Accesos venosos ecoguiados

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MFFCVJVWCKJVJV

MpskrcvbcCfjotmgèmFaèklfm LLLFstvjDívlfjbcCfjotmgèmckHcblflkmbc chctockflmv  M+OltjkìvHstlca!P+Hjtla amvVckbèk

F st vj V rm t m a B èm 4 <( 6= k jw lc hd tc 4 0= 4

4

6

Hmksmacv bc Cfjotmgèm Faèklfm  Mffcvjv wckjvjv | mtrctlmacv cfjoslmbjv cfjoslmbjv

 M+ Oltjkìv Hstlca  P+ Hjtlaamv Vckbèk

2

Svrcb cv aldtc bc9 ․

fjplmt! blvrtldslt | fjhsklfmt pùdalfmhckrc am jdtm

Dmij amv fjkblfljkcv vloslckrcv9 ․

Tcfjkjflhlckrj ‒ Bcdc tcfjkjfct ajv ftìblrjv bc am jdtm bc am hmkctm cvpcflglfmbm pjt ca

․

msrjt j ca alfckflmbjt .pctj kj bc skm hmkctm }sc vsolctm }sc rlckc vs mpj|j j mpj|mk ca svj }sc nmfc bc vs jdtm,+ Kj fjhctflma ‒ Kj pscbc srlalymt cvrm jdtm pmtm glkcv fjhctflmacv+ Vlk jdtmv bctlwmbmv ‒ Kj vc pscbc marctmt! rtmkvgjthmt j ockctmt skm jdtm bctlwmbm m pmtrlt bc cvrm jdtm+

․

Ckrckblckbj }sc9 ․

Tckskflm ‒ Maoskm bc cvrmv fjkblfljkcv pscbc kj mpalfmtvc vl vc jdrlckc ca pcthlvj bca rlrsamt bc ajv bctcfnjv bc msrjt 

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Bjhlklj Pùdalfj ‒ Fsmkbj am jdtm j maoskj bc vsv cachckrjv vc nmaac ck ca bjhlklj pùdalfj vcoùk am ac| wlockrc mpalfmdac! cvrm vlrsmflök kj }scbmtí mgcfrmbm pjt am alfckflm+

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Jrtjv bctcfnjv ‒ Ajv bctcfnjv vloslckrcv kj }scbmk mgcfrmbjv pjt am alfckflm bc klkoskm hmkctm9 ․

․

․

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Ajv bctcfnjv bctlwmbjv bc svjv acoèrlhjv s jrtmv alhlrmfljkcv tcfjkjflbmv pjt ac| kj vc wck mgcfrmbjv pjt aj mkrctljt+ Ajv bctcfnjv hjtmacv bca msrjt5 Bctcfnjv }sc pscbck jvrckrmt jrtmv pctvjkmv vjdtc am ptjplm jdtm j vs svj! fjhj pjt cichpaj bctcfnjv bc lhmock j bc ptlwmflbmb+

Mwlvj ‒ Ma tcsrlalymt j blvrtldslt am jdtm! rlckc }sc bcimt dlck famtj ajv rìthlkjv bc am alfckflm bc cvrm jd

3

Èkblfc MFFCVJV WMVFSAMTCV CFJOSLMBJV

?

L K R T J B SF F L Ö K FJVRC( DCKCGLFLJ Fjhpalfmfljkcv bc am fmkmalymflök wckjvm Lkgjthmflök mpjtrmbm pjt am cfjotmgèm

? ? ? >

CVRCTLALBMB Bcvlkgcfflök bc am vjkbm AJFMALYMFLÖK CVRTSFRSTMV Wct ptlhctm pmtrc+ Jtlckrmflök cvpmflma c lhíockcv gskbmhckrmacv+

< < < <

Ptcfmsfljkcv ockctmacv9 Rlpjv bc fmrìrctcv9 FMKMALYMFLÖK BC AM \SOSAMT LKRCTKM FMKMALYMFLÖK BC AM VSDFAMWLM FMKMALYMFLÖK BC AM WCKM GCHJTMA

== =4 =2 =? =>

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MFFCVJV WMVFSAMTCV CFJOSLMBJV  M+Oltjkìv Hstlca! P+ Hjtlaamv Vckbèk

LKRTJBSFFLÖK Ajvptjfcblhlckrjvpmtmcamffcvjwckjvjrmkrjfckrtmafjhjbcwckmvptjgskbmvptlkflpmacv vjk vjk lkks lkkshc hctm tmda dacv cvUl UlX+ X+ C~lv C~lvrc rck k hsar hsarlr lrsb sb bc fmrì fmrìrc rctc tcv v pmtm pmtm blvr blvrlk lkrj rjv v rlpj rlpjv v bc gskf gskflj ljkc kcv v }sc }sc vjk vjk lkvct lkvctrm rmbjv bjv pmtm pmtm mkrldl mkrldljr jrct ctmpl mplm! m! }slhlj }slhljrct rctmpl mplm! m! hjklr hjklrjt jtly lymf mflö lök k bc fjkvr fjkvrmk mkrcv rcv nchjbl nchjblkíh kíhlf lfmv! mv! ksrtlflökpmtckrctma!hmkcijmotcvlwjbcaè}slbjv|nchjrctmplmckrtcajvhívlhpjtrmkrcv+ Blfnjv Blfnjv ptjfcblh ptjfcblhlckr lckrjv jv vjk tcmalym tcmalymbjv bjv ck sk tmkoj tmkoj bc ajfmal ajfmalymf ymflök lök hs| mhpalj mhpalj rmkrj rmkrj lkrtm lkrtm fjhjc~rtmnjvplrmamtlj!|vctcmalympjtblvrlkrmvcvpcflmalbmbcvhìblfmv+ Mkrctljthckrccamffcvjwckjvjfckrtmavcnmtcmalymbjdmijcahìrjbjbcamvtcgctckflmv mkmrö mkmröhlf hlfmv mv fjhj fjhj hcblj hcblj pmtm pmtm ajfm ajfmalalym ymflö flök k bc blfnj blfnj mffcvj mffcvj+ + Mfrsm Mfrsmahc ahckrc krc am fmkma fmkmalym lymflö flök k bc ajv ajv mffcvjvwckjvjvpjtfjkrtjacfjotíglfjkjvbmskmvctlcbcwckrmimvtcvpcfrjmamrìfklfmfaívlfm! nmdamtch nmdamtchjv jv bc amv wckrmim wckrmimv! v! ajv lkfjkwckl lkfjkwcklckrc ckrcv v | ca fjvrc fjvrc tcma }sc vspjkc vspjkc mýmblt mýmblt cvrm ptífrlf ptífrlfm m m kscvrtmptífrlfmmvlvrckflmanmdlrsma+

