Is methotrexate nephrotoxic

I ntroduction. Methotrexate (MTX), a classical antifolate, is one of the most widely used and studied anticancer agents [1-4].Unlike other anticancer agents, MTX can be safely administered over a wide dose range, ranging from 20 mg/m 2 per week in maintenance chemotherapy for acute lymphoblastic leukemia and treatment of nononcologic diseases including rheumatoid arthritis or psoriasis [4. High-dose methotrexate (HD-MTX) therapy has been used to treat a wide range of oncological malignancies. While the therapy can be tolerated with hydration, urine pH control, and leucovorin rescue therapy, HD-MTX is cytotoxic and can cause renal failure

PPT - Methotrexate PowerPoint Presentation - ID:3340255

Methotrexate (MTX) toxicity can affect multiple organ systems, manifesting as nephrotoxicity, myelosuppression, hepatotoxicity, mucositis, and gastrointestinal upset. Serious adverse events are rare in patients prescribed low-dose methotrexate. We present a case of an 86-year-old female on a weekly dose of oral MTX 12.5 mg for rheumatoid arthritis presenting with painful gingiva and oral. A reduction in hepatic folate stores and toxicity due to a local folate deficiency is one possible toxic effect of methotrexate on the liver. A definitive relationship between folate depletion and hepatotoxicity has not been experimentally confirmed Potentially life-threatening hepatotoxicity, pulmonary damage, and myelosuppression may be seen with use of MTX as either high- or low-dose therapy, while nephrotoxicity is a manifestation of high-dose therapy that occurs rarely, if ever, with low-dose MTX treatment. The major side effects of low-dose MTX are reviewed here Drug-Induced Nephrotoxicity. CYNTHIA A. NAUGHTON, PharmD, BCPS, North Dakota State University College of Pharmacy, Nursing, and Allied Sciences, Fargo, North Dakota. Am Fam Physician. 2008 Sep 15. Nephrotoxic Drugs That Cause Kidney Damage. Before taking any of these drugs, be aware that they are known to cause severe (and sometimes deadly) kidney damage (3,4,5).If you already have kidney problems, these drugs can be deadly even in small doses

Understanding and Managing Methotrexate Nephrotoxicity

  1. ute per 1.73 m 2 )
  2. Nephrotoxic drugs are pharmacotherapies that can lead to a decline in renal function. The drug may need to be discontinued, or the dosing reduced when this happens. Common Nephrotoxic drug
  3. Methotrexate-induced nephrotoxicity is not uncommon, although intrarenal methotrexate crystals have been elusive. This case shows methotrexate crystals deposited within the kidney tubules of a..

Methotrexate is primarily excreted unchanged by the kidney where it can course acute nephrotoxicity resulting in prolonged elimination time of the drug. Data from a 10 years retrospective investigation at our pediatric unit show, that in spite of urine alkalinization and intensive hydration the elimination of methotrexate is prolonged in 20-50%. methotrexate and its metabolites in the renal tubules. Because methotrexate is primarily excreted via the kidneys, elimination of the drug becomes problematic once nephrotoxicity has occurred. Current recommendations for the prevention of methotrexate nephrotoxicity are routin High-dose methotrexate (HDMTX)-induced renal dysfunction can be life threatening, because it delays methotrexate (MTX) excretion, thereby exac-erbating the other toxicities of MTX. HDMTX-induced nephrotoxicity has been managed with high-dose leucovorin, dialysis-based methods of MTX removal Nephrotoxicity is a possible complication of therapy with high-dose methotrexate with most instances comprising grade 1-2 toxicity. Male gender, low albumin, and administration of interacting drugs or furosemide during high-dose methotrexate clearance may predispose patients to nephrotoxicity

Nephrotoxicity is one of the most common kidney problems and occurs when your body is exposed to a drug or toxin that causes damage to your kidneys. When kidney damage occurs, you are unable to rid your body of excess urine, and wastes. Your blood electrolytes (such as potassium, and magnesium) will all become elevated If not treated early and aggressively, methotrexate can damage the ability of normal cells to synthesize DNA leading to cell death and resulting in renal, hepatic, and central nervous system toxicity BACKGROUND High-dose methotrexate (HDMTX)-induced renal dysfunction can be life threatening, because it delays methotrexate (MTX) excretion, thereby exacerbating the other toxicities of MTX Nephrotoxicity results from crystallization of methotrexate in the renal tubular lumen, leading to tubular toxicity. AKI and other toxicities of high-dose methotrexate can lead to significant morbidity, treatment delays, and diminished renal function

