');mask-image:url('data:image/svg+xml;utf8, ');mask-mode:alpha;-webkit-mask-position:center;mask-position:center;-webkit-mask-repeat:no-repeat;mask-repeat:no-repeat;-webkit-mask-size:contain;mask-size:contain}}.wp-block-image :where(.has-border-color){border-style:solid}.wp-block-image :where([style*=border-top-color]){border-top-style:solid}.wp-block-image :where([style*=border-right-color]){border-right-style:solid}.wp-block-image :where([style*=border-bottom-color]){border-bottom-style:solid}.wp-block-image :where([style*=border-left-color]){border-left-style:solid}.wp-block-image :where([style*=border-width]){border-style:solid}.wp-block-image :where([style*=border-top-width]){border-top-style:solid}.wp-block-image :where([style*=border-right-width]){border-right-style:solid}.wp-block-image :where([style*=border-bottom-width]){border-bottom-style:solid}.wp-block-image :where([style*=border-left-width]){border-left-style:solid}.wp-block-image figure{margin:0}.wp-lightbox-container{display:flex;flex-direction:column;position:relative}.wp-lightbox-container img{cursor:zoom-in}.wp-lightbox-container img:hover+button{opacity:1}.wp-lightbox-container button{align-items:center;-webkit-backdrop-filter:blur(16px) saturate(180%);backdrop-filter:blur(16px) saturate(180%);background-color:#5a5a5a40;border:none;border-radius:4px;cursor:zoom-in;display:flex;height:20px;justify-content:center;opacity:0;padding:0;position:absolute;right:16px;text-align:center;top:16px;transition:opacity .2s ease;width:20px;z-index:100}.wp-lightbox-container button:focus-visible{outline:3px auto #5a5a5a40;outline:3px auto -webkit-focus-ring-color;outline-offset:3px}.wp-lightbox-container button:hover{cursor:pointer;opacity:1}.wp-lightbox-container button:focus{opacity:1}.wp-lightbox-container button:focus,.wp-lightbox-container button:hover,.wp-lightbox-container button:not(:hover):not(:active):not(.has-background){background-color:#5a5a5a40;border:none}.wp-lightbox-overlay{box-sizing:border-box;cursor:zoom-out;height:100vh;left:0;overflow:hidden;position:fixed;top:0;visibility:hidden;width:100%;z-index:100000}.wp-lightbox-overlay .close-button{align-items:center;cursor:pointer;display:flex;justify-content:center;min-height:40px;min-width:40px;padding:0;position:absolute;right:calc(env(safe-area-inset-right) + 16px);top:calc(env(safe-area-inset-top) + 16px);z-index:5000000}.wp-lightbox-overlay .close-button:focus,.wp-lightbox-overlay .close-button:hover,.wp-lightbox-overlay .close-button:not(:hover):not(:active):not(.has-background){background:none;border:none}.wp-lightbox-overlay .lightbox-image-container{height:var(--wp--lightbox-container-height);left:50%;overflow:hidden;position:absolute;top:50%;transform:translate(-50%,-50%);transform-origin:top left;width:var(--wp--lightbox-container-width);z-index:9999999999}.wp-lightbox-overlay .wp-block-image{align-items:center;box-sizing:border-box;display:flex;height:100%;justify-content:center;margin:0;position:relative;transform-origin:0 0;width:100%;z-index:3000000}.wp-lightbox-overlay .wp-block-image img{height:var(--wp--lightbox-image-height);min-height:var(--wp--lightbox-image-height);min-width:var(--wp--lightbox-image-width);width:var(--wp--lightbox-image-width)}.wp-lightbox-overlay .wp-block-image figcaption{display:none}.wp-lightbox-overlay button{background:none;border:none}.wp-lightbox-overlay .scrim{background-color:#fff;height:100%;opacity:.9;position:absolute;width:100%;z-index:2000000}.wp-lightbox-overlay.active{animation:turn-on-visibility .25s both;visibility:visible}.wp-lightbox-overlay.active img{animation:turn-on-visibility .35s both}.wp-lightbox-overlay.show-closing-animation:not(.active){animation:turn-off-visibility .35s both}.wp-lightbox-overlay.show-closing-animation:not(.active) img{animation:turn-off-visibility .25s