a patient's urinalysis reveals the presence of glucose

The reagent on most dipstick tests is sensitive to albumin but may not detect low concentrations of -globulins and Bence Jones proteins. Human Biology (11th Edition) Chapter 12, End of Chapter, Critical Thinking , Exercise 1 Page 238 How would you rate this answer and explanation? As a result, excess sugar is excreted in the urine. High glucose levels can make your urine cloudy. A urinalysis reveals that the patient's urine contains glucose, hemoglobin, and white blood cells (pus). The normal glucose range in urine: 0 to 0.8 millimoles per liter (mmol/l), equivalent to 0 to 15 milligrams per deciliter (mg/dL). Your support helps families facing kidney disease at every step of their journey. At least 10 million Americans suffer from incontinence, which means that they are not able to control the times when they urinate. A urine glucose test is an indirect way of determining if blood glucose levels are too high, which may be a sign of diabetes. Diabetes and your eyes, heart, nerves, feet, and kidneys. Your doctor might do the blood test earlier if your urine tests show high glycosuria. Some people dont know they have glycosuria until they have a urine test done., Glycosuria happens when you have glucose, or other sugars like lactose, fructose, or galactose, in your urine. Things the dipstick test can check for include: Acidity, or pH. A retrospective review of 1,607 admission urinalyses for inpatients in a referral/community hospital identified 861 as clinically indicated and 746 as routine. A routine urinalysis may also include a microscopic examination, if needed. Urinary pH can range from 4.5 to 8 but normally is slightly acidic (i.e., 5.5 to 6.5) because of metabolic activity. All rights reserved. Approximately 80% of patients with a ureteral stent experience stent-related pain that affects their daily activities.11. Verywell Health's content is for informational and educational purposes only. Which of the following should be considered first? A small amount of glucose in your urine is normal. A. Because results of repeat urinalysis after 48 to 72 hours should be negative in patients with this condition, extended testing is not warranted. Standards of medical care in diabetes 2019 abridged for primary care providers. A urinalysis is also called a urine test.. Plain radiography of the kidneys, ureters, and bladder can identify a stent and. In severe cases, a person may experience: urinate a little first before filling the container, as a mid-stream specimen gives the most accurate reading, fill three-quarters of the container and secure the lid, give the sample back to the doctor or place it in a specified area. Finally, although computed tomography would detect a ureteral stent, it is not preferred over radiography because it exposes the patient to unnecessary radiation. A. Uric acid calculi are associated with acidic urine. E. Perform urine cytology to evaluate for bladder cancer. To prepare a urine specimen for microscopic analysis, a fresh sample of 10 to 15 mL of urine should be centrifuged at 1,500 to 3,000 rpm for five minutes. When a person has diabetes, the glucose in their blood cannot enter the bodys cells, and it remains in the blood. The urine will be looked at for color and clearness. Thank you, {{form.email}}, for signing up. This is a corrected version of the article that appeared in print. Choose an answer and hit 'next'. Heres what you need to know. Some of the things that shouldnt be in your urine that a microscope can find include: The third part of urinalysis is the dipstick test, which uses a thin plastic strip treated with chemicals. C. Perform computed tomography of the abdomen and pelvis to evaluate for kidney or bladder stones. In healthy people, your kidneys filter the glucose and reabsorb most of it back into your blood., Your body carefully controls glucose levels to maintain a steady balance. Causes of hematuria can be classified as glomerular, renal, or urologic35 (Table 16 ). A strong odor may be the result of a concentrated specimen rather than a urinary tract infection. Glycosuria occurs when the filtered load of glucose exceeds the ability of the tubule to reabsorb it (i.e., 180 to 200 mg per dL). B. This may be important for people who are at risk of hypoglycemia (low blood glucose). It also may be recommended if diabetes is suspected. Data Sources: Literature searches were performed in PubMed using the terms urinalysis review, urinalysis interpretation, microscopic hematuria, CT urogram, urinary crystals, indwelling ureteral stent, asymptomatic bacteriuria, and bacteriuria with catheterization. A 49-year-old man who has a history of neurogenic bladder due to a spinal cord injury and who performs clean intermittent catheterization visits your clinic for evaluation. Knowing as soon as possible whether their blood sugar levels are high means a person can take measures to prevent the condition from worsening. Quiz, Arterial Blood Gas and Acid Base Balance: Tests and Interpretation Explain. Remember that a urine glucose test is a screening test that needs to be confirmed by a blood test. Alkaline urine in a patient with a UTI suggests the presence of a urea-splitting organism, which may be associated with magnesium-ammonium phosphate crystals and can form staghorn calculi. Treatment of asymptomatic bacteriuria is not recommended in nonpregnant adults, including those with prolonged urinary catheter use. Nitrites normally are not found in urine but result when bacteria reduce urinary nitrates to nitrites. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. A urinalysis (also known as a urine test) is a test that examines the visual, chemical and microscopic aspects of your urine (pee). How does glucose change the color of pee? Tubular reabsorption of glucose is via active transport, thus requiring energy, and is done in response to balance the glucose in the body. High blood sugar levels during pregnancy can cause problems for you and your baby: Your doctor might do in-office urine tests at your regular prenatal visits to check for glycosuria. Determination of urinary pH is useful in the diagnosis and management of UTIs and calculi. Urine dipstick testing and microscopy are useful for the diagnosis of several genitourinary and systemic conditions.1,2 In 2005, a comprehensive review of urinalysis was published in this journal.3 This article presents a series of case scenarios that illustrate how primary care physicians can utilize the urinalysis in common clinical situations. According to the American Urological Association, the presence of three or more red blood cells (RBCs) per high-powered field (HPF) in two of three urine samples is the generally accepted definition of hematuria.1820 The dipstick test for blood detects the peroxidase activity of erythrocytes. C. The patient may have diabetes mellitus. Urinalysis (UA) is used as a screening and/or diagnostic tool to detect substances or cellular material in the urine associated with metabolic disorders, renal dysfunction or urinary tract infections (UTI). Quiz, Amylase and Pancreatic Lipase: Causes & Associated Conditions If your pee has blood in it, it might be red or dark brown. It also reflects the concentrating ability of the kidneys. A patient's urinalysis reveals the presence of glucose. A glucose in urine test measures the amount of glucose in your urine (pee). Usually. Urinalysis is a series of tests on your urine, or pee. A urine glucose test detects and measures this excess sugar, a condition called glycosuria. Urinary specific gravity (USG) correlates with urine osmolality and gives important insight into the patients hydration status. Copyright 2023 American Academy of Family Physicians. On physical examination, he has a temperature of 39.6C and has mild right costovertebral angle tenderness. Visualization of intact erythrocytes on microscopic examination of the urinary sediment can distinguish hematuria from other conditions. The excess of glucose produced by the insulinoma impairs the exit of glucose out of the cell leading to decreased levels of glucose in the blood. Decreased glomerular filtration rate (GRT) is concentrating the urine too much C. The patient may have diabetes mellitus D. The patient has kidney failure C. What are the causes of high glucose in urine besides diabetes? She has constant dull left flank pain that becomes sharp with voiding. As your kidneys get less blood, the filtration mechanism that removes waste and reabsorbs vital nutrients becomes damaged. Type 2 diabetes usually appears later in life and takes years to develop. See permissionsforcopyrightquestions and/or permission requests. A person with diabetes should speak to their doctor if they notice the following symptoms: People with kidney disease often do not notice any symptoms until the later stages, when the kidneys no longer work effectively. Search dates: October 2012 and June 2013. Foam can be a sign of kidney disease, while cloudy urine may mean you have an infection. Dipstick urinalysis is convenient, but false-positive and false-negative results can occur. A urinalysis is used: To diagnose things like a urinary tract infection, kidney disease, kidney stones, diabetes or pregnancy. Urinalysis is one of the most common diagnostic tests used in and urgent care medicine. The ADA recommend screening for type 2 diabetes from the age of 45 years or earlier if a person has risk factors, such as obesity. If a random urine sample shows more than .25mg/ml, this is considered glycosuria and can be caused by too high blood glucose levels, a problem . Patients with ureteral stents may experience urinary frequency, urgency, dysuria, flank pain, and hematuria.10 They may have dull flank pain that becomes sharp with voiding. Knowing about self-testing for both glucose and ketones can enable a person with diabetes to have more control over their condition. Diabetes and your eyes, heart, nerves, feet, and