are effective in treating murine visceral leishmaniasis. J Antimicrob Chemother 1999; 43 : 359-66. 64. Navin TR, Arana BA, Arana FE, Berman JD, Chajon JF. Placebo-controlled clinical trial of sodium stibogluconate Pentostam ; versus ketoconazole for treating cutaneous leishmaniasis in Guatemala. J Infect Dis 1992; 165 : 528-34. 65. Al-Abdely HM, Graybill JR, Loebenberg D, Melby PC. Efficacy of the triazole SCH 56592 against Leishmania amazonensis and Leishmania donovani in experimental murine cutaneous and visceral leishmaniases. Antimicrob Agents Chemother 1999; 43 : 2910-4. 66. Rodriguez N, Bailey BN, Martin MB, Oldfield E, Urbina JA, Docampo R. Radical cure of experimental cutaneous leishmaniasis by the bisphosphonate pamidronate. J Infect Dis 2002; 186 : 138-40. 67. Yardley V, Khan AA, Martin MB, Slifer TR, Araujo FG, Moreno SN, et al. In vivo activities of farnesyl pyrophosphate synthase inhibitors against Leishmania donovani and Toxoplasma gondii. Antimicrob Agents Chemother 2002; 46 : 929-31. 68. Nwaka S, Ridley RG. Virtual drug discovery and development for neglected diseases through public-private partnerships. Nat Rev Drug Discov 2003; 2 : 919-28. 69. Croft SL. In vitro screens in the experimental chemotherapy of leishmaniasis and trypanosomiasis. Parasitol Today 1986; 2 : 64-9. 70. Neal RA. Leishmania major: culture media, mouse strains, and promastigote virulence and infectivity. Exp Parasitol 1984; 57 : 269-73. 71. Carrio J, de Colmenares M, Riera C, Gallego M, Arboix M, Portus M. Leishmania infantum: stage-specific activity of pentavalent antimony related with the assay conditions. Exp Parasitol 2000; 95 : 209-14. 72. Agnew P, Holzmuller P, Michalakis Y, Sereno D, Lemesre JL, Renaud F. In vitro growth of Leishmania amazonensis promastigotes resistant to pentamidine is.

Inhibitors J Steroid Pont A, Stevens Med. Rajfer human of steroidogenesis Biochem. PL, DA. l986; 24: 32l. Loose DS, blocks F, Handelsman by 198. J, Brugmand on androgen J, De Coster biosynthesis Invest. and rat. J R. in 193-1 dose effects Feldman adrenal DJ. oral D, steroid Reitz RE, Bochra Ann C, Intern of EndoUeda of UlIrich combe and Vickery JW, J Endocrinol production of the adult lated 236. effects of ketoconazole androgen dependent on testosterone tissues Vickery Orally and BH, Bums J, sperm synthesis. on cytochrone P-450-catalyzed reactions. Trachtenberg treatment AK, J, Franco Halpern and lamisil. The discoverer of Exosurf, Dr. Clements, and the scientists who helped to develop Exosurf at Glaxo Wellcome Inc., were honored with the 1996 Discoverers Award. Exosurf, a therapy for infant respiratory distress syndrome, has helped save the lives of thousands of babies in this country and abroad. The impact of Exosurf and, later, other surfactant substitutes can be best shown in the startling decline of United States infant mortality after the introduction of Exosurf. Between 1988 and 1993, this country's infant mortality rate dropped by 16 percent, a remarkable figure for so short a time. Dr. Clements is a professor at the University of California San Francisco medical school who had devoted much of his career to research on the physiology of respiration. After contributing to the discovery of the role of surfactant in lung function, Dr. Clements designed a synthetic surfactant, the present Exosurf. Burroughs Wellcome, before the merger, licensed the discovery from UCSF and developed the drug. Many Wellcome scientists assisted in resolving problems of quantity product of the surfactant, as well as pre-clinical studies and clinical trials necessary to obtain approval from the Food and Drug Administration. The Exosurf story is an excellent example of the value and power of academic industry collaboration.