FJVRC( DCKCGLFLJ Nm|hùar Nm| hùarlpac lpacv v cvrsbljv cvrsbljv }sc mwmamk mwmamklhpa lhpamkr mkrmt mt am cfjotmgè cfjotmgèm m m cvrm rìfklfm rìfklfm fjhj sk hìrjbj hìrjbj cgcfrlwjckfsmkrjmfjvrc(dckcglf cgcfrlwjckfsmkrjmfjvrc(dckcglflj+Ckrtccaajv lj+CkrtccaajvFmadctrcrmaUllX FmadctrcrmaUllX+Fmafsamtj +Fmafsamtjkskmnjttjbc4000aldtmv kskmnjttjbc4000aldtmv pjtfmbm=000ptjfcblhlckrjv!blfnjfíafsajlkfjtpjtmcafjvrjbcajvmpmtmrjv|cackrtckmhlckrj bcajvsvsmtljv|isvrlglfmblfnjmnjttjckamhckjtrmvmbcfjhpalfmfljkcv!ckamhckjtrmvmbc gtmfmvjv|ckcahckjtrlchpjrcötlfjsvmbjckblfnmrìfklfm+ Pjt Pjt vl gsct gsctm m pjfj pjfj blgc blgctc tckr krcv cv ckrl ckrlbm bmbc bcv v lkrc lkrctk tkmf mflj ljkm kmac acv v lkfj lkfjtp tpjt jtmk mk m vsv vsv ptjr ptjrjf jfja jajv jv bc bc fmkm fmkmal alym ymfl flök ök wckj wckjvm vm ca svj svj bc am cfjo cfjotm tmgè gèm! m! aj }sc }sc bm plc plc m sk lkrc lkrctc tcvm vmkr krc c bcdm bcdmrc rc vjdt vjdtc c amv amv tcpctfsvljkcvacomacvbcamvpjvldacvfjhpalfmfljkcv}scpsblìtmhjvrckctvlvcbchscvrtm}sckj nchjvsvmbjamcfjotmgèmpmtmamfmkmalymflökbcskmffcvjwckjvjfckrtmaUlllX+

Fjhpalfmfljkcv bc am fmkmalymflök wckjvm Tcbskbmkbj Tcbskbmkbj ck ajfjhc aj fjhckrmb krmbj j mkrctljt mkrctljthckr hckrc!blvrlkr c!blvrlkrmv mvckrl ckrlbmbc bmbcv! v!fjhj fjhj amv osèmv osèmv KLFC bc 4004!mfjkvcimkamsrlalymflökbcamcfjotmgèmckamfmkmalymflökbcamvwèmvfckrtmacvpscvblvhlks|cam fjhpal fjhpalfmf fmflj ljkcv kcv bc am rìfklf rìfklfm m .otm .otmflm flmv v m am ajfma ajfmaly lymf mflö lök k bc am cvrts cvrtsfrs frstm tm m pskflj pskfljkm kmt t | m am bc amv amv cvrt cvrtsf sfrs rstm tmv v mb|m mb|mfc fckr krcv cv m cwlr cwlrmt mt,! ,! vsv vsv gtmf gtmfmv mvjv jv .wlv .wlvsm smal alym ymfl flök ök bltc bltcfr frm m bca bca mwmk mwmkfc fc bc am mosi mosim, m,| | blvhlks|ccarlchpjbctcmalymflök.rtmvskpctèjbjbcmptckblymickmbmbcvbcýmdac,+

Amfmkmalymflökwckjvmfckrtma!vldlckptcvckrmskmhjtrmalbmbhs|dmim!ptcvckrmskjv tlcvojv|fjhpalfmfljkcv}sc!mvswcyptjwjfmkskmlkfjhjblbmbpmtmcapmflckrc|skfjkvshjbc tcfstvjvnjvplrmamtljv}scpscbckvctmarèvlhjvUlwX+

