Womens Health

Women's Health Newsletters 1/15/06 - 6/11/06



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********** Health Newsletter ***********
              January 15,  2006
From BackupMD on the Net

1. Statin associated muscle problems
2. Uterine artery embolization for fibroids
3. Reader submitted Q&A - Recurrent urine infections
4. Sleep tips
5. Health tip to share - Duct tape and warts
6. Humor is healthy
1. Statin associated muscle problems
Statins are becoming one of the most widely prescribed 
class of drugs, used mainly for lowering cholesterol 
and for preventing heart attacks in people who have 
previously had a cardiovascular problem. In general, 
statin drugs lower heart attacks by about 2.5% over 5 
years in high risk individuals who have not previously 
had a serious cardiovascular event and by 4.8% in 
individuals who have already had a major cardiovascular 
event. The reduction in both fatal and non fatal heart 
attacks is thought to be worth it for individuals to 
take the risk of serious side effects such as muscle 
dissolving leading to death (rhabdomyolysis) which is 
about 1 in 10,000 people or less. Muscle weakness 
(myopathy) is also a related side effect of statins and 
occurs more commonly than complete muscle destruction 
but the data on how often myopathy occurs and what is 
the normal course is not readily available. 

A recent study from Wisconsin looks at a retrospective 
review of cases of statin associated myopathy to see 
what the expected course is. They found that the 
average duration of statin therapy before muscle 
weakness or pain symptom onset was 6.3 months. 
Resolution of muscle pain occurred on the average 2.3 
months after discontinuation of statin therapy. 
Thirteen percent of patients were hospitalized for the 
management of rhabdomyolysis; 2 had reversible kidney 
dysfunction, and 1 with preexisting kidney 
insufficiency subsequently began lifelong dialysis. 
Patients who had a myopathy from a statin drug often 
received a different statin after an episode of statin-
associated myopathy; 57% reported recurrent muscle 
pain, whereas 43% tolerated other statins without 
recurrent symptoms. 

We still do not have an incidence number for statin 
associated myopathy but it is probably in the range of 
0.5% or less. Now we at least know that most of the 
time the myopathy does regress after stopping the drug 
but it is very likely to recur if another statin is 

Statin associated muscle problems

2.  Uterine artery embolization for fibroids

Uterine artery embolization (UAE) is a radiological 
procedure in which the arteries of the uterus are 
injected with a substance to clot off the blood supply 
to uterine fibroids. It is an alternative to 
hysterectomy. Uterine fibroids are benign muscle 
growths that make the uterus enlarged causing a weighty 
or pressure feeling as well as sometimes abnormal 
menstrual bleeding problems and pain. UAE is not as 
effective in getting rid of fibroid symptoms as is 
hysterectomy (100%) but it is not as risky as surgery. 
It does not require an abdominal incision and patients 
may return to work in a week or less. 

The long term follow up of UAE has not previously been 
determined. A recent study however has looked a a 5 
year follow up of women who underwent a uterine artery 
embolization to see how successful it is. The 
investigators considered the procedure a failure if a 
woman subsequently had a hysterectomy or surgical 
procedure to remove separate fibroids (myomectomy). It 
was also considered a failure if a repeat embolization 
had to be done or even if the symptoms had not resolved 
without any more treatment. 

This study at Georgetown University Hospital in 
Washington D.C. found that UAE was 75% successful at 
getting rid of fibroid symptoms with only one 

Uterine artery embolization for fibroids

3. Reader submitted Q&A - Recurrent urine infections
"My wife is suffering with urinary tract infections 
over the last six years and several times she has taken 
antibiotic courses after Urine examination and culture 
but they have not worked. One of her urologists did her 
TB test and after it was positive by DNA PCR method he 
has given her six months course for TB. She remained 
fine up to one year and after that same problem with 
same frequency occurring. One more thing I want to add 
that periodically some blisters develop on her genital 
area, sometimes inside or up to her thigh. It starts 
very tiny and hard  but within two or three days they 
become big and blister with pus and pain. She feels 
pain with itching in her vagina at the time of 
infection and she can't sit or sleep." - sanjiv 

You have not posed a question but If you did, I suppose 
it would be what is going on and are all these things 

When your wife was treated for TB she received 
antibiotics that may have prevented urinary tract 
infections. Now that she if off of the tuberculosis 
medications, she may be regressing to frequent urine 
infections again. It is time for her to see her 
urologist again. She may need antibiotics on a regular, 
preventative basis to ward off the infections. 

