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1. Hyperemesis Gravidarum/ Pernicious Vomiting Definition: Excessive nausea and vomiting during pregnancy, extending beyond week 12 or causing dehydration, ketonuria, and significant weight loss within the first 12 weeks. Incidence: 1 in 200-300 women Cause: Unknown, but may be associated with increased thyroid function and Helicobacter pylori infection. Signs and Symptoms: • Decreased urine output • Weight loss • Ketonuria • Dry mucous membranes • Poor skin turgor • Elevated hematocrit • Decreased sodium, potassium, and chloride levels • Polyneuritis (in some cases) Assessment: • Hemoglobin: Elevated hematocrit concentration (hemoconcentration) due to inability to retain fluids. • Electrolytes: Decreased sodium, potassium, and chloride levels due to low intake. • Acid-base Balance: Hypokalemic alkalosis (severe vomiting, prolonged period). • Neurological Examination: Polyneuritis due to B vitamin deficiency. Effects (if left untreated): • Intrauterine Growth Restriction (IUGR): Dehydration and inability to provide nutrients for fetal growth. • Preterm birth: Due to complications caused by the condition. • Prolonged hospitalization/home care: Resulting in social isolation. Therapeutic Management: • Fluid and Electrolyte Management: Monitor input and output, blood chemistry to prevent dehydration. • Nutritional Support: Withhold oral food and fluids (usually) and administer total parenteral nutrition (TPN). • Intravenous Fluid Replacement: 3000 ml Ringer's lactate with added vitamin B to increase hydration. • Antiemetic Medication: Metoclopramide (Reglan) to control vomiting. 2. Ectopic Pregnancy Definition: Implantation of a fertilized egg outside the uterine cavity (ovary, cervix, fallopian tube - most common). Incidence: Second most frequent cause of bleeding during the first trimester. Causes: • Obstruction of the fallopian tube: ◦ Adhesions (from previous infection like chronic salpingitis or pelvic inflammatory disease). ◦ Congenital malformations. ◦ Scars from tubal surgery. ◦ Uterine tumor pressing on the proximal end of the tube. ◦ Current use of an intrauterine device (IUD). Signs and Symptoms: • Missed period/amenorrhea. • Positive hCG test. • Sharp, stabbing pain in the lower abdominal quadrants and pelvic pain (at time of rupture). • Scant vaginal spotting/bleeding. • Rigid abdomen (from peritoneal irritation). • Leukocytosis (increased WBC count due to trauma). • Decreased blood pressure and increased pulse rate (signs of shock). • Cullen's sign (bluish tinge around the umbilicus). • Tender mass palpable in the cul-de-sac of Douglas (vaginal exam). • Falling hCG or serum progesterone level (suggesting the pregnancy has ended). • No gestational sac on ultrasound. Therapeutic Management: • Non-ruptured Ectopic Pregnancy: Oral administration of methotrexate followed by leucovorin. • Ruptured Ectopic Pregnancy (emergency): Laparoscopy to ligate bleeding vessels and remove or repair the damaged fallopian tube. 3. Hydatidiform Mole (H-mole)/ Gestational Trophoblastic Disease/ Molar Pregnancy Definition: A gestational anomaly of the placenta consisting of a bunch of clear vesicles resembling grapes. This neoplasm is formed from the swelling of the chorionic villi, resulting from a fertilized egg whose nucleus is lost, and the sperm nucleus duplicates, producing a diploid number 46XX. Incidence: Approximately 1 in every 1500 pregnancies. Risk Factors: • Low socioeconomic group (decreased protein intake). • Women under 18 or over 35 years old. • Women of Asian heritage. • Receiving clomiphene citrate (Clomid) for induced ovulation. Types of Molar Growth: • Complete/Classic H-mole: All trophoblastic villi swell and become cystic. No embryonic or fetal tissue present. High risk for malignancy. • Partial/Incomplete H-mole: Some of the villi form normally. Presence of fetal or embryonic tissue. Low risk for malignancy. Signs and Symptoms: • Uterus expands faster than normal. • No fetal heart sounds heard. • Serum or urine test for hCG strongly positive. • Early signs of preeclampsia. • Vaginal bleeding (dark-brown spotting or profuse fresh flow). • Discharge of fluid-filled vesicles. Diagnosis: • Ultrasound. • Chest x-ray (lung metastasis). • Amniocentesis (no fluid). • Hysteroscopy (via cervix). Management: • Evacuation of the mole: Dilation and curettage (D&C). • Blood transfusion. • Hysterectomy (in some cases). • Monitoring hCG levels: Every 2 weeks until normal. • Contraception: Reliable method for 12 months to prevent confusion with a new pregnancy. 