Posts Tagged ‘Heart Disease’

Fortifying your knowledge of vitamins

By Tyrone M. Reyes, M.D.

Take a multivitamin for insurance.” Until recently, that was the usual advice from physicians, scientists, and other experts. Now, it’s under scrutiny: That’s because if you’re looking for hard evidence that a multivitamin will lower your risk of heart disease, cancer, cataracts, or other major disease, you may be disappointed. In 2006, the US National Institutes of Health held a State-of-the-Science Conference. Its conclusion: “Evidence is insufficient to prove the presence or absence of benefits.”

“Insufficient” is putting it mildly. By the time the scientists narrowed the field to trials that pitted a multivitamin against a placebo and excluded poorly done studies, they ended up with less than half a dozen — two of them done in China and two in France. The single US study looked only at vision. But it’s one thing to lack proof that multivitamins prevent disease. It’s quite another to find evidence that a multi might cause harm. After all, a handful of recent studies have suggested that people who take multivitamins — or a few of the nutrients they contain — might have a slightly higher risk of cancer. Here’s what to do until scientists sort out the confusion.

How To Read A Multivitamin Label

Please refer to the illustration of a made-up multivitamin label on this page. It lists how much of each vitamin and mineral we need to get every day (from food plus supplements), according to the US National Academy of Sciences’ Institute of Medicine (IOM). The IOM’s recommendations vary slightly by age and gender. In most cases, what is listed is the highest value for adults, excluding pregnant and breastfeeding women. The label also lists the Daily Value (DV) for each vitamin or mineral. It is the US Food and Drug Administration’s (FDA) advice on how much to shoot for each day (from food and supplements combined). The DVs, which haven’t been updated in decades, are still used on multivitamin labels. In some cases, the values date from 1968 and don’t reflect the recent research. Here is the current thinking on these nutrients (please refer to the values as indicated in the label):

• Vitamin A (retinol). The Daily Value (5,000 IU or International Units) is outdated. You need only 3,000 IU a day of vitamin A. Too much retinol (typically listed on labels as vitamin A palmitate or vitamin A acetate) may increase the risk of hip fractures, liver abnormalities, and birth defects. Beta-carotene, which the body converts to vitamin A, doesn’t cause those problems, but very high doses (33,000 to 50,000 IU a day) may increase the risk of lung cancer in smokers. Current advice: Don’t get more than 4,000 IU of retinol or 5,000 IU of beta-carotene from your multi (less retinol would even be better). Instead, load up on beta-carotene-rich fruits and vegetables like carrots, cantaloupes, sweet potatoes, and broccoli, which may help prevent some cancers.

• Vitamin C. The DV (60 mg) is lower than the IOM’s recommendations (75 mg a day for women and 90 mg a day for men). Roughly 250 to 500 mg saturates the body’s tissues, so more than that is probably excreted in urine. Taking more than 1,000 mg of vitamin C at one time in a supplement may cause diarrhea.

• Vitamin D. This vitamin helps you absorb calcium and may reduce the risk of cancer, diabetes, and falls. Some people may get too little vitamin D from sunshine or from their food. The IOM recommends 200 IU a day for adults 50 and under, 400 IU for people 51 to 70, and 600 IU for anyone over 70. Some vitamin D experts though say that everyone should get at least 1,000 IU a day. Those amounts include what you get from the sun, from salmon and other fatty fish, and from fortified foods like milk, breakfast cereals, and some brands of yogurt, margarine, and orange juice. They also include the vitamin D that’s added to many calcium supplements. Most multivitamins have 400 IU of vitamin D (the DV).

• Vitamin E. Doses of 30 to 800 IU a day haven’t protected against heart disease or stroke, and 400 IU a day or more may slightly raise the risk of dying. Studies are underway to see if 400 IU a day prevents prostate cancer. To play safe, stick to no more than 100 IU.

• Vitamin K. The IOM recommends 120 mcg/day, yet most multivitamins have much less than the DV (80 mcg). In recent studies, taking extra vitamin K doesn’t strengthen bones, as earlier studies had suggested. You can get K from leafy green, some calcium supplements, and vitamin K supplements. Vitamin K can interfere with blood-thinning drugs like Coumadin, so people who take them should check with their doctor before taking a multi with vitamin K.