The other problem of blisters in the genital area that 
you describe may not be related to the urinary tract 
problem. The gynecology doctor needs to look at them 
when they break out and see if they represent a viral 
infection such as herpes genitalis. If that is the 
case, it will need to be treated differently than a 
urinary tract infection. 

4. Sleep tips

Most people know the importance of adequate sleep. It 
helps learning and memory. While you sleep, your brain 
commits new information to memory through a process 
called memory consolidation. Sleep may also help keep 
your weight down since sleep deprivation often is 
associated with weight gain. Adequate sleep may also 
help prevent falls, traffic accidents or even work 
mistakes. Lack of sleep can cause irritability, 
impatience, problems with concentration, and moodiness 
as well as weaken your immune system. 

The National Sleep Foundation has the following 
suggestions for people who have sleep problems. 

1. Maintain a regular bed and wake time schedule 
including weekends. 
2. Establish a regular, relaxing bedtime routine such 
as soaking in a hot bath or hot tub and then reading a 
book or listening to soothing music. 
3. Create a sleep-conducive environment that is dark, 
quiet, comfortable and cool. 
4. Sleep on a comfortable mattress and pillows. 
5. Use your bedroom only for sleep and sex. 
6. Finish eating at least 2-3 hours before your regular 

Sleep tips

5. Health tip to share - Duct tape and warts

"It sounds crazy but I went to a foot doc who charged 
me $720 to tell me I need surgery. A friend told me 
that he heard about the duct tape on the radio. Put on 
a new piece every day. I used it and have gotten rid of 
massive warts that had been there 3 years with no 
surgery." - Nancy 

6. Humor is healthy

"Secrets Of Personal Growth"

1. As I let go of my feelings of guilt, I am in touch 
with my inner sociopath. 

2. I have the power to channel my imagination into 
ever-soaring levels of suspicion and paranoia. 

3. I assume full responsibility for my actions, except 
the ones that are someone else's fault. 

4. I no longer need to punish, deceive, or compromise 
myself, unless I want to stay employed. 

5. In some cultures what I do would be considered 

6. Having control over myself is almost as good as 
having control over others. 

7. My intuition nearly makes up for my lack of self-

8. I honor my personality flaws for without them I 
would have no personality at all. 

9. Joan of Arc heard voices too. 

10. I am grateful that I am not as judgmental as all 
those censorious, self-righteous people around me. 

11. I need not suffer in silence while I can still 
moan, whimper, and complain. 

12. As I learn the innermost secrets of people around 
me, they reward me in many ways to keep me quiet. 

13. When someone hurts me, I know that forgiveness is 
cheaper than a lawsuit, but not nearly as gratifying. 

14. The first step is to say nice things about myself. 
The second, to do nice things for myself. The third, to 
find someone to buy me nice things. 

15. As I learn to trust the universe, I no longer need 
to carry a gun. 

16. All of me is beautiful, even the ugly, stupid and 
disgusting parts. 

17. I am at one with my duality.

18. Blessed are the flexible, for they can tie 
themselves into knots. 

19. Only a lack of imagination saves me from 
immobilizing myself with imaginary fears. 

20. I will strive to live each day as if it were my 
69th birthday. 

21. I honor and express all facets of my being, 
regardless of state and local laws. 

22. Today I will gladly share my experience and advice, 
for there are no sweeter words than "I told you so!" 

23. False hope is better than no hope at all. 

24. A good scapegoat is almost as good as a solution. 

25. Just for today, I will not sit in my living room 
all day in my underwear in the Dream Motel. Instead, I 
will move my computer into the bedroom. 