4. Premature Cervical Dilatation/ Incompetent Cervix Definition: Premature dilation of the cervix, usually occurring around week 20, when the fetus is too immature to survive. Incidence: About 1% of pregnancies. Causes: • Increased maternal age. • Congenital structural defects. • Trauma to the cervix (cone biopsy, repeated D&C). Signs and Symptoms: • Painless dilation of the cervix. • Pink-stained vaginal discharge. • Increased pelvic pressure. • Rupture of membranes and discharge of amniotic fluid. Therapeutic Management: • Cervical cerclage: Surgical procedure to prevent loss of the child due to premature dilation. • Bed rest: After cerclage surgery, to decrease pressure on the sutures. 5. Abortion Definition: Termination of pregnancy before the fetus is viable (400-500 grams or 20-24 weeks gestation). Types of Abortion: • Spontaneous Abortion: Pregnancy interruption due to natural causes. ◦ Threatened: Mild cramping, vaginal spotting. ◦ Inevitable/Imminent: Profuse bleeding, uterine contractions, cervical dilation. ◦ Complete: All products of conception expelled spontaneously. ◦ Incomplete: Part of the conceptus expelled, some retained in the uterus. ◦ Missed: Fetus dies in utero but is not expelled. ◦ Habitual: 3 or more consecutive spontaneous abortions. • Induced Abortion: Deliberate termination of pregnancy in a controlled setting. Complications of Abortion: • Hemorrhage. • Infection (endometritis, parametritis, peritonitis, thrombophlebitis, septicemia). Management: • Bed rest. • Emotional support. • Sedation. • D&C: Surgical removal of retained products of conception. • Antibiotics. • Blood transfusion. 6. Placenta Previa Definition: The placenta is implanted in the lower uterine segment, covering the cervical os, obstructing the birth canal. Incidence: 5 per 1000 pregnancies. Signs and Symptoms: • Abrupt, painless vaginal bleeding (bright red). • Bleeding may stop or slow after the initial hemorrhage, but continue as spotting. Types: • Total: Placenta completely obstructs the cervical os. • Partial: Placenta partially obstructs the cervical os. • Marginal: Placenta edge approaches the cervical os. • Low-lying: Placenta implanted in the lower rather than the upper portion of the uterus. Therapeutic Management: • Immediate Care: Bed rest in a side-lying position. • Assessment: Monitor vital signs, bleeding, and fetal heart sounds. • Intravenous Therapy: Fluid replacement with large gauge catheter. • Delivery: Vaginal birth (safe for infant if previa is less than 30%). Cesarean section (safest for both mother and infant if previa is over 30%). 7. Abruptio Placenta/ Premature Separation of Placenta/ Accidental Hemorrhage/ Placental Abruption Definition: Separation of a normally implanted placenta after the 20th week of pregnancy, before birth of the fetus. Incidence: Most frequent cause of perinatal death. Causes: • Unknown. • Predisposing Factors: ◦ High parity. ◦ Advanced maternal age. ◦ Short umbilical cord. ◦ Chronic hypertensive disease. ◦ PIH. ◦ Trauma (automobile accident, intimate partner abuse). ◦ Cocaine or cigarette use. ◦ Thrombophilitic conditions (autoimmune antibodies). Classification: • Total/Complete: Concealed hemorrhage. • Partial: Concealed or apparent hemorrhage. Signs and Symptoms: • Sharp, stabbing pain in the uterine fundus. • Contractions accompanied by pain. • Uterine tenderness on palpation. • Heavy vaginal bleeding (may be concealed). • Signs of shock. • Tense, rigid uterus. • Disseminated Intravascular Coagulation (DIC). Therapeutic Management: • Fluid Replacement: IV fluids. • Oxygen: Limit fetal hypoxia. • Fetal Monitoring: External fetal heart rate monitoring. • Fibrinogen Determination: IV fibrinogen or cryoprecipitate. • Lateral Position: Prevent pressure on the vena cava. • Delivery: CS is the method of choice if birth is not imminent. 8. Premature Rupture of Membranes Definition: Rupture of the fetal membranes with loss of amniotic fluid during pregnancy before 37 weeks. Incidence: 5%-10% of pregnancies. Causes: • Unknown. • Associated with: Infection of the membranes (chorioamnionitis), vaginal infections (gonorrhea, streptococcus B, Chlamydia). Signs and Symptoms: • Sudden gush of clear fluid from the vagina with continued minimal leakage. • Nitrazine paper test: Amniotic fluid turns the paper blue (alkaline), urine remains yellow (acidic). • Microscopic examination: Amniotic fluid shows ferning, urine does not. • Ultrasound: Assess amniotic fluid index. • Signs of infection (increased WBC count, C-reactive protein, temperature, tenderness, odorous vaginal discharge). Therapeutic Management: • Bed Rest: To prevent further leakage and risk of infection. • Corticosteroids: To hasten fetal lung maturity. • Prophylactic Antibiotics: To reduce risk of infection. • Intravenous Penicillin/Ampicillin: If (+) for streptococcus B. • Induction of Labor: If fetus is mature and labor does not begin within 24 hours. 