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Potential Savings for those who do not enroll in Medicare Part D Plan For comparison, we then looked up the retail prices for these drugs at drugstore ; to calculate the potential savings from switching to a Consumer Reports Best Buy Drug without enrolling in a Medicare Part D plan. Table 5 summarizes our findings. Potential annual savings available to consumers merely by switching from the high priced drug to the Best Buy drug alternative range from $348 to $1, 908. A person who was taking drugs in each of these categories, and switched from the high priced drug to the Best Buy drug, would save $4, 680 in a year and levofloxacin.

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Drugs contraindicated for concurrent use: Astemizole, terfenadine, flecainide, propafenone, rifampin, simvastatin, lovastatin, midazolam, triazolam, cisapride, pimozide, ergot derivatives, and St. John's wort Drugs that require a modified dose Rifabutin: Cmin increased 3-fold; reduce rifabutin dose to 150 mg qod with standard LPV dose. Methadone: AUC decreased by 53%; monitor for withdrawal. Atorvastatin: AUC increased by 6x; use with caution or use alternative, such as pravastatin. Pravastatin: Levels increased 33%; no dose adjustment. Ketoconazole: Levels increased ketoconazole 200 mg day. by 3x; do not exceed and lexapro.

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Interactions with other medicinal products and other forms of interaction Known Interactions Nifedipine should not be taken with grapefruit juice because bioavailability is increased. Cimetidine may potentiate the antihypertensive effect of nifedipine tablets if it is administered simultaneously. It is reported that serum quinidine levels have been reduced when it is used in combination with nifedipine, irrespective of the quinidine dose taken. The administration of nifedipine and digoxin concurrently may lead to reduced digoxin clearance and therefore, bring about an increase in the plasma digoxin level. Close monitoring of plasma digoxin levels should take place and, if necessary, a reduction in the dosage of digoxin. Phenytoin induces the cytochrome P450 3A4 system. When nifedipine is co-administered with phenytoin, nifedipine's bioavailability is reduced and consequently, its efficacy is weakened. In such cases, the clinical response to nifedipine should be monitored following concomitant administration and, if necessary, consideration should be given to increasing the nifedipine dose. If the nifedipine dose is increased during the co-administration of both drugs, consideration should be given to reducing the nifedipine dose when phenytoin therapy is discontinued. Diltiazem decreases the clearance of nifedipine and hence increases plasma nifedipine levels. Caution should be exercised when both drugs are given simultaneously. A reduction of nifedipine dose may be required when the two are used together. Nifedipine may falsely increase the spectrophotometric values of urinary vanillylmandelic acid. HPLC measurements are not affected. Nifedipine should not be administered concomitantly with rifampicin, as effective plasma levels of nifedipine may not be achieved as a result of enzyme induction. Simultaneous administration of cisapride and nifedipine or quinupristin dalfopristin and nifedipine may lead to increased plasma concentration of nifedipine. Hence, the blood pressure may need to be monitored and a reduction in the nifedipine dose may be necessary. Nifedipine enhances the effect of non-polarising muscle relaxants. Theoretical Interactions Nifedipine is metabolised via the cytochrome P450 3A4 system. Therefore, there are theoretical interactions with drugs such as erythromycin, ketoconazole, itraconazole, fluconazole, fluoxetine, indinavir, nelfinavir, ritonavir and saquinavir that are known to inhibit this enzyme system. Although no in vivo interaction studies with these drugs have been carried out, their coadministration with nifedipine in vitro, have shown increases in nifedipine plasma concentrations. Therefore, the blood pressure should be monitored and, if necessary, a reduction in the nifedipine dose should be considered. Similarly, the potential interaction between nifedipine and nefazodone has not been clinically investigated. Nefazodone is known to inhibit the cytochrome P450 3A4 mediated metabolism of other drugs and therefore, co-administration with nifedipine may increase the plasma concentrations of nifedipine. Again, monitoring of the blood pressure is advised when both drugs are simultaneously administrated with, if necessary, a reduction in the nifedipine dose. Tacrolimus is metabolised via the cytochrome P450 3A4 system. Upon co-administration with nifedipine, the plasma levels of tacrolimus should be monitored and, if necessary, consideration should be given to reducing the tacrolimus dose. Carbamazepine, phenobarbital or valproic acid have been shown to alter the plasma levels of a structurally similar calcium channel blocker, however, no interactive studies have been carried out with these drugs and nifedipine. A decrease with carbamazepine or phenobarbital ; or an and loratadine. Under no circumstances whatsoever should anyone donate blood for the purpose of seeking a hepatitis test at a blood center or any other blood collection agency. Individuals who cannot afford a blood test should be referred to local public health authorities, for example, ketoconazole cream used for.