26. Who can I blame for my problems? Just give me a 
minute. . . . I'll find someone. 

27. Why should I waste my time reliving the past when I 
can spend it worrying about the future? 

28. The complete lack of evidence is the surest sign 
that the conspiracy is working. 

29. I am learning that criticism is not nearly as 
effective as sabotage. 

30. Becoming aware of my character defects leads me 
naturally to the next step of blaming my parents. 

31. To have a successful relationship I must learn to 
make it look like I'm giving as much as I'm getting. 

32. I am willing to make the mistakes if someone else 
is willing to learn from them. 

33. Before I criticize a man, I walk a mile in his 
shoes. That way, if he gets angry, he's a mile away and 

34. All of the evil that I speak, hear, and see, are 
pleasurable to me. 

35. The only friend I have...moved to parts unknown. 

36. When counting my blessings, I count backwards from 

37. They no longer allow me into the confessional. 

38. The person I admire the most is Elmer Fudd. 

39. I enjoy watching a magazine stand. 

40. Experience shows that people who write, can't be 

41. When I am here I wish I was there....and I am. 

That's it for this time. 
Your BACKUPMD on the Net.
Frederick R. Jelovsek MD 

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********** Health Newsletter ***********
              February 12,  2006
From BackupMD on the Net

1. Breast cancer in women not reduced with low fat diet
2. Eradication of H.Pylori helps dyspepsia
3. Reader submitted Q&A - Celiac disease symptoms
4. Antidepressants (SSRIs) and adverse effect on newborns
5. Health tip to share - Traveller's diarrhea
6. Humor is healthy
1. Breast cancer in women not reduced with low fat diet

On and off over the last decade, some scientists have 
suggested that breast cancer was related to the dietary 
intake of fat. They never concluded whether fat was a 
direct cause or if the cause might have been 
carcinogenic substances that were dissolved in the fat 
from environmental fertilizers, insecticides and 
pesticides. Nevertheless the data was not very 
conclusive about dietary fat as a breast cancer cause. 

The recent Women's Health Initiative Randomized 
Controlled Dietary Modification Trial looked at a total 
of 48,835 postmenopausal women, aged 50 to 79 years, 
without prior breast cancer, including 18.6% of 
minority race/ethnicity. Half of the group was placed 
on a low fat diet in which only 20% of the daily 
calorie intake was provided by fat. The other half of 
the group had a regular diet as they preferred. 

The difference between the two groups in change from 
baseline for percentage of energy from fat varied from 
10.7% at year 1 to 8.1% at year 6. In other words the 
low fat group was eating about a third less fat than 
the control group. In spite of that, the incidence of 
newly occurring breast cancer was 0.42% in the low fat 
group and 0.45% in the comparison group. There was no 
significant difference in the incidence of breast 
cancer according to the amount of dietary fat ingested 
over 6 years. 

This is not absolutely conclusive about the lack of a 
cancer cause by dietary fat since it takes about 6-8 
years for a breast cancer to go from a few microscopic 
cells to a detectable lump but it is still pretty good 
evidence about the lack of a major effect. 

Breast cancer in women not reduced with low fat diet

2.  Eradication of H.Pylori helps dyspepsia

Dyspepsia is a term  meaning pain related to the 
digestive tract mainly throat and stomach pain. It 
includes peptic ulcer disease as well as 
gastroesophageal reflux disease. Peptic ulcer disease  
has been found to be caused by an acid-loving bacteria 
called helicobacter pylori. Ulcers respond to 
antibiotic treatment that eradicates H. pylori but it 
is not certain how much gastroesophageal reflux and 
other non ulcer dyspepsia can be improved by treatment 
of the H. pylori bacteria. 

In a British study of over 1500 people who were 
infected with H. pylori, half were treated with 
antibiotic therapy and half were given placebo. Over 
the next two years after treatment, the number of 
people who further consulted their doctors for 
dyspepsia symptoms was reduced by 35%. The net result, 
however is that thirty people with H. pylori would have 
to be treated to prevent one person consulting their 
doctor for dyspepsia. This is not a very cost effective 
ratio. It probably means that most people put up with 
the symptoms of dyspepsia and do not visit their doctor 
or that the infection may spontaneously subside or go 

Still if you are a person suffering from stomach or 
esophageal pain you should consider being tested for H. 
pylori. Home 
are available over the Internet. 