• Thiamine (B-1), riboflavin (B-2), niacin (B-3), B-6. The higher-than-DV levels in many multivitamins are harmless. Two exceptions: More than 100 mg a day of vitamin B-6 can cause (reversible) neurologic damage. And as little as 50 mg a day of niacin can cause flushing. Super-high doses of niacin (3,000 mg a day or more) may cause liver damage, though you won’t find that much in a multivitamin.

• Folic acid. If you could become pregnant, look for a multi with the DV (400 mcg) to reduce the risk of birth defects. Others should probably take less until studies clarify whether high intakes (roughly 1,000 mcg a day or more from supplements and food combined) raise the risk of cancer. Since most multis have 400 mcg, one option is to take your “daily” multi every other day.

• Vitamin B-12. Most multivitamins have at least 6 mcg (the DV). That’s more than the 2.4 mcg the IOM recommends for adults, but it’s perfectly safe. (So are the higher doses — 600 to 800 mcg — that are found in a few multivitamins.) Ten to 30 percent of older people are unable to absorb the B-12 in the form that’s added to supplements and fortified foods. A B-12 deficiency can cause irreversible nerve damage and may masquerade as Alzheimer’s disease.

• Biotin, panthotenic acid. Ignore. You’d have to eat a bizarre diet to run short.

• Calcium. Calcium may help prevent colon cancer and (with vitamin D) may reduce the risk of osteoporosis. Shoot for 1,000 mg a day (if you’re 50 or younger) or 1,200 mg (if you’re over 50). But men should get no more than 200 mg from their multi, since 1,500 mg a day or more may raise prostate cancer risk.

• Iron. Many people, especially premenopausal women, are deficient. But taking too much can cause constipation or iron overload if you’re susceptible. Men and postmenopausal women should look for a multivitamin with no more than 10 mg of iron or should take a multi for premenopausal women every other day. The DV (18 mg) is fine for premenopausal women.

• Phosphorus. Unnecessary to take in a multi. Too much may impair calcium absorption, and we already get more than we need from our food.

• Magnesium. Many people get too little of magnesium from their food (among the best sources: whole grains and beans). A deficiency may increase the risk of diabetes and colon cancer. Look for a multi with at least 100 mg, just for insurance. The IOM recommends 320 mg a day for women and 420 mg for men. More than 350 mg a day from a supplement may cause diarrhea.

• Zinc, copper. Look for 8 mg (women) or 11 mg (men) of zinc and 0.9 mg of copper. There’s no harm in taking a multivitamin with the DVs (15 mg for zinc and 2 mg for copper), but don’t take more than 23 mg zinc. Getting more than 40 mg may make your body lose copper.

• Selenium. Many multis have less than the DV (70 mcg) or the IOM’s recommended level (55 mcg). A large study is under way to see if high doses (200 mcg) can lower the risk of prostate cancer. But a few studies have suggested that taking 200 mcg a day may raise the risk of skin cancer and diabetes, so it’s safest to take no more than about 100 mcg a day.

• Chromium. The IOM recommends only 20 to 25 mcg a day (women) or 30 to 35 mcg a day (men). Many brands have closer to 120 mcg (the DV), which is safe.

• Iodine, magnesium, molybdenum, chloride, boron. Ignore. There’s no evidence that people need more than what they get from their food.

• Potassium. Ignore. The amounts in multis are low. And while the potassium chloride that’s used in supplements may lower blood pressure and the risk of stroke, it won’t help prevent kidney stones and bone loss like the potassium citrate that’s found in fruits and vegetables.

• Nickel, silicon, tin, vanadium. Ignore. It’s not clear that they’re needed.

Source: Philstar

Busting six top health myths

By Ching M. Alano

Nope, we’re not going to talk about sex, lies, and videotape here. It seems everybody’s talking about that, it’s coming out of our ears. We have no Hayden agenda, we simply want to bare the lies, half-truths, and myths that have persisted or been perpetuated through the years.

According to health activist Dr. Joseph Mercola with Rachael Droege, believe or not, there are tons of health information being circulated by media, it’s difficult to separate what is credible from what is not. And some of this information that has been accepted as gospel truth by many experts and health care practitioners are actually myths.

Mercola gives us this friendly advice, “Your health really depends on your own ability to sort through all of the information and pick out what is reliable. Unfortunately, you often cannot rely on the ‘popular’ opinions to give you the best results.”

