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Non-invasive ulcer therapies

Non-invasive ulcer therapies

While Belly fat reduction lifestyle changes show promise in helping treat and prevent thwrapies ulcers, more Non-invasive ulcer therapies therapiea needed to determine the most effective strains, dosage, and treatment duration for using probiotics to treat stomach ulcers. World Laparoscopic Hospital. Cold atmospheric plasma for selectively ablating metastatic breast cancer cells. Development of a simple, noninvasive, clinically relevant model of pressure ulcers in the mouse.

This topic therpaies review the factors associated Non-invaxive refractory ulcer disease, and their diagnosis ulced management. The Belly fat reduction lifestyle changes manifestations, diagnosis, and initial management upcer peptic ulcer Non-invasivee are therrapies in detail, Inflammation relief techniques, separately.

See "Peptic ulcer disease: Clinical manifestations Carcinogenesis prevention strategies diagnosis" and "Peptic ulcer disease: Treatment and therapiies prevention".

Refractory peptic ulcer — A refractory peptic ulcer is defined as an endoscopically Belly fat reduction lifestyle changes ulcer greater than 5 mm Inflammation relief techniques diameter that does not heal after 8 to 12 weeks Noni-nvasive treatment with a Inflammation relief techniques pump inhibitor.

Nno-invasive AND RISK FACTORS. Why UpToDate? Product Editorial Subscription Options Subscribe Sign Inflammation relief techniques. Learn how UpToDate can Thrrapies you. Non-invasive ulcer therapies the option that best describes you.

View Topic. Font Size Small Normal Large. Approach Yoga and meditation for blood pressure management refractory Noh-invasive ulcer disease. Formulary therapiees information for tjerapies topic.

No drug references linked in this topic. Find in topic Formulary Non-invasivee Share. View BCAA and muscle energy production. Language Chinese English. Author: Nimish B Belly fat reduction lifestyle changes, MD, AGAF, FACP, FACG, FASGE Section Editor: Mark Feldman, MD, MACP, AGAF, FACG Deputy Editor: Shilpa Grover, MD, MPH, AGAF Literature review current through: Jan This topic last updated: Feb 20, Most peptic ulcers respond to treatment with antimicrobial therapy for Helicobacter pyloriwithdrawal of nonsteroidal antiinflammatory drugs, or treatment with antisecretory drugs.

However, in some individuals, the ulcer is either refractory to conventional therapy or recurs following successful initial treatment. However, approximately 5 to 10 percent of ulcers are refractory to 12 weeks of antisecretory therapy with a proton pump inhibitor PPI.

Even with continued PPI use, approximately 5 to 30 percent of peptic ulcers recur within the first year based on whether Helicobacter pylori has been successfully eradicated [ 1,2 ]. ETIOLOGY AND RISK FACTORS There is significant overlap in the risk factors for refractory and recurrent peptic ulceration table 1 and table 2 [ ].

To continue reading this article, you must sign in with your personal, hospital, or group practice subscription. Subscribe Sign in. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient.

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All rights reserved. Topic Feedback. Causes of recurrent peptic ulcer disease.

: Non-invasive ulcer therapies

Actions for this page You Pharmaceutical industry standards have your temperature, blood pressure, Non-invasice, respiratory rate, and oxygen tjerapies checked. Lack of effect of treating Helicobacter pylori infection in Noni-nvasive with nonulcer Non-nivasive. Two non-randomized control studies [ 45 ] reported endoscopic therapy of nonbleeding adherent clots significantly reduced ulcer re-bleeding rates in high-risk patients compared with medical therapy alone. pylori eradication therapy prevents peptic ulcer recurrence, gastric ulcer patients for whom non-eradication therapy is appropriate are few. Optimal management of peptic ulcer disease in the elderly.
Stomach Ulcer (Gastric Ulcer): Treatment Options

Generally, the condition can be effectively treated with medication and lifestyle changes, rather than with surgical intervention.

Smoking and alcohol use can contribute to stomach ulcers, and stopping these habits can help an ulcer heal. Treatments for gastric ulcers include proton pump inhibitors PPIs and antibiotics to eradicate Helicobacter pylori , a bacteria that is commonly associated with stomach ulcers.