both}@media (prefers-reduced-motion:no-preference){.wp-lightbox-overlay.zoom.active{animation:none;opacity:1;visibility:visible}.wp-lightbox-overlay.zoom.active .lightbox-image-container{animation:lightbox-zoom-in .4s}.wp-lightbox-overlay.zoom.active .lightbox-image-container img{animation:none}.wp-lightbox-overlay.zoom.active .scrim{animation:turn-on-visibility .4s forwards}.wp-lightbox-overlay.zoom.show-closing-animation:not(.active){animation:none}.wp-lightbox-overlay.zoom.show-closing-animation:not(.active) .lightbox-image-container{animation:lightbox-zoom-out .4s}.wp-lightbox-overlay.zoom.show-closing-animation:not(.active) .lightbox-image-container img{animation:none}.wp-lightbox-overlay.zoom.show-closing-animation:not(.active) .scrim{animation:turn-off-visibility .4s forwards}}@keyframes turn-on-visibility{0%{opacity:0}to{opacity:1}}@keyframes turn-off-visibility{0%{opacity:1;visibility:visible}99%{opacity:0;visibility:visible}to{opacity:0;visibility:hidden}}@keyframes lightbox-zoom-in{0%{transform:translate(calc((-100vw + var(--wp--lightbox-scrollbar-width))/2 + var(--wp--lightbox-initial-left-position)),calc(-50vh + var(--wp--lightbox-initial-top-position))) scale(var(--wp--lightbox-scale))}to{transform:translate(-50%,-50%) scale(1)}}@keyframes lightbox-zoom-out{0%{transform:translate(-50%,-50%) scale(1);visibility:visible}99%{visibility:visible}to{transform:translate(calc((-100vw + var(--wp--lightbox-scrollbar-width))/2 + var(--wp--lightbox-initial-left-position)),calc(-50vh + var(--wp--lightbox-initial-top-position))) scale(var(--wp--lightbox-scale));visibility:hidden}}ol.wp-block-latest-comments{box-sizing:border-box;margin-left:0}:where(.wp-block-latest-comments:not([style*=line-height] .wp-block-latest-comments__comment)){line-height:1.1}:where(.wp-block-latest-comments:not([style*=line-height] .wp-block-latest-comments__comment-excerpt p)){line-height:1.8}.has-dates :where(.wp-block-latest-comments:not([style*=line-height])),.has-excerpts :where(.wp-block-latest-comments:not([style*=line-height])){line-height:1.5}.wp-block-latest-comments .wp-block-latest-comments{padding-left:0}.wp-block-latest-comments__comment{list-style:none;margin-bottom:1em}.has-avatars .wp-block-latest-comments__comment{list-style:none;min-height:2.25em}.has-avatars .wp-block-latest-comments__comment .wp-block-latest-comments__comment-excerpt,.has-avatars .wp-block-latest-comments__comment .wp-block-latest-comments__comment-meta{margin-left:3.25em}.wp-block-latest-comments__comment-excerpt p{font-size:.875em;margin:.36em 0 1.4em}.wp-block-latest-comments__comment-date{display:block;font-size:.75em}.wp-block-latest-comments .avatar,.wp-block-latest-comments__comment-avatar{border-radius:1.5em;display:block;float:left;height:2.5em;margin-right:.75em;width:2.5em}.wp-block-latest-comments[class*=-font-size] a,.wp-block-latest-comments[style*=font-size] a{font-size:inherit}.wp-block-latest-posts{box-sizing:border-box}.wp-block-latest-posts.alignleft{margin-right:2em}.wp-block-latest-posts.alignright{margin-left:2em}.wp-block-latest-posts.wp-block-latest-posts__list{list-style:none;padding-left:0}.wp-block-latest-posts.wp-block-latest-posts__list li{clear:both}.wp-block-latest-posts.is-grid{display:flex;flex-wrap:wrap;padding:0}.wp-block-latest-posts.is-grid li{margin:0 1.25em 1.25em 0;width:100%}@media (min-width:600px){.wp-block-latest-posts.columns-2 li{width:calc(50% - .625em)}.wp-block-latest-posts.columns-2 li:nth-child(2n){margin-right:0}.wp-block-latest-posts.columns-3 li{width:calc(33.33333% - .83333em)}.wp-block-latest-posts.columns-3 li:nth-child(3n){margin-right:0}.wp-block-latest-posts.columns-4 li{width:calc(25% - .9375em)}.wp-block-latest-posts.columns-4 li:nth-child(4n){margin-right:0}.wp-block-latest-posts.columns-5 li{width:calc(20% - 1em)}.wp-block-latest-posts.columns-5 