> Fjhpalfmflök

Tlcvojbcfjhpalfmflökckcavlrlj \sosamtlkr+

Vsdfamwlm

Gchjtma

Kcshjrötm~

10+= m 0+4

=+3 m 6+=

Kj mpalfm

Nchjrötm~

Kj mpalfm

0+2 m 0+7

Kj mpalfm

Lkgcfflök .=000fmr*b,

>+7

2

=3+6

Rtjhdjvlv .=000 fmr*b,

=+4 m 6

0 m =6

> m 62

Pctgjtmflök mtrctlma

6

0!3

7!43

Hmam fjajfmflök

Tlcvoj Dmij

Tlcvoj Cacwmbj

Tlcvoj Dmij

Cvrmvfjhpalfmfljkc Cvrmvfjhpalfmfljkcvcvríkmshckrm vcvríkmshckrmbmvcktcflìkkmfl bmvcktcflìkkmflbjv!ckjdcvjv! bjv!ckjdcvjv!bcvnlbtmrm bcvnlbtmrmbjv|pmflckrcvfj bjv|pmflckrcvfjk k amfjmosamflökmarctmbm+Cvckcvrmvvlrsmfljkcv!bjkbcmhlckrckbct!amcfjotmgèmfjdtmhívgsctym fjhjncttmhlckrmùrlaclkblvpckvmdacpmtmtcmalymtblfnmrìfklfm+ Pjt Pjt jrtj jrtj ambj ambj ca gtmf gtmfmvj mvj bc am rìfklf rìfklfm m vc dmvm dmvm ptlkfl ptlkflpma pmahck hckrc rc ck skm wmtlm wmtlmdla dlalbm lbmb b mkmrö mkmröhlf hlfm m bca pmflc pmflckrc krc j ckskm marc marctm tmflö flök k bca gasij gasij ckblfnm wckm! wckm! |mvcm rjrm rjrma! a! fjk fjk jdvrt jdvrtsff sfflö lök k rjrm rjrmaa pjt skm rtjh rtjhdjv djvlv lv! ! j dlck dlck pmtfl pmtflma ma! ! fjk fjk wckmv wckmv fjam fjampvm pvmbmv bmv }sc blglf blglfsar sarmk mk ca mwmkfc mwmkfc bc am osèm osèm | ca fmrìr fmrìrct ct pjvrctljt+ Amlkflbckflmbccvrmvbjvvlrsmfl Amlkflbckflmbccvrmvbjvvlrsmfljkcv.gtmfm jkcv.gtmfmvjv|fjhpalfmfl vjv|fjhpalfmfljkcv,pscbcblvhlksl jkcv,pscbcblvhlksltvcfjkcasvjbcam tvcfjkcasvjbcam cfjotmgèm+Cvrmrìfklfmkjvdtlkbmskmlkgjthmfl cfjotmgèm+Cvrmrìfklfmkjvdtlkbmskmlkgjthmflökptcwlmmamfmkmalymflö ökptcwlmmamfmkmalymflök}scfjk k}scfjkamrìfklfmfaívl amrìfklfmfaívlfm fm bctcgctckflmvmkmröhlfmvkjvckjvbmdm+Amwlvlökck4Bvshmbmmamwlvlökbjppactpscbcbmtkjv vsglflckrcvlkblfljvpmtmptcbcfltcaì~lrjjgtmfmvjbcamfmkmalymflök+

Lkgjthmflök mpjtrmbm pjt am cfjotmgèm ◊ ◊ ◊ ◊

◊

◊

Ajfmalymflökc~mfrmbcamcvrtsfrstmwmvfsamt+ Wmtlmdlalbmbmkmröhlfm Wmajtmflökbcagasij!caklwcabcfjampvj Wlvsmalymflökbccvrtsfrstmvmb|mfckrcv}scbcdchjvcwlrmtmatcmalymtampskflök.mtrctlmv fctfmkmvmwckmv!pacstm!kctwljv!crf, Wmajtmflökbcamnlbtmrmflökptcwlmmamfmkmalymflökbcskmwèmwckjvmfckrtmama ckfjkrtmhjvskfjampvjgíflabcblfnmwckmckamptlhctmmptj~lhmflökcfjotíglfm+ Amwlvlökbcskrtjhdj}sclhplbmskmfmkmalymflökcvhs|gífla!cwlrmkbjmapmflckrc vsgtlhlckrjvlkkcfcvmtljv+

<

CVRCTLALBMB Amcvrctlalbmbpscbccvrmtfjhptjhcrlbmpjtcancfnjbcfjkrmtfjkskkscwjlkvrtshckrjbckrtj bcafmhpj}sltùtolfj+C~lvrckblgctckrcvhìrjbjvpmtmcwlrmtrmkrjtjhpctamcvrctlalbmbbcblfnm rìfklfm!fjhjcwlrmtcafjkrmoljbcblvrlkrmvckgcthcbmbcvwèmfsríkcm+ Pjtcaajajvmsrjtcvtcfjhlckbmkvlchptc!msk}scvcwm|mmtcmalymtskmvlhpacc~pajtmflök cfjotíglfmvcosltskmvhèklhmvpmsrmvbccvrctlalbmbjmvcpvlmckrtcc~pajtmflök|c~pajtmflök