And now, here are the top six health myths and the facts, according to Dr. Mercola.

1. Myth: Saturated fat causes heart disease.

Fact: Separating fat from fiction, Dr. Mercola stresses that it is not the saturated fat in the foods we eat that is giving us heart disease, but rather — and much more — it is the excess carbohydrates from our starch- and sugar-laden diet that are making us fat and unhealthy, as well as causing epidemic levels of a host of diseases like diabetes and heart disease. Then there are the trans fats, which raise bad cholesterol in the blood, a risk factor for cardiovascular diseases.

Dr. Mercola explains, “The reason why many people have not succeeded with the original diet-heart hypothesis that says a low-fat, high-carb diet is the best diet for the heart is likely explained by metabolic typing. We each have one of three nutritional types and each suits people to a different type of diet. Some people will benefit from a “high”-carb program that is two-thirds carbs as vegetables, while others need to follow a diet that is higher in protein to function optimally.”

2. Myth: Low-fat diets are healthy.

Fact: Fat chance. Our body cannot function properly without adequate amounts of fat —from blood clotting to vitamin absorption to brain function. Which is why a low-fat diet can be dangerous. Among the dangers are: It raises bad (LDL) cholesterol; won’t prevent prostate cancer; can increase risk of injury; increases triglyceride (a type of fat found in the blood that’s important to good health); won’t prevent prostate cancer; can increase risk of injury; may increase risk of stroke; worsens heartburn; denies children essential nutrients.

What makes low-fat diets harmful is the fact that people tend to replace the fats with grains and sugars. “If vegetables were substituted instead, then it is far less likely that there would be a problem,” asserts Mercola.

He adds, “Also, many people have adopted low-fat diets as a way to lower their cholesterol. Not only are low-fat diets not the key to lowering cholesterol, as mentioned above, they may actually raise bad cholesterol. But low cholesterol does not necessarily mean good health. For instance, low cholesterol is linked to many problems including aggressive behavior, depression, suicide, and stroke.

Yes, we all need some beneficial fats in our diet to stay healthy and avoiding fat like the plague and striking it out of our diet is a prescription for disaster, says Mercola.

3. Myth: Sun causes skin cancer.

Fact: It’s probably the hottest — and one of the most inaccurate myths — going around. We all need sunshine to stay healthy. Although sun exposure can cause skin cancer, appropriate sunlight actually prevents cancer. Exposure to the sun provides many other benefits such as promoting the formation of vitamin D. There’s also strong evidence that sunlight protects against MS and colon, ovarian, and breast cancers.

Of course, that doesn’t mean you can expose yourself to the sun as much as you want. Here’s Dr. Mercola’s bright prescription: “At the beginning of the season, go out gradually and limit your exposure to perhaps as little as 10 minutes a day. Progressively increase your time in the sun so that in a few weeks, you will be able to have normal sun exposure with little risk of skin cancer. Remember to never get burned, that is the key.”

He cautions everyone, “Using sunscreen is not a good way to limit your sun exposure; in fact, sunscreen is one of the last things you want to put on your body, and sunblock does not stop skin cancer. Sunscreen is a toxic chemical that can cause problems in your system and increase your risk of disease. A far more logical solution would be to creatively use your clothing to block the sun’s rays during your build-up time. Additionally, consuming many whole vegetables will increase antioxidant levels in the body, which will provide protection against any sun-induced radiation damage. If you are interested in preventing disease by way of the sun, I cannot urge you strongly enough to read the book that I am calling one of the most important health books of all-time, The Healing Sun by Dr. Richard Hobday.”

4. Myth: Milk does the body good.

Fact: Commercial pasteurized milk is not a health food and should be avoided. The problem lies in the pasteurization process, combined with the source of largely unhealthy cows. When milk is pasteurized, the structure of the milk proteins changes (denaturization) into something far less than healthy.

Sally Fallon of the Weston Price Foundation says it best: Pasteurization destroys enzymes, diminishes vitamin content, denatures fragile milk proteins, destroys vitamin B12 and vitamin B6, kills beneficial bacteria, promotes pathogens and is associated with allergies, increased tooth decay, colic in infants, growth problems in children, osteoporosis, arthritis, heart disease, and cancer.