Eradication of H.Pylori helps dyspepsia

3. Reader submitted Q&A - Celiac disease symptoms

"Can you tell me the symptoms of celiac disease. I am 
45 years old who has had a hysterectomy about 7 years 
ago.  I had my gall bladder removed in September.  
Since my surgery, my digestive system has been out of 
whack.  My doctor seems to think that I may have celiac 
disease." - Vetti 

Statistically, the odds are that you have 
gastrointestinal problems common in about 1/3 of 
patients after having their gall bladder removed. This 
is called post cholecystectomy syndrome. However celiac 
disease is not as uncommon as one thinks. 

Celiac disease is a condition of diarrhea, weight 
loss and malnutrition among other symptoms that is 
caused by a genetic sensitivity to gluten in the 
diet that destroys cells that line the bowel 
tract. Gluten is found in barley, oat, rye, wheat 
and other grains.  In people with celiac disease, 
gluten sets off an autoimmune reaction that 
attacks the body's own gastrointestinal lining 

While once thought to be a rare disease, recent studies 
show it is more common than doctors expect. The test 
for celiac disease is a blood test that looks for 
IgA/IgG/IgM tissue Transglutaminase (tTG) which is 
found in the bowel lining and IgA Gliadin. It is 
important to understand that people can have a food 
intolerance to gluten but not necessarily have celiac 
disease. If you have a food 
allergy test that is positive for glutens, you 
should then have a specific test for celiac disease. 
Celiac disease test kit
A study reported in the Archives of Internal Medicine 
looked at different groups of people across the U.S. to 
see how common this disease is. They found: 

in individuals who are having bowel symptoms, the 
   risk is 1 in 56 

in individuals who are asymptomatic and do not 
   have a family history of celiac disease, the 
   risk is 1 in 133. 

in individuals who have a parent, sibling or child 
   with celiac disease, the risk was 1 in 22 

in individuals who have an aunt, uncle, 
   grandparent, niece or nephew with celiac 
   disease, the risk was 1 in 39 
This prevalence is more frequent than most doctors 
have previously thought and it turns this 
condition from a rare one to something that should be 
looked for more commonly. If you or someone you know is 
suffering from frequent bowel problems or has 
gastrointestinal intolerance to pasta, breads, cereals 
and so forth, you may want to seek out testing for 
celiac disease. 

4. Antidepressants (SSRIs) and adverse effect on newborns

There has been some suggestive evidence recently that 
the anti-depression medications Paxil(R), Prozac(R), 
Zoloft(R) and other drugs belonging to the selective 
serotonin reuptake inhibitors (SSRIs) cause problems in 
newborns if mom takes them during pregnancy. 
Originally, SSRIs have been thought to be safe during 

A study from San Diego looked at newborns who developed 
what is called persistent pulmonary hypertension 
(PPHN). This is a serious condition that can result in 
death of the newborn, difficulty breathing and low 
oxygen levels. The investigators looked at this because 
previous studies had suggested, but not proven, that 
SSRIs taken in the last half of pregnancy resulted in 
more PPHN. 

The study found a 6-fold increase in persistent 
pulmonary hypertension of the newborn in women who used 
SSRIs after the 20th week of pregnancy. In contrast, 
neither the use of SSRIs before the 20th week of 
gestation nor the use of non-SSRI antidepressant drugs 
at any time during pregnancy was associated with an 
increased risk of PPHN. 

The net result of this study is that women taking SSRIs 
during pregnancy should definitely discontinue them 
even if the depression becomes worse. 