li:nth-child(5n){margin-right:0}.wp-block-latest-posts.columns-6 li{width:calc(16.66667% - 1.04167em)}.wp-block-latest-posts.columns-6 li:nth-child(6n){margin-right:0}}.wp-block-latest-posts__post-author,.wp-block-latest-posts__post-date{display:block;font-size:.8125em}.wp-block-latest-posts__post-excerpt{margin-bottom:1em;margin-top:.5em}.wp-block-latest-posts__featured-image a{display:inline-block}.wp-block-latest-posts__featured-image img{height:auto;max-width:100%;width:auto}.wp-block-latest-posts__featured-image.alignleft{float:left;margin-right:1em}.wp-block-latest-posts__featured-image.alignright{float:right;margin-left:1em}.wp-block-latest-posts__featured-image.aligncenter{margin-bottom:1em;text-align:center}ol,ul{box-sizing:border-box}ol.has-background,ul.has-background{padding:1.25em 2.375em}.wp-block-media-text{box-sizing:border-box;direction:ltr;display:grid;grid-template-columns:50% 1fr;grid-template-rows:auto}.wp-block-media-text.has-media-on-the-right{grid-template-columns:1fr 50%}.wp-block-media-text.is-vertically-aligned-top .wp-block-media-text__content,.wp-block-media-text.is-vertically-aligned-top .wp-block-media-text__media{align-self:start}.wp-block-media-text .wp-block-media-text__content,.wp-block-media-text .wp-block-media-text__media,.wp-block-media-text.is-vertically-aligned-center .wp-block-media-text__content,.wp-block-media-text.is-vertically-aligned-center .wp-block-media-text__media{align-self:center}.wp-block-media-text.is-vertically-aligned-bottom .wp-block-media-text__content,.wp-block-media-text.is-vertically-aligned-bottom .wp-block-media-text__media{align-self:end}.wp-block-media-text .wp-block-media-text__media{grid-column:1;grid-row:1;margin:0}.wp-block-media-text .wp-block-media-text__content{direction:ltr;grid-column:2;grid-row:1;padding:0 8%;word-break:break-word}.wp-block-media-text.has-media-on-the-right .wp-block-media-text__media{grid-column:2;grid-row:1}.wp-block-media-text.has-media-on-the-right .wp-block-media-text__content{grid-column:1;grid-row:1}.wp-block-media-text__media img,.wp-block-media-text__media video{height:auto;max-width:unset;vertical-align:middle;width:100%}.wp-block-media-text.is-image-fill .wp-block-media-text__media{background-size:cover;height:100%;min-height:250px}.wp-block-media-text.is-image-fill .wp-block-media-text__media>a{display:block;height:100%}.wp-block-media-text.is-image-fill .wp-block-media-text__media img{height:1px;margin:-1px;overflow:hidden;padding:0;position:absolute;width:1px;clip:rect(0,0,0,0);border:0}@media (max-width:600px){.wp-block-media-text.is-stacked-on-mobile{grid-template-columns:100%!important}.wp-block-media-text.is-stacked-on-mobile .wp-block-media-text__media{grid-column:1;grid-row:1}.wp-block-media-text.is-stacked-on-mobile .wp-block-media-text__content{grid-column:1;grid-row:2}}.wp-block-navigation{position:relative;--navigation-layout-justification-setting:flex-start;--navigation-layout-direction:row;--navigation-layout-wrap:wrap;--navigation-layout-justify:flex-start;--navigation-layout-align:center}.wp-block-navigation ul{margin-bottom:0;margin-left:0;margin-top:0;padding-left:0}.wp-block-navigation ul,.wp-block-navigation ul li{list-style:none;padding:0}.wp-block-navigation .wp-block-navigation-item{align-items:center;display:flex;position:relative}.wp-block-navigation .wp-block-navigation-item .wp-block-navigation__submenu-container:empty{display:none}.wp-block-navigation .wp-block-navigation-item__content{display:block}.wp-block-navigation .wp-block-navigation-item__content.wp-block-navigation-item__content{color:inherit}.wp-block-navigation.has-text-decoration-underline .wp-block-navigation-item__content,.wp-block-navigation.has-text-decoration-underline .wp-block-navigation-item__content:active,.wp-block-navigation.has-text-decoration-underline .wp-block-navigation-item__content:focus{text-decoration:underline}.wp-block-navigation.has-text-decoration-line-through .wp-block-navigation-item__content,.wp-block-navigation.has-text-decoration-line-through .wp-block-navigation-item__content:active,.wp-block-navigation.has-text-decoration-line-through .wp-block-navigation-item__content:focus{text-decoration:line-through}.wp-block-navigation:where(:not([class*=has-text-decoration])) a{text-decoration:none}.wp-block-navigation:where(:not([class*=has-text-decoration])) a:active,.wp-block-navigation:where(:not([class*=has-text-decoration])) a:focus{text-decoration:none}.wp-block-navigation .wp-block-navigation__submenu-icon{align-self:center;background-color:inherit;border:none;color:currentColor;display:inline-block;font-size:inherit;height:.6em;line-height:0;margin-left:.25em;padding:0;width:.6em}.wp-block-navigation .wp-block-navigation__submenu-icon svg{display:inline-block;stroke:currentColor;height:inherit;margin-top:.075em;width:inherit}.wp-block-navigation.is-vertical{--navigation-layout-direction:column;--navigation-layout-justify:initial;--navigation-layout-align:flex-start}.wp-block-navigation.no-wrap{--navigation-layout-wrap:nowrap}.wp-block-navigation.items-justified-center{--navigation-layout-justification-setting:center;--navigation-layout-justify:center}.wp-block-navigation.items-justified-center.is-vertical{--navigation-layout-align:center}.wp-block-navigation.items-justified-right{--navigation-layout-justification-setting:flex-end;--navigation-layout-justify:flex-end}.wp-block-navigation.items-justified-right.is-vertical{--navigation-layout-align:flex-end}.wp-block-navigation.items-justified-space-between{--navigation-layout-justification-setting:space-between;--navigation-layout-justify:space-between}.wp-block-navigation .has-child .wp-block-navigation__submenu-container{align-items:normal;background-color:inherit;color:inherit;display:flex;flex-direction:column;height:0;left:-1px;opacity:0;overflow:hidden;position:absolute;top:100%;transition:opacity .1s linear;visibility:hidden;width:0;z-index:2}.wp-block-navigation .has-child .wp-block-navigation__submenu-container>.wp-block-navigation-item>.wp-block-navigation-item__content{display:flex;flex-grow:1}.wp-block-navigation .has-child .wp-block-navigation__submenu-container>.wp-block-navigation-item>.wp-block-navigation-item__content .wp-block-navigation__submenu-icon{margin-left:auto;margin-right:0}.wp-block-navigation .has-child .wp-block-navigation__submenu-container .wp-block-navigation-item__content{margin:0}@media (min-width:782px){.wp-block-navigation .has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container{left:100%;top:-1px}.wp-block-navigation .has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container:before{background:#0000;content:"";display:block;height:100%;position:absolute;right:100%;width:.5em}.wp-block-navigation .has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-icon{margin-right:.25em}.wp-block-navigation .has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-icon svg{transform:rotate(-90deg)}}.wp-block-navigation .has-child .wp-block-navigation-submenu__toggle[aria-expanded=true]~.wp-block-navigation__submenu-container,.wp-block-navigation .has-child:not(.open-on-click):hover>.wp-block-navigation__submenu-container,.wp-block-navigation .has-child:not(.open-on-click):not(.open-on-hover-click):focus-within>.wp-block-navigation__submenu-container{height:auto;min-width:200px;opacity:1;overflow:visible;visibility:visible;width:auto}.wp-block-navigation.has-background .has-child .wp-block-navigation__submenu-container{left:0;top:100%}@media (min-width:782px){.wp-block-navigation.has-background .has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container{left:100%;top:0}}.wp-block-navigation-submenu{display:flex;position:relative}.wp-block-navigation-submenu .wp-block-navigation__submenu-icon svg{stroke:currentColor}button.wp-block-navigation-item__content{background-color:initial;border:none;color:currentColor;font-family:inherit;font-size:inherit;font-style:inherit;font-weight:inherit;line-height:inherit;text-align:left;text-transform:inherit}.wp-block-navigation-submenu__toggle{cursor:pointer}.wp-block-navigation-item.open-on-click .wp-block-navigation-submenu__toggle{padding-left:0;padding-right:.85em}.wp-block-navigation-item.open-on-click .wp-block-navigation-submenu__toggle+.wp-block-navigation__submenu-icon{margin-left:-.6em;pointer-events:none}.wp-block-navigation-item.open-on-click button.wp-block-navigation-item__content:not(.wp-block-navigation-submenu__toggle){padding:0}.wp-block-navigation .wp-block-page-list,.wp-block-navigation__container,.wp-block-navigation__responsive-close,.wp-block-navigation__responsive-container,.wp-block-navigation__responsive-container-content,.wp-block-navigation__responsive-dialog{gap:inherit}:where(.wp-block-navigation.has-background .wp-block-navigation-item a:not(.wp-element-button)),:where(.wp-block-navigation.has-background .wp-block-navigation-submenu a:not(.wp-element-button)){padding:.5em 1em}:where(.wp-block-navigation .wp-block-navigation__submenu-container .wp-block-navigation-item a:not(.wp-element-button)),:where(.wp-block-navigation .wp-block-navigation__submenu-container .wp-block-navigation-submenu a:not(.wp-element-button)),:where(.wp-block-navigation .wp-block-navigation__submenu-container .wp-block-navigation-submenu button.wp-block-navigation-item__content),:where(.wp-block-navigation .wp-block-navigation__submenu-container .wp-block-pages-list__item button.wp-block-navigation-item__content){padding:.5em 1em}.wp-block-navigation.items-justified-right .wp-block-navigation__container .has-child .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-right .wp-block-page-list>.has-child .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-space-between .wp-block-page-list>.has-child:last-child .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-space-between>.wp-block-navigation__container>.has-child:last-child .wp-block-navigation__submenu-container{left:auto;right:0}.wp-block-navigation.items-justified-right .wp-block-navigation__container .has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-right .wp-block-page-list>.has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-space-between .wp-block-page-list>.has-child:last-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-space-between>.wp-block-navigation__container>.has-child:last-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container{left:-1px;right:-1px}@media (min-width:782px){.wp-block-navigation.items-justified-right .wp-block-navigation__container .has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-right .wp-block-page-list>.has-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-space-between .wp-block-page-list>.has-child:last-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container,.wp-block-navigation.items-justified-space-between>.wp-block-navigation__container>.has-child:last-child .wp-block-navigation__submenu-container .wp-block-navigation__submenu-container{left:auto;right:100%}}.wp-block-navigation:not(.has-background) .wp-block-navigation__submenu-container{background-color:#fff;border:1px solid #00000026}.wp-block-navigation.has-background .wp-block-navigation__submenu-container{background-color:inherit}.wp-block-navigation:not(.has-text-color) .wp-block-navigation__submenu-container{color:#000}.wp-block-navigation__container{align-items:var(--navigation-layout-align,initial);display:flex;flex-direction:var(--navigation-layout-direction,initial);flex-wrap:var(--navigation-layout-wrap,wrap);justify-content:var(--navigation-layout-justify,initial);list-style:none;margin:0;padding-left:0}.wp-block-navigation__container .is-responsive{display:none}.wp-block-navigation__container:only-child,.wp-block-page-list:only-child{flex-grow:1}@keyframes overlay-menu__fade-in-animation{0%{opacity:0;transform:translateY(.5em)}to{opacity:1;transform:translateY(0)}}.wp-block-navigation__responsive-container{bottom:0;display:none;left:0;position:fixed;right:0;top:0}.wp-block-navigation__responsive-container :where(.wp-block-navigation-item a){color:inherit}.wp-block-navigation__responsive-container .wp-block-navigation__responsive-container-content{align-items:var(--navigation-layout-align,initial);display:flex;flex-direction:var(--navigation-layout-direction,initial);flex-wrap:var(--navigation-layout-wrap,wrap);justify-content:var(--navigation-layout-justify,initial)}.wp-block-navigation__responsive-container:not(.is-menu-open.is-menu-open){background-color:inherit!important;color:inherit!important}.wp-block-navigation__responsive-container.is-menu-open{animation:overlay-menu__fade-in-animation .1s ease-out;animation-fill-mode:forwards;background-color:inherit;display:flex;flex-direction:column;overflow:auto;padding:clamp(1rem,var(--wp--style--root--padding-top),20rem) clamp(1rem,var(--wp--style--root--padding-right),20rem) clamp(1rem,var(--wp--style--root--padding-bottom),20rem) clamp(1rem,var(--wp--style--root--padding-left),20em);z-index:100000}@media (prefers-reduced-motion:reduce){.wp-block-navigation__responsive-container.is-menu-open{animation-delay:0s;animation-duration:1ms}}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content{align-items:var(--navigation-layout-justification-setting,inherit);display:flex;flex-direction:column;flex-wrap:nowrap;overflow:visible;padding-top:calc(2rem + 24px)}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content,.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-navigation__container,.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-page-list{justify-content:flex-start}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-navigation__submenu-icon{display:none}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .has-child .wp-block-navigation__submenu-container{border:none;height:auto;min-width:200px;opacity:1;overflow:initial;padding-left:2rem;padding-right:2rem;position:static;visibility:visible;width:auto}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-navigation__container,.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-navigation__submenu-container{gap:inherit}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-navigation__submenu-container{padding-top:var(--wp--style--block-gap,2em)}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-navigation-item__content{padding:0}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-navigation-item,.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-navigation__container,.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__responsive-container-content .wp-block-page-list{align-items:var(--navigation-layout-justification-setting,initial);display:flex;flex-direction:column}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation-item,.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation-item .wp-block-navigation__submenu-container,.