These include difficulty getting through normal activities . These criteria sets are the Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) criteria, which are graded, and the Besta criteria (Table).7,8, Evaluation should include examination for SFN signs and exclude large fiber neuropathy signs, nerve conduction studies (NCS) to rule out large fiber polyneuropathy, and skin biopsy or quantitative sensory testing (QST). 2021;121: 102662. Small fiber neuropathies. Etemadifar M, Sigari AA, Sedaghat N, Salari M, Nouri H. Acute relapse and poor immunization following COVID-19 vaccination in a rituximab-treated multiple sclerosis patient. Two patients with markedly reduced intraepidermal nerve fiber densities and one with normal skin biopsy had severe and moderate coronavirus disease 2019 (COVID-19); the remainder experienced mild COVID-19 symptoms. McArthur JC, Stocks EA, Hauer P, Cornblath DR, Griffin JW. Eur J Pediatric Neurology. Article Post COVID-19 vaccination-associated neurological complications. PubMed Manage cookies/Do not sell my data we use in the preference centre. Salinas MR, Dieppa M. Transient akathisia after the SARS-Cov-2 vaccine. Because the study measured just one possible facet of SFN (sudomotor dysfunction), it's possible . 2021;69: 102803. PubMed Gao J-J, Tseng H-P, Lin C-L, Shiu J-S, Lee M-H, Liu C-H. Venous sinus thrombosis and cerebral hemorrhage are more common in women between the ages of 30 and 50 than in men (Table 2) [8]. Google Scholar. 2021;122(3):7935. Since then, dozens of studies have validated its presence in somewhere around 40% of FM patients. Chemali KR, Zhou L. Small fiber degeneration in post-stroke complex regional pain syndrome I. Neurology. 32. The potential of COVID19 to cause small fiber neuropathy (SFN) . Clin Neurol Neurosurg. 2012;45(1):86-91. Neurology. Organizations representing experts in cancer, organ transplantation and autoimmune diseases support COVID-19 vaccination for their patients. Appointments 866.588.2264. 2021. https://doi.org/10.1007/s13760-021-01775-2. 2023 BioMed Central Ltd unless otherwise stated. Top Magn Reson Imaging. The most important and most common complications are cerebral venous sinus thrombosis (more about AstraZeneca), transverse myelitis (more about Pfizer, Moderna, AstraZeneca, and Johnson & Johnson), Bell's palsy (more about Pfizer, Moderna, AstraZeneca), GBS (more about Pfizer, AstraZeneca, and Johnson & Johnson), and the first manifestation of MS (more about Pfizer). 2018;20(1):1-6. ggdc fulfill service phone number; copenhagen, denmark circle houses for sale; covid vaccine and small fiber neuropathy. Ideggyogyaszati Szemle. Pain medications can be used as monotherapy or in combination to increase efficacy, such as gabapentin with nortriptyline and pregabalin or gabapentin with tramadol. 2010;15(1):57-62. JAAD Case Rep. 2021;15:601. Contribution of QSART to the diagnosis of small fiber neuropathy. Associated conditions in small fiber neuropathy - a large cohort study and review of the literature. Transverse myelitis has been observed after injection of mRNA and adenovirus-based vaccines, and it is noteworthy that mRNA-based vaccines can cause exacerbation or early manifestation of MS and neuromyelitis optica. I am 85 with small fiber neuropathy that is getting worse. Skin biopsy may also show amyloid deposition. Impaired VEGF-A-Mediated Neurovascular Crosstalk Induced by SARS-CoV-2 Spike Protein: A Potential Hypothesis Explaining Long COVID-19 Symptoms and COVID-19 Vaccine Side Effects? Pain Res Manag. In fact, the viral antigens of the vaccine stimulate an immunological response in the spinal cord [62]. 