Bladder Infection in Pregnancy:
The Natural Alternative to Antibiotics

Normal Changes in the Urinary Tract

A urinary bladder infection is one of the most common complications during pregnancy. This website is intended to allow you as a pregnant women to become an informed patient who can manage your own care, ask the right questions, insist on adequate management and information, and seek an optimal outcome for yourself. Perhaps it will even help the health practicioners who are giving care, obstetricians in particular, to better understand and, hopefully, incorporate into their practice the natural, drug-free approach to urinary tract infection (UTI), especially its prevention and treatment in pregnancy.

Bladder infection is a very common medical complication of pregnancy which - if left untreated - can cause serious problems.

During pregnancy, there are normal changes in the urinary tract that contribute to an increased susceptibility to bladder infections, such as:

• the anatomical changes: the growing uterus causes kidney enlargement and compression of the ureters and bladder;
• the functional changes: the bladder does not empty completely; the urine is not as acidic and it contains more sugars, protein, and hormones.

The Third Trimester

However, women who experience an untreated urinary tract infection during their third trimester of pregnancy are at greater risk of delivering a child who suffers from:

• mental retardation and/or
• developmental delay.

Besides childhood development delays, a bladder infection during pregnancy can cause:

• low birth weight
• premature labor
• pyelonephritis (when an ascending urinary tract infection has reached the pyelum (pelvis) of the kidneys), sometimes called urosepsis
• kidney infection (nephritis).

Types of Bladder Infection in Pregnancy

2. Acute urethritis or cystitis: urethral or bladder infection that causes symptoms including pain or burning with urination, frequent urination, feeling of needing to urinate, and fever.

3. Pyelonephritis: a kidney infection that causes symptoms including those of acute cystitis plus flank (back) pain. Pyelonephritis may lead to preterm labor, severe infection, and adult respiratory distress syndrome.

The most common microorganisms that cause bladder infection during pregnancy is uropathogenic Escherichia coli bacteria (E. coli), normally present in the vagina and rectal area.

Other organisms causing urinary tract infection may include:

• group B streptococcus (GBS), and
• sexually transmitted gonorrhea and chlamydia.

Diagnosis of bladder infection in pregnancy include urine testing and culture for bacteria. (Most women are tested at the first prenatal visit and during pregnancy, if needed).

Group B Streptococcus

Group B streptococcus is a concern as one out of every four or five pregnant women carries GBS in her rectum or vagina.

In the pregnant mother, GBS can cause a urinary tract infection and lead to preterm labor and birth - premature babies are more susceptible to GBS infection than full-term babies.

Group B streptococcus diagnosed can be cultured from a mother's urine. Cultures are usually done between 35 and 37 weeks of pregnancy and may take a few days to complete. Cultures collected earlier in pregnancy do not accurately predict whether a mother will have GBS at delivery.

Chlamydia Infection

• the cervix
• rectum, and
• eye.

Persons with chlamydia infections often have no symptoms. Consequently, they may transmit the infection to other people without knowing it. However, when the symptoms do occur, their type and severity will depend on the site of the infection and the person's response to it.

Women who do have symptoms of chlamydia infection may notice:

• an increased vaginal discharge
• irritation of the area around the vagina, or
• burning pain with urination.

To diagnose chlamydia, a special test must be done by a health professional.

Chlamydia infection is easily treated with an antibiotic medication. However, if it is not detected and treated, chlamydia infection can lead to complications, such as pelvic inflammatory disease, a condition that signals the infection has spread to the uterus and fallopian tubes.

Symptoms of pelvic inflammatory disease include:

• lower abdominal pain
• painful intercourse
• irregular periods
• spotting and
• fever.

This serious condition requires prompt medical attention.

In pregnant women, chlamydia infection can be passed on to their newborn children, where it can cause:

• eye infections and
• pneumonia.

E. Coli Infection

Various harmless strains of E. coli are normally present in the body - but they do not belong in the urinary tract.

Theses bacteria have multiple little hairs called cilia that function like little feet that allow them to climb from the skin around the vagina, up the urinary tube, into the bladder.

If E. coli get into the bladder or the urethra (tube that carries urine from the bladder), the body has ways of fighting them off - including the obvious methods of simply flushing them out with the urine.