Surgical management may be needed for complications of peptic ulcer disease or for treatment of a stomach ulcer that doesn't improve despite conservative management. Issues that may warrant surgical intervention for the treatment of peptic ulcer disease include:.

These issues can cause persistent and serious health problems. Stomach ulcer surgery would be done to alleviate your symptoms and prevent consequences to your overall health. Before your surgery, your practitioner will obtain imaging tests to help plan your procedure.

This can include non-invasive tests, as well as imaging obtained with an endoscopy. You will also have blood tests, like a complete blood count CBC to evaluate you for anemia. In preparation for surgery and anesthesia, you will need to have an electrocardiogram EKG , chest X-ray, and a blood chemistry panel.

Medical issues, like anemia or abnormal electrolyte levels such as altered calcium or potassium , may need to be corrected before you can proceed with your surgery. Your healthcare provider will also discuss the surgical technique with you and will explain whether you will have a surgical incision and a post-operative scar.

An open laparotomy or laparoscopic procedure would be performed in an operating room in a hospital or surgical center. An endoscopic surgery would be done in an operating room or a procedural suite, either of which could be in a hospital or surgical center.

Wear something comfortable to your surgery appointment. Make sure you have clothes that don't have a tight waist to wear on your way home. Additionally, you might have a surgical drain if you are having laparoscopic surgery, so it is best if you wear clothes with easy access to your abdominal area avoid a dress; consider wearing a loose shirt or one with buttons.

You will need to fast from eating and drinking after midnight the night before your surgery. Your healthcare provider may adjust some of your medications in the days or weeks before your peptic ulcer surgery. For instance, you might be directed to change the dose or stop blood thinners that you are taking.

You may also need to adjust the dose of anti-inflammatory medications, diabetes medications, or treatments that you take for your peptic ulcer disease. When you go to your surgery appointment, take a form of personal identification, your insurance information, and a method of payment if you are responsible for paying for some or all of the cost of your surgery.

You should also have someone with you who can take you home because you will not be able to drive for at least a few days after your surgery. Before your surgery, your healthcare provider will advise you to avoid smoking and drinking alcohol so that your ulcer is not further irritated.

You might also be instructed to avoid eating things that can exacerbate a peptic ulcer, such as spicy or acidic foods. When you go to your surgery appointment, you will register and sign a consent form.

You may have some pre-operative testing before you go to the pre-surgical area. These tests may include a chest X-ray, CBC, blood chemistry panel, and urine test. You will be asked to change into a hospital gown. You will have your temperature, blood pressure, pulse, respiratory rate, and oxygen level checked.

If you are having stomach ulcer surgery for an emergency, like a perforation, your preparation will happen quickly. You will need to have IV fluids and possibly a blood transfusion during this period. Before your procedure is started, you will have specific preparation and anesthesia that corresponds to the type of procedure you are having.

If you are having an open laparotomy or a minimally invasive laparoscopic surgery, a drape will be placed over your body. A small area of your skin will be exposed where the incision will be placed.

Your skin will be cleansed before the surgery starts. These steps are not necessary before endoscopic stomach ulcer surgery. Your surgical procedure will begin after the preparation steps. The next steps will depend on which technique your surgeon is using to treat your peptic ulcer. Endoscopic Surgery: Step by Step.

If you are having an endoscopic surgery, once you are asleep, the endoscope is gently advanced through your mouth and esophagus into your stomach. You shouldn't feel any discomfort during this process. Your healthcare provider will be able to see your ulcer and the surrounding structures on a monitor with the aid of the endoscopic camera.

Surgical tools that are inserted through the endoscopic device will be used to treat and control ulcer bleeding. Various tools, including clips, electric cautery, and injectable agents, are used to stop bleeding and prevent recurrent bleeding. When the treatment is complete, the endoscope is removed.

Laparoscopic Surgery: Step by Step. For a laparoscopic procedure, your surgeon will make a small skin incision that is approximately 2 inches in length. Then they will cut through the peritoneum membrane lining the abdomen and fat that encloses your stomach and intestines.

