forstoerret-bryst-gynaekomasti
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<Provider Id="sundheddkcms"> <Item Id="{9F4BE313-735B-404F-B59D-4725A11B0EA3}" Name="forstoerret-bryst-gynaekomasti" Type="PHContentPage" ParentProviderId="sundheddkcms" ParentItemId="{09B71287-C524-4DFA-8A02-08F51D705966}" SortOrder="200" PublishDate="2010-06-29T14:31:00" DeleteDate="2999-12-31T00:00:00" PotItemType=""> <Content> <LinkListField Name="Spot2"> <LinkField linktype="internal">{A12FFEB9-7D21-4130-9428-1457C5AB696B}</LinkField> </LinkListField> <HtmlField Name="FactContent"><![CDATA[<h2>Fakta</h2> <ul> <li>Gynækomasti er en godartet forstørrelse af mandens brystvæv</li> <li>Forstørrelsen ledsages sjældent af symptomer, om end brystvævet i forbindelse med væksten kan blive meget ømt </li> <li>Hos omkring halvdelen af alle drenge vil hormonændringer under puberteten medføre gynækomasti, men hævelsen går i sig selv igen i løbet af 1-2 år</li> <li>Tilstanden skal kun behandles af kosmetiske grunde eller ved mistanke om kræft - sidstnævnte er sjældent</li> </ul>]]></HtmlField> <HtmlField Name="PageContent"><![CDATA[<h2>Hvad er gynækomasti?</h2> <p>Gynækomasti er en forstørrelse af det mandlige brysts kirtelvæv på den ene eller begge sider.</p> <img style="width: 200px; height: 200px; float: left;" alt="Foto af forstørret bryst hos mand" src="889FF86D9E814288A123EA9147CBCFCA-200-200" text="Gynækomasti er en forstørrelse af det ene eller begge bryster hos en mand" title="Foto af forstørret bryst hos mand" height="200" width="200"> <h2>Hvad er symptomerne på gynækomasti?</h2> <p>Vækst af brystet, og der er sjældent andre symptomer udover evt. lettere brystspænding og ømhed ved berøring.</p> <h3>Hvilke symptomer skal du være særligt opmærksom på?</h3> <p>Mandens brystkirtelvæv har i udgangspunktet samme potentiale som hos kvinden og i de sjældne tilfælde hvor kirtelvævet stimuleres, som ved f.eks. hormonel forstyrrelse ved testikelkræft, kan kirtelvævet vokse. Mænd med gynækomasti kan som kvinder udvikle brystkræft. </p> <h3>Hvordan stilles diagnosen?</h3> <p>Målet med undersøgelsen er at udelukke anden sygdom. Sygehistorien og undersøgelsen af patienten er vigtig. </p> <p>Lægen vil i sin undersøgelse, og ved hjælp af blodprøver, kontrol af testiklerne og tegn til sygdom i lever og nyrer samt tegn på hormonforstyrrelser. Mænd med gynækomasti kan som kvinder udvikle brystkræft. Disse mænd skal, udover at undersøges for årsagen til brystdannelse, henvises til udredning med <a href="~/link.aspx?