3. Following that situation in 2020, the World Health Organization had to declare a global health emergency. Retrieved February 28, 2023 from www.sciencedaily.com . Living with cranial neuropathy Monitoring blood sugar . If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. AntiTS-HDS and antiFGFR-3 were more common in female persons and those with NLD-SFN.31 Another retrospective study of 322 people with pure SFN and dysautonomia detected antiTS-HDS in 28% and antiFGFR3 in 17%, but the presence of these antibodies did not correlate with neuropathy symptom scores, autonomic dysfunction, or IENFD reduction, making the significance of these antibodies questionable.32 These findings suggest antiTS-HDS and antiFGFR3 are unlikely to be pathogenic, and it is uncertain whether presence of these antibodies is an epiphenomenon indicating immune-mediated SFN. There have been many reports of the Pfizer vaccine being associated with olfactory [66], visual [67], auditory [68, 69], and sometimes abducens nerve palsy. Chiu H-H, Wei K-C, Chen A, Wang W-H. CAS FOIA Samara V, Sampson J, Muppidi S. FGFR3 antibodies in neuropathy: what to do with them? According to the vaccine study literature, adverse effects have always been part of the mass vaccination strategy, but ultimately the desired effects of the vaccination are more significant. According to data from the CDC, VAERS, and EMA databases, the short-term outcome of COVID-19 vaccination is promising, but in the medium and long term, especially with some vaccines, side effects have been reported that are worrisome. 2011;76(20):1758-1765. doi:10.1212/WNL.0b013e3182166ebe. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. SARS-CoV-2; long-haul COVID-19 symptoms; neurological complications; post-acute COVID-19 syndrome; small fiber neuropathy. Autoimmun Rev. Article 2021;3(3):169. GBS is also a peripheral nerves and nerve roots injury that presents with severe motor weakness and paralysis of the legs or four limbs and is more common in the elderly after vaccination with adenovirus-based vaccines [ 65 ]. mRNA-based vaccines can increase the risk of herpes zoster [72]. Two received the Pfizer-BioNTech vaccine, one Moderna, and one Johnson & Johnson. Epub 2022 Apr 19. 1 Standardized diagnostic criteria for SFN are not fully established and skin biopsy remains the diagnostic . 2021. https://doi.org/10.1136/bmj.n1786. Odozor CU, Kannampallil T, Ben Abdallah A, Roles K, Burk C, Warner BC, Alaverdyan H, Clifford DB, Piccirillo JF, Haroutounian S. Pain. Side effects and perceptions following Sinopharm COVID-19 vaccination. This was approximately three weeks after receiving the third dose of the Moderna severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. A diagnostic cutaneous nerve laboratory should be used for processing and interpretation. Zhou L, Siao P. Lateral femoral cutaneous neuropathy caused by prone positioning to treat COVID-19-associated acute respiratory distress syndrome. Ozonoff A, Nanishi E, Levy O. Bells palsy and SARS-CoV-2 vaccines. Demonstrating new-onset or worsened sudomotor function post-COVID-19 on comparative analysis of autonomic function pre-and post-SARS-CoV-2 infection. At the same time, there are many reports of side effects after getting a COVID-19 vaccine. I am 85 with small fiber neuropathy that is getting worse. Finsterer J. New Engl J Med. . Clipboard, Search History, and several other advanced features are temporarily unavailable. Autonomic neuropathy can be a complication of many diseases and conditions and can be a side effect from some medications. European Journal of Medical Research Sharifian-Dorche M, Bahmanyar M, Sharifian-Dorche A, Mohammadi P, Nomovi M, Mowla A. Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review. Headache. Following the COVID-19 virus epidemic, extensive, coordinated international research has led to the rapid development of effective vaccines. Each type of vaccine can play a different role in increasing the risk of manifestation of these disorders (Tables 2, 3). Discussion: Management of SFN consists of identifying and treating underlying causes, alleviating neuropathic pain, and optimizing function. My neurologist thought it would be a good idea for me to wait with the covid vaccine and not be first in line to see how it affected other people with neuropathy. Johnson & Johnson is testing a coronavirus vaccine known as JNJ-78436735 or Ad26.COV2.S.Clinical trials showed that a single dose of the vaccine had an efficacy rate of 72 percent in the United . official