These bacteria, however, have evolved ways of anchoring themselves to the cells of the urinary tract.

The invading E. coli take advantage of receptors naturally found on the cells of the mucosal lining of the urinary tract. (Receptors are like molecular "docking bays" for substances which the cells need for their normal growth and development).

Like pirates in an old movie, E. coli use "grappling hooks", called type I pili, to first hook on to these receptors, and then to invade the cell. (These pathogenic "grappling hooks" are composed of long, fibrous chains of a molecular "glue" called adhesin).

Once inside the cell, E. coli can live and reproduce in safety, shielded from many of the body's defensive immune responses.

In fact, they are so sophisticated that when the body detects that cells have been infected and activates the cell suicide program to destroy the bacteria, E. coli can actually flee the dying host cell before it is flushed out - and look for new cells to invade!

Survival Rate of E. Coli

Bacteria E. coli are able to survive antibiotic treatment for bladder infections by reverting to an inactive state.

Within several days of antibiotic treatment, the number of bacteria reproducing drop to zero. Not all the bacteria are killed, though.

About 3 percent of the bacteria may be still present in a dormant state after treatment with ciprofloxacin (Cipro) and about 7 percent may linger after treatment with trimethoprim-sulfamethoxazole (Bactrim/Septra).

Even after a month of antibiotic exposure, about 10 million of the original 1 billion bacteria may remain.

Antibiotic treatment does not successfully kill all the bacteria participating in the infection and may, in fact, encourage many of the bacteria to persist in a resting state.

Therefore, current standard drug treatments for bladder infections are not adequate and this phenomenon may account for many of the repeat urinary tract infections.

New Antibiotic-Resistant Strain of E. Coli

The analyzed strain, resistant to trimethoprim-sulfamethoxazole, a popular two-drug combination, shows a pattern of resistance to multiple antibiotics and has genetic characteristics called "virulence factors" that increase its ability to infect the urinary tract.

Not much is known about how new strains of bacteria that infect the urinary tract arise and spread. There is also no evidence that the new strain of E. coli is causing any increase in kidney infections or other serious complications.

It could be that this organism has been around forever and has now acquired resistance to several antibiotics. It could have been introduced, perhaps through contaminated food.

Standard Antibiotic Treatments

Typically, women who have frequent recurrences (three or more a year) are offered antibiotic treatments, such:

• low doses of antibiotics for long periods of time (as long as 6 months to 2 years)
• single doses of antibiotics after sexual intercourse
• short courses (1 or 2 days) of antibiotics when symptoms appear.

Usually, stronger antibiotics are given than for single, acute episodes of bladder infection (cystitis); after acute symptoms have subsided, prophylactic, or preventive, therapy with low-dose antibiotics is recommended.

Besides antibiotics, normally employed in a trial and error fashion with varying degrees of success, medical treatments also include:

• antidepressants to effect a change in the bladder lining
• water dilation of the bladder
• surgery - up to (and including) bladder removal.

Doctors' Choices of Antibiotics

Almost all antibiotics will work for urinary tract infection. However, over the past 10 years, fewer doctors prescribe, for exapmle, a 10-day course of generic Bactrim or Septra, recommended by the Infectious Disease Society of America.

Bactrim and Septra
Septra and Bactrim are both brand names for a combination antibiotic called trimethoprim-sulfamethoxazole.

Trimethoprim and sulfamethoxazole are both compounds that block the internal production of folic acid (folate) needed by most bacteria to survive. These compounds, relatively safe for humans, are lethal to many bacteria.

Unfortunately, this inexpensive and quite effective, standard antibiotic for bladder infections is notorious for developing rash and allergies to it, frequently, life-threatening allergies. It is one of those famous sulfur drugs to which people have adverse reactions.

Other side effects have been reported in virtually every organ system in the body, including the kidneys. Sulfa drugs may precipitate in the urine, producing crystals that can cause bleeding, urinary obstruction, or kidney damage.

Septra also interacts with Dilantin, with methotrexate, and with anticoagulant medications; it should be used cautiously if these other drugs are being taken.

Generic Bactrim also tends to disrupt the intestinal bacteria more than other drugs, such as Macrobid, and cause stomach upset.