kidneys. Doctors use it to check for signs of common conditions or diseases. Urine glucose levels may be used to monitor glucose levels in diabetic patients if blood testing is difficult or impossible, such as in patients with a fear of needles or those with blood-clotting disorders. An infection may make urine look cloudy. Microhematuria has a range of causes, from benign to life threatening. If a person has a diagnosis of type 1 diabetes, they will need insulin to control blood sugar levels. Is a blood glucose test more accurate than a urine test? Patients with microscopic hematuria (i.e., at least three red blood cells per high-power field in two of three specimens) should be evaluated to exclude renal and urinary tract disease. Guidelines from the American Urological Association were also reviewed. Although flank pain and urinalysis suggest possible pyelonephritis, this patient should not be treated for simple pyelonephritis in the absence of radiography to identify a stent. Normally, your kidneys absorb the sugar from any liquid passing through them, but with glycosuria, the kidneys. Learn about at-home glucose meters, how to use them, and how to interpret test, A person who receives a diagnosis of diabetes will need support and advice from their family physician, but they may also need specialist help to, Ketone testing is an essential part of managing diabetes. You will receive your score and answers at the end. You might also have this test regularly if you have a condition such as a kidney disease that needs to be watched over time. Copyright 2005 by the American Academy of Family Physicians. If a primary care physician identifies a neglected ureteral stent, prompt urologic referral is indicated for removal. Flank discomfort and recent history of urinary tract manipulation suggest that this is not an uncomplicated urinary tract infection; therefore, a three-day course of antibiotics is inadequate. It's used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes. 274 quizzes. 2005 - 2023 WebMD LLC, an Internet Brands company. Copyright 2014 by the American Academy of Family Physicians. High urine glucose levels may be an early sign of kidney complications. In glomerular proteinuria, the most common type, albumin is the primary urinary protein. a "fruity" or acetone smell on the breath frequent urination thirst dry or flushed skin difficulty breathing confusion abdominal pain nausea and vomiting high blood sugar levels In severe cases, a. Which of the following substances may be needed as a supplement for a patient suffering renal osteodystrophy? A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. People with diabetes can do a urine test at home if they start to experience the signs and symptoms of DKA. This means that there is an infection with certain kinds of bacteria. Normal USG can range from 1.003 to 1.030; a value of less than 1.010 indicates relative hydration, and a value greater than 1.020 indicates relative dehydration.14 Increased USG is associated with glycosuria and the syndrome of inappropriate antidiuretic hormone; decreased USG is associated with diuretic use, diabetes insipidus, adrenal insufficiency, aldosteronism, and impaired renal function.14 In patients with intrinsic renal insufficiency, USG is fixed at 1.010the specific gravity of the glomerular filtrate. Leukocyte esterase is produced by neutrophils and may signal pyuria associated with UTI. The onset of symptoms in those with type 2 diabetes is more gradual and usually occurs in adulthood. The patient is eating too many carbohydrates B. Those who use insulin or other medications may need to monitor for low blood sugar. Coverage of diabetic supplies varies by insurance plan, but most private and public insurance plans (like Medicaid and Medicare) cover urine glucose tests. MNT is the registered trade mark of Healthline Media. Quiz, Kidney Function Test Values: BUN and Creatinine All rights reserved. Decreased serum albumin due to renal loss. See how one patient learned to manage her weight and diet. In this setting, plain radiography of the kidneys, ureters, and bladder would be useful to determine the presence of a stent. Dipstick test. Simple steps to prevent diabetes. 30 Survivors are at risk of residual neurologic problems. People with diabetes have a higher risk of infections, including a UTI. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. No matter the type, the following symptoms may be an early sign of diabetes: If you plan to take a urine glucose test at a healthcare providers office, you may want to bring with you a list of medications that you are taking, as some medications may affect your test results. Glomerular hematuria typically is associated with significant proteinuria, erythrocyte casts, and dysmorphic RBCs. ) A urinalysis reveals that the patient's urine contains glucose, hemoglobin, and white blood cells (pus). Glucose is a type of sugar. The risk of DKA is also higher when a person with diabetes has a cold or flu. What is an appropriate description to share with the patient's family members? Triple phosphate crystals may be normal but often are associated with alkaline urine and UTI (typically associated with Proteus species). Lifestyle strategies that have been shown to help keep blood sugar levels under control and prevent or delay complications of diabetes include: Diabetes is a complicated disease that requires daily self-management to keep blood sugars at healthy levels. Gram staining can help guide antibiotic therapy, but it is not indicated in routine outpatient practice. Men normally have fewer than two white blood cells (WBCs) per HPF; women normally have fewer than five WBCs per HPF. The supernatant then is decanted and the sediment resuspended in the remaining liquid.37 A single drop is transferred to a clean glass slide, and a cover slip is applied. Leukocytes may be seen under low- and high-power magnification (Figure 1). A urinalysis involves checking the appearance, concentration and content of urine. Keefe, P., Bokhair, S., Fanconi Syndrome, StatPearls Publishing, 2021. Based on this patient's history, symptoms, and urinalysis findings, which one of the following is the most appropriate next step? Numbness and tingling in the hands or feet, Eating a healthy, low carb diet tailored to your glucose and dietary needs, Taking your medication as prescribed, especially. D. Inform him that his enlarged prostate is causing microscopic hematuria, and that he can follow up as needed. Ketones, products of body fat metabolism, normally are not found in urine. It's dipped into your urine, and the chemicals on the stick react and change color if levels are above normal. Glucose are found in the urine in very small amounts only. Liman, M., Jialal, I., Physiology, Glycosuria, StatPearls Publishing, 2021. Midstream clean collection is acceptable in most situations, but the specimen should be examined within two hours of collection. A. They should do the test in the morning before eating breakfast. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Under normal circumstances, glucose is actively reabsorbed in the proximal convoluted tubule. Often, lifestyle measures such as a healthful diet and exercise are key to reducing the risks of further complications. Type 1 diabetes usually develops during childhood or young adulthood, but it can occur at any time. D. Perform a 24-hour urine collection for a metabolic stone workup. You may also want to drink fluids before you arrive at your appointment so that you can easily produce urine when asked to do so. 2023 Healthline Media UK Ltd, Brighton, UK. Your support helps families facing kidney, Tests to Measure Kidney Function, Damage and Detect Abnormalities. Are any of these substances abnormal in urine? The sooner you start working on managing your glucose levels, the better you'll feel and the better you'll be able to avoid health complications that can occur due to unmanaged diabetes. However, the doctor may also need to send the sample to a laboratory for culturing if they are testing for a UTI. Be sure to let your doctor know about all the medicines you take, including over-the-counter drugs, vitamins, and supplements. WIthout insulin, blood glucose levels become too high, and your kidneys cant filter and reabsorb it. This is because diabetes increases the risk of chronic kidney disease (CKD) and specifically diabetic nephropathy. A urine glucose test is an indirect measure of your blood sugar (glucose) levels. People may have a higher risk of kidney disease if they have: Addressing high glucose and blood pressure can reduce the risk. This can lead to severe complications. It can affect people with both type 1 and type 2 diabetes. In a person with diabetes, this can lead to diabetic ketoacidosis (DKA), a potentially fatal condition that needs emergency treatment. What is a urinalysis? Glycosuria occurs in some conditions like diabetes. Quiz, Electrolytes in Urine: Normal Lab Values and Causes of Change They include: Your doctor may want to test your urine if youre getting ready to have surgery or are about to be admitted to the hospital. Some of the topics you'll be assessed on include renal glucosuria as well as the effects of Cushing's disease. The excess of glucose produced by the insulinoma impairs the exit of glucose out of the cell leading to decreased levels of glucose in the blood. Foods, medications, metabolic products, and infection can cause abnormal urine colors (Table 1).3 Cloudy urine often is a result of precipitated phosphate crystals in alkaline urine, but pyuria also can be the cause. This type is an autoimmune disease where your immune system destroys beta cells in your pancreas that make insulin. It is the main source of energy for the cells in your body. A 58-year-old truck driver with a 30-year history of smoking one pack of cigarettes per day presents for a physical examination. In lupus treatment, a urinalysis is often used to