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1.
The condition of septic arthritis was treated in 12 foals with 21 affected joints (Group I) and in 27 adult horses. The adult horses were divided into three groups, based on aetiology of the condition: haematogenous (Group II, n = 6), iatrogenic (Group III, n = 6), and perforating trauma (Group IV, n = 15). The treatment consisted of an initial systemic antibiotic that anticipated the microbial agents that were considered most likely per group, repeated through-and-through joint lavages every other day and non-steroidal anti-inflammatory drugs. The antibiotics were adjusted to the results of bacteriological culture and susceptibility tests. Joint lavages were continued until the white blood cell count dropped below 15 G/l and bacteriological culture was negative, after which a single dose of a short-acting corticosteroid was administered intra-articularly. Joint recovery rate in group I was 71%. Patient recovery rate of the foals, however, was lower (42%). Three foals were killed for reasons other than arthritis; one foal because of an arthritis-related problem and three foals because of persistent arthritis. Overall joint recovery rate, equalling patient recovery rate, in the adult horses was 81%. The expected predominance of Streptococcus spp. in haematogenous arthritis in adult horses was not confirmed, indicating that in these cases also, an initial antibiotic treatment with a broad-spectrum combination is preferable. It is concluded that with intensive treatment, the prognosis of septic arthritis in the adult horse can be classified as fair to even good. Results in the foals are not as good, but this seems to be more due to the specific problems surrounding the equine neonate than to unresponsiveness to the treatment.  相似文献   

2.
REASONS FOR PERFORMING STUDY: Contamination and infection of synovial cavities are a common occurrence in clinical practice and, if inadequately treated, may have career or life threatening consequences for affected horses. HYPOTHESIS: The objectives in treating contamination and infection of joints, tendon sheaths and bursae are most effectively met by endoscopic surgery. METHODS: Over a 6 year period, cases of synovial contamination and infection admitted to a referral clinic were evaluated and treated endoscopically. The horses received local and systemic antimicrobial drugs with minimal nonsteroidal anti-inflammatory medication but no other medical or surgical treatment. All arthroscope and instrument portals and, whenever possible, all traumatic wounds were closed. Diagnostic information, endoscopic observations and results of treatment were evaluated retrospectively. RESULTS: A total of 140 affected animals were referred and 121 cases were treated endoscopically. These involved 70 joints, 29 tendon sheaths, 10 bursae and in 12 cases a combination of synovial cavities. The most common aetiologies were open wounds (n = 54) and self-sealing punctures (n = 41). Foreign material was identified endoscopically in 41 but predicted prior to surgery in only 6 cases. Osteochondral lesions were evident at surgery in 51 and recognised before surgery in 25 cases; 32 horses had intrathecal tendon or ligament defects. Follow-up information was obtained for 118 animals; 106 (90%) survived and 96 (81%) returned to their preoperative level of performance. The presence of osteitis/osteomyelitis, other osteochondral lesions and marked deposits of pannus were associated with nonsurvival. For those animals which survived, non-Thoroughbred horses, a combination of synovial structure involvement and regional i.v. antimicrobial administration were associated with reduced post operative performance. Marked pannus, regional i.v. antimicrobial administration and duration of systemic antimicrobial administration were associated with a group combining nonsurviving animals and those with reduced post operative performance. CONCLUSIONS: Endoscopic surgery makes a valuable contribution to the management of synovial contamination and infection. POTENTIAL RELEVANCE: The information obtained from and therapeutic options offered by endoscopy justify its early use in cases of synovial contamination and infection.  相似文献   

3.
Contrast radiography was used to determine the position, shape, relationship and capacity of a number of tendon sheaths and bursae which have clinical significance in the horse. It was possible to establish the normal range of radiographic anatomy for these structures. Some variation in the extent and form of tendon sheaths were found between individual horses and between foals and adults.  相似文献   