website and that any information you provide is encrypted Due to the leakage of these genetic materials and their binding to factor 4 platelet, autoimmunity develops [29]. Because QSART is very sensitive to antihistamines and antidepressants, which affect sweating, these medications should be discontinued 48 hours prior to the study. Professor Consider a lip biopsy if Sjgrens syndrome or seronegative sicca syndrome is suspected. Thromb Res. With autonomic involvement palpitations, orthostatic dizziness, skin discoloration, bowel constipation, urinary retention, sexual dysfunction, dry eyes, dry mouth, and sweating abnormalities may occur. Post COVID-19 vaccine small fiber neuropathy Muscle Nerve. Individuals should test their bath water with a body part without numbness before putting their feet into the water, be careful with cooking, and avoid sleeping with their feet near a fireplace.40 Refer patients to physical therapy for gait training if a gait abnormality is reported or detected. Changes on how the central nervous system processes pain, fatigue, or other signals can lead to a variety of symptoms. Dagostino V, Caranci F, Negro A, Piscitelli V, Tuccillo B, Fasano F, Sirabella G, Marano I, Granata V, Grassi R. A rare case of cerebral venous thrombosis and disseminated intravascular coagulation temporally associated to the COVID-19 vaccine administration. Ann Med Surg. small-fiber neuropathy, an autoimmune disorder . eNeurological Sci. Recognizing vaccine-induced immune thrombotic thrombocytopenia. The paper below reiterates that: Recently, vaccine distribution Shy ME, Frohman EM, So YT, et al. Lancet Infect Dis. 2021;358: 577606. Please enable it to take advantage of the complete set of features! 35. 2013;48(6):883-888. 2015;138(Pt 1):43-52. Early outcomes of bivalirudin therapy for thrombotic thrombocytopenia and cerebral venous sinus thrombosis after Ad26. Comment on small fiber neuropathy associated with SARS-CoV-2 infection: Author response. Of the remaining seven patients who had normal skin biopsies, six showed no clinical neuropathy signs and one exhibited signs and had abnormal AFT. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. 2021;2(4):16971. Br Med J Publ Gr. Diabetic neuropathy in older adults. The benefit of topical anesthetics, however, is often limited. 21. de Greef BTA, Hoeijmakers JGJ, Gorissen-Brouwers CML, Geerts M, Faber CG, Merkies ISJ. It is noteworthy that rare and scattered reports have been published on the side effects of Sinopharm and other inactivated virus-based vaccines (Table 1). J Neurol. 2021;96(8):E3013. 24. eNeurologicalSci . The collected literature indicated that the neurological side effects associated with SARS-CoV-2 vaccines included headache, transverse myelitis, Guillain-Barre Syndrome (GBS . The preclinical evaluation of Covid vaccine AZ (study 514559) evidenced vaccine distribution) to various body tissues beyond injection site including sciatic nerves [4]. Finally, discovering whether these disorders are accidental or whether the vaccine is the main cause of them requires future studies, ongoing efforts to gather evidence, and long-term monitoring. The Food and Drug Administration on Monday . JAAD Case Rep. 2021;12:589. Varma-Doyle A, Villemarette-Pittman NR, Lelorier P, England J. eNeurologicalSci. Hosseini, R., Askari, N. A review of neurological side effects of COVID-19 vaccination. Intraepidermal nerve fiber density at the distal leg: a worldwide normative reference study. Provided by the Springer Nature SharedIt content-sharing initiative. Cephalalgia. Thaisetthawatkul P, Fernandes Filho JA, Herrmann DN. Khan S, Zhou L. Characterization of non-length-dependent small-fiber sensory neuropathy. Autonomic testing is useful when autonomic symptoms are present. It is also important to explain that pain medications are used to control pain, burning, or tingling, but not numbness. The symptoms of peripheral neuropathy may look like other conditions or medical problems. Some patients may experience burning pain or coldness and electric shock-like brief painful sensations. Wichova