Bcvlkgcfflök bc am vjkbm Vlchptccvfjkwcklckrcmpalfmtmaoùkptjbsfrjbcvlkgcfrmkrcptcwlm|pjvrctljthckrcmfmbm c~pajtmflökjrìfklfmbcfmkmalymflök+Vlkchdmtojkjpmtcfcvsglflckrcpmtmcwlrmtsklkkcfcvmtlj rtmvpmvjbchmrctlmafjkrmhlkmkrcbcskpmflckrcmjrtj+Hsfnjhívcgcfrlwjtcvsarmamfjajfmflök bcmaoùkhmrctlmadmttctm!mahckjvmvìprlfj!ckrtccartmkvbsfrjt|amplcabcapmflckrc+Pmtmc~lvrck amvgskbmvbcaírc~}scvcfjajfmkckamvvjkbmvlkrtmfmwlrmtlmvjdlckmbncvlwjvrtmkvpmtckrcvfjhj ajvRcombcthfjajfmbjvckamvvjkbmvalkcmacv+ Mvèhlvhjcasvjbcocacvrìtla!jcasvjbcftchmvmkrlvcprlfmvfjhjcadcrmblkc!svmbjvfjhj hcbljvfjkbsfrjtcvvjkbcotmkm|sbmpmtmfjkvcosltblfnjptjpövlrj+Rckchjvpjtrmkrjskmv vctlcbccachckrjv}scpscbckvctbcotmkm|sbmpmtmfjkvcosltskmmbcfsmbmmvcpvlm}scvctík c~palfmbjvckcafstvj+ =Rcombcth 4Skosmkrccvrctla 6Gskbmvbcfíhmtmpmtmampmtjvfjplm 2Gskbmvcvpcfèglfmvpmtmamvjkbmcfjotíglfm

AJFMALYMFLÖK CVRTSFRSTMV Wct ptlhctm pmtrc+ Jtlckrmflök cvpmflma c lhíockcv gskbmhckrmacv+ Fsmkbjwmhjvmlbckrlglfmtcvrtsfrstmv wmvfsamtcvbcdchjvgmhlalmtlymtkjvfjkamv lhíockcvcfjoìklfmv9mkcfjlfmv!nlpjcfjlfmv cnlpctcfjlfmv|mwlvrmvckajvptlhctjv fmpèrsajv+ Ckrt Ckrtc c ajv ajv Mtrc Mtrcgm gmfr frjv jv! ! ca }sc }sc kjv kjv pcth pcthlr lrc c lbck lbckrl rlgl glfm fmt t skm skm cvrt cvrtsf sfrs rstm tm wmvf wmvfsa samt mt cv ca aamhmbj aamhmbj Tcgscty Tcgsctyj j pjvrctlj pjvrctljt+ t+ Fslbmbj Fslbmbj fjk ca mtrcgmfrjbcamTcgtmfflök!pscvrj}sccvskm mtrcgmfrjbcajfmalymflök+

=0 Ckrìthlkjvockctmacv!vcbcdckdsvfmtamvcvrtsfrstmvwckjvmvjmtrctlmacvhcblmkrcskfjtrc rtmkvwctvma|fjkglthmtamvhcblmkrcskfjtrcajkolrsblkma+ Pjt rmkrj rmkrj vl blfnj blfnj nmyaj nmy aj bltlolhj bltlolhjv v bc hmkctm hmkctm ajkolrsb ajkolrsblkma lkma j dlck rtmkvwc rtmkvwctvma tvma m amv cvrtsfrs cvrtsfrstmv tmv ca tcvsarmbjvctíbjvlhíockcvrjrmahckrcblvrlkrmv+ Amhmkctmhívvckflaambcblvfctkltamcvrtsfrstmwckjvmfjkammtrctlmacv}scamwckmvcfjampvmma nmfctptcvlökvjdtccaamfjkamvjkbmcfjotíglfm!|ammtrctlmamrc+Vldlck!maoskmvmtrctlmv.vjdtcrjbj fsmkrjhckjvfmaldtcrckom,pscbckfjampvmtvcrmhdlìk+

Ca Bjpp Bjppac act t Fjaj Fjajt! t! ca Pjc Pjct t Bjppa Bjppact ct | vjdtc vjdtc ca Bjppa Bjppact ct Psavmb Psavmbj j kjv kjv pcthlr pcthlrck ck am lbckrl lbckrlglf glfmf mflö lök k bc amv amv cvrtsf cvrtsfrst rstmv mv wckjvm wckjvmv v | mtrctlmacv+Ìvrmvvcbcdcklbckrlglfmtrmkrjckskfjtrcrtmkvwctvmafjhjckskjajkolrsblkma+ Ca Bjppac Bjppact t Fjajt Fjajt tcolv tcolvrt rtm m am bltcff bltcfflö lök k bca gasi gasij j vmko vmkosè sèkc kcj9 j9 mysa mysa fsmk fsmkbj bj ca gasi gasij j vc macim!|tjijfsmkbjvcmfctfm+

Bcpckbcbcamjtlckrmflökbcamvjkbm.vlam vjkbmcvrípctpckblfsamtma vjkbmcvrípctpckblfsamtmawmvj!pscbckj wmvj!pscbckj bcrcfrmtgasij,+

Skm Skm wcy wcy ajfm ajfmal alym ymbm bm | rtmv rtmv sk ckrt ckrtck ckmh mhlc lckr krj j mbcf mbcfsm smbj bj! ! am ajfm ajfmal alym ymfl flök ök | pskf pskflö lök k bc am cvrtsfrstmvmtrctlm cvrtsfrstmvmtrctlmacv*wckjvm acv*wckjvmvvcfjkvloschcblmkrcamwlvlö vvcfjkvloschcblmkrcamwlvlökbltcfrmbcampskrmbcammosim+Cvrjcv kbltcfrmbcampskrmbcammosim+Cvrjcv gskbmhckrmapmtmlhpcbltacvljkcvckcvrtsfrstmvmb|mfckrcv+