4.
Arthroscopic surgery has been reported to provide advantages in the management of infected joints in man and the use of endoscopy (arthroscopy) is now common in treating infected synovial structures in horses. It is proposed that the objectives in managing contaminated and infected joints, tendon sheaths, and bursae are optimized by inclusion of arthroscopy in their evaluation and treatment. This requires no additional equipment over and above that commonly used for equine arthroscopy, although motorized apparati are highly advantageous. This paper describes the author's current protocol in managing such cases and discusses the role of arthroscopy and its relationship with other concurrently employed treatment modalities. Its principal contributions to case management are considered to be comprehensive evaluation of the cavity, identification and removal of foreign material and contaminated or infected tissues, and by concurrent directed high-pressure lavage. These produce efficient mechanical cleansing of the cavity, which is combined with minimal tissue trauma and uncomplicated postoperative care.  相似文献   

5.
Two horses were examined due to lacerations at the level of the craniodistal antebrachii. Further evaluation of the lacerations revealed communication with the extensor carpi radialis tendon sheath and potentially the antebrachiocarpal joint. Positive contrast arthrography performed via the palmarolateral pouch of the antebrachiocarpal joint was used to diagnose communication with the extensor carpi radialis tendon sheath. Both the joints and tendon sheaths were treated aggressively with surgical debridement and lavage, followed by post operative medical management and rehabilitation. Both horses made a full recovery and are performing in their intended level of use with acceptable cosmetic results. Traumatic communication with the carpal joints should be considered when evaluating lacerations involving the forelimb extensor tendon sheaths.  相似文献   

6.
Contrast radiography, using a 25 per cent solution of sodium diatrizoate, has been used for the investigation of tenosynovitis and bursitis in horses. The procedure was undertaken on a series of 32 clinical cases and on specimens obtained at autopsy. Lesions affecting the extensor tendon sheaths at the carpus, the digital sheath, the tarsal sheath and the bursae at the elbow, hock and fetlock were examined by this means. The results showed the procedure offered the clinician useful information about the nature of the interior of these structures, particularly as regards the presence of adhesions and anastomoses between adjacent sheaths and joint capsules. Together with other clinical and laboratory findings, contrast radiography can assist in assessing the prognosis and in formulating appropriate treatment.  相似文献   

7.
OBJECTIVE: To compare gentamicin concentrations achieved in synovial fluid and joint tissues during IV administration and continuous intra-articular (IA) infusion of the tarsocrural joint in horses. ANIMALS: 18 horses with clinically normal tarsocrural joints. PROCEDURE: Horses were assigned to 3 groups (6 horses/group) and administered gentamicin (6.6 mg/kg, IV, q 24 h for 4 days; group 1), a continuous IA infusion of gentamicin into the tarsocrural joint (50 mg/h for 73 hours; group 2), or both treatments (group 3). Serum, synovial fluid, and joint tissue samples were collected for measurement of gentamicin at various time points during and 73 hours after initiation of treatment. Gentamicin concentrations were compared by use of a Kruskal-Wallis ANOVA. RESULTS: At 73 hours, mean +/- SE gentamicin concentrations in synovial fluid, synovial membrane, joint capsule, subchondral bone, and collateral ligament of group 1 horses were 11.5 +/- 1.5 microg/mL, 21.1 +/- 3.0 microg/g, 17.1 +/- 1.4 microg/g, 9.8 +/- 2.0 microg/g, and 5.9 +/- 0.7 microg/g, respectively. Corresponding concentrations in group 2 horses were 458.7 +/- 130.3 microg/mL, 496.8 +/- 126.5 microg/g, 128.5 +/- 74.2 microg/g, 99.4 +/- 47.3 microg/g, and 13.5 +/- 7.6 microg/g, respectively. Gentamicin concentrations in synovial fluid, synovial membrane, and joint capsule of group 1 horses were significantly lower than concentrations in those samples for horses in groups 2 and 3. CONCLUSIONS AND CLINICAL RELEVANCE: Continuous IA infusion of gentamicin achieves higher drug concentrations in joint tissues of normal tarsocrural joints of horses, compared with concentrations after IV administration.  相似文献   

8.
The possibilities for imaging soft tissue structures, especially fluid-filled cavities such as articulations, bursae or tendon sheaths, have been improved markedly by sonography in recent years. Ultrasonic examinations were performed on the common tendon sheath of the musculus flexor hallucis longus and the musculus tibialis caudalis, from the medioplantar aspect of the tarsus, in 12 sound adult draft- and warm blood horses, and in 5 animals with a distended common sheath. The diagnostic precision of the sonographic examination of the tendon sheath is excellent and is superior to conventional radiography. A nuclear magnetic resonance tomogram of an isolated equine tarsus is presented for comparison method.  相似文献   