H, Miller ME, Derebery MJ. 2022 Oct 3;10:977827. doi: 10.3389/fped.2022.977827. Adams D, Suhr OB, Hund E, et al. Int Med Case Rep J. Ogbebor O, Seth H, Min Z, Bhanot N. Guillain-Barr syndrome following the first dose of SARS-CoV-2 vaccine: a temporal occurrence, not a causal association. Intravenous immunoglobulin (IVIG) is ineffective for treatment of idiopathic painful SFN. Examination may detect dryness, coldness, and skin discoloration in the feet and distal legs (ie, red, white, and purple), as well as orthostatic tachycardia and hypotension.4, SFN often negatively impacts quality of life both physically and mentally because of neuropathic pain, numbness, and dizziness, which may affect gait and lead to falls especially later in life when falls are already more common.5,6. Acute transverse myelitis associated with COVID-19 vaccine: a case report. SSRN. Nayere Askari. Epub 2023 Jan 26. It is under development for the treatment of autoimmune small fiber neuropathy, X-linked agammaglobulinemia, hypogammaglobulinemia, chronic inflammatory demyelinating polyneuropathy (CIDP). Therefore, vaccination is like a shock to the recurrence of VZV and subsequent herpes zoster [71]. Google Scholar, who.int. medRxiv. But those symptoms may be just the tip of the iceberg. Google Scholar. Springer Nature. Since SFSN usually does not involve large sensory fibers that convey . eCollection 2022. 2022. https://doi.org/10.1093/qjmed/hcab335. Razok A, Shams A, Almeer A, Zahid M. Post-COVID-19 vaccine Guillain-Barr syndrome; first reported case from Qatar. Clark RT, Johnson L, Billotti J, Foulds G, Ketels T, Heard K, Hynes EC. J Autoimmun. I'm 28F too, with an official diagnosis of small fiber neuropathy. 2022;75:103293. The Food and Drug Administration warned on Monday that Johnson & Johnson's coronavirus vaccine can lead to an increased risk of a rare neurological condition known as Guillain-Barr syndrome . 2022;50(1): e80. 2021. https://doi.org/10.1007/s10072-021-05662-9. California Privacy Statement, The diagnostic criteria for small fibre neuropathy: from symptoms to neuropathology. Ramdeny S, Lang A, Al-Izzi S, Hung A, Anwar I, Kumar P. Management of a patient with a rare congenital limb malformation syndrome after SARS-CoV-2 vaccine-induced thrombosis and thrombocytopenia (VITT). SFN may underlie the paresthesias associated with long-haul post-COVID-19 symptoms. Typically, the attacks begin in the hands and feet. Wearing padded socks and supportive shoes can help foot protection and promote ulcer healing. 2021;114(7):5312. 2017;126:135-138. 2021. https://doi.org/10.1155/2021/3619131. Int J Res Pharma Sci. COV2. Channa L, Torre K, Rothe M. Herpes zoster reactivation after mRNA-1273 (Moderna) SARS-CoV-2 vaccination. In addition to these, the CDC recommends seeking emergency medical care . Comput Struct Biotechnol J. Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus [published correction appears in Pain. Muscle Nerve. J Neurol Sci. 26. A review of neurological side effects of COVID-19 vaccination, https://doi.org/10.1186/s40001-023-00992-0, https://doi.org/10.1007/s10072-021-05662-9, https://doi.org/10.1038/s41598-022-17514-3, https://doi.org/10.1007/s13760-021-01775-2, https://doi.org/10.9734/ijmpcr/2021/v14i130124, https://doi.org/10.1007/s12024-021-00440-7, https://doi.org/10.1016/j.nrleng.2021.05.002, https://doi.org/10.6061/clinics/2021/e3286, https://doi.org/10.1080/14992027.2021.1931969, https://doi.org/10.1136/postgradmedj-2021-141022, https://doi.org/10.1007/s00415-021-10780-7, https://doi.org/10.1016/j.nrleng.2021.04.002, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. A point mutation in the . Immune-mediated disease flares or new-onset disease in 27 subjects following mRNA/DNA SARS-CoV-2 vaccination. 2021;14:349. 127 other instances of nerve injury and 301 cases of various forms of neuropathies (including 207 cases of peripheral neuropathy) listed in the MHRA database [2]. SFN is mostly length-dependent (LD-SFN), displaying a stocking or stocking-glove pattern of involvement. J Neurol. 