Keflex and Macrodantin
These alternatives to Septra and Bactrim are commonly used both for the active treatment and long-term prevention of urinary tract infections. They seem to be more effective and even safer than Septra, although each carries risks of its own.

As you can see, in prescribing antibiotics, the risks and benefits must be always balanced!

Cipro and Marcrobid
The majority of doctors opt for newer (and more expensive) antibiotics, such as Cipro (a type of fluoroquinolone) or an often-prescribed drug, generic Marcrobid.

An often-prescribed by obstetricians generic Marcrobid tends to have minimal negative effect on the intestine, as most of this drug is concentrated in the bladder.

This trend may be due to doctors, adopting a new drug, believing it is the better drug. Therefore, it runs counter to the formal recommendations for drugs to be used first, such Bactrim, in the treatment of urinary tract infections.

There are also differences between the medical specialties in prescribing antibiotics:

• internists are most likely to prescribe fluoroquinolones, such as Cipro, and
• obstetricians are most likely to prescribe nitrofurantoin, such as Marcrobid.

Limitations of the Antibiotic Treatments

Bacteria E. coli are able to survive antibiotic treatment for bladder infections by reverting to an inactive state.

Although, within several days of antibiotic treatment, the number of bacteria reproducing drop to zero - NOT ALL the bacteria are killed.

For example, after treatment with ciprofloxacin

• about 3 percent of the bacteria may be still present in a dormant state.

After treatment with trimethoprim-sulfamethoxazole

• about 7 percent of the bacteria may still linger.

Even after a month of antibiotic exposure, about 10 million of the original 1 billion bacteria may remain.

It is a well-known fact that antibiotic treatments:

• do NOT successfully kill all the bacteria participating in the infection and
• may, in fact, encourage many of the bacteria to persist in a resting state.

Therefore, current standard drug treatments for bladder infections are not adequate and this phenomenon may account for many of the repeat urinary tract infections (in 15 percent of cases, bladder or kidney infections can become a recurring problem, or they can stop responding to the antibiotics).

Drawbacks of the Antibiotic Treatments

• antibiotics successfully kill both the unwanted micro-organisms and wanted micro-organisms
• long-term or often repeated antibiotic use leads to major disturbance in normal body microflora, and sometimes to major disruption in health
• antibiotics, such as Bactrim, may cause stomach upset, rash, and allergic reactions
• many women to end up with nasty yeast infections; as the friendly bacteria are killed off along with the bad bacteria, the antibiotic insensitive yeast can then grow out of control.

Therefore, due to the hazards, especially of prolonged antibiotic therapy, the need for antibiotics used to clear up the infection, should be reduced, as ALL antibiotic therapies carry with them the risks of developing

• antibiotic-resistant bacteria
• gastrointestinal problems, and
• adverse effects, especially on the liver and kidneys.

D-Mannose: The Natural Alternative to Antibiotics

Even more remarkably, D-mannose accomplishes this feat without killing a single bacterium! (Exactly how does this it will be explained later).

Suffice it to say that, because it gets rid of bladder infection-causing bacteria without committing "bactericide," people who use it suffer none of the unwanted side effects of antibiotics:

• no gastrointestinal (GI) problems,
• no yeast infections, and
• no resistant bacteria.

In fact, D-mannose has no adverse side effects of any kind.

It Tastes Good!
As a bonus, D-mannose actually tastes good. Where a "spoonful of sugar" helped the medicine go down in Mary Poppin's day, with D-mannose, a spoonful of sugar IS the medicine.

It Is Effective and Safe! Because it is so effective and so benign, women (even pregnant women) who are susceptible to recurrent bladder infections, can safely take D-mannose as a preventive measure to head off future attacks. It Is Suitable for Children D-mannose is also ideally suited for children with bladder infections. Because it tastes so good (it is a sugar, after all!), children actually enjoy taking it.

It Is Just As Effective As Antibiotics
Although D-mannose is virtually unknown to practitioners of conventional medicine, many research reports have demonstrated its mode of action and effectiveness against E. coli, the microorganism that causes most bladder infections.

Moreover, nearly 15 years of clinical experience have shown that it is just about as effective at curing bladder infections as antibiotic drugs.