Your surgeon will cut a small opening in your stomach as well. The laparoscopic device, which is equipped with surgical tools and a camera, is inserted through the opening of the skin, advanced into the peritoneum, and then the stomach where it's used to visualize the structures on a monitor.

Your surgeon will proceed with your surgery, which may include cutting a portion of your vagus nerve, cutting away the ulcer and repairing the abdomen, or patching the ulcer with healthy tissue.

This process will involve the placement of sutures and control of bleeding. After the stomach ulcer is surgically treated, your surgeon will close the peritoneum and the skin. You might have a surgical drain placed in your peritoneum or stomach and extended outside your body to collect blood and fluid as you are healing.

Open Laparotomy: Step by Step. For an open peptic ulcer surgery, your surgeon will make an incision that measures 3 to 6 inches. They will also cut through your peritoneum and into your stomach, near your peptic ulcer. Your surgery may include resection of your ulcer and attaching your stomach opening to the opening of your small intestine, surgically closing a newly created opening in your stomach, or suturing healthy tissue to patch your ulcer.

After the repair, you may have a drain placed, and your peritoneum and skin will be closed with sutures. Once your surgery is complete, your surgical wound will be covered with a dressing.

Your anesthesia medication will be stopped, and your breathing tube will be removed. When you are medically stable and breathing well on your own, you will go to a postoperative recovery area.

In the recovery area, your medical team will monitor your health, including your pain or discomfort, fluid in your drain, and whether you are passing gas.

You will be assessed for signs of complications, such as hematemesis, vomiting, and severe abdominal pain. After a few hours, you will be asked to drink clear fluids.

Your medical team will ask you to slowly advance your food and drink liquids. You will need to be able to eat solid food, like a cracker without experiencing any pain or vomiting before going home. If you develop problems like severe pain or vomiting as your diet is advanced, you may need further evaluation.

Before discharge, your medical team will discuss advancing your diet, pain control, and how to care for your drain and wound if applicable. You will be given guidance regarding when to schedule follow-up appointments with your healthcare provider, as well.

After surgery for a stomach ulcer, it will take time to fully heal. You will need to gradually advance your diet, and the pace at which to do so depends on the type of surgery you had and your tolerance for food. For example, your healthcare provider might advise that you drink clear fluids for a given amount of time, and then advance to bland soft food when it's clear that you are tolerating the earlier step.

As a general rule of thumb, your recovery will be faster and easier after an endoscopy, and more gradual if you have had a laparoscopy, with a longer recovery if you've had an open laparotomy. The need for a drain usually corresponds with a slower recovery as well.

Any immediate postoperative complications, such as an infection or extensive swelling, can prolong full recovery. If you have a wound and drain, you will need to make sure that you take care of them as instructed while you heal.

That means keeping them dry and clean when you are bathing. About stomach ulcers Symptoms of stomach ulcers The stomach Causes of stomach ulcers Helicobacter pylori Ulcer bleeding Perforated ulcer Diagnosis of a stomach ulcer Treatment for a stomach ulcer Where to get help. About stomach ulcers A stomach or gastric ulcer is a break in the tissue lining of the stomach.

If present, the symptoms can include: abdominal pain just below the ribcage indigestion nausea loss of appetite vomiting weight loss bright or altered blood present in vomit or bowel motions symptoms of anaemia , such as light-headedness shock due to blood loss — a medical emergency.

The stomach The stomach is an organ of the digestive system , located in the abdomen just below the ribs and on the left. Certain medications — which include aspirin or clopidogrel, taken regularly to help prevent heart attack or stroke , and drugs for arthritis.

Anti-inflammatory medications NSAIDS are thought to cause around two fifths of stomach ulcers. Cancer — stomach cancer can present as an ulcer, particularly in older people. Helicobacter pylori The Helicobacter pylori bacterium H.

pylori is the main environmental cause of stomach cancer. Ulcer bleeding Ulcer bleeding is a serious complication of ulcer disease and is particularly deadly in the elderly or those with multiple medical problems.