_id=2971E7F7C90B4CDA97CEB4BA8DE23486&_z=z">mammografi</a>.</p> <ul> </ul> <h2>Hvorfor får man gynækomasti?</h2> <ul> <li>Gynækomasti er en ufarlig og forbigående tilstand hos drenge i puberteten og skyldes ungdommens hormonændringer</li> <li>Hos voksne mænd er tilstanden som regel godartet og uden god forklaring, men den kan også skyldes en sygdom. Først og fremmest skal man udelukke <a href="~/link.aspx?_id=B71322729AC045A9901113B5C98008FF&_z=z">kræft i testiklen</a> og brystkræft hos mænd, som er to relativt sjældne sygdomme</li> <li>En anden sjælden årsag er sygdom i hypofysen (en hormonproducerende kirtel i hjernen)</li> <li>Bivirkninger til medicin</li> <li>Misbrug af stoffer eller alkohol</li> <li>Brug af anabole steroider</li> </ul> <h3>Er gynækomasti arveligt?</h3> <p>Gynækomasti er ikke arveligt.</p> <h2>Hvordan behandler man gynækomasti?</h2> <p>Gynækomasti kræver sjældent behandling, da sygdom meget sjældent er årsagen. Det vigtigste er at blive beroliget og forklaret, at det typisk er en uskyldig tilstand. </p> <p>Hvis man har fysiske eller kosmetiske gener eller i tilfælde af brystkræft, fjernes brystvævet ved operation.</p> <h2>Hvordan udvikler sygdommen sig?</h2> <p>Hos omkring halvdelen af alle drenge vil hormonændringer under puberteten medføre gynækomasti, men hævelsen går i sig selv igen i løbet af 1-2 år. </p> <p>Udvikler man derimod gynækomasti senere i livet, vil det normalt ikke forsvinde igen og vil ved gener skulle fjernes ved operation. Dog gælder det, at gynækomasti udløst af medicin oftest forsvinder, når man ophører med medicinen.</p> <h3>Hvor hyppig er gynækomasti?</h3> <ul> <li>Gynækomasti ses forbigående hos halvdelen af alle drenge i puberteten</li> <li>Hos voksne forekommer det langt sjældnere (under 1 %)</li> <li>Gynækomasti ses relativt hyppigt hos overvægtige mænd, da fedtvæv indgår aktivt i hormonproduktion</li> </ul> <h2>Vil du vide mere?</h2> <ul> <li><a href="~/link.aspx?_id=B71322729AC045A9901113B5C98008FF&_z=z">Testikelkræft</a> </li> <li><a href="~/link.aspx?