It Has No Known Drawbacks
At first glance, D-mannose may sound too good to be true: a "medicine" that's highly effective, perfectly safe, pleasant to use, inexpensive, and available without a doctor's prescription. Yet, it is true!

Unlike virtually any conventional medication, and many natural or "alternative" treatments as well, D-mannose has no known drawbacks.

E. Coli Bacterial Infections

The urinary tract reacts to a bacterial infection in much the same way that the upper respiratory system reacts to a cold virus. The tissues become inflamed, irritated, and swollen. Just as it's hard to breathe through swollen and inflamed nasal passages, swollen and inflamed urinary ducts can partially obstruct normal flow, making it painful and difficult to pass urine.

Built-In Safeguards
Ordinarily, the urinary system is hostile territory for bacteria, viruses, or any other microorganisms.

Bugs that do make their way into a healthy urinary tract are likely to find an inhospitable acidic environment (pH <5.5).

Bugs are also subject to attack by the body's immune defenses. (Adult men have the added protection of a specific bacterial growth inhibitor squirted directly into the urinary system by their prostate gland.)

Even if microorganisms manage to overcome these considerable obstacles, they would typically be flushed out with the normal flow of urine. So effective are these natural antibacterial defenses that in a study in which bacteria were instilled directly into the bladders of guinea pigs, simple urination expelled 99.9 percent of the bugs.

Despite all these built-in safeguards; each year millions of people, overwhelmingly women, still develop bladder infections.

Urethritis
Most bladder infections begin when bacteria originating in the bowels travel to and grow in the urethra. Infections limited to the urethra are known as "urethritis."

Cystitis
When bacteria travel upstream to the bladder, the infection is called "cystitis."

Nephritis
Infections that reach the kidneys are known as "nephritis" or "pyelonephritis."

The E. coli that cause most bladder infections are among the most common friendly bacteria in the gastrointestinal (GI) tract, where they aid digestion, produce a few vitamins, and in general, behave themselves without bothering us.

However, when E. coli and other bugs exit the lower GI tract, they may gain entry to the urinary tract via the urethra, where they may attach to the internal lining of the bladder, multiply, and spread.

Other Infectious Bacteria
Although up to 90 percent of bladder infections are caused by E. coli, the remaining 10 percent are caused by bacteria known as

• Chlamydia
• Mycoplasma
• Neisseria gonorrhea
• and others.

Unlike E. coli, these bugs tend to be transmitted via sexual contact and rarely cause the more serious bladder and kidney infections.

Still, all of these non-E. coli infections combined amount to no more than 10 percent of all bladder infections.

Bladder Infection Treatment With D-Mannose

While there's nothing essentially wrong with killing disease-causing bacteria, this approach does have some very serious drawbacks, as we have noted earlier. Happily, "bacteria-cide" is not the only possible avenue of attack.

More Natural Way
Another, more natural way to eliminate E. coli infections from the urinary tract is to beat them at their own game. If they're going to cause trouble, bacteria usually have to find a way to adhere (stick) to the body tissue they're infecting. In bladder infection, E. coli attach to cells lining the bladder and urinary tract using filmy, hair-like projections called fimbria on their cell walls.

At the tip of each fimbrium is a glycoprotein (a combination carbohydrate and protein) called a lectin that is programmed to bind to the first molecule of the sugar mannose that it encounters.

It turns out that molecules of mannose (produced inside urinary tract lining cells) naturally dot the surfaces of these cells. Here they act as "receptors," inviting the fimbria of E. coli to attach, and allowing them to bind to the tissue in a tight, Velcro-like grip.

If not for this attachment to the cell's mannose, any E. coli that had successfully ventured up the urethral river would be unable to stick to the slippery surface and would be washed right back out on the next tide of urination.

How Does D-Mannose Work?

The E. coli couldn't turn around without bumping into D-mannose "just floating around" in the urine. Unable to resist the tasty bait they suddenly find themselves swimming in, they would latch onto the nearest mannose molecules, and happily sail off into the porcelain sunset.

Those few E. coli left clinging to mannose molecules on cells then become easy prey for white blood cells and other agents of the immune system.

E. Coli Coated With D-Mannose
In addition to its natural occurrence in the cells lining the epithelial tract, the sugar D-mannose is also found in relatively large quantities in fruit such as peaches, apples, oranges, and certain berries, like cranberries and blueberries.