2021. https://doi.org/10.7759/cureus.16624. Muscle Nerve. portugus; News/Update/Help. The significance of new association with autoantibodies, including antibodies to trisulfated heparin disaccharide (TS-HDS) and fibroblast growth factor 3 (FGFR3), needs further investigation. 2021;12:879. Jenna Birch, 28, was finally properly diagnosed with small fiber neuropathy, a rare nerve disorder, after experiencing searing pain all over her body since childhood. Find information and tools about neurological diseases to assist patients and caregivers. Cranial neuropathy can't always be prevented. Medical insurance, however, usually approves the test after presence of SFN symptoms and absence of large fiber polyneuropathy (normal NCS) are documented. These included 63, 17, and 50 percent of skin biopsies, electrodiagnostic tests, and autonomic function tests, respectively. Nine patients received symptomatic neuropathy treatment with paresthesias controlled in seven (77.8%). Unique imaging findings of neurologic phantosmia following Pfizer-BioNtech COVID-19 vaccination: a case report. Introduction/aims: Life-threatening symptoms, such as difficulty breathing or irregular heartbeat. There was a recent report of Ramsey Hunt Syndrome (RHS after the Pfizer vaccination. Hoffman EM, Watson JC, St Sauver J, Staff NP, Klein CJ. The pain is severe and refractory to treatment, but spontaneously improves after 12 to 24 months.23. Ann Med Surg. None of the other authors has any conflict of interest to disclose. Our findings suggest that symptoms of SFN may develop during or shortly after COVID-19. It is thus important to reassure patients about the benign course of SFN. Posted by cue @cue, Feb 15, 2021. Immunol Res. Consider genetic testing if there is an early onset of SFN symptoms or a positive family history. 2021;11(4):285. In a study of 17 patients referred for neurological evaluation of otherwise-unexplained long-COVID, most had test results demonstrating peripheral nerve damage. Spectrum of neurological complications following COVID-19 vaccination. National Library of Medicine Figure 1. PubMed Central Pain. Screening for associated conditions is important for etiology-specific treatment to control symptoms and slow down disease progression. 2021. https://doi.org/10.7759/cureus.13426. BMJ Case Reports CP. Peters MJ, Bakkers M, Merkies IS, Hoeijmakers JG, van Raak EP, Faber CG. Patients may also report squeeze sensation, coldness, or itchy skin. According to the WHO, in the case of side effects of inactivated virus-based vaccines, especially Sinopharm, the most common local and systemic adverse reactions are injection site reactions, fatigue, fever, headache, and allergic dermatitis, which are self-limiting, and the person does not need to be hospitalized [11, 12]. Brain. Description. Side effects of COVID-19 vaccination have been reported more frequently in people with a history of immune-related diseases or who are more sensitive to age and physiological conditions. 2021;69:205211. Of the 17 patients (aged mean 43.3 years, 68.8% women 94.1% White) who had COVID-19 between February 21, 2020, and January 19, 2021, 16 had mild COVID and 1 had severe COVID due to critical care . According to reports, these complications are more common in men and women between the ages of 20 and 60 [9]. Garg RK, Paliwal VK. Microorganisms. . . Optic neuritis in a patient with seropositive myelin oligodendrocyte glycoprotein antibody during the post-COVID-19 period. Because the results of the phase 4 studies are the proper criteria for how the vaccine works in the real world [5]. We describe the case of a 57-y-old female who presented 1 week after receiving the second dose of the Pfizer coronavirus disease 2019 (COVID-19) vaccine with subacute onset of intense burning dysesthesias in the feet, gradually spreading to the calves and minimally into the hands, unaccompanied by . 