The fact that glomemlonephritis can be produced by complexes prepared from chicken antibody raises the question as to whether complement is involved in the pathogenesis of the lesions 24 ; . Chicken antibody is generally believed to be unable to fix mammalian complement. However, the observations on hemolysis with chicken antibody and mouse complement indicate that chicken antibody can in fact bind and activate mouse complement, although very inefficiently. This conclusion is supported by observations concerning the ability of chicken antibody and mouse complement to opsonize bacteria 25 ; . Therefore, it is not possible to exclude completely the participation of complement in the pathogenesis of the lesions, although on the basis of the small amount fixed, it would not appear to play an important role in the production of this kind of tissue damage. The administration of cortisone diminished the severity of the glomerulonephritis produced by intravenously administered soluble antigen-antibody complexes. However, in these animals, glomerular capillary loops were often filled with amorphous, eosinophilic material which was shown to contain both antigen and antibody by the fluorescent antibody technique 15 ; . This material may also contain fibrin. In view of the minimal inflammatory reaction within glomeruli, the presence of large amounts of this material may be due to the paucity of neutrophiles, which have been shown to phagocytize and metabolize antigen and antibody in the Arthus reaction 26 ; . Furthermore, it has been shown that cortisone inhibits regeneration of the RES following blockade 27 ; . In this way blockade produced by the initial injection of antigen-antibody complexes could persist and favor the deposition in glomeruli of material subsequently injected. It is possible that the deposition of the eosinophilic material in glomeruli in these mice may occur as a result of mechanisms analogous to those operating in the generalized Shwartzman reaction. In this situation also, eosinophilic material accumulates in glomeruli and animals may be prepared for this reaction by pretreatment with cortisone 28 and macrodantin.

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Based on this report, the use of ketocinazole in methadone maintained patients who are unstable on higher doses of methadone cannot be generally recommended, due to the potential hepatotoxicity of the drug.
A comparison of 1% ketoconazole, 1% piroctone olamine and 1% zinc pyrithione formulations and miconazole. For patients with a disease or injury recorded as a principal diagnosis see Boxes 7.5 and 7.6 ; , over half of all separations in Australian hospitals in 200304 had a principal diagnosis in five of the broad ICD-10-AM chapter groups. These were Diseases of the digestive system, Neoplasms, Diseases of the circulatory system, Injury and poisoning and Contact with health services including dialysis, chemotherapy and rehabilitation ; Tables S28 and S29 ; . Chronic diseases see Chapter 2 ; were represented in some high-volume diagnoses in 200304. There were around 64, 000 separations with a principal diagnosis of Asthma and chronic obstructive pulmonary disease, 76, 000 for Rheumatoid arthritis and osteoarthritis, and 42, 000 for Heart failure Figure 7.5 ; . Also of high volume was childbirth: there were. Patents Office Journal precious metal or coated therewith combs and sponges; brushes except paint brushes brush-making materials; articles for cleaning purposes; unworked or semi-worked glass except glass used in building glassware, porcelain and earthenware included in this class ; . Textiles and textile goods included in this class bed and table covers; curtains of textile or plastic and mirtazapine.