Take note, says Mercola: Raw milk sours naturally, but pasteurized milk turns putrid and processors must remove slime and pus from pasteurized milk by a process of centrifugal clarification.

What’s so sad is the fact that milk is one of the healthiest foods available prior to its being

5. Myth: Fish is good for you.

Fact: Of course, fish is one of the healthiest meats on the planet as it is loaded with beneficial omega-3 fats, but the sad truth is fish (and shellfish) easily accumulate high levels of chemical residues from the water they live in. Residues in fish can be as much as nine million times the amount found in the water!

Some of the contaminants found in fish flesh are mercury; PCBs; radioactive substances like strontium, toxin metals like cadmium and lead.

But it’s okay to eat very small fish like anchovies and sardines as they are small enough to have minimal contamination.

6. Myth: Whole grains are good for you.

Fact: The whole truth is that while we agree that whole grains are better than refined grains, whole grains are still not something that most people should be eating, says Mercola.

Mercola gives the facts and figures: “Well over 75 percent of Americans would benefit from severely limiting or eliminating all grains — refined, whole, sprouted or otherwise — from their diets. This is because nearly everyone with high insulin levels benefits from avoiding grains; yes, even whole grains. People in this group would be anyone who is or has: overweight, high blood pressure, high cholesterol, or diabetes.”

Now you know the real meat vis-a-vis these myths.

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We’d love to hear from you. E-mail us at ching_alano@yahoo.com.

Hormone therapy: An update on risks and benefits

By Tyrone M. Reyes, M.D. (The Philippine Star)

More than 60 years ago, experts found that giving estrogen to women going through menopause could relieve some of the changes associated with this change of life — including hot flashes, night sweats, and vaginal dryness. Later on, replenishing estrogen levels was thought to provide a range of other benefits for women once they no longer produced as much of this hormone naturally. In fact, in the 1980s and ‘90s, doctors often prescribed hormone therapy not only to relieve menopausal symptoms but also to help women prevent chronic conditions such as heart disease and osteoporosis, and improve their quality of life after menopause.

However, that all changed in 2002, when a large clinical trial called Women’s Health Initiative (WHI) reported that older women given a popular therapy combining estrogen and a synthetic form of progesterone (Progestin) had an increased risk of developing heart disease, breast cancer, stroke, and blood clots. As concerns about the health hazards associated with all types of hormone therapy grew, doctors became hesitant in prescribing these medications and many women discontinued taking them.

Today, the news about hormone therapy isn’t quite as alarming. Although it’s no longer recommended that women use it long term to prevent serious conditions such as heart disease, there’s evidence that the hormone estrogen may offer some health benefits for women who take it early in menopause. Estrogen remains the most effective treatment for menopausal hot flashes, night sweats, and vaginal dryness. In short, hormone therapy isn’t all good or all bad. Yet, this fact has left many women more confused than ever. To learn the latest on the risks and benefits of hormone therapy and how this information might apply to you, read on.

Hormones And Menopause

Your ovaries, the two small oval-shaped organs found on each side of your uterus, produce eggs as well as the two female hormones, estrogen and progesterone. During the months or years before menopause — a time known as perimenopause — your body begins to make less of these hormones.

When you reach menopause, your periods stop altogether and your ovaries no longer produce eggs. (Menopause is defined as having no periods for 12 months.) Your ovaries also make much less estrogen and no longer provide your body with any progesterone — the hormone that prepares your body for pregnancy.

Natural menopause happens on average around the age of 51, but can occur anytime between the ages of 40 and 60. However, certain medical or surgical treatments, as well as some medical conditions, can bring on menopause earlier than expected. For instance, a hysterectomy can bring on immediate menopause — if your ovaries are removed along with your uterus during the surgical procedure. In some cases, chemotherapy and radiation, used for cancer treatments, also can cause menopause by damaging ovaries and shutting down hormone production.

No matter when and how you go through menopause, symptoms can result as your body adjusts to the change in estrogen levels. The most common are hot flashes. Lower levels of estrogen can also contribute to vaginal and urinary changes. But that’s not all. Estrogen, or the lack of it, can affect other parts of your body as well – including your skin, blood vessels, heart, bones, brain, and breasts.