_id=F663AD25A8AC4C6AA9019637244A7B7B&_z=z">Gynækomasti - for sundhedsfaglige</a></li> </ul>]]></HtmlField> <TextField Name="DoctorsHandbookID">2351</TextField> <TextField Name="PageTitle">Forstørret mandlig bryst, gynækomasti</TextField> <TextField Name="NavigationTitle">Forstørret bryst, gynækomasti</TextField> <CheckBoxField Name="ShowInMenu">true</CheckBoxField> <CheckBoxField Name="ShowInContentField">true</CheckBoxField> <DateTimeField Name="RevisedDate">2023-10-31T09:46:00</DateTimeField> <LinkListField Name="Authors"> <LinkField linktype="internal">{F45E0930-717B-4509-A99F-CE9546ACB8F6}</LinkField> <LinkField linktype="internal">{9240F87A-FE81-40E5-A079-F715F683A0B5}</LinkField> </LinkListField> <LinkListField Name="Organization"> <LinkField linktype="internal">{DBBC5F07-FEB9-4FAC-8DCA-1C8C28C4F5B5}</LinkField> </LinkListField> <LinkListField Name="SearchAreaID"> <LinkField linktype="internal">9</LinkField> </LinkListField> <TextField Name="Description">Gynækomasti er en godartet forstørrelse af brystet hos mænd. 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c9m8DfDwrHbyW0DwtcRTFrmcwvaymZy7Wi24TdGVPAmKqC3QkivolPA9vLa2n7kC4C9CDtHTI342joQOnTHJJrpfBHhWGDTbdZLeXeFQifcNzt5zbrdwedickZ4PJyK9XbTHjtYYxEuMAfh2OMY7H8M+leJg+B4SoKrUiqjmk3Jz9pKyt8U5JN6tW03v30+OzvjPEvGOjRxCjCM6kfdjyJKLhuk3zJ3el9LPW97fJvijwPFLZ3QFoksQXzfNK4eMtwfPkPErYJAwmc9wMZ/I79ob4GQ22qz6vo1q1ld6T/AKVpl5E+ZRLnmC5xkyREg8njI696/f3WNOSVJo/JXC8SEgc+4B6nPOO2BjuK+Nvi54Jt9V/tKJLJpVNtt82a3SE5IwQCoycDoOcnHFaZdSqcNZrSxGGrzhGp+5qU6dWTounK106LjZb23d7bnqZRmMc7pTwuM5Z1JU+elUTtOM4WSlGTtyvXbaWl0ra/jdJ4ag8R+HpLS5s43nGnhb60lUKEK25+0mKZsIS4yAFYkk9M5x+pP/BND4ytdeCb/wDZc8UTTf8ACS/C2O+1z4WTSwO48Q/CqS5EtzYSXLPvN74QvLiS2WBCZZNOnjZE8qFivyJqHgi40e/msW85rc5ItxApBIHOFAzgdSR0HXrXnt1/wkngnxP4e8d+CdRvdF8W+DtRh1/QrpJfsySSWbea2kXZjIN3o+vWIa1vLZyQyuUYdAf6C8L+PqfDGcww1etKplWYN08Wqvvui3/BrKLunGi51HNJq947WPjvFzwyp+IfC08HTdKjnmBf1rKcXVk4RljKNNzUanLd+yrQpzo1KeqlGrzXbhyy/o9yM4GB3AHGBjPAPIAXn2HNH9eR9D0P41wHwt+KvhP40+AtB+I/g29tbrT9cs4E1bTIJwL3wz4lUJ/bHhrV1dA1te2Eu+WNMDfayR8FcE+gHAJAxgHAx0wOBj2x09q/tGM6dSMZ0pc9OSTjK1r6J6K701VnfU/zDxGGxGDr1sLiqM8PiMPUlRr0KitOlVp2jUpzWylCd1ZdOV9bJKKKKZiFFFFAGtof/H5N/wBe5/8ARkVFGh/8fk3/AF7n/wBGRUUAZ9z/AMfU3/Xxd/8AobVEoyygkAEgZIyBz1IHJA9BUtz/AMfU3/Xxd/8AobVEM5GG2nIw2cbT2bPbHXPbrTjuvVfmC3XU/nt/4ORPFGpaX+yL+zd4KtiV0Xx3+1RFea9k5lmm8DeDJL/Q2jOcrHHca5ebl6gORgA1/Oh8GIWN7paRriK8nDMpUAmSNwy/KR3cA/MCp78V/TD/AMHDvgebxH+xb8G/GltZR3bfC/8Aai8NzandvcGE6VpPj7w5faD9pmt14uHvL3R4IYpCMqzoODiv59vgP4UeciYN5UqyRp9svgXWJd4DQxAA/OV+UAEENg+1fg3jJmEcIqClp7XA0vZK+sqiqVfc2926V27Pa1up/XX0acm/tGrTlRXNHD47FQk+WyvL2dRO+m92kr9N1dpfrH8AtAmvTDPMwuXW+T7QsxKNCjW5CJEsG3cqtjcVBVR944r9s/gv4Yt/sVlNbpF5kdlpq4jKS/u1b9+hLHPLnoAD1OK/IH4CWt1AdOtsNJModreXaTeeW4ILRsf+WYVPmU/eGQeDmv2R+DF3FHDClzZ/v5FtGObdbfyhtG25AXnLkAkdfbmv4Sp5pQxfElGnUhO06/tOaC51DmnUg017vWmmpJq/NtaKb/vLi2jWw3Ds6tF8k0oR0V3aFvPz66rXex9veGfDfn23MKxEggBQTjIx1HvyRz6+1dJfaG9rawQyA+aT+7bk/wDj3QZ44bHFbngu4SXTEH3pVxkwAqMepHcDt+I7jPTa1HiAeq5nHPqPfj3PYV/UGHyLAzyWnOnDnpyo0eWVuW/KnpZN3V306I/i/Mc4xrzirRmv3anKDtL4+Rxs37ujtK69XY+eNX094xLE/wA3+kZ47jjqO4PrjH614x4y0NpLceZDnzcngEkc+nUevTH519IajGIn5x5k3Jzj6n8QfXr9a838QR/JKIsrKbcGMzdRx7/iefp0yK/GM7y+nTxEpQS9rH4lZNQ+G2uzbs1b3bW8z9J4dzGspUXKWklrrrdNfq7rrf0ufnt4v8BwTSSzooF0xuQkskc0DfKD9pICkFtw9M57dK+ZPG3glEtI3FvKWiJAAYbiITuDAZJIJ5zjpg9eR+gHjmazhu9LBHm6hPJcW9lEcfMTbNkL6nIJOCQOp45rwzxN4YjNpeTS283lFcxJk/aFiIyyhug5428MBjjvXkYmUsDRw+Koxm+Sbk5Qjfl5eRpPVayu1e91bbdn7nkeKjXoToYmdL6yocyVXXmUVsu19G976fPyX9iD4lXfw8+Nd18NL9xa+D/jM8wS3chItK8e2Fu82la25OB5ut2EMuk3LE7pLiKHuQK/ZMgqSrAqVJDK33lKkqwb0KsCpz0IIPNfz0+PrW70LVY9X0cCx1fRr2x1fRLqW5JaHVLC6W80+S5IOCscqKe5GO2DX7pfCT4iW/xe+F/gf4kxQeRceK9Bjk1e2XO218SWMgtfEFguR/qxeRG5HBB8/PWv7k8G+J1nvDFHBVJ1J4jKoyoUHVS9pPAQ96EpzXxTi3PdK991dn8EfSh4I/sPivC8U4Sgo4TiRyw+NdNWjHOaPM/b1Y6+x+vYaDqzac71aVSWrlZeh0UevAGCQQOgI4I/A8UV+vrVJ9z+XgooooA1tD/4/Jv+vc/+jIqKND/4/Jv+vc/+jIqKAM+5/wCPqb/r4u//AENqgPQ844POcY989vrU9z/x9Tf9fF3/AOhtUS8MCDggjB9Oev4UCeqaTs2nr28z4e/4KZfCe3+NX7AH7VHg8zeRf6R4Etvifok32YSC31f4Wavp/iqNDMfufaNPXVozIOVDluDX8uf7Neny6h4e0PU1ht4BfRJqBt1Hn/aJGgimRg56DdKCCfY9q/s1+KPhg+NPhN8YfAxt45j4w+DvxV8MQW0xxBI+q+BNft7GaY4B8pb0RNJ3CA4Ffx1fslFpvA3hKB7SOS5jgTSbycT+ZGlzpVy+mXFzHGOZLSM2jJEmTvUBe9fzL9JKrUweUZBjVCpKm1icJXqQW3skq1FvRJNRcoJXvrzXsuU/tf6HWKp18x4ry6dn7Gng8ZRpXWjqXoVqzdvsyUXype85JXSifq58FfCrRR2N5BetLC+9JXGd5u4xuktFzgEgvtUj+LkdOP09+FumTRRwTSGWFFeCESS/8fMu1B/o7+qoRyT1xmvjP4I6Ukj28J/et5kflu0AhtwpQDK2nAVsYKnA2n1xz+m3w48OQ7LeOKHzX+TMo5PDDBJPrjGck5PTJxX8IcHYKeaZ7N0q9XndWVo82i1V9bK+qXRXXqf2f4g5pHLspq0pScedRnfo07Xv2ttfW9+mp774N1KS0h/ejEK4Ky8YJz74PJ9P/wBfUavrfmwAnrtufK9hk8A4OBgZ7Y9O1c7a2D2CussORJcSHGBgdee/v6e47DF1y8i2Ak/6vC9eMk/5Pb68gV/UeLzTF5VlEMJP7FGkormatprqou+6632W6P5H+p0MfmP1uHvKcpz5klrz8ui1TVmmr31vbS1nzuuawnmfvJj5Q6fX68ntk89PpivPNf1vFtKFmx/o+POnGevOOQeuemOuB2qXV724NxPFEDFGuT5xH+jkn0x69OCM14r4+8SS6J4f1C5lPNpa3c4jFqP9KuYJ82lt3zk8