9. Pregnancy-Induced Hypertension (PIH)/ Toxemia Definition: Vasospasm occurring in both small and large arteries during pregnancy, causing elevated blood pressure, proteinuria, and edema. Incidence: Rarely occurs before 20 weeks of pregnancy. Risk Factors: • Multiple pregnancy. • Primiparas younger than 20 or older than 40. • Low socioeconomic background. • Five or more pregnancies. • Hydramnios. • Underlying diseases (heart disease, diabetes). • Rh incompatibility. • History of H-mole. Categories: • Gestational Hypertension: Blood pressure 140/90 or greater, without proteinuria or edema. • Preeclampsia: Blood pressure 140/90 or greater, with proteinuria and edema. • Eclampsia: Seizures or coma accompanied by preeclampsia. Therapeutic Management: • Preeclampsia: Bed rest, balanced diet, left lateral position. • Severe Preeclampsia: Hospitalization, diazepam, hydralazine, magnesium sulfate. • Eclampsia: Magnesium sulfate, diazepam, oxygen therapy, left lateral position
Updated 63d ago
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Chapter 1introduction to medterm Word Parts Word Root Definition: The foundation of a medical term Purpose: It serves to provide a general meaning of the word. It illustrates the body part or system being discussed. Sometimes, a word root may be an action. Things to know: A medical term may have more than one word root. Example: Cardi - Word root for “heart” Medical Prefix Definition: A word part added to the beginning of a medical term to change its meaning. Purpose: Medical prefixes illustrate location (of an organ, mass, etc), number of parts, or time (frequency). Things to know: When written alone, medical prefixes are followed by a hyphen to indicate that they are medical prefixes. It is incorrect to write one without a hyphen after. There are 2 subcategories of medical prefixes. Medical prefixes may have more than one meaning. A medical term may only have one medical prefix. Example: anti- meaning “against”. This medical prefix explains location. Medical Suffix Definition: A word part added to the end of a medical term to add meaning. Purpose: Explains condition, disease, or procedure. Things to know: EVERY MEDICAL TERM MUST HAVE A MEDICAL SUFFIX. Oftentimes, a medical suffix is added and combined to a word root, but sometimes it can be added directly to a medical prefix. Similar to a medical prefix, a medical suffix must have a hyphen, but it is written at the beginning of the medical suffix. It is incorrect to write a medical suffix without a hyphen when it is by itself. Medical suffixes may have more than one meaning. Medical terms may only have one medical suffix. Example: -cyte, meaning cell. The medical term “dystrophy” is an example of a medical term with a prefix and suffix combined with each other. The medical prefix -trophy, means nourishment, development, and it explains condition. Combining Vowel Definition: A vowel added to a word to create its combining form or to connect word parts. Purpose: It helps with being able to pronounce the medical term easily. It connects word root to word root Things to know: Sometimes, when connecting a word root to a medical suffix, a combining vowel isn’t needed. To see whether or not a combining vowel is needed, determine if there is a consonant or vowel at the beginning of the medical suffix. If it begins with a consonant, use a combining vowel. If it begins with a vowel, do not use a combining vowel. When writing a word root by itself, it is usually written in its combining form. A combining form is a word root with a combining vowel. A COMBINING FORM IS NOT A WORD PART. A medical term may have more than one combining vowel. Example: Usually the vowel “o”, but occasionally an i or a. Combining form example: “cardi/o” or “cardio”. NO MEDICAL TERMS ARE WRITTEN WITH A “/” IN THEM. Medical Prefix Subcategories Common Prefixes Definition: They are the more common medical prefixes in medical terminology. Example: anti-, a common prefix that explains location Number Prefixes Definition: They pertain to the number of items, or measurement. Example: bi-, a number prefix that explains number of items Medical Suffix Categories Common Suffixes Definition: They are the more common medical suffixes in medical terminology. Example: -cyte, a common suffix Adjective Suffixes Definition: They are used to convert a word root into an adjective. Example: -ac, a adjective suffix that means, “pertaining to” Surgical Suffixes Definition: Indicates surgical procedure. Example: -centesis, a surgical suffix that means, “puncture to withdraw fluid” Procedural Suffixes Definition: Indicates procedural processes or instruments. Example: -gram, a procedural suffix that means, “record or picture” Interpreting Medical Terminology Step 1st… Divide the medical term into its word parts. Example: gastr/o/enter/o/logist 2nd… Define each word part. Example: gastr: word root for stomach o: combining vowel, no meaning enter: word root for small intestine o: combining vowel, no meaning logist: one who studies 3rd… Combine the meaning of the word parts.(You may have to slightly alter the order of the translation). Example: One who studies the stomach and the small intestine. *Spelling; sometimes there will be different pronunciations of a term, but they only have one correct spelling Chapter One Vocabulary Common Combining Forms Combining form Meaning Example w/ definition aden/o gland Adenorrhexis Rupture of gland carcin/o cancer Carcinogenesis Produces cancer cardi/o heart Cardiologist One who studies the heart chem/o chemical Chemotherapy Treatment with chemical cis/o To cut Incision Process of cutting into dermat/o skin Dermatologist One who studies the skin enter/o Small intestine Gastroenterology One who studies the stomach and small intestine gastr/o stomach Gastrorrhexis Rupture of the stomach gynec/o female Gynecology The study of females hemat/o blood Hematic Pertaining to the blood hydr/o water Hydrocele Protrusion of water In the scrotum immun/o protection Immunology Study of protection laryng/o Voice box Otorhinolaryngologist One who studies the ears, nose, and voice box nephr/o kidney Nephritis Inflammation of the kidney ophthalm/o eye Ophthalmology The study of the eye ot/o ear Otic Pertaining to the ear path/o disease Pathology The study of disease pulmon/o lung Pulmonary Pertaining to the lungs rhin/o nose Rhinoplasty Surgical repair of the nose osteo bone Osteoporosis Porous bone Common Prefixes a- Without, away from Aphasia Without speech an- without Anorexic Without appetite ante- Before, in front of Antepartum Before birth anti- Against Antibiotic Against life auto- self Autoimmune Self protection brady- slow Bradycardia Slow heartbeat contra- against Contraception Against conception de- without depigmentation without pigment dys- Painful, difficult, abnormal dystrophy abnormal nourishment endo- Within, inner endoscope instrument to view within epi- Upon, over epigastric upon or over the stomach eso- inward esotropia inward turning eu- Normal, good eupnea normal breathing ex- External, outward exostosis condition of external bone exo- outward exotropia outward turning extra- Outside of extracorporeal outside of the body hetero- different heterosexual pertaining to a different sex homo- same homosexual pertaining to the same sex hydro- water hydrotherapy treatment with water hyper- Over, above hypertrophy over development hypo- Under, below Hypodermic under the skin in- Not; inward infertility not fertile inter- Between, among intervertebral between the vertebrae intra- Within, inside intravenous inside of a vein macro- large macromolecule large molecule micro- small microtia small ears myo- To shut myopia to shut eyes, squint neo- neo neonatal newborn pan- all pansinusitis inflammation of all sinuses para- Beside, near, abnormal; two like parts of a pair paranasal beside the nose per- through percutaneous through the skin peri- around pericardial around the heart post- after postpartum after birth pre- before preoperative before a surgical operation pro- Before, in front of prolactin before milk pseudo- false pseudoscience false science retro- Backward, behind retroperitoneal behind the peritoneum sub- Below, under subcutaneous under, below the skin supra- above suprapubic above the public bone tachy- Rapid, fast tachycardia fast heartbeat trans- Through, across transurethral across the urethra ultra- Beyond, excess ultrasound high