Types Of Hormone

Hormone therapy typically involves the use of estrogen with or without progesterone. Women who’ve had a hysterectomy and no longer have a uterus can use estrogen alone. Women who still have a uterus need to take estrogen along with a progestin. This combination prevents the overgrowth of cells in the lining of the uterus (endometrium), a problem that can lead to the development of endometrial (uterine) cancer.

In the past, hormones were typically taken in pill form (oral therapy). This is still a common form of hormone therapy. However, there are an increasing number of other options available for delivering hormones to other parts of the body (locally), such as to the vagina. These include skin patches, creams, gels, sprays and vaginal rings, tablets or creams.

Risks And Benefits

There’s no question that hormone therapy is one of the most effective treatments for severe menopausal symptoms. However, hormones are no longer routinely recommended for women just because they’re in their menopausal years. This is especially true for women who have a current or past history of breast cancer, heart disease, stroke or blood clots.

The reason has to do with the results of WHI — a set of clinical trials that examined the long-term effects of postmenopausal hormone therapy on heart disease, osteoporosis, colorectal cancer, and breast cancer risk. The thousands of women in the randomized trials, which compared specific hormones against placebos, were between the ages of 50 and 79. However, the average age of the women entering the trials was 64.

One part of the trial was halted in 2002. The reason: After about five years, the women who were taking a prescription drug combining estrogen plus progestin had a small but significantly increased risk of heart disease, breast cancer, stroke, and blood clots in the leg (deep vein thrombosis) or lung (pulmonary embolism). Another part of the trial was dropped in 2004. That’s because after almost seven years, the women who were taking only a prescription estrogen had an increased risk of stroke and blood clots.

Nevertheless, hormone therapy did offer some benefits. The risk of bone fractures was reduced in the women taking the combination hormone therapy and in those taking estrogen alone. The risk of colorectal cancer also was reduced in women taking estrogen and progestin. Another major finding was that most of the women who had menopausal hot flashes and night sweats at the start of the study got relief from these signs and symptoms when they started hormone treatment. Today, most experts consider hormone therapy to be a safe and reasonable option for healthy women who are bothered with menopausal symptoms such as hot flashes. In addition, newer research is finding again that hormone therapy may offer women some long-term health benefits when started in the early years of menopause.

Reducing Risks

If you chose however to take hormone therapy, how can you protect yourself from potential health risks? According to data from WHI, it’s important to pay attention to the following:

• Timing. The closer you are to menopause when you take hormone therapy, the less likely you may be to facing serious health risks. For instance, recent research has indicated that women in their 50s who take hormones to relieve menopausal symptoms may not have increased risk of heart disease. In fact, some evidence suggests that estrogen may actually protect the heart when taken within the first 10 years of menopause.

• Dosage. Some menopause symptoms, such as hot flashes, can last for years. But it’s best to use the lowest effective dose for the shortest amount of time.

• Delivery method. Today, with more options to deliver hormone therapy, it may be more effective and possibly safer to apply it directly than orally. For example, estrogen vaginal cream or a vaginal ring is often recommended for menopausal symptoms limited to the urinary tract and genital area, such as vaginal dryness. Direct application of a very low dose of estrogen to the affected tissue can provide relief from symptoms while minimizing side effects.

Tailoring Treatment

When it comes to hormone therapy, one thing is clear: There’s no one treatment that’s right for all women. The only way to determine if hormone therapy is right for you is to talk with your gynecologist about your own menopausal symptoms and your personal risk of such conditions as osteoporosis, heart disease, stroke, blood clots, and breast cancer.

Questions you may want to ask include when to begin, what type and dose are most appropriate for you, the possible health risks and side effects, additional tests or procedures you might need, and the length of time you need to be on hormone therapy. You may also need to review your treatments with your doctor on a periodic basis to make sure they’re still your best option. As researchers learn more and more about hormone therapy and other menopausal treatments, recommendations may change. The types of hormone therapies available and your risk of certain conditions also may change over time.

Source: Philstar.com

Sleep Apnea Linked to Mortality Risk

Sleep-disordered breathing, or sleep apnea, is a common health condition associated with adverse health outcomes, including high blood pressure and heart disease. Now, evidence from the landmark Sleep Heart Health Study demonstrates that moderate to severe obstructive sleep apnea is associated with an increased risk of death, especially in middle-aged men.