cDHOK/Eq2cYnF4qtKU01KvUaV37tuXrbVPXXTa7T2X6xkOTU5Rw65ITck/gnflXu7+71/DfTd/Oc/wARrHXfitqlhYL/AGlc+Dre509ordLq4GnanrA+zXN3dEnbpxtbU5+Uk88jiup13UfL082NrH5004M07TkkG5j/AHClTjGCcHPQg5xmvFfCB8UrDcW95b6d4djurg6vqT3P2a2udWuNR/f3FxeNbDJuFXAUEjp0yK9Ke4I09F0u0urwwnLTTCD/AI+f4cEjpwMc9K9ytVwlHL/q9TEzU6U5RfOuf+R3V2uW+7Wt9kz9Op4GcK9OrCldKMYUqnNbWPxNJLqpK1nola+tz5m+JGkJkxH7Psiy7HsGPLA9uDxnuK+zP2B/Et23hTx98NruQyxeGtVtfF+gST3BCwWfiORoNTsQOMBb+EydeAcHtXiN54K1HUmuPNjN2iXUkjed/wAe1wZk+0GJsc4UjHGRxwBjNJ8OfFcvwA+J3h/xNqBjsvA3iV08KeNJJp/JsLbStZuUW21Vbqf/AEZLjRdRMd9JuGBYmTOAK/SPBrjXBZDxflmFqYjlwWOvleIclalGOOShTqyl73LOnio4d011blrFK5+c+OvB2I4z8O88w2Cpe2zPL6UM8y6itZyq5UlUxMKeqcpzwFTF8ui1T0d2frSDkZ4554OR+B7j0NFTq0UirJb3MN7byKslve27K9ve27gNBeW7r8rwXURSeF1+Vo5FZeCKhbqfqf51/d+2jd7de/n8z/LL5cvk915fLYSiiigDW0P/AI/Jv+vc/wDoyKijQ/8Aj8m/69z/AOjIqKAM+5/4+pv+vi7/APQ2qE9Dnp3qa5/4+pv+vi7/APQ2qGgDT0dki1nTEnjSaFry0trqGQ4jmsru4jguopP9iSCSRX6Aqx/H+NT4Q+HX+Hnxb+OXwtvVskm+Hvxx+K3hWK0svmt9Ps4PGl9fQrbYBLSpBdxBlOB8uAOa/saSRonSVeXiZZFH+1GQyjnjqBwePXiv5RP2hfDi/Cz/AIKZ/tg+Fbv/AEK38UfEHRvi9oEjZRbrQ/iXodnryqot8gmW586MEdc9eTX4D9JDL3jPDupiIw5pYHMaLnL+SliqNei5br4XFO2vNe3u2uf1P9EXMFhfEvG4KcuVZlw9iowvqnPCYrDVmrfa9yT6q1r6rQ/WX4M3dm8djJFEJHuDtM6W589hHAkWXI+7kdTgY5JNfqh8Lbe3+xRMIuYYYlDEZx8wxwOoHUjqa/HT4G6vatYWX2i5Ery3Kyf6LgyxybMxWkighSI4/vmUB9oJPOK/YL4NTLJZ24Mlu0aWyTQxA8kNjBOOT1wM+3BOK/hbwceHjxFOlBbRqXfNfW8dlbRad9b623P7Q8Z1WjlkKl38dLo9uVdnq1rbTv0Pe7ry/mwRCcN+8NsSDgHgjnj1X+fbzDW7OOXP/LbjBIIgXIyc/ZjzkHGAR/jXqGrT+VaSSSHksADN8vJ4yBjAIOMj1yOc155qLvMYftKQIzTND5obk4z0weSRnGfxHXP9C8X4eGKh9WkuZ80ZqH83Lypq+qjve7Ttfot/5oyOVWElVTUrScXH4buOt09Xr6dDyrUNL8xphLLjzbm3hiGOOOfTHPHrnHevm/4p6Q2pXml6MZYP+JlrFqJBBybW2t9twcj/ALYHr15/H7NktraHm3i8+SK3Pmjk7eMe4znv+HHGPk/4zta2GpeFL5JxC0Wv6dbyjOP9Hui1tccjGDm4AyeMdMDNfj+dZRPKsGql4VOZSquMHr7/ACe63rbl763vsra/s3B2ZTxOYexjzO1GVpRjzNXS0cVazdk15J9N/LV8F6eLiLbDb3sW65EXnnnjscjGB04zwcCvStD8AR3lvG7xYiz5587A+70A7EYOFz7ccDOTJr+m2MsMURy0bH7TLxhQcgH2yMdAPXJrCvv2h/Dng+0aTU9SsrdYmJGZJgCAeAcjBHtnHpxX5/h8fRq4mft62In7SbnOlDCOTpp2snL2ur3SfKtbn6lilxHXw8Y5dhpxq2d+ZuN725WrLybaVvmmj6B0n4R6Tdr9pjhYSW2Y4MXGFMTffbHIJz6en418c/thfCy20fQ9MgSCGawjtL64uLfd8rRuhhu89jiNzk4yD0weKytT/wCCmvwJ8OubVvEVrcTxsfOXRrC/unHc5FtaMdwPUn3P188uPir4h/bv8YN4I+ELQ6Ppej+Hv7X8ReMvE1jPpsWl6LeXC2ck2nWF0EvtavFDblsyn2KUjbIwBOP13hHJ559mOV4DI8szJ5lisTGNLFVKFbDYRKFOVWUpVqlJJqnCnJtK6Ter1SfwNXHZvwvWx/EHFecYPAcPZVgq2JzGpUxMcS6Mb0qVKnCOG9rUnWxNacKdOHJDmadr2dvpv/gn58Sz8RP2crLSp724u9Y+EXjHWvhpeXM+Nv8AZmnn7b4dt90JZz5emTvGrPlyEBPTj7ZGMcdO3JPHbk8n6nn1ryz4J/BrwZ8Afh3o/wAMfA0Mkun2DXGqazrd9b21vrPjTxJqDMdT8S6qbYxg38uDFY26nFpZLHEPukn1MdBjgYGATk47ZOTk+pycnnJ61/o3gKFbDYDBUK8lPEUcLh6GJltzV6NJQlK13bmSTtd201dz/MDifH5fmnEnEGY5VRnhstx2d5rjMBhp3/dYTEYpzpNRcYunz3cvZtO27etkUUUV1HiGtof/AB+Tf9e5/wDRkVFGh/8AH5N/17n/ANGRUUAZ9z/x9Tf9fF3/AOhtUNTXP/H1N/18Xf8A6G1Q0AHTnIGO56D3PsOp9q/m2/4LFeF7n4f/ALb37NnxqsdKuo9H+MPwM1D4earr8Vs/2GXx18L9bcaZpF1eMPJj1k+ELuzuYLY/vGgKkcEZ/pJKlvlGMt8oycDJ45J4A9SenWvzC/4LFfCnUvid+wd418R+HwzeIf2dPHHhD9obSkdPNubjR/D923h7x5b2RUBh9q0LUbO4ZkYeYLA+ZuVRj5bjbI1xFwjxBlDg6ksVluIlhoJXbxuHSrYeNt25NSSs7rdJ7P8AQfCniV8JeIfC2eOoqdGhmdHDYmTaX+z4uSo1Fez3fKrWd/I+SP2c/FUM2mWeZI/NluQJ44xmRnaIpm6AJZH55H3hnFfsx8EvE0cdhYK8hGI1gWRJo5IYfLxmN4R84JAx8x469QK/mR/Zj+JMV5Dpl3HLO1pqn2eaO4QMI5Yrm2ilt5JnU/LI25SMEZ5564/dj4E+LHQwO7pA0tvHEXcYVnBAZtp4LdeepOATxz/k9w5Ux3C/G9Sm5zp+yx83zK0OVSezTUuZ268yemieh/rRx1llPP8AheM6S56joUcUna7lFq0dF8POm9dbW2d9P1Q1S4F7pgeIZ814W2MMwglc/KxyMgYOBycdemfMbyRI35uJi4ydrLkA/wB4ZHfBOevX2xq6ZqkGoeH0ie43EAbSjdMdxjABHpx/OvPvEeoG0EDSLc5NwbeJ4EZp9463DKOsbj1GAPoa/pLjLHqdLLcbQ+GtRoTqWfx1GlzST0sm3tZpaeSf8qZLlzhXr4OS5XSr1IJNfDZp3fV81lpo1bd7LoftkYJ5IZjzKOFI44OCAevGc+1fI37R90sPh83UagfZ9R0yeF4PmuB/xMrPAC4J7kfzr3+41AiM4JMkJMrD+HE+SARnHGR19Bx3PyZ+0ZeyT+DtcdSQtvpE8kEag7xd2zLc43DkEYBHp29K/Ls8zNVsu5NYv3knzXf2W/srTt99j9a4JyypDOsNU5G1qrPTp33v5Wv13PLPFWq3Nw1zbW+oRRxIizsIADd4wDgqOeMenqfWvjv4n6S2uo0U18LhZeGhQ4a45wFUA9exwCQemAa+gdfnnuLCxvd0zefaWUpMSbbvH2YTspVV3HIB4Jw3PXnHgfjS8lEWwoLKZf3ME06hxulPngjy8ENjjjkYx0r8fyzG14ZjOUIRnOnieZOS5rWtolZb2196ysr73P6LpUqX1dOOt1fpdWtZNr59nZL0PijxF4f03Qba6ktdNtbWdN6eTYoihvPYqC8rAncerHOc5A6AH0r9nb433/wW+Mnwz+IkuoSWOi6ZrlnoPjKEXC+XqvgDWHTStUh1TJ2GOxlmTVMqA0cduxDKea4vxdbS6jdzo8uYW/dyRLwZZYPmNyo67AQcgDgemBXB+ItIhuNK+xIUYT2U9qkghh8sma2dCD83OSx5Pzd+oNf1V4ecS1sDjMlr87dTDY6lUoyUuW1KMuWph5aSvGrRnUpza199Ss+W0vyjjjhjD5zkmf5ZUp01hc2yzE5fUSoU6iqyq0ZVKUkqimozpVqEJwaae6s9Lf18u1m5imsJ0urG7jju9OuozujuLG6RZ7K4ibvFcWskMsZHBR1PSmkYJHpx+VfLX7D/AMSLr4sfsk/A3xhqmX1Sz8Pz+A9Ynuslxq3gW8bQ/tKqp+aP7EtsozkHaCc4zX1KOg5zx1xjPvjtn0r+/YTjUp060GnTr041abXWEkrP5PTzt6pf4+47CVcvxuMwFeLjWwWLxGEqJ/zYetOldpbcygpW6Xtra7KKKKo5TW0P/j8m/wCvc/8AoyKijQ/+Pyb/AK9z/wCjIqKAM+5/4+pv+vi7/wDQ2qGprn/j6m/6+Lv/ANDaoaAEYZBGM5BGOucjpjvmo7/wxpHjXSPEPgHXYI7jw94/8O+IvAGsRyRpLHLp