frequency sound waves un- not unconscious not conscious Number Prefixes bi- two bilateral two sides hemi- half hemiplegia paralysis of half the body mono- one monoplegia paralysis of one extremity multi- many Multigravida female pregnant more than once nulli- none nulligravida female with no pregnancies poly- many polyuria large amounts of urine primi- first primigravida first pregnancy quadri- four quadriplegia paralysis of 4 semi- half, partial semiconsciousness partially conscious tetra- four tetraplegia paralysis of 4 tri- three tricep muscle with three heads Common Suffixes -algia pain gastralgia stomach pain -cele hernia, Protrusion cystocele Protrusion of the bladder -cyte cell lymphocyte white blood cell -dynia pain cardiodynia heart pain -ecstasis dilation bronchiectasis dilated bronchi -gen that which produces carcinogen that which produces cancer -genesis Produces, generates spermatogenesis produces sperm -genic producing, produced by carcinogenic producing cancer -ia state, condition Bradycardia condition of Slow heartbeat -iasis abnormal condition lithiasis abnormal condition of stones -iatry medical treatment podiatry medical treatment for the foot -ism state of hypothyroidism state of low thyroid -itis Inflammation appendicitis inflammation of the appendix -logist One who studies Cardiologist one who studies the heart -logy Study of pulmonology the study of the lung -lysis destruction hemolysis blood destruction -lytic destruction thrombolytic clot destruction -malacia abnormal softening chondromalacia abnormal cartilage softening -megaly enlargement, large osteomegaly enlarged bone -oid resembling fibroid resembling fibers -oma tumor, mass, swelling carcinoma cancerous tumor -osis abnormal condition cyanosis abnormal condition of being blue -pathy disease adenopathy gland disease -phobia Fear of arachnophobia fear of arachnid -plasia growth, development hyperplasia excessive development -plasm Formation, development neoplasm new formation -ptosis drooping blepharoptosis drooping eyelid -rrhage Excessive, abnormal flow hemorrhage excessive bleeding -rrhagia Abnormal flow, condition cystorrhagia abnormal flow from bladder -rrhea Discharge, flow Rhinorrhea discharge from the nose -rrhexis rupture adenorrhexis ruptured gland -sclerosis hardening arteriosclerosis hardening of an artery -stenosis narrowing angiostenosis narrowing of a vessel -therapy treatment Chemotherapy treatment with chemicals -trophy Nourishment, development hypertrophy excessive development -ule small venule small vein Adjective Suffixes -ac Pertaining to cardiac Pertaining to the heart -al Pertaining to duodenal Pertaining to the duodenum -an Pertaining to ovarian Pertaining to the ovary -ar Pertaining to ventricular Pertaining to a ventricle -ary Pertaining to Pulmonary Pertaining to the lungs -atic Pertaining to lymphatic Pertaining to lymph -eal Pertaining to esophageal Pertaining to the esophagus -iac Pertaining to chondriac Pertaining to cartilage -ic Pertaining to gastric Pertaining to the stomach -ile Pertaining to penile Pertaining to the penis -ine Pertaining to uterine Pertaining to the uterus -ior Pertaining to superior Pertaining to above -nic Pertaining to embryonic Pertaining to an embryo -ory Pertaining to auditory Pertaining to hearing -ose Pertaining to adipose Pertaining to fat -ous Pertaining to intravenous Pertaining to within a vein -tic Pertaining to acoustic Pertaining to hearing Surgical Suffixes -centesis Puncture to withdraw fluid Amniocentesis Puncture to withdraw amniotic fluid -ectomy Surgical removal colectomy surgical removal of the colon -ostomy Surgically create opening adenostomy surgically create opening into a gland -otomy Cutting into gastrotomy cutting into the stomach -pexy Surgical fixation rhinopexy surgical fixation of the nose -plasty Surgical repair otoplasty surgical repair of the ear -rrhaphy suture dermorrhaphy suture of the skin Procedural Suffixes -gram record or picture electroencephalogram record or picture of the electrical activity inside of the brain -graph instrument for recording electrocardiograph instrument for recording the heart's electrical activity -graphy process of recording electrocardiography process of recording the heart's electrical activity -meter instrument for measuring audiometer instrument to measure hearing -metry process of measuring audiometry process of measuring hearing -scope instrument for viewing gastroscope instrument for viewing the stomach -scopy