Methotrexate-induced acute kidney injury in patients with

Nephrotoxicity Associated with Low-dose Methotrexate and

Methotrexate can cause severe liver problems including liver scarring (fibrosis), cirrhosis, and liver failure that may not get better (possibly irreversible) and can cause death. In people with psoriasis who take methotrexate tablets, liver fibrosis or cirrhosis may happen without any symptoms or abnormal liver tests Moderate Interactions. These medications may cause some risk when taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation. SELECTED NEPHROTOXIC. Nephrotoxicity is a poisonous effect of some substances, both toxic chemicals and medications, on the kidney. Risk factors of drug-induced nephrotoxicity include drug overdose, drug-drug interactions and drug-related adverse effects. Nephrotoxins are chemicals displaying nephrotoxicity. Drugs remain a relatively common cause of acute and.

Read the Clinical Chemistry Journal's December 2010 Clinical Case Study and student discussion. An 18-year-old male presented with pain and swelling in his left leg that he noted after playing football. An x-ray of the affected leg showed a destructive lesion that prompted a concern for malignancy. Subsequent tests, including magnetic resonance imaging, a bone scan, and a needle biopsy of the. Methotrexate (MTX) is one of the most widely used anticancer agents, and administration of high-dose methotrexate (HDMTX) followed by leucovorin (LV) rescue is an important component in the treatment of a variety of childhood and adult cancers. HDMTX can be safely administered to patients with normal renal function by the use of alkalinization.

Risk of liver disease in methotrexate treated patient

Paeoniflorin-6′-O-benzene sulfonate (CP-25) is a derivative of Paeoniflorin. We investigate beneficial effect of CP-25 on methotrexate (MTX) induced nephrotoxicity in rats. Plasma blood urea nitrogen (Bun), plasma creatinine (CREA), urine CREA and protein in the rats were quantitatively measured. Renal tissues were pathologically observed. This page includes the following topics and synonyms: Nephrotoxic Drug, Nephrotoxin, Drug-induced Nephrotoxicity, Medication Causes of Acute Kidney Injury, Medication Causes of Acute Tubular Necrosis, Medication Causes of Interstitial Nephritis, Medication Causes of Glomerulonephritis, Medication Causes of Prerenal Failure, Medication Causes of Postrenal Failure, Toxic Nephropathy, Drug.

Methotrexate has become the most commonly prescribed disease-modifying anti-rheumatic drug.However, toxicity is an important drawback of MTX therapy and permanent discontinuation of MTX for adverse effects occurs in 1 patient out of 10. Although high-dose MTX is known to be nephrotoxic, data on low-dose MTX renal effects are scanty. We report an insidious and progressive deterioration of renal. Methotrexate may increase the nephrotoxic activities of Tenofovir disoproxil. Tenoxicam: The serum concentration of Methotrexate can be increased when it is combined with Tenoxicam. Tepotinib: Tepotinib may decrease the excretion rate of Methotrexate which could result in a higher serum level High-dose methotrexate (HDMTX)-induced renal dysfunction can be life threatening, because it delays methotrexate (MTX) excretion, thereby exacerbating the other toxicities of MTX. HDMTX-induced nephrotoxicity has been managed with high-dose leucovorin, dialysis-based methods of MTX removal, thymidine, and with the recombinant enzyme.