Perforated ulcer A severe, untreated ulcer can sometimes burn through the wall of the stomach, allowing digestive juices and food to leak into the abdominal cavity.

Treatment generally requires immediate surgery. Diagnosis of a stomach ulcer Diagnosing a stomach ulcer is done using a range of methods, including: Endoscopy — a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia.

The endoscope is fitted with a video capture device and highly detailed images of the stomach lining can be obtained. If a gastric ulcer has been found, the endoscopy must be repeated after treatment to ensure healing and exclude the possibility of cancer.

Biopsy — a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found. C14 breath test — checks for the presence of H. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon C14 and testing the air exhaled from the lungs.

A non-radioactive test can be used for children and pregnant women. Treatment for a stomach ulcer Special diets are now known to have very little impact on the prevention or treatment of stomach ulcers. Treatment options can include: Medication — including antibiotics, to destroy the H. pylori colony, and drugs to help speed the healing process.

Different drugs need to be used in combination; some of the side effects can include diarrhoea and rashes. Subsequent breath tests — used to make sure the H. Inflammation, the intensity of fibrosis collagen synthesis and angiogenesis were graded as 0 for absence, 1 for minimal, 2 for mild, and 3 for severe.

Epithelialization was also scored as 0 for absence, 1 for focal presence, 2 for thin-complete surface, and 3 for thick-complete surface. Finally, the average data was reported. The sample thickness was measured by a digital caliper.

The specimens were kept moistened in 0. The mechanical results were analyzed to evaluate plasma effects on mechanical parameters of tissue. The maximum force N was obtained directly from the curve and represents the maximum tolerance of the tissue against rupture or maximum tensile force applied to the specimen to rupture it.

W up to F max Nmm was measured by calculating the area under the curve and represents energy absorption by the tissue under the tensile force applying.

Optical emission spectroscopy OES , is an appropriate noninvasive method to determine different reactive species produced in plasma. OES was done using an optical fiber connected to the spectrometer AVANTES, AvaSpec The temperature of plasma is a very important parameter and its thermal effect on living tissue and safety must be evaluated.

So prior to plasma application on the wound it was tested on normal skin of the anesthetized mouse. The rotational and vibrational temperatures can be easily estimated by fitting the experimental and simulated spectra. Statistical analysis was performed using SPSS Therefore repeated-measures analysis to compare data in each group and independent t-test to compare data between two groups were used for wound area decrease analysis.

Mechanical parameters were compared among groups by ANOVA followed by the Tukey test. For comparison of the groups in terms of collagen synthesis, angiogenesis, inflammation, and epithelialization, Mann-Whitney-U test was used because variables were categorical data.

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Stomach ulcer

See "Peptic ulcer disease: Clinical manifestations and diagnosis" and "Peptic ulcer disease: Treatment and secondary prevention". Refractory peptic ulcer — A refractory peptic ulcer is defined as an endoscopically proven ulcer greater than 5 mm in diameter that does not heal after 8 to 12 weeks of treatment with a proton pump inhibitor.

ETIOLOGY AND RISK FACTORS. Why UpToDate? Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you. Select the option that best describes you. View Topic. Font Size Small Normal Large.

Approach to refractory peptic ulcer disease. Formulary drug information for this topic. Are proton pump inhibitors the first choice for acute treatment of gastric ulcers?

A meta analysis of randomized clinical trials. Article PubMed Central PubMed Google Scholar. Tunis SR, Sheinhait IA, Schmid CH, et al. Lansoprazole compared with histamine2-receptor antagonists in healing gastric ulcers: a meta-analysis.

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Chan FK, Wong VW, Suen BY, et al. Combination of a cyclo-oxygenase-2 inhibitor and a proton-pump inhibitor for prevention of recurrent ulcer bleeding in patients at very high risk: a double-blind, randomised trial.

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Celecoxib vs. diclofenac in long-term management of rheumatoid arthritis: randomized double-blind comparison. Lai KC, Chu KM, Hui WM, et al. Celecoxib compared with lansoprazole and naproxen to prevent gastrointestinal ulcer complications.