process of viewing gastroscopy process of viewing the stomach Singular Endings to Plural ending singular plural -a vertebra vertebrae -ax thorax thoraces -ex/-ix appendix appendices -is metastasis metastases -ma sarcoma sarcomata -nx phalanx phalanges -on ganglion ganglia -us nucleus nuclei -um ovum ova -y biopsy biopsies *The EMR, or electronic medical record is important because it has important information about patients and the staff that work with them. Nearly 100,00 people die every year from medical errors, so it is imperative to have accurate information. *EHR, or electronic health record is an electronic record of patient information. *HIPAA, or the Health Insurance Portability Accountability Act makes sure that information about patients, including EMR and EHR stay confidential. It is important that patient’s information status confidential because it can greatly impact one's quality of life. HIPAA was passed in 1996. EMR History and Physical Written or dictated by admitting physician; details patient’s history, results of physician’s examination, initial diagnoses, and physician’s plan of treatment. Physician's Orders Complete list of care, medications, tests, and treatments physician orders for patient. Nurse's Notes Record of patient’s care throughout the day; includes vital signs, treatment specifics, patient’s response to treatment, and patient’s condition. Physician's Progress Notes Physician's daily record of patient’s condition, results of physician’s examinations, summary of test results, updated assessment and diagnosis, and further plans for patient’s care. Consultation Reports Reports given by specialists whom physician has asked to evaluate patient. Ancillary Reports Reports from various treatments and therapies patient has received, such as rehabilitation, social services, or respiratory therapy. Diagnostic Reports Results of diagnostic tests performed on patient, principally from clinical lab (e.g., blood tests) and medical imaging (e.g., X-rays and ultrasound). Informed Consent Document voluntarily signed by patient or a responsible party that clearly describes purpose, methods, procedures, benefits, and risks of a diagnostic or treatment procedure. Operative Report Report from surgeon detailing an operation; includes pre- and postoperative diagnosis, specific details of surgical procedure itself, and how patient tolerated procedure. Anesthesiologist’s Report Relates details regarding substances (such as medications and fluids) given to patient, patient’s response to anesthesia, and vital signs during surgery. Pathologist’s Report Report given by pathologist who studies tissue removed from patient (e.g., bone marrow, blood, or tissue biopsy). Discharge Summary Comprehensive outline of patient’s entire hospital stay; includes condition at time of admission, admitting diagnosis, test results, treatments and patient’s response, final diagnosis, and follow-up planResults of diagnostic tests performed on patient, principally from clinical lab (e.g., blood tests) and medical imaging (e.g., X-rays and ultrasound) Healthcare Settings Acute Care or General Hospitals Provide services to diagnose (laboratory, diagnostic imaging) and treat (surgery, medications, therapy) diseases for a short period of time; in addition, they usually provide emergency and obstetrical care. Specialty Care Hospitals Provide care for very specific types of diseases; for example, a psychiatric hospital. Nursing Homes or Long-Term Care Facilities Provide long-term care for patients needing extra time to recover from illness or injury before returning home, or for persons who can no longer care for themselves. Ambulatory Care Centers, Surgical Centers, or Outpatient Clinics Provide services not requiring overnight hospitalization; services range from simple surgeries to diagnostic testing or therapy Physicians’ Offices Provide diagnostic and treatment services in a private office setting. Health Maintenance Organization (HMO) Provides wide range of services by a group of primary-care physicians, specialists, and other healthcare professionals in a prepaid system. Home Health Care Provides nursing, therapy, personal care, or housekeeping services in patient’s own home. Rehabilitation Centers Provide intensive physical and occupational therapy; includes inpatient and outpatient treatment/ Hospices Provide supportive treatment to terminally ill patients and their families.
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