Role of Ketotifen in Methotrexate-induced Nephrotoxicity in Rats. Marwa M. M. Refaie 1, Salwa A. Ibrahim 1, Shaimaa A. Sadek 2, and Aly M. Abdelrahman 1. 1 Department of Pharmacology, Faculty of Medicine, Minia University, Minia, Egypt These drugs include cisplatin, adriamycin, cyclophosphamide, daunorobicin, methotrexate, doxrubicine and mitramycin. Other Nephrotoxic Drugs There are several other drugs known for their toxic effects to the dog's kidneys such as angiotensin-converting enzyme inhibitors (ACE) such as enalapril, benazepril, diuretic drugs such as furosemide. Methotrexate (MTX) is one of the most widely used anti-cancer agents, and administration of high-dose methotrexate (HDMTX) followed by leucovorin (LV) rescue is an important component in the treatment of a variety of childhood and adult cancers. HDMTX can be safely administered to patients with normal renal function by the use of alkalinization, hydration, and pharmacokinetically guided LV rescue Conclusions: Hypoalbuminemia was associated with prolonged methotrexate clearance, and it remained significant after adjusting for the methotrexate dose and concomitant use of nephrotoxic agents. Patients with hypoalbuminemia were more likely to have bilirubin elevation, both markers of synthetic liver function

Nephrotoxic Chemotherapy Agents: Old and New. In the last several decades, advancements in chemotherapy have improved the overall survival of cancer patients. These agents, however, are associated with adverse effects, including various kidney lesions. This review summarizes the nephrotoxic potential of chemotherapy agents, old and new, as well. Methotrexate in combination with leflunomide can increase the risk for pancytopenia. Enhancement of nephrotoxicity may be seen if high-dose methotrexate is administered in combination with a potentially nephrotoxic chemotherapeutic agent (e.g. cisplatin) High-dose methotrexate (HDMTX), defined as a dose higher than 500 mg/m 2, can cause significant toxicity, including acute kidney injury (AKI) in 2%-12% of patients. Nephrotoxicity results from crystallization of methotrexate in the renal tubular lumen, leading to tubular toxicity. Risk factors for MTX-nephrotoxicity: 1 The use of radioisotope renography established the diagnosis and followed the resolution of the patient's MTX-induced nephrotoxicity. AB - Toxicity from intermediate-dose methotrexate (MTX) is unusual. A severely obese adolescent with acute lymphoblastic leukemia experienced significant, delayed nephrotoxicity from intermediate-dose MTX

The incidence of severe nephrotoxicity from high dose methotrexate (HDMTX) in osteosarcoma is 1.8%, and is fatal in 4% of patients who experience acute, severe nephrotoxicity . HDMTX-induced acute kidney injury (AKI) is a non-oliguric decrease in glomerular filtration rate (GFR) heralded by an acute rise in serum creatinine Clinical use of thymidine as a rescue agent from methotrexate toxicity. Invest New Drugs 1991; 9:281. Abelson HT, Fosburg MT, Beardsley GP, et al. Methotrexate-induced renal impairment: clinical studies and rescue from systemic toxicity with high-dose leucovorin and thymidine. J Clin Oncol 1983; 1:208 Methotrexate may cause nephrotoxicity by several mechanisms, including changes in glomerular hemodynamics, direct tubular toxicity and precipitation of methotrexate or a metabolite within the. methotrexate, N-acetylcysteine, nephrotoxicity ORIGINAL ARTICLE INTRODUCTION Nephrotoxicity is one of the serious dose-limiting complications of methotrexate (MTX) when used in the treatment of various malignancies including leukemias and lymphomas, and nononcologic diseases such as rheumatoid arthritis, psoriasis Dastychová, E.: Allergic contact dermatitis in methotrexate manufacture. Contact Dermatitis 48(4): 226-227, 2003. Deng, H., et al. : Investigating genetic damage in workers occupationally exposed to methotrexate using three genetic end-points

Patients receiving NSAIDs chronically in combination with diuretics, ACEIs, or ARB, are at risk for diminished hypotensive response, elevated serum creatinine, and acute kidney injury. They should be monitored for altered blood pressure and serum creatinine, particularly during the first few months of combination therapy The present invention provides compositions and methods to reduce renal damage caused by nephrotoxic drugs such as methotrexate. The invention provides compositions comprising a substituted cyclodextrin, methotrexate and a pharmaceutically acceptable carrier, where the cyclodextrin is present in an amount effective for substantially inhibiting the nephrotoxic effect of the methotrexate Methotrexate is known to cause severe drug interactions when taken with many types of medications. Those taking methotrexate should be aware of the drug interactions and speak with their doctor about the drugs or supplements they are taking prior to starting treatment with methotrexate Methotrexate (MTX) is an anti-metabolite most commonly used in chemotherapy and immunosuppressant in auto-immune diseases. This activity describes the indications, action, and contraindications for Methotrexate as a valuable agent in treating a wide variety of neoplastic diseases. to avoid possible nephrotoxicity. Monitoring for pulmonary.