Extracted in the form of D-mannose, a white crystal sugar similar to glucose, it can be easily dissolved in a liquid and swallowed. (Mannose can also be synthesized from other simple sugars.)

When someone with bladder infection consumes a dose of D-mannose, the sugar is absorbed in the upper GI tract, but at a much slower rate than most other sugars. (For example, glucose is absorbed more than eight times faster.)

Moreover, unlike other sugars, D-mannose is not readily converted to glycogen (and stored) in the liver, but instead passes directly into the bloodstream largely unchanged.

As the D-mannose-laden blood passes through the kidneys, a considerable proportion of the sugar is extracted and added to the urine.

The D-mannose-sweetened urine flows from the kidneys through the ureters to the bladder and on to the urethra, literally sugar-coating any free-floating E. coli it might encounter, so they can't stick to cells any more.

It also unsticks most of the E. coli already "Velcro-ed" to the inner surface of the bladder and urinary tract, ultimately flushing them all down the drain.

It Is Scientifically Proven
First, the "molecular mechanism" of the action of D-mannose on E. coli is scientifically proven. There's no argument at all about this among researchers who have studied it.

Second, literally tens of thousands of women working with natural medicine doctors have successfully applied this science to their own bladder infections.

Therapeutic Value of D-Mannose
Considerable circumstantial evidence, combined with common sense and over 15 years of clinical experience, makes a compelling case for the therapeutic value of D-mannose.

Laboratory Studies
In one laboratory study, for example, rats' urinary tracts were inoculated with E. coli. Within one day, those rats also given D-mannose were found to have significantly lower levels of bacteria in their urine.

In another study, administering a mannose-like substance (niethyl a-D-mannopyranoside) to E. coli-infected mice led to a 90 percent reduction in bacterial attachment to the urinary tract.

Research in humans shows that ingesting D-mannose significantly elevates blood mannose levels, a prerequisite if urinary levels are to rise.

Epidemiological Evidence
Perhaps the best available evidence, though, comes from the experience of people who have used it. Natural medicine-oriented physicians have been recommending D-mannose to people with bladder infection since the mid-1980s with great success.

A 5-Year-Old Girl
For example, in one case, a 5-year-old girl had almost continuous bladder infections for her entire life that had failed to respond to every antibiotic therapy her physicians tried (72 doctors in all!).

At the end of their rope, her doctors were now considering a kidney transplant, since her kidneys were starting to fail due to years of chronic infection.

Since urine culture showed her bladder infection was due to E. coli, she was started on D-mannose (1 tsp in a glass of water every 2-3 hours). Within 48 hours, her infection had vanished, and her kidneys were saved!

"Honeymoon Cystitis"
D-mannose can also be very effective in cases of "honeymoon cystitis." It's not uncommon for women to avoid sex because they get a bladder infection nearly "every time" they have intercourse.

If a urine culture shows the presence of E. coli, taking D-mannose, 1 teaspoon 1 hour prior to intercourse, will mostly likely completely eliminate further infections.

Recurrent Bladder Infections
Physicians experienced with D-mannose report that women prone to very frequent recurrent bladder infections that are not necessarily related to sexual intercourse can also often benefit from taking D-mannose preventively. To save expense, some women have been able to "taper down" their dosage and dose frequency.

Single Bladder Infections
By far the most frequent success with D-mannose has been achieved by the thousands of women who have suffered single (non-recurrent) episodes of bladder infection.

In over 90 percent of such cases, 1 teaspoon of D-mannose every 2 to 3 hours usually clears the infection in 1 to 3 days.

Try D-Mannose PLUS First

PLEASE NOTE: Even though symptoms are improved within 24 hours, D-mannose Plus should be continued for 2 to 3 days after the last symptom is gone, just to "make sure."

A Word of Caution
If a bladder infection treated with D-mannose Plus does not show significant improvement within 24 hours (about 10 percent of cases), it is likely that the causative organism is not E. coli, and consider using herbal remedies, such as our proprietary Uribiotic Formula or B.L.D.R. Liquid Remedy and/or Pure Essential Oil of Wild Oregano, as the infection can spread into the upper urinary tract, namely, the kidneys, causing serious problems.