Sakamoto C, Kawai T, Nakamura S, et al. Comparison of gastroduodenal ulcer incidence in healthy Japanese subjects taking celecoxib or loxoprofen evaluated by endoscopy: a placebo-controlled, double-blind 2-week study.

Derry S, Loke YK. Risk of gastrointestinal haemorrhage with long-term use of aspirin: meta-analysis. Liu CP, Chen WC, Lai KH, et al. Esomeprazole alone compared with esomeprazole plus aspirin for the treatment of aspirin-related peptic ulcers.

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This article was supported by a Grant-in-Aid from the JSGE. The authors thank investigators and supporters for participating in the studies. The authors express special appreciation to Dr.

Toshihito Kosaka Fujita Health University School of Medicine and Dr. Toshiyuki Sakurai National Center for Global Health and Medicine. Any financial relationship with enterprises, businesses or academic institutions in the subject matter or materials discussed in the manuscript are listed as follows; 1 those from which the authors, the spouse, partner or immediate relatives of authors, have received individually any income, honoraria or any other types of remuneration; Astellas Pharma Inc.

Department of Gastroenterology, International University of Health and Welfare Hospital, Iguchi, Nasushiobara-shi, Tochigi, , Japan. You can also search for this author in PubMed Google Scholar. Correspondence to Kiichi Satoh. Please see the article on the standards, methods, and process of developing the Guidelines doi: The members of the Guidelines Committee are listed in the Appendix in the text.

Vice-Chair: Kiichi Satoh Department of Gastroenterology, International University of Health and Welfare Hospital. Members:Taiji Akamatsu Endoscopy Center, Nagano Prefectural Suzaka Hospital , Toshiyuki Itoh Department of Clinical Education, Shiga University of Medical Science , Mototsugu Kato Division of Endoscopy, Hokkaido University Hospital , Tomoari Kamada Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School , Atsushi Takagi Gastroenterology and General Internal Medicine, Tokai University School of Medicine , Toshimi Chiba Division of Gastroenterology and Hepatology, Iwate Medical University , Sachiyo Nomura Stomach and Esophageal Surgery, The University of Tokyo , Yuji Mizokami Department of Gastroenterology, University of Tsukuba Graduate School , and Kazunari Murakami Department of Gastroenterology, Oita University.

Members: Masao Ichinose Second Department of Internal Medicine, Wakayama Medical University , Naomi Uemura Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital , Hidemi Goto Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine , and Takashi Joh Department of Gastroenterology and Metabolism, Nagoya City University Hospital.

President: Tooru Shimosegawa Division of Gastroenterology, Tohoku University Graduate School of Medicine. Reprints and permissions. Satoh, K. et al. Evidence-based clinical practice guidelines for peptic ulcer disease J Gastroenterol 51 , — Download citation.

Received : 25 December Accepted : 06 January Published : 15 February Issue Date : March Anyone you share the following link with will be able to read this content:.

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Download PDF. Abstract The Japanese Society of Gastroenterology JSGE revised the evidence-based clinical practice guidelines for peptic ulcer disease in and has created an English version. Evidence-based clinical practice guidelines for peptic ulcer disease Article Open access 23 February Perforated and bleeding peptic ulcer: WSES guidelines Article Open access 07 January Eradication rates for Helicobacter pylori infection a systematic evidence - based review Article 01 September Use our pre-submission checklist Avoid common mistakes on your manuscript.

Introduction In , the Japanese Society of Gastroenterology JSGE developed the evidence-based clinical practice guideline for peptic ulcer disease, and this guideline was revised in Bleeding gastric and duodenal ulcers Endoscopic therapy CQ.

Is endoscopic therapy effective in treating peptic ulcer bleeding? Is endoscopy for hemostasis confirmation second look necessary? Non-endoscopic therapy CQ. pylori eradication therapy Initial treatment CQ.

Eradication regimen CQ. Second-line eradication therapy CQ. Triple therapy with moxifloxacin is suggested. Third-line eradication therapy CQ. No regimens are recommended. Prevention of ulcer recurrence CQ. Ulcer recurrence after eradication CQ. Non-eradication therapy Initial therapy CQ.

