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How To Choose Cleansers ? Five Best Dermatologist Tips .

Psoriasis info and tips from a leading board certified dermatologist

Choosing the  right  cleansers  for our  body an face is  very important .. Unfortunately studies   show   that  our   main consideration in choosing a cosmetic or a  cleanser  is   the packaging … . If the soap will  make our skin  too dry – the  skin will look tired and our  wrinkles will be more prominent. If the cleanser  we  use  would be too delicate the  will skin remain oily and shiny with increased  risk of  breakouts.

How to cleanse  oily skin ?

With oily skin-   the effective removal of grease and dirt accumulated on the skin and clog the glands is needed. On the other hand, especially in people prone to pimples or acne, using  a  soap that  is too harsh  will  irritate the skin. In addition  ,  a  soap  which  is  too  drying  would  irritate the  skin  resulting in excessive stimulation and  more secretion of fat  from the  sebaceous glands in the skin.  Thus,  we have to look for  a  good  but  mild   cleanser for oily skin.

How to cleanse dry skin?

Dry skin should choose a  cleanser  or soap containing a moisturizer. If  possible   the  cleanser   should have   detergent free on its  label. Always remove the washing with water or damp cloth. A good cleanser  for dry skin will leave on the skin after washing, a very delicate fatty layer  that  you  will  no  want  to  remove   but too  much  rubbing. If you   dry  skin on the face  – do not  use  on the face   a  soap   that is  intended  for  washing the hand  or  body.

How to clean skin combination skin  (mix  of  dry  and  oily  skin) ?

The best method in such cases is to use two types of soap or cleansers! Brightest areas in the center of the forehead, nose and chin should cleaned  with soaps for oily skin and the rest of the face & Neck – with  a  cleanser  for  normal skin.

How to clean sensitive skin ?

For  sensitive   skin  you need   to  use   a “soap without soap”. These  kind  of cleansers   are   suitable  to  people with very sensitive skin, eczema and skin (such as asthma and skin Atopic dermatitis and  rosacea).

Choosing  a  cleanser  –  Five most common mistakes

[1] Excessive cleaning of the face:

Too much  cleansing  is  bad  both  for  dry  skin and oily  skin.  It  will over  dry   skin  and  in oily   skin will cause  over-stimulation and increase of  the secretion of fat. In any case – regardless of skin – it is not recommended cleanse the  face for  more than twice a day.

[2] Using too large amount of the cleanser:

As the amount of the  cleanser  smaller – the  effect on the skin will be better. Therefore, we recommend using a small amount (no more than a  size of  a  small green pea).  Dilute it in water palm before application on the skin.

[3] Using harsh detergents on  the face  and  hands:

Using  alcohol containing cleansers will result  in  a pleasant feeling of tight skin after use.  Even so – you should avoid them!  Regular use of these  types  of  cleansers  – will  caused the skin to be too dry, scaly and sometimes itchy and  covered  fine scales. Thus- for  any  type of skin  you should avoid alcohol containing cleansers!

[4] Rubbing of the skin while cleaning:

Scrubbing and  rubbing the skin will dry  and  irritate the skin.   In cases  of  persons  with   acne   and may  worsen the  acne   and  causes  breakouts.

[5] Leaving residue of  soaps  and  cleansers  on the  face:

Most people do not remove  the   cleanser of the skin  after  washing. Recommendation – splash some  water  on your face wash , at least 3 times to  remove  all  cleanser  residues !

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Skin Tightening – New Technology Allows Painless Effective Results

EndyMed PRO  3DEEP   System

EndyMed   (3DEEP  technology ) received FDA clearance in 2009 for the EndyMed PRO™ system for the non-invasive treatment of facial wrinkles and rhytides. A pivotal long-term, multicenter efficacy study for facial wrinkle reduction using EndyMed™ proprietary 3DEEP™ technology-shoed  its  efficacy  and safety  on  reduction  of  wrinkles.To date, several hundred patients have undergone facial and body treatments with EndyMed PRO. Patients consistently report pleasant treatments, with no pain and high satisfaction with the results.

What  it’s unique  –  3DEEP vs Conventional RF Technologies  ?