Antidepressants (SSRIs) and adverse effect on newborns

5. Health tip to share -  Traveller's diarrhea

Giardia intestinalis is a parasite that can cause long 
term diarrhea, gas and nausea symptoms. These symptoms 
start 1-2 weeks after exposure and may last 2-6 weeks. 
Visitors to foreign countries as well as backpackers 
and hikers in the U.S. are more likely to pick up this 
parasite.  Actually anyone who ingests water from 
pools, spas, lakes and rivers can get this. While tests 
of water for Giardia are expensive (see your public 
health department) you can inexpensively check your 
water for coliform bacteria (Bacteria 
water test kit). If positive that means fecal 
contamination and increases the likelihood of giardia 

An alcohol extract of the cooking herb oregano is a 
natural therapy found to be effective against 
giardiasis. Antibiotic therapy to treat this from a 
doctor is often metronidazole or tinidazole. 

6. Humor is healthy
"Swiss Chocolate"

A man from Switzerland is walking down the beach and 
comes across an old bottle. He picks it up, pulls out 
the cork and out pops a genie. 

The genie says, "Thank you for freeing me from the 
bottle. In return I will grant you three wishes." 

The man says "Great! I always dreamed of this and I 
know exactly what I want. First, I want one billion 
dollars in a Swiss bank account." Poof! There is a 
flash of light and a piece of paper with account 
numbers appears in his hand. 

He continues, "Next, I want a brand new red Ferrari 
right here." Poof! There is a flash of light and a 
bright red brand-new Ferrari appears right next to him. 

He continues, "Finally, I want to be irresistible
to women."

Poof! There is a flash of light and he turns into a box 
of chocolates. 

That's it for this time. 
Your BACKUPMD on the Net.
Frederick R. Jelovsek MD 

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********** Health Newsletter ***********
              March 12,  2006
From BackupMD on the Net

1. Prediction of death from physical impairment
2. Melatonin ineffective for secondary sleep problems
3. Reader submitted Q&A - Facial itching and tearing
4. Tendency to develop blood clots
5. Health tip to share - Cocoa intake and heart health
6. Humor is healthy
1. Prediction of death from daily activities
You have probably already heard about a risk scoring 
system that is predictive of how likely one is to die 
in the short term future. I think it is worthwhile to 
look at the independent risk factors that the 
investigators found in this Journal of the American 
Medical Association article. Basically the 
investigators examined individuals over 50 years of 

They found that the risk of dying in the next four 
years according to risk score was: 
Risk score       Risk of dying 
                 in next 4 years

0-5 points         less than 4%
6-9 points             15%
10-13 points           42%
14+ points             64%
The key knowledge, however is what they found the risk points to be:
Factor              Risk points
Age 60-64               1
Age 65-69               2
Age 70-74               3
Age 75-79               4
Age 80-84               5
Age 85+                 7

Gender male             2
diabetes                1
cancer                  2
lung disease            2
heart failure           2
tobacco use             2
body mass index <25     1