== Pmtmcaajcvkcfcvmtljtcfjtb Pmtmcaajcvkcfcvmtljtcfjtbmt}sccanmysartmvökl mt}sccanmysartmvöklfjcvhs|glkj!pjtaj}sccvpjvldacfjkgskbl fjcvhs|glkj!pjtaj}sccvpjvldacfjkgskblt t ckampmkrmaambcacföotmgjskmvcfflökbcammosim}sckjfjttcvpjkbcfjkampskrm+Pjtcaajcv tcfjhckbmdacsrlalymtmosimvcvpcflmacvhívcfjoìklfmvfjktcgsctyjckblfnmpskrm!|mblvpjkldacv ckcahctfmbj+ Skmwcylbckrlglfmbmvamvcvr Skmwcylbckrlglfmbmvamvcvrtsfrstmv tsfrstmv!pjbtchjvtcm !pjbtchjvtcmalymtam alymtampskflökwckjvmfjk pskflökwckjvmfjkskfjtrcrtmkvwc skfjtrcrtmkvwctvma| tvma| rìfk rìfklf lfm m bc pskf pskflö lök k ‑gsc ‑gsctm tm bc pamk pamkj‘ j‘ .ck .ck am }sc }sc vöaj vöaj wctc wctchj hjv v am pskr pskrm m bc am mosi mosim, m, j sk fjtr fjtrc c ajkolrsb ajkolrsblkma lkma |rìfklfmbc |rìfklfmbc pskflök‑ckpamkj pskflök‑ckpamkj‘.ckam ‘.ckam }scwctchjvrjbjcatcfjt }scwctchjvrjbjcatcfjttlbj tlbjbc bc ammosim!fjk ammosim!fjk hcijtwlvsmalymflökpmtmcwlrmtpskfljkcvbccvrtsfrstmvmb|mfckrcv,+ C~lvrck4hmkctmvbctcmalymtampskflök9bcgjthmbltcfrm.wlvsmalymflökbltcfrmbcamwmkfcbcam mosim!dlckvcmckpamkjjgsctmbcpamkj,jbcgjthmlkbltcfrm.lbckrlglfj!ajfmalyj!hmtfjamyjkmbc pskflökckamplca!|tcmalyjampskflökvlkcacföotmgj,+

RìfklfmbcVcablkoct Rtmv ajfmalymt ca wmvj vc ptjfcbc m am pskflök.vsdfamwlm!|sosamtjgchjtma,fjk skm mosim mosim! ! lkrtj lkrtjbsf bsflck lckbj bj m fjkrl fjkrlksm ksmfl flök ök skmosèmhcríalfmgac~ldac9 ( Ajfmalymt ca wmvj bcvcmbj pctfsrmk pctfsrmkcmhc cmhckrcfjk krcfjk skmmosimhjkrmbm ckskm ictlkom ictlkom fjkvsctj!mvpltm fjkvsctj!mvpltmkbjnmvrm kbjnmvrm jdrckctvmkotc+ (Lkrtjbsfltamosèmhcríalfmmrtmwìvbcammosimpjtvsc~rtchjhívgac~ldac.cac~rtchjfstwjvlaj rlckcamosèmckfscvrlök,!mwmkymkbj=*2m=*6bcvsajkolrsb+ (Tcrltmtammosimvsicrmkbjamosèm ( Rtmv Rtmv pmvmt pmvmt ca blamr blamrmbj mbjt! t! lkvctr lkvctrmt mt ca fmrìr fmrìrct ct m rtmwì rtmwìv v bc am osèm! osèm! mvcos mvcostí tíkbj kbjvc vc bc }sc am hlvhm hlvhm mpmtcfcpjtcac~rtchjbl mpmtcfcpjtcac~rtchjblvrmabcafmr vrmabcafmrìrctmkrcvbclkr ìrctmkrcvbclkrtjbsfltaj tjbsfltajckcawmvj!nmvr ckcawmvj!nmvrmampjvlfl mampjvlflökbcvcmbm+ ökbcvcmbm+ Ckjfmvljkcvnmdtí}scmhpalmt Ckjfmvljkcvnmdtí}scmhpalmtfjkskmnjimbcdlvrstè fjkskmnjimbcdlvrstèamlkflvlökckplcapmt amlkflvlökckplcapmtmpcthlrlt mpcthlrltamptjotcvlö amptjotcvlök k bcablamrmbjtfmrìrctmrtmwìvbcamhlvhm.B,+Pscbcgmwjtcfctamlkrtjbsfflökbcafmrìrctcaoltmtaj ckskvckrlbj|ckjrtjhlckrtmvvclkrtjbsfc+ (Tcrltmtamosèmhcríalfm|fjkcfrmtskptjajkombjtmafmrìrct

Ptcfmsfljkcv ockctmacv9 =+(Cvjdalombmamrìfklfmcvrìtla!pjt}scamvcpvlvcvamfjhpalfmflökhívfjhùk+ 4+(Amlkrtjbsfflökbcafmrìrctbcdctcmalymtvcckskítcmbjkbcamcvrctlalbmbcvrìmvcostmbm+

=4 6+(Cavlvrchmbcfmrìrctwckjvjfckrtma!kjbcdcvctsvmbjpmtmmalhckrmflökpmtckrctma!hlckrtmv vccvrìhjklrjtlymkbjamP+W+F+ 2+(Vlcafmrìrctcvsvmbjpmtmmalhckrmflökpmtckrctmabcdctèm9 (Kjsvmtvcpmtmjrtjptjpövlrj.hcblfmflökjptjbsfrjvvmkosèkcjv,+ (Kjfjkcfrmtmaamwcbcrtcvpmvjv+