The EndyMed PRO system and its 3DEEP next-generation RF technology allows  targeted, controlled and contained deep dermal heating, with minimal surface energy flow. 3DEEP is a safe and effective noninvasive technique to improve the appearance of age-related rhytides and lax skin. Furthermore, EndyMed PRO procedures are performed without anesthetics, and to date, all patients reported no pain during treatment.

Study Highlights:

Subgroup of 30 patients were treated for facial and neck wrinkles with careful follow-up of up to 3 months post-treatment, with very positive results

The study’s efficacy endpoint was considered by pre-treatment photographs (baseline) assessed and graded by 2 dermatologists

blinded to the study and patients .Wrinkles were classified according to the Fitzpatrick Wrinkle Scale, Immediately after each treatment, treated area was visually assessed for skin responses, including edema, erythema, hypopigmentation,    hyper-pigmentation, and textural changes

Results: Significant statistical improvement in all (100%) 30 patients with skin improvement  of at least 1 score or more, according to the Fitzpatrick scale. The only skin responses reported were mild, transient erythema and edema in a few cases, which resolved within 10 to 30 minutes

All (100%) 30 patients reported no pain during 3DEEP treatment.

Patient video:


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Fractional Skin Resurfacing Using New Radio-Frequency Technology

3deep, endymed pro, fractional skin resurfacing, FSR, termage

EndyMed PRO™ Fractional Skin Resurfacing (FSR)

The EndyMed PRO™ Fractional Skin Resurfacing (FSR)   provides a unique 3-dimensional skin resurfacing treatment for  skin rejuvenation and  treatment  of  acne  scars. It combines microfractional RF skin ablation with volumetric dermal anti-wrinkle effects – in a single pulse. The treatment procedure is minimally-invasive and patients report minimal pain and short downtime. FSR treatment results in brighter skin, reduction of epidermal hyperpigmentation, improvement of skin texture, smoothing of wrinkles, and treatment of acne scars.

Why 3DEEP FSR Multilayer Therapy?

The upper skin layers (stratum corneum and epidermis) are best treated with fractional ablation, which allows removal of damaged skin cells to reduce of skin roughness and hyperpigmentation. Fractional ablation also allows minimal downtime. The dermis, however, is best treated with non-ablative, deep dermal heating, which leads to collagen remodeling, while reducing scars and wrinkles.

3DEEP Multilayer Therapy:

EndyMed PRO FSR’s single, 3DEEP pulse simultaneously performs microfractional ablation of epidermis and provides deep volumetric, non-ablative dermal heating. Furthermore, skin aging manifests differently in the numerous layers of the skin; each layer requires a different treatment approach to achieve the most effective results. With previous modalities, achieving effective skin rejuvenation throughout the different layers required a combination of different modalities, resulting in extended treatment time, multiple cost, and different levels of pain and discomfort.

Specifically, EndyMed PRO FSR’s novel 3DEEP technology maximizes the interaction of multiple RF sources for controlled delivery of energy to the stratum corneoum, epidermis and dermis. At the same time, tiny (300 micron) electrodes deliver just enough energy to achieve the desired degree of ablation. The unique 3DEEP FSR Handpiece treatment array is composed of more than 100 electrodes, which creates a microfractional mesh of ablation dots for minimal downtime.

FSRBA ACNEscasr Fractional Skin Resurfacing Using   New  Radio Frequency  Technology

EndyMed PRO™ Fractional Skin Resurfacing

Courtesy of Dr Preechaphol Mathawanich (Thailand)

Before 3DEEP FSR treatment n1 week after treatmentn n4 weeks after treatment

FSRBAwrinkles Fractional Skin Resurfacing Using   New  Radio Frequency  Technology

EndyMed PRO™ Fractional Skin Resurfacing

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Can I Sun Protect My Kids ?

A severe sunburn is dangerous for a small child in both the immediate and the distant future.  It has been unequivocally proved that severe sunburns in childhood increases the risk of developing melanoma in later life.  Studies show that most of the cumulative ultraviolet radiation absorbed by a person during his or her lifetime is absorbed during the first 18 years.  The amount of radiation to which children and teenagers are exposed is one of the primary causes of sun-induce damage to the skin and of the later risk of developing skin cancer.