Methotrexate (MTX), formerly known as amethopterin, is a chemotherapy agent and immune-system suppressant. It is used to treat cancer, autoimmune diseases, and ectopic pregnancy and for medical abortions. Types of cancers it is used for include breast cancer, leukemia, lung cancer, lymphoma, gestational trophoblastic disease, and osteosarcoma. Types of autoimmune diseases it is used for. Increased organ specific adverse reactions may also occur when methotrexate is coadministered with hepatotoxic or nephrotoxic products. If coadministration cannot be avoided, monitor closely for methotrexate adverse reactions when coadministered with: • Oral antibiotics (including neomycin) Methotrexate is an effective anticancer and immunosuppressive agent. However, nephrotoxicity is one of the complications of its use. On the other hand, curcumin, a naturally occurring polyphenolic compound, is reported to have antioxidant and anti-inflammatory properties. Those two properties are likely to prevent methotrexate-induced nephrotoxicity Urinary pH Keywords Pharmacokinetics · High-dose methotrexate · Nephrotoxicity · Outpatient · Osteosarcoma · Sarcoma O. Mir (&) · S. Ropert · J. Alexandre · J.-P. Durand · F. Goldwasser Department of Medical Oncology, Introduction Teaching Hospital Cochin, Université Paris Descartes, Assistance Publique, Hôpitaux de Paris, 27, rue du. Irreversible acute renal failure and nephrotoxicity may occur following high-dose intravenous (IV) methotrexate therapy, although it has also been reported in patients receiving subcutaneous and oral administration of methotrexate. Nephrotoxicity is primarily caused by the precipitation of methotrexate and 7-hydroxymethotrexate in the renal.

Nephrotoxic products; Probenecid; Nitrous Oxide. Coadministration of methotrexate with nitrous oxide anesthesia potentiates the effect of methotrexate on folate-dependent metabolic pathways, which may increase the risk of severe methotrexate adverse reactions. Avoid nitrous oxide anesthesia in patients receiving methotrexate As well, Leucovorin (a Methotrexate rescue agent) is routinely given with high dose Methotrexate to replenish folic acid and reduce Methotrexate-associated toxicities, including nephrotoxicity. Monitoring of patients receiving high dose Methotrexate should include serum creatinine and Methotrexate levels Nephrotoxicity is one of the serious dose-limiting complications of methotrexate (MTX) when used in the treatment of various malignancies and nononcological diseases. The aim of this study was to i..

Major side effects of low-dose methotrexate - UpToDat

Protective Effects of Curcumin Against Nephrotoxic Agents

Drug-Induced Nephrotoxicity - American Family Physicia

Increased exposure of the kidney on the basis of route, dose, and duration of drug exposure; drug-related immune effects (such as B-lactams, PPIs, NSAIDs, and immune checkpoint inhibitors); combined nephrotoxic drug exposure; and drug and metabolite insolubility in the urine (such as methotrexate, acyclovir, and sulfadiazine) lead to kidney injury Methotrexate Toxicity. Methotrexate is a drug which is often unintentionally involved in medication misadventure. Because of its unusual dosage requirements (e.g. weekly rather than daily dosing) it is particularly associated inadvertent mistakes by patients and medical staff. This may occur as a result of confusion by patients with other.

Top 16 Nephrotoxic Drugs That Cause Kidney Damag

Nephrotoxicity eman 2013

High-dose methotrexate (HDMTX, >1 g/m 2) administered as an intravenous (i.v.) infusion is an important component in the treatment regimens for a variety of cancers . HDMTX-associated severe acute renal failure (ARF) is an infrequent but serious complication because MTX is predominantly excreted in the urine • Methotrexate may accumulate in effusions leading to delayed excretion and haematological toxicity - drain pleural effusions and ascites before starting • Review the use of nephrotoxic drugs or other drugs which may interact with methotrexate before starting, including NSAIDs (delay renal tubular secretion Background/aim: Methotrexate (MTX) has been widely used for treatment of cancer and rheumatoid arthritis, but its use has been limited by its nephrotoxicity. This study was carried out to determine whether garlic exerts a protective effect against MTX-induced nephrotoxicity