2022 Mar 15;434:120118. doi: 10.1016/j.jns.2021.120118. Small fiber neuropathy underlying dysautonomia in COVID-19 and in post-SARS-CoV-2 vaccination and long-COVID syndromes. Pulmonary embolism, transient ischaemic attack and thrombocytopenia after the Johnson & Johnson COVID-19 vaccine. Classification of neurological complications observed after COVID-19 vaccination. doi: 10.1002/mus.27554. Three weeks after mild COVID-19, one patient was diagnosed with critical illness axonal neuropathy and another with multifocal demyelinating neuropathy; 10 or more received diagnoses of small-fiber neuropathy. Baldelli L, Amore G, Montini A, Panzera I, Rossi S, Cortelli P, Guarino M, Rinaldi R, DAngelo R. Hyperacute reversible encephalopathy related to cytokine storm following COVID-19 vaccine. The importance of safety cannot be overemphasized, considering that pain, numbness, dizziness, and drowsiness can lead to physical injuries especially with increasing age. 2021;64(1):70-76. COVID vaccines and neuropathy. Brain. Romn GC, Gracia F, Torres A, Palacios A, Gracia K, Harris D. Acute transverse myelitis (ATM): clinical review of 43 patients with COVID-19-associated ATM and 3 post-vaccination ATM serious adverse events with the ChAdOx1 nCoV-19 vaccine (AZD1222). Fear can aggravate pain and depression, making treatment difficult. Tidsskrift for Den norske legeforening. Int J Med Pharm Case Rep: 20-24. . 2022;362: 577765. volume28, Articlenumber:102 (2023) sharing sensitive information, make sure youre on a federal Small fiber neuropathy is a condition characterized by severe pain attacks that typically begin in the feet or hands. Dyer O. Covid-19: Regulators warn that rare Guillain-Barr cases may link to J&J and AstraZeneca vaccines. In my opinion, covid absolutely can cause this. Clin Imaging. That way, you can control the sugar content but still enjoy a sweet treat. You might be interested in this ARTICLE published in May 2022 in the journal, Neurology. Privacy Controlled trials of IVIG for SFN associated with sarcoidosis or Sjgrens syndrome are needed to confirm efficacy and facilitate insurance coverage of IVIG. Ismail II, Salama S. A systematic review of cases of CNS demyelination following COVID-19 vaccination. Most patients first describe it as a stabbing, burning, or abnormal sensation of the skin, such as tingling or itchiness. The attacks usually consist of pain described as stabbing or burning, or abnormal . All Rights Reserved Privacy Policy, Headache & Pain, Headache & Pain, Neuromuscular, Neuromuscular, Small fiber neuropathy, Neuropathy, Neuropathic Pain, Pain, Numbness, Parasthesia, Sensory neuropathies, Restorative and Rehabilitative Treatments for Stroke in the Outpatient Setting, Dementia Insights: Avoiding Burnout in Dementia Care, Addressing Lifestyle Factors in Poststroke Care, Closing Care Gaps by Thinking, Talking, and Treating Migraine, Understanding Chiari Malformation Comorbidities, Remote Electrical Neuromodulation Device Helps Prevent Migraines, New Insights into Athletes with Slow Recovery from Concussion, Web-Based Treatment Effective for Vertigo. New York, NY, Neuromuscular & Autonomic Complications of COVID-19, Amir H. Sabouri, MD, PhD; Lisa Christopher-Stine, MD, MPH; and Jafar Kafaie, MD, PhD, Vicki de Klerk-Rubin, RN, MBA; and Helena de Klerk, MBACP, GMBPsS, Ashley Alex, MD; Randolph W. Evans, MD; Paul G. Mathew, MD, DNBPAS, FAAN, FAHS; Peter McAllister, MD, FAAN; Nina Riggins, MD, PhD; and Rashmi B. Halker Singh, MD, FAHS, FAAN, Gerald S. Steiman, MD; and Sandra Plunkett, RN, MS. Sign up to receive new issue alerts and news updates from Practical Neurology. COVID-19 vaccination can sometimes have severe side effects on nervous system, including the brain, spinal cord, cranial nerves, and peripheral nerves, and has been shown to have adverse vascular, metabolic, inflammatory, and functional effects on the brain [1]. Association of long-term opioid therapy with functional status, adverse outcomes, and mortality among patients with polyneuropathy. Evidence for the criteria strength and consistency is weak, however. Ramasamy MN, Minassian AM, Ewer KJ, Flaxman AL, Folegatti PM, Owens DR, Voysey M, Aley PK, Angus B, Babbage G. Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial.
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