Until the infant is six months old, he or she should not be exposed to the sun between the hours of 9 a.m. and 4 p.m., and a child under the age of one year should not be taken to the beach or swimming pool during the late morning and early afternoon hours.  Whenever the infant leaves the house, the amount of time spent in the sun, including going from one shady spot to the next, should be kept to an absolute minimum, and the baby carriage should be covered with a sun shade.  The most effective means of protection is clothing which covers the body: a shirt with long sleeves, pants, socks, and if the child is old enough, a wide-brimmed hat.  A sunscreen should not be applied to the skin of an infant younger than six months because of the risk of an allergic reaction.

A sunscreen with a sun protection factor of 15 should be applied to exposed areas of the skin of infants older than six months of age. The best sunscreen for a child of this age is a non-chemical one, containing titanium oxide, and not a sunscreen containing chemical substances which might cause an allergic reaction or tearing eyes.


It is important that children wear suitable clothing, that they not remove their shirts out of doors, that they wear wide-brimmed hats and wear sunglasses that screen ultraviolet radiation.  Before leaving the house in the morning, a sunscreen should be applied to all exposed areas of the body.  A parent should make sure that the rules for protecting the skin are followed when the child is away from home: at the day-care center, in the kindergarten, at school, at camp, etc.  Kindergarten and other teachers should be requested to plan outdoor activities and gym lessons before 10 a.m.

A study recently done showed that hats which do not have wide brims are not effective in protecting the face from the sun.  A British researcher named Duffy examined the amount of protection afforded by 28 different types of hats.  He found that all of them protected the forehead but that none of them protected the chin.  The study showed that a hat with a visor protects the nose but leaves the rest of the face exposed to radiation.  On the other hand, a hat with a brim 5-7 centimeters (2-3 inches) wide gives the face the same protection as a sunscreen with an SPF of 3.  Since that is a relatively low factor, in addition to wearing a hat, a sunscreen should be applied.


Teen-aged children have to be very courageous and secure to protect themselves from the sun.  Unfortunately, young people are under a great deal of social pressure to meet their friends at the beach on the weekends, to broil together during the hottest hours and to return home lobster-red but happy.  The skin peels a few days later and gives them the mistaken impression that the damage has been repaired and that they can continue broiling themselves the following week.  In research done on several hundred teenagers it was found that despite their awareness of the damages of solar radiation, they continued exposing themselves to the sun, especially at the beach and swimming pool during the hottest hours of the day.  Only 80% of the girls and 40% of the boys used a sunscreen, and those who did use them applied them in ways which did not provide adequate protection.


Keep infants and children out of the sun during the heat of the day.

Dress children in suitable clothing.

Keep an eye on the clock.

Use a sunscreen.

Beware of reflected light.

Check you own skin and that of your children frequently.

Give your children a personal example.


In a study done in northern Europe, it was found that people who work in offices and spend their two weeks of vacation on the beach in a hot country are exposed to the same amount of UVB that they receive during the rest of the year.

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Acne Treatment Update- Dermatologist’s View

Acne treatment   dermatologist  advice


In light of my experience in treating thousands of cases of acne, I would advise any young person who begins to develop acne to consult a dermatologist.  The appearance of the pustules themselves as well as the marks and scars they leave have an enormous influence on the mood and even on the social standing of a young person.

It is most unfortunate that many young people do not know that 99% of acne cases can be treated, and that proper treatment prescribed by a skilled dermatologist can greatly alleviate the suffering and symptoms.

Individual treatment is prescribed according to the severity and type the acne.  During the first visit at the dermatologist’s office, the doctor examines the acne, determines which factors worsen the case and explains to the patient how to avoid them.  Since most of the ointments and lotions used to treat acne dry the skin, I advise the use of a soap which cleans the skin but does not dry it.  In most cases an antibiotic liquid should be swabbed onto the skin in the morning (brand names: Acnetrim, Akne-mycin, Dalacin T), and in the evening an ointment or gel containing a substance called benzoyl peroxide (brand names: Panoxyl Gel, Oxy, Akneroid) should be applied.  These substances open the sebaceous glands and reduce the number of bacteria found in them.  If there are many blackheads or whiteheads present, it is advisable to use a preparation containing various concentrations of retinoic acid (brand names: Retin A, Locacid).  Since the use of retinoic acid can cause redness and sensitivity, it is important to protect the skin from direct sunlight during the morning and afternoon hours.