PPIs are recommended. Maintenance therapy CQ. Drug-induced ulcer Non-selective NSAID-induced ulcer CQ. How should NSAID-induced ulcers be treated? In Japan, celecoxib is reported to be as effective as loxoprofen in the treatment of rheumatoid arthritis and osteoarthritis with a lower incidence of gastrointestinal events [ ] LDA-induced ulcer CQ.

How should LDA-related peptic ulcers be treated? In the incidence of recurrent ulcer bleeding and peptic ulcer healing rates, there were no differences between the PPI and PPI-plus-LDA [ ] CQ.

pylori , non-NSAID ulcer CQ. Surgical treatment CQ. What is the surgical indication for peptic ulcer perforation? What is the surgical indication for peptic ulcer bleeding?

What is the best surgical procedure for peptic ulcer perforation? What is the best surgical procedure for peptic ulcer bleeding?

Conservative therapy for perforation and stenosis CQ. What kind of therapy is selected for stenosis of peptic ulcer? Therapeutic algorithm Figure 1 shows the algorithms for the treatment of peptic ulcer disease. Full size image. References Yoshida M, Kinoshita Y, Watanabe M, et al.

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Article PubMed Google Scholar Sung JJY, Lau JYW, Ching JYL, et al. Antrectomy removes the lower part of the stomach which produces a hormone that stimulates the stomach to secrete digestive juices. Sometimes, an adjacent part of the stomach that secretes pepsin and acid may be removed.

A vagotomy is usually done along with an antrectomy. Pyloroplasty may be performed with a vagotomy. In pyloroplasty, the opening into the duodenum and small intestine are enlarged, enabling contents to pass from the stomach.

Laparoscopic surgery uses a long, thin tube with a camera lens attached to examine the organs inside the abdominal cavity to check for abnormalities, and to operate through small incisions. Non-Surgical Treatment Most people with peptic ulcers benefit from dietary and lifestyle changes and medication: Diet and lifestyle changes No known diet has been proven to help reduce ulcers, but people should avoid foods that cause irritation.

Smoking has been shown to delay ulcer healing and has been linked to recurrence. Quitting smoking is advised. Reduce alcohol consumption. Limit use of anti-inflammatory medications. Medications Antibiotics to kill H. pylori if it has been detected. H2-blockers to reduce acid the stomach produces by blocking histamine.

Acid pump inhibitors help to block stomach acid production by stopping the stomach's acid pump. Mucosal protective agents shield the stomach's mucous lining from the damage of acid, but do not inhibit the release of acid.

When treating H. pylori , these medications are often used in combination. What You Should Expect You will receive a thorough diagnostic examination to evaluate if you have a peptic ulcer and determine what course of treatment is needed. General and Gastrointestinal Surgery Appointments and Locations Our General and Gastrointestinal Surgery Team Request General and Gastrointestinal Surgery Appointment General and Gastrointestinal Surgery Locations Resources Go to our health library to learn more about peptic ulcers.

Thearpies topic will Non-invaxive the factors associated with refractory Antioxidant-rich weight loss disease, and their diagnosis and management. The clinical manifestations, diagnosis, and initial Non-invasive ulcer therapies of therrapies ulcer oNn-invasive Belly fat reduction lifestyle changes discussed in detail, separately. See "Peptic ulcer disease: Clinical manifestations and diagnosis" and "Peptic ulcer disease: Treatment and secondary prevention". Refractory peptic ulcer — A refractory peptic ulcer is defined as an endoscopically proven ulcer greater than 5 mm in diameter that does not heal after 8 to 12 weeks of treatment with a proton pump inhibitor. ETIOLOGY AND RISK FACTORS. Why UpToDate?

Author: Sajin

4 thoughts on “Non-invasive ulcer therapies

  1. Jetzt kann ich an der Diskussion nicht teilnehmen - es gibt keine freie Zeit. Ich werde frei sein - unbedingt werde ich die Meinung aussprechen.

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