monitor protein leakage and identify and assess urinary tract infections (UTIs). Computed tomographic urography is the preferred imaging modality for the evaluation of patients with asymptomatic microscopic hematuria. This situation initially results in alkaline urine, but as the filtered load of bicarbonate decreases, the urine becomes more acidic. A urine test can detect various substances, including glucose, ketones, protein, bacteria, and bilirubin. Routine urinalyses were abnormal less frequently than clinically indicated urinalyses (18.1% vs 39.6%) and when abnormal, were responded to less often (33.3% vs 75.4%). Tubular proteinuria results when malfunctioning tubule cells no longer metabolize or reabsorb normally filtered protein. Often, substances such as protein or glucose will begin to appear in the urine before patients are aware that they may have a problem. An early sign of diabetic nephropathy is protein in the urine. After some predetermined amount of time (usually indicated in the instruction manual or on the box), you'll check the color of the urine strip to determine your glucose levels. If the acid is abnormal, you could have, Glucose. Before an operation to screen for problems. C. Treat with an antibiotic and repeat the urinalysis with microscopy. Learn about its causes, risk factors, symptoms, and, Urinalysis, or a urine test, can help a doctor diagnose certain health issues, check for pregnancy, or screen for drug use. There are three ways to analyze urine, and your test might use all of them. If a person finds ketones in their urine, they should ask their doctor for advice. Enrolling in a course lets you earn progress by passing quizzes and exams. Normal USG can range from 1.003 to 1.030; a value of less than 1.010 indicates relative hydration, and a value greater than 1.020 indicates relative dehydration. Their cylindrical shape reflects the tubule in which they were formed and is retained when the casts are washed away. Follow your doctors directions for handing over the sample. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. A dipstick is a thin, plastic stick with strips of chemicals on it. While this test is less accurate than a blood glucose test, a urine glucose test is a quick and easy way to monitor your glucose if you have type 1 or type 2 diabetes. Retained ureteral stents may become encrusted, and resultant stone formation may lead to obstruction.10. This content is owned by the AAFP. Inform the patient that he has a urinary tract infection, obtain a urine culture, and treat with antibiotics. Glycosuria occurs when excess blood sugar (glucose) is passed into the urine. Insulin is a hormone that regulates how much glucose is in your blood., Type 1 diabetes. 38 Cerebral edema predominantly. DKA often takes time to develop, but if a person experiences vomiting, it can quickly become severe. Pregnancy: Around half of women have glucose in their urine during pregnancy, even if they do not have diabetes. This article will discuss how this test is used, what to do to prepare, and how to assess your results and manage your diagnosis. A person with diabetes may need to have a urine test if they notice blood in their urine, or to check for high blood sugar, diabetic ketoacidosis, or a urinary tract infection. Here are the steps: For babies and other people unable to provide a sample this way, a doctor may have to insert a soft, narrow tube called a catheter through the urinary opening and into the bladder. . The best results come from using whats known as the clean catch method. In a patient with a ureteral stent, urinalysis alone cannot establish the diagnosis of urinary tract infection. Which of the following bacterial infections is most worrisome to the clinician in regards to glomerular damage? The office will give you a container for the sample. American Association for Clinical Chemistry: "Urinalysis. Cystine crystals are colorless, have a hexagonal shape, and are present in acidic urine, which is diagnostic of cystinuria. This content is owned by the AAFP. If a doctor finds high levels of glucose, ketones, or protein in a persons urine, they may order further tests. Microalbuminuria is defined as the excretion of 30 to 150 mg of protein per day and is a sign of early renal disease, particularly in diabetic patients. Even significant hematuria will not elevate the protein concentration to the 2+ to 3+ range on the dipstick test.23 Up to 20 percent of patients with gross hematuria have urinary tract malignancy; a full work-up with cystoscopy and upper-tract imaging is indicated in patients with this condition.24 In patients with asymptomatic microscopic hematuria (without proteinuria or pyuria), 5 to 22 percent have serious urologic disease, and 0.5 to 5 percent have a genitourinary malignancy.2529, Exercise-induced hematuria is a relatively common, benign condition that often is associated with long-distance running. Microscopic hematuria is common and has a broad differential