In severe and moderate cases of acne it is advisable to complement the treatment with the use of antibiotics from the tetracycline group.  Antibiotic treatment can last from four months to several years, and in most cases has no side effects.

In exceptionally severe cases, those which do not respond to antibiotic treatment, a drug called Roaccutane should be considered.  This preparation is based on Vitamin A and represents a real breakthrough in treating dermatological diseases.  It reduces the size of the enlarged sebaceous glands of people suffering from severe cases of acne and thus leads to a significant improvement in the most difficult conditions.  The course of treatment lasts three months and only in extremely rare cases is an additional three-month course necessary.  Accutane’s most usual side effect is a dryness and slight peeling of the skin around the lips and fingernails, and these disappear when the treatment has been completed.  In spite of the fact that the drug is considered safe, it is advisable to check the level of blood lipids and liver function monthly during the course of the treatment.

IMPORTANT: It is absolutely forbidden to initiate a pregnancy while this drug is being taken or until at least two months after the cessation of treatment.

Remember that at least a month to six weeks will be necessary before the influence of any acne treatment is noticed, and that the treatment must continue for a matter of months.  Sometimes the condition becomes worse at the beginning of the treatment, and for that reason it is important for the patient to schedule regular visits to the dermatologist at least once every other month, since the treatment may have to be changed as it progresses.

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Psoriasis Treatment- Most Effective Dermatologist’s Rules

Psoriasis info and tips from a leading board certified dermatologist

Psoriasis Treatment-

Despite the fact that psoriasis cannot be cured, there are various treatments which will slow the rate at which the cells multiply and ease the inflammation.  Suitable creams and ointments can greatly reduce the patches in most of the mild to moderate cases.

The use of preparations containing salicylic acid will cause the thick scale to peel; preparations containing cortisone will depress the inflammation; preparations containing coal tar derivatives (Alphosyl, for example) and anthralin (Dithocream, Psoralon) reduce the rate at which the skin cells divide.  In most cases, the combination of drugs appropriate for the individual patient causes a marked reduction in the symptoms and the skin appears almost normal.

During the last few years it has been shown that prolonged use of preparations containing high concentrations of steroids cause irreversible damage to the skin.  It has also been shown that the skin becomes accustomed to steroids to the point where the concentration must be increased every few weeks to achieve the same results.  In addition, psoriasis patients noted that after the completion of steroid treatment there is often a worsening of the condition; this is known as the rebound phenomenon.

When psoriasis is spread over a large area of the body, the treatment is usually a combination of preparations containing coal tar derivatives and exposure to UVB ultra-violet rays.  This treatment is called phototherapy and involves the use of a specially built apparatus.  The treatment is given during a hospital stay averaging four weeks, or at phototherapy units which the patient visits several times a week.  Phototherapy usually achieves remission after about thirty treatments.

Another possible treatment for moderate to severe cases of psoriasis is exposure to the sun at the Dead Sea in Israel.  As opposed to treatments at phototherapy units in which the patient is exposed to UVB for a few minutes at a time, the treatment at the Dead Sea requires the patient to be exposed to the sun for a few hours daily, and that demands a great deal of time.

Another disadvantage of treatment at the Dead Sea is that it depends on the weather; the treatment is not effective during the winter.  In the past fifteen years a new treatment, called PUVA, has been developed.  It is based on a drug called Psoralen, which comes in pill form, and on exposure to UVA ultra-violet rays an hour and a half after the pills have been taken.

The pills cause increased sensitivity of the skin and eyes to sunlight, and patients  taking the drug must wear special sunglasses for at least 24 hours after the drug has been ingested.  Treatments at the Dead Sea and at phototherapy units involve similar dangers to excessive exposure to the sun, including accelerated aging of the skin and the increased risk of skin growths.