Nephrotoxic drugs - wikido

Methotrexate (MTX) is widely used in the treatment of various malignancies and nononcological diseases but its use has been limited by its nephrotoxicity. Silymarin (SLY), a natural flavonoid, has been reported to have antioxidant, anti-inflammatory and anti-apoptotic effects Methotrexate Tablets can cause embryo-fetal toxicity, including fetal death. For non-neoplastic diseases, Methotrexate Tablets is contraindicated in pregnancy. Increased organ specific adverse reactions may also occur when methotrexate is coadministered with hepatotoxic or nephrotoxic products Abstract. Background: Nephrotoxicity is one of the known side effects of methotrexate (MTX) therapy despite the use of conventional protective measures. Our objectives were to evaluate the effects of N-acetylcysteine (NAC) on MTX-induced toxicity in renal tubular cells and to evaluate whether adjunctive use of NAC interferes with MTX antitumor activity in the B-cell lymphoma ABSTRACT: Methotrexate (MTX) is used in the treatment of rheumatic diseases, psoriasis, and cancer. Since more than 90% of MTX is excreted via the kidneys, nephrotoxicity is one of the most important reasons restricting the use of this drug Drug-induced nephrotoxicity is caused by nephrotoxic drugs or toxins which damage kidneys and can lead to nephritis or renal toxicity. The causative drug must be identified and its use must be.

Acute Methotrexate-Induced Crystal Nephropathy NEJ

Nephrotoxicity is one of the adverse effects of both methotrexate and non-steroidal anti-inflammatory drugs; and its combined administration should be done with caution. This is a case of an elderly woman, a known case of rheumatoid arthritis, who presented in severe bone marrow suppression due to methotrexate toxicity following aceclofenac. protection against methotrexate nephrotoxicity. Curcumin has shown renal protective properties against gentamicin-and cisplatin- induced renal toxicities ([ ]and[ ], resp.) as well as diabetic nephropathy[ ]. e presentstudy therefore was designed to assess the possible renoprotective e ec

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Prevention of Methotrexate Induced Nephrotoxicity and

does methotrexate get into breast milk. yes. can methotrexate penetrate CNS. yes, at high doses. methotrexate tissue distribution is highest in. kidney gallbladder spleen liver which metabolite is responsible for nephrotoxicity. 7-OH-MTX. alpha t1/2. 1.5-3.5 hours. beta t1/2. 8-15 hours. low dose clearance. 36-138 ml/min/m2. high dose. Management of Patients with Acute Methotrexate Nephrotoxicity with High-Dose Leucovorin. Carlos D. Flombaum, Renal Division, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Drug-induced nephrotoxicity contributes to acute kidney injury (AKI) and represents a major problem in the clinical setting. We investigated the possible involvement of NLRP3 inflammasome activation in methotrexate (MTX)-induced nephrotoxicity and the protective potential of ferulic acid (FA), pointing out the role of PPARγ and Nrf2/HO-1 signaling

High-Dose Methotrexate-Induced Nephrotoxicity in Patients

carboplatin and methotrexate both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. chlorpropamide. chlorpropamide will increase the level or effect of methotrexate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor. Methotrexate is partially bound to plasma proteins, and drugs that can displace. Methotrexate levels to be monitored every 24 hours until level is less than 0.1 micromol/L. Methotrexate is renally eliminated. Renal function must be evaluated prior to treatment. Methotrexate exits slowly from third space compartments (e.g. pleural effusions or ascites), resulting in a prolonged terminal plasma half-life and unexpected toxicity View This Abstract Online; Hispanic ethnicity is associated with prolonged clearance of high dose methotrexate and severe nephrotoxicity in children and adolescents with acute lymphoblastic leukemia Methotrexate is indicated in the treatment of gestational choriocarcinoma, chorioadenoma destruens, and hydatidiform mole.. In acute lymphocytic leukemia, methotrexate is indicated in the prophylaxis of meningeal leukemia and is used in maintenance therapy in combination with other chemotherapeutic agents. Methotrexate is also indicated in the treatment of meningeal leukemia