9.
Reasons for performing study: Injuries of the calcaneal insertions of the superficial digital flexor tendon and their relationship to displacement of the tendon from the calcaneus have not previously been reported. Objectives: To describe findings made on clinical cases with disruption of the calcaneal insertions of the superficial digital flexor tendon (SDFT) including observations on their role in horses with unstable subluxation of the tendon. To describe novel surgical techniques and the results of treatment. Hypotheses: Disruption of the calcaneal insertions of the SDFT is associated with lameness and distension of the calcaneal bursa. Unstable displacement of the SDFT from the calcaneus is a more complex injury than incomplete disruption of one of its calcaneal insertions. Methods: The case records and diagnostic images of horses with lesions involving the calcaneal insertions of the SDFT, which were confirmed by endoscopic evaluation of calcaneal bursa between 2005 and 2009, were reviewed. Results: Nineteen horses were identified including 7 that had unstable displacement of the tendon from the calcaneus. Following endoscopic surgery, 9 of 12 horses with stable tendons and 6 of 7 horses with unstable displaced SDFTs returned to work. Conclusion: Tearing of the calcaneal insertions of the SDFT is associated with lameness and distension of the calcaneal bursa; endoscopic removal of the torn tissue carries a good prognosis. Horses with unstable displacement of the tendon have also disruption of the tendon fibrocartilage cap. Removal of this results in stable subluxation and can return horses to athletic activity. Both lesions can be detected by preoperative ultrasonography. Potential relevance: Tearing of the calcaneal insertions of the SDFT should be included in the differential diagnoses of lame horses with distended calcaneal bursae. Tearing of the tendon fibrocartilage cap in horses with unstable displacement of the SDFT is a plausible explanation of the clinical features of the injury and explains previously unreliable results of reconstructive surgeries. Subtotal resection is a technically demanding technique but appears to offer an improved prognosis.  相似文献   

10.
Septic arthritis/tenosynovitis in the horse can have life‐threatening consequences. The purpose of this cross‐sectional retrospective study was to describe ultrasound characteristics of septic arthritis/tenosynovitis in a group of horses. Diagnosis of septic arthritis/tenosynovitis was based on historical and clinical findings as well as the results of the synovial fluid analysis and/or positive synovial culture. Ultrasonographic findings recorded were degree of joint/sheath effusion, degree of synovial membrane thickening, echogenicity of the synovial fluid, and presence of hyperechogenic spots and fibrinous loculations. Ultrasonographic findings were tested for dependence on the cause of sepsis, time between admission and beginning of clinical signs, and the white blood cell counts in the synovial fluid. Thirty‐eight horses with confirmed septic arthritis/tenosynovitis of 43 joints/sheaths were included. Degree of effusion was marked in 81.4% of cases, mild in 16.3%, and absent in 2.3%. Synovial thickening was mild in 30.9% of cases and moderate/severe in 69.1%. Synovial fluid was anechogenic in 45.2% of cases and echogenic in 54.8%. Hyperechogenic spots were identified in 32.5% of structures and fibrinous loculations in 64.3%. Relationships between the degree of synovial effusion, degree of the synovial thickening, presence of fibrinous loculations, and the time between admission and beginning of clinical signs were identified, as well as between the presence of fibrinous loculations and the cause of sepsis (P ≤ 0.05). Findings indicated that ultrasonographic findings of septic arthritis/tenosynovitis may vary in horses, and may be influenced by time between admission and beginning of clinical signs.  相似文献   