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Ettinger, S. J. and Feldmen, E.C. 2000 ; . Disease of the ear. In: Textbook of Veterinary Internal Medicine. 5th Edn. Vol. II W. B. Saunders Philadelphia. pp: 993. Fachini, B. and Del, C. 1981 ; . Microorganisms isolated from dogs with otitis and their sensitivity to antibiotics. Canine Gaceta Veterinaria. 43: 658664. Farca, A.M., PiromalliMaffei, F.G. and Re, G. 1997 ; . Potentiating effect of EDTA-Tris on the activity of antibiotics against resistant bacteria associated with otitis, dermatitis and cystitis. J. Small Anim. Prac. 38: 243-245. Finger, S.A.; Velapatino, B.; Kosek, M.; Santivanez, L.; Dailidiene, D.; Quino, W.; Balqui, J.; Herrera, P.; Berg, D.E. and Gilman, R.H. 2006 ; . Effectiveness of enterobacterial repetitive intergenic consensus PCR and random amplified polymorphic DNA fingerprinting for Helicobacter pylori strain differentiation. Appl Environ Microbiol. 72 7 ; : 4713-4716. Feijo, F.M.C.; Souza, N.F and Ramadinha, R.H.R. 1998 ; . A study of the yeast Malassezia pachydermatis by examination of skin cytology in the dog. Revista Brasileira de Medicina Veterinaire. 20 2 ; : 66-68. Frank, M.; Gragery, G.; Mangal, J.P.; Porchies, P. and Ducos, K. 1981 ; . Neoplasm of the external acoustic meatus of dogs and cats. Cited in Vet. Bull. 1982 ; , 52: 2547. Franz, N. 2001 ; . Efficacy and safety of Otomax Reg. for the treatment of otitis externa in dogs. Tierarztliche Umschau. 56 3 ; : 141-145. Fraser, G. 1961 ; . Factors predisposing to canine external otitis. Vet. Rec. 73: 55. Fraser, G.; Withers, A. R. and Spruell, J. S. A. 1970 ; . Otitis externa in dog. J. Small. Anim Pract. 2: 32-47. Fresure, G.; Gregor, W.W.; Mackensif, C.P. and Spreull, J.S.A. 1970 ; . Microbiology of otitis externa. J. Small. Anim. Pract. 10: 735. Gabal, A.M. 1986 ; . Antifungal activity of ketoc0nazole with emphasis on zoophilic fungal pathogens. Am. J. Vet. Res. 47 6 ; : 1229-1234. Gaitanis, G.; Velagraki, A.; Frangoulis, E.; Mitroussia, A. Tsigonia, A.; Tzimogianni, A.; Katsambas, A. and Legakis, N. J. 2002 ; . Identification of Malassezia species from patient skin scales by PCRRFLP. Clin. Microbiol. Infect. 8: 162-173. Ganesh, T.N.; Thilager, S.; Balasubramanian, N.N. and Rao, V.N.A. 1988 ; . Study on microbial etiology of otitis externa in dogs. Cheiron.17: 8284. Gedek, B.; Brutzel, K.; Gerlack, R.; Netzer, F.; Rocken, H.; Unger, H. and Symoens, J. 1979 ; . The role of Pityrosporum pachydermatis in otitis.