bathing difficulties    2
difficulty walking 
  several blocks        2
difficulty managing
  money                 2
difficulty pushing 
  large objects         1
As you can see, physical limitations are just as predictive of death in the near term future as are medical problems such as heart failure or diabetes. Prediction of death from daily activities ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2. Melatonin ineffective for secondary sleep problems ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Sleep disorders are a widespread problem and may affect as many as 20% of people at a given time. Sleep problems can be primary like unexplained insomnia or they may be secondary to other conditions such as sleep apnea, shift work, jet lag, medicines, mental health problems etc. Because sleeping pills are fairly sedating and can produce side effects even after awaking from sleep, many people look to alternative medical therapies that may be safer. Since melatonin is a natural hormone that is low during awake hours and elevated during sleeping hours, investigators have used melatonin to try to aid in going to sleep faster in people who have trouble getting to sleep. Melatonin has also been used for jet lag and for people who work evening and night shifts to see if they will benefit from taking it. Some studies have implied that melatonin may be effective but when you look at all of the studies that have evaluated melatonin for secondary sleep disorders they do not seem to show any significant benefit to melatonin use. Melatonin ineffective for secondary sleep problems ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3. Reader submitted Q&A - Facial itching and tearing ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ "Two years ago, at age 42, I suffered a mild stroke. Since then, I have had periods of weeks at a time in which the left side of my face itches terribly, and my eye tears up. My doctor said it is an allergy and suggested an antihistamine. I never had an "allergy" before. The neurologist did not seem interested in it if it is not a "pre-stroke" symptom. Any suggestions why I have these periods now?" - MEH What you describe has been reported after strokes but it is not a very common post stroke complication. Most itching (pruritus) is due to a histamine release in the skin due to skin trauma, rashes, bacterial, yeast or fungal infections or skin conditions such as psoriasis or eczema. This histamine release is a "peripheral" cause of pruritus. Itching can also be caused centrally in the brain. In your case this is what is going on. It is thought to be a "sensitization" of the pain fibers in the brain rather than histamine release in the skin of the affected area. Because a stroke usually affects only one half of the brain (right or left), central causes of pruritus do not involve histamine release in the skin and thus do not respond to antihistamine medications. Since the itching is on the left side of the face and you have tearing on the left, this would indicate that the mini-stroke affected some brain cells on the right side of the brain in the area of the facial nerve. They probably made the cells supersensitive to any stimulus so that the itching is brought on by minor things that you may not even be aware of. I suspect your neurologist is aware that this can be a post stroke symptom but just does not have any medicines to treat the problem with. I am not sure whether any anti-epileptic medications might lessen these attacks like they do with aberrant electrical irritation that causes seizures. I could not find any suggestions for treatment in a review of articles on Pub Med. If the symptoms present a major problem for you so that they interfere with your daily activities, I would suggest you go to a major medical center that has some neurologists who are very experienced with mini-strokes and who might be willing to work with you trying some different types of medications. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4. Tendency to develop blood clots ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Blood clots are an uncommon occurrence. Many times blood clots are associated with trauma or surgery that injures the blood vessels, but they can also be associated with various conditions and diseases. Many are unaware that most of the people who develop spontaneous blood clots unassociated with trauma or surgery have either a disease or genetic tendency to form these clots. Such conditions might be: Deficiencies of natural anticoagulants: anti thrombin, protein C and protein S Genetic alterations: Factor V Leiden or Factor II Increased clotting factors such as high Factor VIII level Immune problems like antiphospholipid antibody syndrome (APS) Any of these clot producing conditions make a person at more risk of having a blood clot associated with hormone use (birth control pills, hormonal replacement), pregnancy or any trauma or surgery. The magnitude of risk has not been well described. In looking at one condition, Antiphospholipid antibody syndrome (APS), investigators in Canada looking at the worlds' medical literature found the following risk of blood clots: Among patients with APSs, the absolute risk of developing new thrombosis (blood clots) is low (less than 1% per year) in otherwise healthy patients without prior thrombotic events. The risk may be moderately increased (up to 10% per year) in women with recurrent fetal loss without prior thrombosis, and is highest (>10% in the first year) in patients with a history of venous thrombosis who have discontinued anticoagulant drugs within 6 months. They also found that aspirin appears to be as effective as moderate-intensity warfarin anticoagulant (Coumadin(R)) for preventing recurrent stroke in APS patients with a history of prior stroke. Tendency to develop blood clots ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5. Health tip to share - Cocoa intake and heart health ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Cocoa intake may be healthy for your heart. At least that's what one study of elderly men found. As with all food studies there may be other factors responsible for an outcome rather than the food that was measured but in a Dutch study of elderly men followed for 15 years, those who had the highest cocoa intake calculated from all the food they regularly ate and drank, had half the death rate from cardiovascular disease compared to men who had almost zero cocoa intake. Their blood pressures were also less. This suggests that chocolate may be heart healthy. - FRJ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. Humor is healthy ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ An 80 year old man was arrested for shop lifting. When he went before the judge, the judge asked him, "What did you steal?" He replied: "a can of peaches." The judge asked him why he had stolen them and he replied that he was hungry. The judge then asked him how many peaches were in the can.? He replied 6. The judge then said, "I will give you 6 days in jail." Before the judge could actually pronounce the punishment the man's wife spoke up and asked the judge if she could say something. He said, "What is it?" The wife said "He also stole a can of peas." ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ That's it for this time. Your BACKUPMD on the Net. Rick Frederick R. Jelovsek MD ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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