Researchers studied 6,441 men and women aged 40 years or older participating in the Sleep Heart Health Study in order to determine whether sleep apnea was associated with mortality. They found that individuals with severe sleep apnea had a 40% increased risk of death compared to those without sleep-disordered breathing. The researchers also discovered that the oxygen deprivation associated with as little as eleven minutes of sleep apnea a night doubled the mortality rate in men.

Sleep apnea affects about 1 in 10 women and 1 in 4 men. The interruptions in breathing which occur with sleep apnea lower the level of oxygen in the blood and may cause individuals to arouse from deep sleep as they struggle to breathe. The findings of this study show that sleep apnea is a major risk factor for mortality, independent of other major risk factors such as age, hypertension, heart disease, and diabetes, particularly among men aged 40 to 70 with severe sleep-disordered breathing.

Source:

Public Library of Science Medicine, published online August 18, 2009.

Created on: 08/25/2009
Reviewed on: 08/25/2009

Your rating: None

Acid Reflux and Heartburn

stomachHeartburn or pyrosis is a painful and burning sensation in the esophagus, just below the breastbone usually associated with regurgitation of gastric acid. The pain often rises in the chest and may radiate to the neck, throat, or angle of the jaw. Heartburn is a major symptom of gastroesophageal reflux disease; acid reflux is also identified as one of the causes of chronic cough, and may even mimic asthma. Despite its name, heartburn actually has nothing to do with the heart; it is so called because of a burning sensation near to where the heart is located – although some heart problems may give rise to a similar burning sensation. Compounding the confusion is the fact that hydrochloric acid from the stomach comes back up the esophagus because of a problem with the cardiac sphincter, a valve which misleadingly contains the word “cardiac,” referring to the cardia as part of the stomach and not, as might be thought, to the heart.

According to the Mayo clinic, chest pain that is not related to heart disease is most commonly caused by acid reflux syndrome or GERD, which is gastro-esophageal reflux. The terms are used interchangeably. In order to determine if a person is experiencing acid reflux chest pain, doctors may use tests to measure acid levels in the esophagus, this is the tube that carries food from the mouth to the stomach. A symptoms diary is also helpful to determine if the pain is acid reflux chest pain or another condition. If a person notes that the chest pain occurs when other acid reflux syndrome symptoms are present, then the doctor may conclude that the pain is caused by the acid reflux syndrome.

Studies have shown that between 22 and 66 percent of patients who had chest pain that was not related to heart disease suffered from acid reflux syndrome. This is not to say that all non-cardiac chest pain is acid reflux chest pain, there are other possible causes. Researchers have investigated the possibility that some chest pain, not caused by heart disease or acid reflux syndrome, may be caused by a heightened sensitivity to pain in some organs. Studies have shown that in some patients, the muscles of some organs are sensitive and quick to send pain signals to the brain. No one knows why this happens, but research does continue.

Once the determination is made that no heart disease is present, treatment of acid reflux chest pain is no different form treatment of acid reflux syndrome without chest pain. Antacids or proton pump inhibitors are commonly prescribed. Acid reflux syndrome should be carefully monitored to be sure that stomach acid is not damaging the esophagus. It does not appear that acid reflux chest pain is related to damage of the esophagus.

Some people prefer to treat acid reflux syndrome with herbs or botanicals and dietary or lifestyle changes. If these effectively reduce stomach acid, then they should relieve the acid reflux chest pain. Some lifestyle changes that can help relieve acid reflux syndrome include giving up tobacco and/or alcohol use and weight loss. Some dietary changes that can relieve acid reflux syndrome include eating smaller meals more frequently and removing highly acidic, fried and fatty foods from the diet.

There are many herbs and botanicals that may relieve acid reflux syndrome and therefore acid reflux chest pain. These include fennel seed or oil, ginger root, chamomile and aloe. These ingredients and others are sometimes combined by herbalists to create a product for relief of acid reflux syndrome.

It has been said that acid reflux chest pain can mimic heart pain, but most people experience a burning sensation rather than a sharp, squeezing pain. The symptoms and intensity of acid reflux syndrome symptoms vary greatly. In addition to acid reflux chest pain, most people experience nausea, but some people actually vomit. In cases of unexplained vomiting, acid reflux syndrome is one of the first conditions that doctors suspect.

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