Duced chemokine and regulated upon activation, normal T-cell expressed and secreted RANTES ; .38 Similarly, fexofenadine has been shown to inhibit the tumor necrosis factor induced release of IL-8, in the late-phase allergic response, as well as basal ICAM-1 expression on epithelial cells and histamine-mediated induction of IL-6 and -glucuronidase, a marker of exocytosis.40, 50, 51 Cetirizine also has shown anti-inflammatory effects and inhibition of interferon gammainduced expression of membrane ICAM-1 in cultured keratinocytes.36 SAFETY: UNDESIRABLE PHARMACOLOGICAL AND CLINICAL EFFECTS DRUG INTERACTIONS The ability of a drug to work with the intended effector systems may be compromised by its interactions at sites other than the targeted receptors, thereby affecting its bioavailability. Therefore, differences can exist among antihistamines because of variations in their metabolic profiles. For example, the second-generation antihistamines astemizole and terfenadine, which are no longer available in the United States, and loratadine are substrates of the hepatic cytochrome P-450 isoenzymes, a group of enzymes found in the liver and small intestine. Consequently, they are susceptible to interactions with other drugs that are metabolized by this system, such as kstoconazole and erythromycin, which can increase the plasma concentrations of these antihistamines.21, 48 In contrast, fexofenadine, cetirizine, and desloratadine do not undergo cytochrome P-450 metabolism and therefore do not pose a risk in terms of this mechanism. However, other mechanisms, such as the potential for interaction with the efflux and uptake transporters P-glycoprotein and organic anion transporting peptide, also have been investigated. Various drugs, such as ketoconazole, and foodstuffs, such as grapefruit juice, interact with these proteins and modify the absorption and elimination of many antihistamines, including fexofenadine and deslor1172 Mayo Clin Proc and monistat and ketoconazole. Small amounts of an adrenergic drug, such as epinephrine, may also help. 16. Bedrest with head of bed 30-45 Bedrest with bathroom privileges Up with assist 17. Thigh high support hose Pneumatic thigh highs Lovenox 40mg subc daily start 18. Respiratory Care Consult Rehabilitation Medicine consult and nabumetone.
Two separate in vitro systems were used to measure the interaction of nortriptyline with three human with CYP isoforms CYP2C19, CYP2D6 and CYP3A4 Bactosomes, Cypex ; . System 1: Nortriptyline was incubated in 96 well plates with separate CYP isoforms in the presence of 1: CYP an NADPH regenerating system. CYP activity was monitored using the following fluorogenic substrates: the CYP2C19 CEC; CYP2D6 AMMC; CYP3A4 - BFC. IC50 values were calculated and compared to those of control inhibitors CYP2C19 Tranycylpromine; CYP2D6 Quinidine; CYP3A4 - Ketocobazole ; . System 2: Nortriptyline was incubated in 96 well plates with a mixture of CYP isoforms in the presence of 2: of NADPH. CYP activity was monitored using the following substrates as an in vitro cocktail: CYP2C19 Mephenytoin: CYP2D6 Bufuralol: CYP3A4 - Midazolam; using LC MS MS detection as previously reported 3 ; . IC50 values were calculated and compared to those of control inhibitors as above ; . inhibitors.
ABSTRACT The constitutive androstane receptor CAR ; and the pregnane X receptor PXR ; play a major part in the control of drug metabolism and transport. We have previously shown that PXR and CAR expression is controlled by the glucocorticoid receptor GR ; and proposed the existence of a signal transmission cascade GR- PXR CAR ; -drug metabolizing and transporter systems. In the current study, we investigated the effect of ketoconazole and other azole-derived drugs, miconazole and fluconazole, on the transcriptional activity of the human GR hGR ; in HeLa and HepG2 cells, and in primary human hepatocytes. The data show that ketoconazole inhibits GR transcriptional activity and competes with dexamethasone for hGR binding. In primary human hepatocytes, ketoconazole inhibits the expression of 1 ; GR-responsive genes tyrosine aminotransferase and both PXR and CAR; 2 ; CAR and PXR target genes.