D-Mannose Powder PLUS: Dietary Supplement

Serving Size: 1 Level Teaspoon (4.7 grams)
Servings Per Container: 30

Amount Per Serving:

• d-Mannose: 1,500 mg
• Cranberry (vaccinium macrocarpon): 800 mg
• Vitamin C (as ascorbic acid): 60 mg

Other Ingredients: Natural mixed berry flavor, xylitol, citric acid and sucralose.

Contains no added starch, salt, wheat, gluten, corn, coloring, dairy products or preservatives.

Keep container tightly closed in a cool, dry and dark place. Keep out of reach of children.

Recommended Intake

For relief from a urinary tract infection, repeat four to five (4-5) times per day.

For prevention of a urinary tract infection, drink once a day.

Description: D-Mannose is a naturally occuring simple sugar, closely related to glucose. Clinical studies have demonstrated its ability to prevent E. Coli bacteria from adhering to the inner walls of the bladder, potentially reducing the incidence and severity of urinary tract infections. D-Mannose Powder Plus combines d-Mannose with Cranberry extract to enhance its effectiveness.

PLEASE NOTE: These statements have not been evaluated by the Food and Drug Administration (FDA). This product is not intended to diagnose, treat, cure or prevent any disease.

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Effective in Paraplegic Bladder Infections

Neurological conditions like paraplegia, a spinal cord injury, also called spinal cord impairment (SCI), usually result in neurogenic bladder - an unstable or atonic bladder, with no muscle tone.

People with spinal cord injuries have lost, partial or complete, control over their bladder and sphincter due to the compromised nerve receptors that are responsible for:

• contracting and relaxing the muscles of the bladder and the sphincter, and
• registering feelings of pressure or release.

Due to this condition, most paraplegics are exposed to the regular use of catheters and drugs. (The more traditional cap and bag, with continual drainage, is falling from favor even though it is a safer system).

However, catheters often increase the risk of the urinary tract injuries and repeated bladder infections - a common problem in people with spinal cord impairment.

Exposed to repeated or long-term courses of antibiotics, in time, they also develop resistance to drugs what makes maintaining healthy urinary tract for them even more difficult.

However, contrary to a popular belief and common medical practice, people with spinal cord injuries or spinal cord impairment:

• do NOT have to suffer from chronic bladder infections and
• do NOT have to be exposed to vicious antibiotics.

It is our clinical experience that paraplegics, especially those who use catheters, can successfully remedy, and most importantly, prevent bladder infections with the help of supplemental D-Mannose.

Therefore, you, or someone you know or hold dear, who suffers from paraplegia, should give this natural E. Coli fighter serious consideration.

If Your Infection Persists

Not ALL urinary tract infections are caused by E.coli. Therefore, if you try a course of D-Mannose and infection persists, it is likely NOT caused by E. coli bacteria but by some other pathogen or pathogens, like Chlamydia, Mycoplasma, or - more likely - Proteus or Staphylococcus aureus ("Staph").

In that case, don't just keep going on with the supplement in hopes that it will eventually "kick in." Discontinue the use of D-Mannose.

The Natural Urinary Tract Support:

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	D-Mannose Pure Powder: UTI Natural Remedy
	The Low-Grain, Low-Sugar Delight: UTI Cookbook
	FREE e-Pamphlet: Say NO! to Urinary Bladder Infection

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Contact us by or by phone: 1. 705. 876. 9357 (US/Can)
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© 2003-2008 Remedy-Bladder-Infection.com. Stop Urinary Bladder Infection Naturally. The Natural UTI Cure, Treatment and Prevention with D-Mannose Pure Powder PLUS. Alternative, herbal and nutritional treatment for cystitis, urethritis, urethral syndrome in women. Prevent and remedy urinary tract infection (UTI) without antibiotics. The information provided herein on bladder infection and the natural alternatives to antibiotics is a general overview on bladder infection and may not apply to everyone; therefore, it should not be used for diagnosis or treatment of any medical condition. While reasonable effort has been made to ensure the accuracy of the information on bladder infection in pregnancy, Full of Health Inc. assumes no responsibility for errors or omissions, or for damages resulting from use of the bladder infection information herein.
URIBIOTIC is a registered trademark of Full of Health, Inc.

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