Rlpjv bc fmrìrctcv9 =+( Vlamvrlf .pjaèhctjbcvlalfjkm,+ (Wckrmimv9 )Vcvshlklvrtmcvrìtla )Cvtmbljpmfj Fmrìrct lkgmkrla lkgmkrla Dtjwlmf Dtjwlmf+ Wm chdsrl 4+( Fmrìrct chdsrlbj bj ck sk fmrìr fmrìrct ct bc bmftö bmftök! k! nmvrm nmvrm =7 fh+ bc am fjkc~ fjkc~lö lök+ k+ Wjashcklkrctkj0!6ha+

(Wckrmimv9amfsdlctrmbcbmftökpcthlrcamglimflökckcarcilbjfcasamtvsdfsríkcj|pscbctcbsfltam lkflbckf lkflbckflmbclkgcff lmbclkgcfflök+ lök+Ca Cafmr fmrìrct ìrctvc vc glimm glimm plca!vöajckcapskrjbcvmalbm plca!vöajckcapskrjbcvmalbmbc bc amhlvhm| amhlvhm| cvgíflabc cvgíflabc alhplmt+ (Lkfjkwcklckrcv9 ) Ca blíh blíhcr crtj tj tcam tcamrl rlwm wmhc hckr krc c otmk otmkbc bc bca bca fmrì fmrìrc rct t hív hív pc}s pc}scý cýj j blvp blvpjk jkld ldac ac! ! aj }sc }sc tcbs tcbsfc fc amv amv pjvldlalbmbcvbclkvctflökckajvptchmrstjv1<00o+ )Cvhèklhmhckrctmbljpmfj+ 6+( Fmrìrc Fmrìrctcv tcv bc pjalst pjalstcrm crmkj kj j bc rcgaök rcgaök+ Nmk vsvrlrsl vsvrlrslbj bj m ajv P+W+F+ P+W+F+ .pjalwlk .pjalwlklaj laj,! ,! pjt rckct rckct hckjt hckjt rckbckflmmackbstcflhlckrjfjkcarlchpj|pjtrmkrjmamtjrstm+ (Wckrmimv9 )Vjkhívtèolbjv}scajvbcvlalfjkm!aj}scgmflalrmvslkrtjbsfflökpctfsríkcm+ )Vjktmbljjpmfjv+ )Vcvshlklvrtmkcvrìtlacv+ )Vjkhívgíflacvbcglimtmplca+ (Lkfjkwcklckrcv9 )Mshckrjbcfjhpalfmfljkcvrtjhdörlfmv+

=6

MAOJTLRHJBCESHMT\FNSMKPMTMAJVMF MAOJTLRHJBCESHMT\FNSMKPMTMAJVMFFCVJVWMVFS FCVJVWMVFSAMTCVOSLMB AMTCVOSLMBJV JV PJTCFJOTMGÈM =+Ajfmalymtcawmvjckvscicfjtrj.fjtrcrtmkvwctvma,+ 4+Fckrtmtcawmvjckampmkrmaambcacföotmgj+ 6+Lbckrlglfmtwckmv|mtrctlmv9c~fasltrtjhdjvlvjcvrckjvlv+Fjhptjdmtfjhptcvldlalbmb!psavmrlalbmb! tcvpscvrmmaWmavmawm+SvmtBjppactFjajt|BjppactPsavmbj+ 2+Tjrmtamvjkbmpmtmjdrckctcawmvjckvscicamtoj.ajkolrsblkma,+ 3+Fckrtmtcawmvjckampmkrmaambcacföotmgj+ 7+Tc(fjkglthmtlbckrlglfmflökbcwckmv|mtrctlmv9c~fasltrtjhdjvlvjcvrckjvlv+Fjhptjdmt fjhptcvldlalbmb!psavmrlalbmb!tcvpscvrmmaWmavmawm+SvmtBjppactFjajt|BjppactPsavmbj+ ?+Vlvcsrlalymrìfklfmlkbltcfrmbcpskflökcfjotíglfm9hmtfmtamrtm|cfrjtlmbcawmvjmpskfljkmt+ >+VLvcsrlalymrìfklfmbltcfrmbcpskflökcfjotíglfm9lkvctrmtammosim|oslmtvchcblmkrcamvlhíockcv cfjotíglfmvpmtmpskflökbcawmvjblmkm+ <+Fjhptjdmtfjttcfrmfmksamflökbcawmvjfjkcacföotmgj+

Bchmkctmcv}schírlfmc~palfmtchjvajvptlkflpmacvmffcvjvwckjvjvsvmbjvfjhùkhckrcsvmbjv+ =+ \SOSAMTLKRCTKM 4+ VSDFAMWLM 6+ DMVÈALFM 2+ GCHJTMA \AMFMKMALYMFLÖKBCAMMTRCTLMTMBLMA+