11.
OBJECTIVE: To evaluate use of infrared spectroscopy for diagnosis of traumatic arthritis in horses. ANIMALS: 48 horses with traumatic arthritis and 5 clinically and radiographically normal horses. PROCEDURES: Synovial fluid samples were collected from 77 joints in 48 horses with traumatic arthritis. Paired samples (affected and control joints) from 29 horses and independent samples from an affected (n = 12) or control (7) joint from 19 horses were collected for model calibration. A second set of 20 normal validation samples was collected from 5 clinically and radiographically normal horses. Fourier transform infrared spectra of synovial fluids were acquired and manipulated, and data from affected joints were compared with controls to identify spectroscopic features that differed significantly between groups. A classification model that used linear discriminant analysis was developed. Performance of the model was determined by use of the 2 validation datasets. RESULTS: A classification model based on 3 infrared regions classified spectra from the calibration dataset with overall accuracy of 97% (sensitivity, 93%; specificity, 100%). The model, with cost-adjusted prior probabilities of 0.60:0.40, yielded overall accuracy of 89% (sensitivity, 83%; specificity, 100%) for the first validation sample dataset and 100% correct classification of the second set of independent normal control joints. CONCLUSIONS AND CLINICAL RELEVANCE: The infrared spectroscopic patterns of fluid from joints with traumatic arthritis differed significantly from the corresponding patterns for controls. These alterations in absorption patterns may be used via an appropriate classification algorithm to differentiate the spectra of affected joints from those of controls.  相似文献   

12.
Sixteen horses were allotted to 4 groups of 4 horses each to evaluate the effect of tendon sheath lavage with 4 solutions (balanced electrolyte solution, 0.1% povidone-iodine, 0.5% povidone-iodine, and 0.5% chlorhexidine). The synovitis caused by 0.1% povidone-iodine lavage was not appreciably worse than that caused by balanced electrolyte solution lavage, but the 0.5% povidone-iodine and chlorhexidine lavages caused severe synovitis, and, therefore, should not be used for tendon sheath lavage.  相似文献   

13.
REASONS FOR PERFORMING STUDY: Clinical lesions of the deep digital flexor tendon and navicular bone are being reported with increasing frequency. However, the role of direct visualisation by navicular bursoscopy in the diagnosis and management of such injuries has not been explored. HYPOTHESIS: Navicular bursoscopy: 1) corroborates information obtained from other, noninvasive imaging modalities; 2) allows direct visualisation of lesions unidentified by other diagnostic modalities; 3) provides further information on morphology of lesions; and 4) permits minimally invasive surgical access to lesions. METHODS: The case records of all horses that underwent diagnostic navicular bursoscopy for the investigation of lameness admitted to 2 referral clinics (the Royal Veterinary College and Reynolds House Referrals) were evaluated retrospectively. Follow-up information was obtained by telephone questionnaire. RESULTS: Twenty-three bursae were examined endoscopically in 20 horses. Tears of the deep digital flexor tendon were seen in all horses (22 bursae). In 8 bursae, cartilage lesions were also present and in one bursa this was the only abnormal finding. Computed tomography and low field magnetic resonance imaging predicted tendon lesions in most cases, but failed to identify cartilage damage. Greater than 6 month follow-up information was available for 15 animals of which 11 were sound and 9 had returned to preoperative levels of performance. CONCLUSION: Lameness localised to the foot may result from tears of the deep digital flexor tendon and/or navicular fibrocartilage loss. Navicular bursoscopy allows comprehensive evaluation of these changes and also permits appropriate lesion management. POTENTIAL RELEVANCE: The diagnostic information obtained from and therapeutic options offered by bursoscopy justify its use in horses with clinical findings localising lameness to the navicular bursa.  相似文献   

14.
Septic arthritis was induced in one antebrachiocarpal joint of seven horses by the intra-articular injection of 1 mL Staphylococcus aureus suspension containing a mean of 10(5) colony-forming units. Twenty-four hours after inoculation, four horses were treated by regional perfusion with 1 g of gentamicin sulfate, and three horses received 2.2 mg/kg gentamicin sulfate intravenously (IV) every 6 hours. Synovial fluid was collected for culture and cytology at regular intervals, and the synovial membranes were collected for culture and histologic examination at euthanasia 24 hours after the first treatment. Gentamicin concentration in the septic synovial fluid after three successful perfusions was 221.2 +/- 71.4 (SD) micrograms/mL; after gentamicin IV, it was 7.6 +/- 1.6 (SD) micrograms/mL. The mean leukocyte count in the inoculated joints decreased significantly by hour 24 in the successfully perfused joints. Terminal bacterial cultures of synovial fluid and synovial membranes were negative in two horses with successfully perfused joints. S. aureus was isolated from the infected joints in all three horses treated with gentamicin IV.  相似文献   