Evaluation of incidence and risk factors for high-dose

Risk reduction: You give a little more methotrexate, then avoid other drugs that will increase risk of nephrotoxicity from methotrexate (ex., NSAIDs, aminoglycosides, salicylates and piperacillin). 8 Consider the dose: Capping the dose at 100mg or giving 112.5mg comes nowhere close to higher doses used for cancer (upwards of 1-10g per m2). 10. Methotrexate (MTX) is a widely used chemotherapeutic agent; nevertheless, the nephrotoxicity associated with its use has limited its clinical use. Rebamipide (REB) is a gastro-protective agent with diverse promising biological activities. Here, we investigated the renoprotective effects of REB against MTX-induced nephrotoxicity in rats

Nephrotoxicity (Renal Toxicity) - Managing Side Effects

For example, methotrexate (MTX) nephrotoxicity depends upon crystallization of the parent compound and its metabolites. This crystallization is highly favored with the acidic urine pH that exists in the normal host with average protein intake. Thus, both inherent properties of a particular drug and the kidney-specific environment contribute to. Adult: Initial recommended dose: 12 g/m 2 as a 4-hr infusion, followed by folinic acid, as part of combined therapy. May increase dose to 15 g/m 2 in subsequent treatments if initial dosage is insufficient to achieve peak serum methotrexate levels of 454 mcg/mL at the end of the infusion. Methotrexate infusion is administered on postoperative.

Intrathecal Methotrexate Nephrotoxicity - Abstract

Keywords: high-dose methotrexate, methotrexate concentration, toxicities, patient characteristics, risk predictors, acute lymphoblastic leukemia Introduction Acute lymphoblastic leukemia (ALL) is a relatively infrequent malignant hematopoietic neoplasm in children. 1 Methotrexate (MTX) is an effective drug for the treatment of ALL Methotrexate is given as an Injectable or oral preparation. It is used at night and the usual recommended starting dose is 7.5 - 10 mg per week and increasing dose versus response to 15 mg / week. The drug takes approximately 4-6 weeks for a response to start. Nephrotoxicity. Hepatotoxicity. Pulmonary toxicity

High‐dose methotrexate‐induced nephrotoxicity in patients

Methotrexate 1. Methotrexate 2. 48 hours by glomerular secretion and active tubular secretion • Minimal metabolism only 7-OH MTX potentially nephrotoxic • Drugs which reduce RBF (NSAID) , nephrotoxic (cisplatin ) , weak organic acids (Aspirin , Piperacillin) increase toxicity. Infrequent but potentially severe nephrotoxicity Carboplatin. Methotrexate (especially high dose) Nitrosoureas (especially semustine) Rare reports of nephrotoxicity Actinomycin D. Anthracyclines.

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To the Editor: . Even in the era of precision and targeted therapies for neoplastic disorders, high dose methotrexate (HDMTX)—defined as >1 g/m 2 —remains a staple for the treatment of many hematologic, systemic solid and central nervous system tumors. While lower doses of methotrexate are typically well tolerated, HDMTX requires aggressive supportive care to reduce the risk of drug. Nephrotoxicity is a common adverse effect of many. Nephrotoxicity is a common adverse effect of many chemotherapeutic agents. Damage is often identifiable clinically by changes in glomerular filtration rate, creatinine clearance, blood urea nitrogen, urine protein, and urine output. The most common agents causing chemotherapy-associated. The inherent nephrotoxicity of drugs and their transport and metabolism by the kidneys play an important role in the occurrence of acute tubular injury. Apical transport of the aminoglycosides by endocytosis and apical pinocytosis of filtered hydroxyethyl starch into cells lead to acute tubular dysfunction. Methotrexate is an effective. Methotrexate (MTX) chemotherapy is often limited by its severe side effects, which include nephrotoxicity. In the continuous search for efficient antioxidants that could ameliorate this toxic condition of MTX, our study aimed to evaluate the efficiency of N-acetyl cysteine (NAC), Trolox methyl ether (Trolox-Me), and curcumin as potent antioxidants using an in vitro model of MTX-induced toxicity Methotrexate Tablets prescription and dosage sizes information for physicians and healthcare professionals. Pharmacology, adverse reactions, warnings and side effects

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