=2

FMKMALYMFLÖK BC AM \SOSAMT LKRCTKM Cvrm Cvrm cv am fmkma fmkmaly lymf mflö lök k ptcgct ptcgctlbm lbm pjt ajv ajv mkcvr mkcvrcvl cvlöaj öajoj ojv! v! ptlkfl ptlkflpma pmahck hckrc rc pjt vs hckjt hckjt rmvm rmvm bc fjhp fjhpal alfm fmfl fljk jkcv cv+ + Vs ptlk ptlkfl flpm pma a lkfj lkfjkw kwck cklc lckr krc c cv }sc }sc am mtrc mtrctl tlm m fmtö fmtörl rlbm bm vsca vscac c vlrs vlrsmt mtvc vc ck amv amv lkhcblmfljkcv!|vlkskmwlvlökfamtmjskckrtckmhlckrjmbcfsmbj!ampskflökbcblfnmmtrctlmkjcv lkgtcfsckrc!ajfsmackvlrsmfljkcvbcmarctmfljkcvbcamfjmosamflökpscbcvctskptjdachm+Pjtjrtj ambjcvcamffcvjfjkhckjtrmvmbcgtmfmvjv!bclkgcffljkcv|fjkfmvlksampjvldlalbmbbcptjwjfmt skkcshjrötm~+ Srlalymhjvckcvrcfmvjskmvjkbmalkcmabcmarmgtcfsckflm+ Cvrtsfrstmvmb|mfckrcvpctjblgèf Cvrtsfrstmvmb|mfckrcvpctjblgèflacvbcmafmkymt lacvbcmafmkymt.msk}sckjlhpjvldac,vjkcakctwljwmoj!cakctwlj .msk}sckjlhpjvldac,vjkcakctwljwmoj!cakctwlj gtìklfj!lkfasvjpckcrtmtckcaaè}slbjfcgmajttm}sèbcjckpmflckrcvbcaombjv+ Pjtamhcijtgmflalbmbbchmkcij|vscgcfrlwlbmb!ptcgctlhjvskfjtrcrtmkvwctvmabcammtrctlm fmtörlbm|vsmfjhpmýmkrc!amwckm|sosamtlkrctkm+ Rtmvlbckrlglfmflökbcamwckm|sosamt lkrctkm!|fjkglthmflök.vloslckbjca maojtlrhjbcEshmt|Fnsmk,!ptjfcbchjv mtcmalymtampskflök‑gsctmbcpamkj‘+

=3 Pskflökhcblmkrc wlvsmalymflökbltcfrmbca mwmkfcbcammosim .lhmockvspctljt,+

Wlvsmalymflökbca ‑kccbacrlp‘9ampskrm bcammosimvc ckfsckrtmbckrtjbcam wckm!amvmkotctcgas|c .lhmoìkcvlkgctljtcv,+

Fjkglthmflökbcamajfmalymflökbcapcajbckrtjbc amwckm!fjkglthmtfjkcaBjppactFjajt}sc cgcfrlwmhckrccvamwckm+

=7 Rmhdlìkvcpscbcfmkmalymtfjkam vjkbmckcacicajkolrsblkma+

=?

FMKMALYMFLÖK BC AM VSDFAMWLM Bcamhlvhmhmkctm}scckcamkrctljtmpmtrmbj!bltlolhjvhcblmkrcvjkbmalkcmafjkmpj|jckam vjhdtmfamwlfsamtdsvfmkbjcvrtsfrstmvwmvfsamtcv+ Amfjhpalfmflökhívgtcfsckr Amfjhpalfmflökhívgtcfsckrccvcakcshjrötm~!bcptcbjh ccvcakcshjrötm~!bcptcbjhlkljly}slctb lkljly}slctbj!aj}scjfsttcfsmkbjkj j!aj}scjfsttcfsmkbjkj wlvsmaly wlvsmalymhj mhjv v fjttcfr fjttcfrmhck mhckrc rc am mosim+ mosim+ Cv ptljtlr ptljtlrmtl mtlj j ajfmal ajfmalymt ymt am pacstm pacstm hcblmkr hcblmkrc c cfjotmgè cfjotmgèm m pmtm mvè cwlrmtvspskflök+vctcfjhlckbmtcmalymtampskflö cwlrmtvspskflök+vctcfjhlckbm tcmalymtampskflökdmijwlvsmalym kdmijwlvsmalymflökbltcfrm flökbltcfrm+Rmhdlìkcaèkblfcbc +Rmhdlìkcaèkblfcbc gtmf gtmfmv mvjv jv cv hm|j hm|jt t pscv pscv kj vlch vlchpt ptc c vc fjkv fjkvlo losc sc wlvs wlvsma maly lymt mt fjtt fjttcf cfrm rmhc hckr krc c am vmal vmalbm bm bc am wckm wckm vsdfamwlm+

Cadtmyjbcdcfjajfmtvcpcomtvcma fsctpj!|m}scckmbbsfflökam wckmvcfjampvm+

=>

FMKMALYMFLÖK BC AM WCKM GCHJTMA Bcsvjfjhùkckcafmhpjbcajvfslbmbjvlkrckvlwjv|pmtmfmrìrctcvbcblíalvlv!cvskmwèmbcgífla lkgcfflök!hm|jtrtjhdjvlv|}sctc}slctcpjtrmkrjhívfslbmbjv+Vsrìfklfmcvvlhlamtmamv mkrctljtcvfjkskmgíflaajfmalymflöksrlalymkbjamcfjotmgèm+ Ajfmalymtchjvamvcvrtsfrstmvwmvfsamtcvfjajfmkbjamvjkbmrtmkvwctvmackcapalcosclkoslkma+

Amwckmgchjtmavcajfmalymhcblmamammtrctlmgchjtma+Cakctwljgchjtmacvamcvrtsfrstmnlpctcfjlfm amrctmamammtrctlm+Amwckmvcfjampvmmanmfctfjhptcvlökfjkamvjkbm+ CaBjppactFjajt|caPjctBjppactkjv pcthlrcklbckrlglfmtamvcvrtsfrstmv wmvfsamtcv+