15.
A total of 43 horses were used for the study of the pharyngeal bacterial flora. The median value of the number of bacteria in the group of 19 normal horses was 3.8 × 104 cfu/g of secretions. This value was 6.4 × 104cfu/g in horses with grade I pharyngitis, 1.3 × 105 cfu/g in horses with grade II pharyngitis and 3.5 × 106 cfu/g in horses affected with grades III and IV pharyngitis. Corynebacterium spp, coagulase-negative staphylococci, Nocardia spp, Moraxella spp and Enterobacter spp were the most frequently encountered bacteria in the normal animals as well as in horses affected with pharyngitis of grades I or II. Moraxella spp were isolated in 87.5% of the horses with pharyngitis of grades III and IV, followed by Streptococcus zooepidemicus, Pseudomonas aeruginosa, coagulase-negative staphylococci and Enterobacter spp. No fastidious bacteria, nor strict anaerobes were isolated from any of the 43 horses. None of the microorganisms were found in 100% of the animals and the majority of the isolates were opportunistic bacteria. These results demonstrate that the isolation of Moraxella spp and S. zooepidemicus in large numbers is frequent in horses with lymphoid follicular hyperplasia grades III and IV. Fungi were isolated in small numbers from two or three horses in each group.  相似文献   

16.
Studies evaluating the effects of dobutamine in horses do not consistently report increases in cardiac output despite increases in arterial blood pressure. The concurrent administration of the α2 agonist clonidine, in people, inhibited the chronotropic effects of dobutamine and increased left ventricular stroke work ( Zimpfer et al. 1982 ). Our study was performed to determine if pre‐medication with an α2 agonist affects the response to dobutamine in anaesthetized horses. Eleven horses were anaesthetized on four separate occasions for one of four randomly assigned treatments; (I) no xylazine, no dobutamine (II) xylazine, no dobutamine (III) no xylazine, dobutamine, and (IV) xylazine, dobutamine. Horses received 0.02 mg kg?1 of butorphanol IV 10 minutes prior to anesthetic induction. Two minutes prior to induction, groups II and IV received 0.5 mg kg?1 of IV xylazine. Anaesthesia was induced with 6–7 mg kg?1 of thiopental and maintained with halothane. End‐tidal halothane concentrations were maintained between 1.1 and 1.2% in groups I and III, and 0.9–1.0% for groups II and IV. Heart rate, cardiac output, right atrial pressure, and systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressure were recorded 30 minutes after beginning halothane anaesthesia (T10). Cardiac output was estimated using Lithium dilution ( Linton et al. 2000 ). Baseline measurements were repeated twice, at 5‐minute intervals (T5 and T0). At time 0 (T0), an IV infusion of either saline (100 mL hour?1) or dobutamine (0.001 mg kg?1 minute?1) was started and data recorded at 5‐minute intervals for 30 minutes (T5 – T30). Stroke volume and systemic vascular resistance (SVR) were calculated. Data were analysed using repeated measures anova (p < 0.01 significant) and Newman–Keuls for multiple comparisons. Cardiac output and stroke volume increased over time in groups III and IV. Cardiac index was higher in groups III and IV than in groups I and II from T10 until completion of the study. Estimates of cardiac index at T30 for groups I–IV were 45 ± 9, 46 ± 11, 71 ± 11, and 78 ± 19 mL kg?1 minute?1, respectively (mean ± SD). Stroke index was higher in groups III and IV than in groups I and II from T15 to T30. Values for stroke index at T30 for groups I–IV were 0.98 ± 0.19, 1.11 ± 0.18, 1.46 ± 0.21, 1.74 ± 0.33 mL kg?1. Heart rate decreased from T10–T30 in groups I and II. Heart rate was greater in groups I and III than in groups II and IV at T5 and T0. Values for heart rate at T0 for groups I–IV were 48 ± 5, 42 ± 5, 50 ± 4, 43 ± 4 beats minute?1. Systolic arterial pressure, DAP and MAP were higher in groups III and IV than in groups I and II from T5 to T30. There were no differences in SVR between groups. Dobutamine at 0.001 mg kg?1 minute?1 increased cardiac output, blood pressure, and stroke volume. Premedication with xylazine at 0.5 mg kg?1 did not appear to affect the response to dobutamine.  相似文献   