/i/RLzQQwjkV4yttcXyT7NpUSQq+N6AiWnK7oyNHI8TxsHjkQkNFIrBlkQjoysA4I53AGjS6ctY2kmtrpq35X+8mSlZODtOMoyg9XacXeLstW09rWd9j+Gr9mrUtX+HuoeJvhZr81xaa18J/iJ4u+H2q6ZcBgbObwp4gv9MtPNkbLMX02GxuV3ZwkwxwRX7xfADxub20sRc3Qi8xYPKgjuZHMMsUrO1yWKncZiAroSVXOSBX5m/8FS/AFp8Cv+CmPi/WdCt7DQvDP7THw78GfHOxtbEOgHi2WM+E/H1zNA4ECzTa5ZQ3UixJtLSlm3E5P0B+z74ukBsw0kk8hghmtW+1Ijy7GVJkaJVA2kbt4IHJJPrX+YnjbwzDhfj3NsVGDp0nmCrUW7q9KvTp1ItNvtNxVtG43Ts2f7EeDHE0eOfDPIsTWrKdaplVPD1YXTqRr4SMMNVhOKS5bSpcyunpK3Rt/wBDXgPxOdW8PJJbCBrr7zQeYBEuMnKuDyeu0d2GMHrUfiHVFtxBIHn2TTFmNxOqGOY5BC5yQMc7QQBjjjp4P8JPFVummRweUYrcwQT4hG54AZWBEYjDGVccFjkAfTNd94nlguWgcN5kfmG4iQkn7NKMeVLKCeY5F5w3HQ4610Y3GxxuR4ScJe0qyoR91NO7tBKz1Sa13639D4ynk1Ohn+LjUioxjWmnJr3U9N1fuut+vkht7rcby72uJRbgARXVvMzSOOgDIEIPOOv3eOnWvmX463slx4e1O7kNwm20eyjSSZWR4blTb+aUjwGckjJILE8k84r1q+1SdYpoVaRUM5EBVo1yMHIUjGOv3c8c968C+JBF9ZXFssskEM1tv5iEq/aB0T5gRw2WA7E5xkZr4XE1pzoyjy0eZTlGUars48vK046pPm69rLV7L9H4ZwHsMbHFQi4+y5buSuo8y000V3ZvTZLWx51p+sWOreDPClwlwvm/8Izp+xCcTQvDp9vbXLSuPnJHksdzk4JY9Ca8P8URQXiyqhIgEO6O9kOZQwgbkIcjgjgnnnArZ8CTPN4Nt7aaxvLZ9K1HxLpIZY0d4vJv7kETMXyyhQoVWJCqNoAUDHJeJoQFRJDNFDFCQ+Xa53yZwJ9sJT90BgMv3QOM4zX5pVpVqeY1nKuqPLP2afMqftKm8VrdXld62vHazP1fB0af1WTs9ZuXXaTWnolfVd3uj5112OxtJjgNcySAhY2+R2zgEjnILZySOO3rXnOs26GMEfYYz50sot8PuUIg4xxjuDtGD39/Tdca2Mk8ZSJnhmBDs43AZ4GT8yjvgccc9K8z1xoZpZCmI3iTyYi3UyOB0zyS3QcnI4Nft3ASrRng3XrTnFSvD2mk76c143vG+lnrfokkfIcQKKoV1JX5UmtvPv13Xz6s/aT/AIJJa9Lqv7MHi3w/9nS3i8DfHTxvp8NwkjSm7TxFaWmtGEoxYQRgxsBtCgZJA61+oICkD5QOOnBx7Z746Z71+QH/AAR01i4uvhl+0loMptRYaL8ZtC1K2S3ieOf7ZrPhh/tPmswG/YIRkHIAOOnFfrzk+p/Ov9Nciqe0yPJJWa/4ScBu73/crW9le/fqf46eJdGOH8QeM6UL8keJM1kk1a3ta6q2/wC3ea342V7Aep+p/nSVMACBkA8DtTXAA4AHPp9a9U+INLQ/+Pyb/r3P/oyKijQ/+Pyb/r3P/oyKigDPuf8Aj6m/6+Lv/wBDaoamuf8Aj6m/6+Lv/wBDaoaACj5jwvDfw5GRu7ZHfntnmijBJwBkkgAcck8Ac8cnjmhbq+3UPTR9L6L5vofzxf8ABwl8GtQn8C/sv/tg6IiPF8EvG938EviZM3mRTw+DfirfHVvBepRRYfzILDxjBcWcrMQq+bEh+TgfCX7PXjUltIv7eZ2uVsreAy3jRLFbN5pWQSKhCb2I+fPL45PQ1/Un+1R8AtM/ar/Zh+PX7OWredAvxW+Gmt6ZoN/bRQzXOk+M9Agk8TeAtQt45gUivE8RadDYm4tgt1Al9JJFIpdif4mv2XPHGorph0jW0t9O8S6PIfD/AIo0+USs2meKNB1O50rXrWWE7vMb7dZzKrEMwOSCTnP8q/SX4UWZYHK85oUl7WCnhMRUtf8AgUK06LeqTbU5X1+wt9Lf3h9Dni5RedcL4qvFKnGeJo0b3vSxk6VOPJNaPknCdSTirS9otE7t/wBSPwZ8breaZBcwSEmGCNZB9kOJDCVV3jy3yQP8xCqNo4IGa+ptTZr8W0amL/SbeOR3jlx5Vj/yzimiQh/MX+80hwDwMV+U37O/jRp7S3SSdd0SCLyYxcqrRsQCrKIApX2IwD7cj9LfDd1p1+llo80zBpJoRDLZ3MH2gPKN629xvm8t48ZxG2RzgCv5p4dw1THYClRrUoutSbhN1Y+ySaSXuxbXMn11dkt9T+nOK6MMDjp4qN4RquLjPkc1ed90tfdtbZN9Opk61avbSTQytayeTcYCoriGc8g+RKOmP9kjOBnvXh/ji8MbsI5lRLaDKureZ5Z45ngOQeOhcdO+a+r/ABPpN/NagxRNIkJuLiSWWOCH7MLXiISQRABTP/ESBk9cnFfJvj/SzAs0kVqYhLB5w2SF5RGDk/aWHzSKc9HJGD04FeHn+VYjB4yk4UIwhUm41HFPR+4ouSlvvLs+up6nCOZRxVGfNJTqqEJWi7KaSlok+qb1vf4vI+b/AAWytZ+N7eFFVIvFV/cylJSBbLdabBIxjEh/e75WaVxjDOzMQWJNcR4nvHSRUZrjZF56xy27x3AuVRPJ8qVUK+Um5vu8KDhsV1fg6BF03xwLhGlkbxRePb4yzCOHS7cwLMTyyP8A3WJX1HeuE8XxI8dw+BZs1uZlgjhkbcDyfJVWBcswziUFc8npX5tnGVVf7c0pQrwjVoz9nVlyw9or+zlJXu7Pmvy2equz9IwVaU8JBOUY3vq9b3S6rta3bXS2x4RfTRxyTNujmZoZGInRYGzu/iaQOSRjAY9gB3zXnGqX8EtvO77JECXB3MoQqyJ1Dgc7cZVgRkjIwDUvinVI7dpGWQ28Ae2jO1i0mUfMnfI3DmRcgHowPfxPxX4mUpcjzGS38iUkKxQHOeey5IwCMEkHGa/buBstxWJhhpKDi1UhJ3u9I6uKtvr93oz4bifH08LTrybbXJKKV0r8yhZu90kmtvPvv+xn/BFHxtpmov8Atg+BFuZm1rT9e+GPjcpgvbrol3pd5oW0THIkuZLo7nJJdjgEnAr9yV+6vX7o69eg6+h9R2Nfzbf8EJPFdn/wvf8Aa48F+QHvNf8AhT4B8UW98FUx29roPiqSF7Z3x8okMoO0tjnOOM1/SSM4GeuBn61/pFkFJUeHuH4LWTyPLHUlspVYYZU5yS1snypq7b7tn+RXiXP2nHfFFXpWzSpVSbu1enTTTfXW7v5jsn1P5mjJPUk/jSUV6p8Ka2h/8fk3/Xuf/RkVFGh/8fk3/Xuf/RkVFAE1xo92bqb95bf8fN2P4+7P/wBM6h/sO8/57W/5yf8AxqiigA/sO8/57W/5yf8Axqj+w7z/AJ7W/wCcn/xqiigC1p+nX2nX+n6hHJbM+nX1tfRoGkXLW08c5UEQnb5oj2MQOVY5yOK/g0/as8ORfAH/AIKaftqfC/Rra0bQ7T436l4k0QWMslounw/ECz03xjJatCtvHGzWN5qV9GoXMZMpdfvMKKK/NfFyjSq8DZjKpCM5UatKdNyV3CdpLmj52bT7ptPQ/d/o5YrEYbxLwMaFR041sPCnVSUWp01i6FoPmi/d8lY/Rr9nfxTfQmJ4mn8vcPMElzukf5gCVdIYzHxj5VODjGRX6r+F/F86zaNGIpCJyspYyLuEqfck+599MYVs5Xt2oor+Ccvr1o1vdm1erWva2tnC3T+up/p9n+GoYjDVPbUo1OSnQ5ea+nMpXtqt+Vfd6n2F4Tgl163uXu5vku7KW5mRo45DI8JUBXkCRO6Pn94rEhjnINeA/E3wo1mb820lsuxt/wAySZde0LYJ/c/NjZyuB92iivpuLKUK2S5bWqJurOtU5qilOEpfwficJRvbpfa7ta7PzHhyrVoZ/jKNGcqdKKfLTi7RV73svkvuPhtba80HxNr2jobXyvEOmDWYGQM4tbywe4t5TIrRx70uIkUMBnO1AwwqkeJePzMrs0BWOe4g3tcBnVhjPyBACPLJBBTdtx2oor8ZxFOFXM6NSpFTnOvT5pS3lZ6X6dX+uyP2zDVJwwFNxk09dU/Q+P8A4iBrZZNsMBke3huSUJiTzCwBO1IwMMAN2ACckEmvkPxX4hnkE8UduEjk8wxq0/mAPJmN1cNB80QILIhJAOOBRRX9P+H+Fw6oytShp7O2j096a0100379T8Y8ScbiaWGxHs6rXuveMJbKNrc8ZW+W/U/Tn/ggJM0/7U/7T7XMMUs5/Z703SkkDukaXkfjaC5N2YApjdPKIiCkBsjOADX9UH9h3g4E8BA4BJcE+5AiIye/NFFf25g6cIZTkXJFR/4Rcv2/68r+v+GR/l5xrVqVuKc7qVZuc5Y6qnJ7tKMLbWWnoH9h3n/Pa3/OT/41R/Yd5/z2t/zk/wDjVFFanyxraNo14LyQCS2/49iOC4JIeLJJ8o5zmiiigD//2QA=]]></Media> 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