A new type of preparation, based on Vitamin D, may improve the treatment of mild to moderate cases.  This ointment, called calcifortriol (brand name: Daivonex), is more convenient to use than those containing coal tar derivatives and safer than those containing cortisone.

According to recent studies in Great Britain, hundreds of patients reported an improvement after using this product, without experiencing any significant side effects.  Since its use is limited to 100 grams a week, it is unsuitable for treating cases of widespread psoriasis.

One of the greatest achievements in dermatology in the last few years was the development of a group of medications called the retinoids.  These drugs, whose chemical composition is close to that of Vitamin A, brought about a breakthrough in the treatment of certain skin diseases, psoriasis among them.  One of these drugs, called Tigason, is suitable for the treatment of the severe cases of psoriasis which do not respond to ointments or phototherapy.

Since this drug is teratogenic (may cause abnormalities in fetuses), it may not be taken within two years before a planned pregnancy, and any women of child-bearing age who does take it is required to use some sort of contraceptive device.

An additional disadvantage of Tigason is that it produces a sticky sensation on the skin, slight peeling around the lips and fingernails and in rare instances an increase in blood lipids or an impairment of liver function.  Despite these side effects, it is a particularly effective drug and greatly improves the quality of the patients’ lives.

Within the last few years out-patient clinics have been opened for psoriasis treatment.  These clinics give the patients topical treatments during 3-4 hours, after which the patient is exposed to 10-20 minutes of ultraviolet radiation.

The advantage of this method is that the patient can continue his or her regular routine without long hospital stays or trips to the Dead Sea.  An additional advantage is that the patient comes home without any visible signs of having undergone treatment and does not have to use any unpleasant-smelling creams or ointments at home.


Unfortunately, psoriasis cannot be completely cured.  No drug has yet been developed which can prevent psoriasis attacks once and for all.  Proper treatment, however, can cause a remission for long periods of months or even years.

This is possible if the treatment is geared to the severity of the disease and if treatment is continued even when there are very few symptoms present.  Regular treatment of the disease even when it is in remission can prevent its worsening at a later stage.

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Nail Fungi – Onychomycosis Can Be Cured !

nail fungus info and tips from a leading board certified dermatologist

Nail Fungi – Onychomycosis

Onychomycosis of Nail fungus is a very common problem. 35 Million Americans suffer from nail fungus.

Nearly 50% of people aged 60 and above are stricken with some type of nail fungus.
The common features are dryness and disintegration of the nail plate in toe nails and less commonly in the finger nails.

The incidence of fungus infections of the nails increases with age. It usually begins with the toenails, and after a number of years may migrate to the fingernails. Most patients who suffer from fungus infections of the toenails also suffer from athlete’s foot, the symptoms of which are maceration and cracks of the skin and an intense itch. The affected nails are usually thick and yellow, with flaking upper surfaces.

The fingernails of housewives and of people who work in hot, moist environments (such as cooks and bakers) can be affected by a fungus called Candida. In these cases the skin surrounding the affected nails becomes red and infected; the damage begins at the base and sides of the nail.

Since there are other diseases which affect the nails, such as psoriasis, laboratory tests should be performed before treatment is begun in order to confirm the presence of a fungus and its exact classification.

The 4 types of onychomycosis:

Distal subungual onychomycosis is the most common
form of tinea unguium, and is usually caused by Trichophyton rubrum, which invades the nail bed and the underside of the nail plate.
White superficial onychomycosis (WSO) is caused by fungal invasion
of the superficial layers of the nail plate to form “white islands” on the plate. It accounts for only 10 percent of onychomycosis cases.
Proximal subungual onychomycosis is fungal penetration of the newly formed nail plate through the proximal nail fold found more commonly when the patient is immunocompromised.

Candidal onychomycosis is Candida species invasion of the fingernails, usually
occurring in persons who frequently immerse their hands in water.


Despite the fact that fungus infections of the nails are not painful, they should always be treated. Untreated nails serve as a reservoir of fungi which spread to the surrounding skin, causing itching and discomfort when jewelry is worn.

In a relatively high percentage of cases, antifungal creams and lotions are not effective in curing infections of the nails. When only one nail has been affected, it may possibly be cured by dissolving the nail in a cream containing a high concentration of urea and fungicide. Unfortunately, this treatment fails in most cases, and the fungus must be treated with oral medications. The specific medication prescribed depends upon the type of fungus involved. Fingernails are renewed every six to eight months, whereas for toenails the process takes a year to eighteen months, and therefore the treatment must be continued for several months until all symptoms of the disease have disappeared.

Systemic antifungal medications,

terbinafine and itraconazole are quite effective but involve risk of adverse effects including liver function impairment and loss of tatste (Terbinafine) high cost.

Topical madicated nail paints

containing ciclopirox or amorolfine involve
Treatment of at least a year; some with daily application and some with twice weekly application. One of these kits includes mechanical nail filers.

Nd:YAG laser has been approved for onychomycosis treatment.
Clinical studies show effect in small minority of patients. Very high cost , and multiple treatment needed.

Over the internet offerings; different solutions requiring twice daily application for at least a year. Very slow improvement if any due to low compliance.

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Athlet’s Feet Treatment And Prevention Are Possible


Athletes Feet Treatment And Prevention-

Fungus infections between the toes are very common, particularly in hot countries.  The warmth and moisture produced (between the fourth and fifth toes especially) provide an ideal environment for the development of fungi.They multiply and cause itching, maceration of the skin (the outer layer of the skin absorbs water, turns white and sloughs off); later, painful cracks appear.

Continued wearing of rubber-soled shoes or heavy boots increases the risk of this type of infection.  If left untreated it may spread to the soles of the feet and to the toenails.  Cracks between the toes can provide a source of bacteria which cause a serious skin infection called erysipelas.  Treating this disease in its early stage is simple.  For fifteen minutes every evening, the feet should be soaked in a basin of hot water to which a disinfectant soap containing iodine has been added.

After the feet have been thoroughly dried, a fungicidal cream or ointment should be applied to the soles of the feet and between the toes.  There are many such preparations on the market today, including Agispor, Cicloderm and Myco Hermal.  Treatment should be continued for two to three weeks after the symptoms have disappeared.

Prevent Reinfection-

To prevent reinfection, the feet should be exposed to the air as often as possible.  Cotton socks are preferable; shoes with leather soles (in which the feet perspire less) or sandals should be worn.  Wash the feet often and dust them with talc to absorb perspiration.

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Hair Loss and Nutrition – Is There Really A Connection ?

Nutrition and skin info and tips from a leading board certified dermatologist

Hair Loss and Nutrition –

The quality of the food we eat and the amount of protein it contains are extremely important for normal hair growth.  Protein is essential for the formation of keratin, the principal component of hair.  Protein is found in large amounts in meat, poultry, eggs, milk, cheese, and soy beans and legumes.

Vegetarians and people (usually young girls) on strict reducing diets are liable to suffer from severe thinning of the hair.  In these cases, hair loss is usually experienced about three months after the diet has begun.

The situation is reversible, and once a proper diet with a sufficient amount of protein has been instituted, hair loss will stop and hair growth will be renewed.  Other causes of thinning hair are iron deficiency anemia, a lack of zinc and an excess of Vitamin A.

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Hair Loss -Effective Prevention And Treatment

Hair loss in women

Hair loss can appear six to eight weeks after an illness accompanied by a high fever, such as influenza or pneumonia.  This type of hair loss is usually temporary, and ordinary hair growth is resumed in a matter of months.

Malfunction of the thyroid gland can also lead to thinning hair, a condition which will reverse itself as soon as proper treatment has been initiated.

In some cases certain medications can increase hair loss.  Among these medications are anti-coagulants, drugs for the treatment of gout, anti-depressants, beta-adrenergic blocking agents used to treat hypertension (high blood pressure) and irregular heartbeat (for instance, Deralin), and drugs containing Vitamin A derivatives.

Hormone disturbances in women, which lead to the excessive growth of body hair and irregular menstrual periods, are also liable to cause thinning of the hair.

Treatment of these disturbances usually leads to the return of normal hair growth.

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