17.
Eight horses with synovial sepsis induced by trauma were treated by arthroscopic/tenoscopic debridement and lavage followed by the implantation of a gentamicin-impregnated collagen sponge. Seven of them responded favourably and were sound six months after treatment. The other underwent a further surgical procedure and recovered. Gentamicin-impregnated collagen sponges appear to be a safe and useful adjunct in the treatment of septic joints and tendon sheaths, and have the advantage of being bioabsorbable.  相似文献   

18.
Seventy-seven horses with atrial fibrillation (AF) were treated orally with quinidine sulfate (QS) at the University of Pennsylvania, School of Veterinary Medicine, Thirty-seven horses (48%) had adverse reactions to QS, the most common of which were nasal mucosal edema, anorexia, colic, and diarrhea. The mean highest daily QS dose was slightly greater in horses showing toxicity (P less than 0.1) and their conversion rate was less (P less than 0.05). A schedule of gradually increasing QS dose was time consuming, costly and not associated with fewer adverse reactions. Horses were compared by their response to QS: conversion for at least 12 months (Group I; 25 horses); reversion with 12 months (Group II; 8); nonconversion (Group III; 14). All horses with congestive heart failure (CHF) failed to convert. The mean age (P less than 0.05), total QS dose and highest daily QS dose (P less than 0.05) were significantly greater in Group III horses. The mean duration of signs before treatment and occurrence of adverse reactions to QS were greater in horses in Group II and III than Group I. (P less than 0.05). All horses in Groups I and II returned to performance, and many (81%) were successful. Most Group III horses (13/14) are known to have died. It was concluded that most horses with AF uncomplicated by CHF have a good prognosis when treated early with QS. Delayed QS therapy may reduce chances for conversion of AF or increase the probability of reversion.  相似文献   

19.

Background

This study was performed to determine the prevalence of ulcers in the gastric squamous and glandular mucosa in Polish pleasure horses.

Study design

Medical records from gastroscopic examinations of 108 pleasure horses of different breeds were reviewed. The study population consisted of two groups; group I (n = 48) with horses that expressed mild clinical signs of gastric ulcer syndrome (EGUS) including poor appetite, slight weight loss or poor body condition, and group II (n = 60) with horses that had no signs of gastrointestinal problems. The age range was 4–10 years, including 5 males, 34 castrated males (geldings) and 69 mares. The prevalence, distribution and severity of gastric ulcers were recorded. Lesions involving the squamous mucosa and the glandular mucosa of the antrum and pylorus were graded and compared between groups.

Results

Significant difference was found in the presence and severity of gastric ulcers between the two groups of horses. The overall prevalence of gastric ulcers in the first group of horses (n = 48) was 59% while in the group of clinically healthy horses (n = 60) the prevalence of gastric lesion was 40% (P = 0.004). Almost 19% of horses from group I had between 6–10 lesions (EGUS score III) and nearly 19% had either >10 localized lesions or very large diffuse lesions (EGUS number score IV). The number of ulcerations in affected horses were significantly lower in group II compared to group I (P = 0.016) as 10% of horses had 6–10 lesions (EGUS number score III) and nearly 14% had either >10 localized lesions or very large diffuse lesions (EGUS number score IV). Gastroscopy revealed that nearly 32% of horses from the second group had an ulceration EGUS score ≥ II.

Discussion and conclusions

This study confirms that gastric ulcerations can be prevalent in apparently clinically normal pleasure horses and a complete gastroscopic examination including the examination of the pylorus is advisable to evaluate this syndrome.  相似文献   

20.
Seventy appendicular skeletal physeal fractures in 67 horses were reviewed and classified using the Salter-Harris classification. All the horses were less than 2 years old (mean age at injury 6.2 months). The mean age at injury for pressure physeal fractures (5.2 months) was significantly less (p < .05) than for traction physeal fractures (8.3 months). The majority (67.2%) of the horses were female. Forty-eight (69%) pressure physes and 22 (31%) traction physes were affected. The most common pressure and traction physeal fracture sites were the proximal femoral physis and the proximal ulnar physis, respectively. Sixty-seven physeal fractures were classified: 14 as Type I (20.9%), 42 as Type II (62.7%), six as Type III (8.9%), and five as Type IV (7.5%). Forty-six pressure physeal fractures were classified: six as Type I (13.0%), 30 as Type II (65.2%), five as Type Hi (10.9%), and 5 as Type IV (10.9%).  相似文献   

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