CkamgjrjbcaPjctBjppactlbckrlglfmhjv 4cvrtsfrstmvmtrctlmacv9ammtrctlmgchjtma vspctglflma|amptjgskbm+Amwckmgchjtma vclbckrlglfmmamly}slctbmbcblfnmv cvrtsfrstmv+

=<

FMKMALYMFLÖKBCAMMTRCTLMTMBLMA Vclbckrlglfmammtrctlmtmblmafjkamvjkbmrtmkvwctvma|vlchptcsvmkbjcaBjppactFjajtjcaPjct Bjppact+Vcoltmamvjkbmpmtmdsvfmtammtrctlmckvscicamtoj.vjkbmajkolrsblkma,+Ampskflökvc tcmalymtíckcvrccic!hcblmkrcwlvsmalymflökbltcfrm+

4=

UlXCaaljrRVI!Gmtj}slHN!MthvrtjkoTG!NmkvjkOF+Oslbcalkcvgjtojjbptmfrlfclkfckrtmawckjsvfmrncrctlymrljk+INjvpLkgcfr=<<254>9 =76(?7+

UllX Fmawctr K! NlkbB! Hf_laalmhv Hf_laalmhv TO! Rnjhmv Rnjhmv VH! Dcwctac| Dcwctac| F! Bmwlbvjk Bmwlbvjk M+ Rnc cggcfrlwckcv cggcfrlwckcvv v mkb fjvr(cggcfr fjvr(cggcfrlwckcv lwckcvv v jg sartmvjskb sartmvjskb ajfmrlkobcwlfcvgjtfckrtmawckjsvmffcvv9mv|vrchmrlftcwlc+NcmarnRcfnkjaMvvcvv40069?.=4,+

UlllX+TmkbjapnMO!FjjeBI!OjkymacvFM!PtlddacFO+Sartmvjskboslbmkfcgjtpamfchckrjgfckrtmawckjsvfmrncrctv9mhcrm(mkma|vlvjg rncalrctmrstc+FtlrFmtcHcb=<<754294036(>+ KmrljkmaLkvrlrsrcgjtFalklfmaC~fcaackfc+Oslbmkfcjkrncsvcjgsartmvjskbajfmrlkobcwlfcvgjtpamflkofckrtmawckjsvfmrncrctv+ Ajkbjk9KLFC!4004+UKLFCRcfnkjajo|MpptmlvmaKj2<+X

UlwXFmaashEO!_nlhvrctG+Lkrctwckrljkmawmvfsamttmbljajo|mkblkrctwckrljkmakcstjwmvfsamttmbljajo|9mtcpjtrjgrncKmrljkma FjkglbckrlmaCk}slt|lkrjPctljpctmrlwcBcmrnv+Bmrmfjaacfrljkpctljb=Mpt=<<>rj6=Hmt=<<<+Ajkbjk!KFCPJB!4000+ RtjrrlctVI!WctchmelvF!J/DtlckI!MsctML+Gchjtmabccpwclkrntjhdjvlvmvvjflmrcblrnfckrtmawckjsvfmrncrctlymrljk9 tcvsarvgtjhmptjvpcfrlwc!tmkbjhlycbrtlma+FtlrFmtcHcb=<<3546934(<+

JRTMVTCGCTCKFLMV

Kmrlj Kmrljkma kma Lkvrlr Lkvrlrsrc src gjt gjt Falklf Falklfma ma C~fcaa C~fcaackf ckfc+ c+ KLFC KLFC rcfnkj rcfnkjajo ajo| | mpptm mpptmlvm lvmaa oslbmk oslbmkfc fc Kj 2<9 sartm sartmvjs vjskb kb ajfmrlk ajfmrlko o bcwlfcvgjt bcwlfcvgjt pamflkofckrtm pamflkofckrtmaawckj wckjsvfmrncrc svfmrncrctv+Ptjpj tv+Ptjpjvma vma rjhjwcoslbmkfc rjhjwcoslbmkfc rjrnc vrmrlfalvr+ vrmrlfalvr+ Ajkbjk9KLFC!4003+Mwmlamdacgtjh +klfc+jto+se*pbg*rm02
KmrljkmaLkvrlrsrcgjt KmrljkmaLkvrlrsrcgjtFalklfmaC~f FalklfmaC~fcaackfc+KLFC caackfc+KLFCrcfnkjajo|mppt rcfnkjajo|mpptmlvmaoslbm mlvmaoslbmkfcKj2<9Oslbmkfcjkrnc kfcKj2<9Oslbmkfcjkrnc svcjgsartmvjskbajfmrlkobcwlfcvgjtpamflkofckrtmawckjsvfmrncrctv+Ajkbjk9KLFC!4004+Mwmlamdac gtjh+klfc+jto+se*pbg*sartmvjskbZ2
DjbcknmhMT+Sartmvjskblhmolkod|mkmcvrncrlvrv9rtmlklkomkbmfftcblrmrljklvvscv+DtIMkmcvrn 40075<792=2‖=?+

HfotcojtH!TmvnlbM!VmdacK!EstlmkI+LhpmfrjgKLFCoslbmkfcjkrncptjwlvljkjgsartmvjskb hmfnlkcvgjtfckrtmawckjsvfmrncrctlymrljk+DtIMkmcvrn40075+

Eshmt M! Fnsmk M+ Sartmvjskb oslbcb wmvfsamt mffcvv9 cgglfmf| cgglfmf| mkb vmgcr|+ Dcvr Ptmfr Tcv Falk Mkmcvrncvlja 400<5 46.6,9 4<<(6==+

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