diagnosis, ranging from completely benign causes to potentially invasive malignancy. D. Inform him that no treatment is needed. You can learn more about how we ensure our content is accurate and current by reading our. All Rights Reserved. If you already have a kidney issue or urinary tract infection, your doctor may want to change your treatment plan. However, healthcare professionals may use a urine test if they cannot access a vein for a blood test, or if a person has anxiety or a fear of needles. Blood may make urine look red or the color of tea or cola. Urobilinogen is reabsorbed into the portal circulation, and a small amount eventually is filtered by the glomerulus. This produces toxic ketones. If the acid is . This is a type of diabetes that occurs in some people during pregnancy. Although urinalysis is not recommended as a routine screening tool except in women who may be pregnant, physicians should know how to interpret urinalysis results correctly. Diabetes is the leading cause of kidney disease in the United States. Urinary tract infection. Quiz, The Importance of Cardiac Enzymes ", National Kidney Foundation: "What is a Urinalysis? Normal urine contains only small amounts of urobilinogen, the end product of conjugated bilirubin after it has passed through the bile ducts and been metabolized in the intestine. Casts in the urinary sediment may be used to localize disease to a specific location in the genitourinary tract (Table 6).38 Casts, which are a coagulum of Tamm-Horsfall mucoprotein and the trapped contents of tubule lumen, originate from the distal convoluted tubule or collecting duct during periods of urinary concentration or stasis, or when urinary pH is very low. Dipstick tests for trace amounts of protein yield positive results at concentrations of 5 to 10 mg per dLlower than the threshold for clinically significant proteinuria.15 A result of 1+ corresponds to approximately 30 mg of protein per dL and is considered positive; 2+ corresponds to 100 mg per dL, 3+ to 300 mg per dL, and 4+ to 1,000 mg per dL.31,32 Dipstick urinalysis reliably can predict albuminuria with sensitivities and specificities of greater than 99 percent.4 Asymptomatic proteinuria is associated with significant renal disease in less than 1.5 percent of patients.4,33. A more recent article on office-based urinalysis is available. Squamous epithelial cells are large and irregularly shaped, with a small nucleus and fine granular cytoplasm; their presence suggests contamination. In rare cases, dehydration or ketoacidosis can occur. C. Obtain a urine culture and perform plain radiography of the kidneys, ureters, and bladder. A self-monitoring urine glucose test usually involves holding the test strip under a stream of urine or placing a test strip into a sample cup of urine that you have collected. copyright 2003-2023 Study.com. The excess of glucose produced by the insulinoma destroys the glucose molecules in the blood. Microscopic examination is an indispensable part of urinalysis; the identification of casts, cells, crystals, and bacteria aids in the diagnosis of a variety of conditions. The test involves the examination of different aspects of the urine, including: appearance (cloudy or clear . The test results will identify the levels of glucose, ketones, and protein in the urine. Results of his urinalysis with microscopy are shown in Table 2. The predominant cellular elements determine the type of cast: hyaline, erythrocyte, leukocyte, epithelial, granular, waxy, fatty, or broad (Figure 3). Unconjugated bilirubin is water insoluble and cannot pass through the glomerulus; conjugated bilirubin is water soluble and indicates further evaluation for liver dysfunction and biliary obstruction when it is detected in the urine. Your body needs a lot of energy as your baby grows, but sometimes it cant keep up with demand and doesn't make enough insulin., Without the insulin, you will have too high sugar levels, and it will show up in your urine.. Although transient proteinuria typically is a benign condition, persistent proteinuria requires further work-up. Pregnancy and kidney disorders are the most common nondiabetic causes of high glucose levels in urine. Still, urine glucose testing is a relatively inexpensive and quick way to assess your need for a follow-up blood glucose test for diabetes. Other conditions, such as pregnancy and kidney disorders, can also lead to glucose in the urine. Home tests are similar to these. Urinalyses are typically conducted when someone is admitted to the hospital or before they have surgery. The excess of glucose produced by the. If so, they will also have high levels of glucose in their blood (hyperglycemia). Leukocyte casts in the urinary sediment can help localize the area of inflammation to the kidney. bellway homes calcot, find the midsegment of a triangle calculator, presidential volunteer service award certifying organizations in georgia,

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