Cimetidine: Administration of multiple daily doses of cimetidine 400 mg tid for 4 days ; resulted in a 20% decrease in the mean oral clearance of quetiapine 150 mg tid ; . Dosage adjustment for quetiapine is not required when it is given with cimetidine. P450 3A Inhibitors: Coadministration of ketoconazole 200 mg once daily for 4 days ; , a potent inhibitor of cytochrome P450 3A, reduced oral clearance of quetiapine by 84%, resulting in a 335% increase in maximum plasma concentration of quetiapine. Caution is indicated when SEROQUEL is administered with ketoconazole and other inhibitors of cytochrome P450 3A e.g., itraconazole, fluconazole, and erythromycin ; . Fluoxetine, Imipramine, Haloperidol, and Risperidone: Coadministration of fluoxetine 60 mg once daily imipramine 75 mg bid ; , haloperidol 7.5 mg bid ; , or risperidone 3 mg bid ; with quetiapine 300 mg bid ; did not alter the steady-state pharmacokinetics of quetiapine. The last miracle weight-loss drug embraced by consumers was fen-phen, because ketoconazole topical cream. Discontinued minocycline administration; fluconazole 40 mg mL ; 2.5 mL daily for 2 wk; 2% ketoconazole shampoo 3 times per week as needed Ketoconazolle 200 mg PO daily for 2 wk; 2% ketoconazole shampoo 2-3 per week; 0.04% tretinoin microgel daily; 4% benzoyl peroxide wash daily Discontinued minocycline administration; ketoconazole 200 mg PO daily for 3 wk; 2% ketoconazole shampoo daily; 0.4% tretinoin microgel at bedtime; 1% clindamycin lotion daily; 2.5% benzoyl peroxide wash daily and lamisil. The Medical Letter and Treatment Guidelines are available in a searchable format either by IP authentication or secure password login. For a free trial go to: : medicalletter html institutions or contact Gene Carbona at: 800-211-2769 x315 or gene medicalletter.
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Discussion The absorption of balicatib is rapid. A major metabolite, AEE325, is formed quickly, probably during absorption. The elimination appears to be formation-rate limited. The between subject variability in clearance was 12.2%. This estimate was not appreciably changed by inclusion of covariates. Approximately 13% of balicatib clearance is attributable to renal elimination when the predicted creatinine clearance is 6L h 70kg. An unexpected finding was a decrease in peripheral compartment volume of distribution for balicatib with increasing dose. The effect of ketoconazole treatment on bioavailability of AAE581 was more on bioavailability than effect on clearance. This is in line with ketoconazole inhibition of CYP3A4 in the gut wall as well as in the liver. Conclusions The PK model describes both the central shape and the variability in time course of balicatib and a major metabolite after the first dose and over 12 weeks of treatment. The main covariates identified by NONMEM which predict between subject differences are weight and dose volume of distribution ; , weight and renal function clearance ; and ketoconazole bioavailability. Amorolfine HCl Nail Laquer Kit 5% 5ml Amorolfine HCl Crm 0.25% Loceryl Nail Laquer Kit 5% 5ml Benzoic Acid Co Oint Clotrimazole Soln 1% Clotrimazole Crm 1% Clotrimazole Pdr 1% Canesten Crm 1% Canesten Soln 1% Canesten AF Crm 1% Econazole Nit Crm 1% Ecostatin Crm 1% Ketocoonazole Crm 2% Nizoral Crm 2% Daktarin Gold Crm 2% Miconazole Nit Crm 2% Miconazole Nit Dust Pdr 2% Daktarin Crm 2% Daktarin Dual Action Pdr 2% Daktarin Dual Action Pdr Spy 0.16% 100g Tioconazole Nail Soln 28.3% Trosyl Nail Soln 28.3% + Applic Nystatin Crm 100, 000u g Nystaform Crm Tinaderm M Crm Exelderm Crm Mycil Oint Monphytol Paint + Brush Aciclovir Crm 5% Zovirax Crm 5% Zovirax Cold Sore Crm 5% Soothelip Cold Sore Crm 5% Virasorb Cold Sore Crm 5% Herpid Soln 5% Penciclovir Crm 1% Alverine Cit Cap 60mg.

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