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__container,.wp-block-navigation__responsive-container.is-menu-open .wp-block-page-list{background:#0000!important;color:inherit!important}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__submenu-container.wp-block-navigation__submenu-container.wp-block-navigation__submenu-container.wp-block-navigation__submenu-container{left:auto;right:auto}@media (min-width:600px){.wp-block-navigation__responsive-container:not(.hidden-by-default):not(.is-menu-open){background-color:inherit;display:block;position:relative;width:100%;z-index:auto}.wp-block-navigation__responsive-container:not(.hidden-by-default):not(.is-menu-open) .wp-block-navigation__responsive-container-close{display:none}.wp-block-navigation__responsive-container.is-menu-open .wp-block-navigation__submenu-container.wp-block-navigation__submenu-container.wp-block-navigation__submenu-container.wp-block-navigation__submenu-container{left:0}}.wp-block-navigation:not(.has-background) .wp-block-navigation__responsive-container.is-menu-open{background-color:#fff}.wp-block-navigation:not(.has-text-color) .wp-block-navigation__responsive-container.is-menu-open{color:#000}.wp-block-navigation__toggle_button_label{font-size:1rem;font-weight:700}.wp-block-navigation__responsive-container-close,.wp-block-navigation__responsive-container-open{background:#0000;border:none;color:currentColor;cursor:pointer;margin:0;padding:0;text-transform:inherit;vertical-align:middle}.wp-block-navigation__responsive-container-close svg,.wp-block-navigation__responsive-container-open svg{fill:currentColor;display:block;height:24px;pointer-events:none;width:24px}.wp-block-navigation__responsive-container-open{display:flex}.wp-block-navigation__responsive-container-open.wp-block-navigation__responsive-container-open.wp-block-navigation__responsive-container-open{font-family:inherit;font-size:inherit;font-weight:inherit}@media (min-width:600px){.wp-block-navigation__responsive-container-open:not(.always-shown){display:none}}.wp-block-navigation__responsive-container-close{position:absolute;right:0;top:0;z-index:2}.wp-block-navigation__responsive-container-close.wp-block-navigation__responsive-container-close.wp-block-navigation__responsive-container-close{font-family:inherit;font-size:inherit;font-weight:inherit}.wp-block-navigation__responsive-close{width:100%}.has-modal-open .wp-block-navigation__responsive-close{margin-left:auto;margin-right:auto;max-width:var(--wp--style--global--wide-size,100%)}.wp-block-navigation__responsive-close:focus{outline:none}.is-menu-open .wp-block-navigation__responsive-close,.is-menu-open .wp-block-navigation__responsive-container-content,.is-menu-open .wp-block-navigation__responsive-dialog{box-sizing:border-box}.wp-block-navigation__responsive-dialog{position:relative}.has-modal-open .admin-bar .is-menu-open .wp-block-navigation__responsive-dialog{margin-top:46px}@media (min-width:782px){.has-modal-open .admin-bar .is-menu-open .wp-block-navigation__responsive-dialog{margin-top:32px}}html.has-modal-open{overflow:hidden}.wp-block-navigation .wp-block-navigation-item__label{overflow-wrap:break-word}.wp-block-navigation .wp-block-navigation-item__description{display:none}.link-ui-tools{border-top:1px solid #f0f0f0;padding:8px}.link-ui-block-inserter{padding-top:8px}.link-ui-block-inserter__back{margin-left:8px;text-transform:uppercase}.components-popover-pointer-events-trap{background-color:initial;cursor:pointer;inset:0;position:fixed;z-index:1000000}.wp-block-navigation .wp-block-page-list{align-items:var(--navigation-layout-align,initial);background-color:inherit;display:flex;flex-direction:var(--navigation-layout-direction,initial);flex-wrap:var(--navigation-layout-wrap,wrap);justify-content:var(--navigation-layout-justify,initial)}.wp-block-navigation .wp-block-navigation-item{background-color:inherit}.is-small-text{font-size:.875em}.is-regular-text{font-size:1em}.is-large-text{font-size:2.25em}.is-larger-text{font-size:3em}.has-drop-cap:not(:focus):first-letter {float:left;font-size:8.4em;font-style:normal;font-weight:100;line-height:.68;margin:.05em .1em 0 0;text-transform:uppercase}body.rtl .has-drop-cap:not(:focus):first-letter {float:none;margin-left:.1em}p.has-drop-cap.has-background{overflow:hidden}p.has-background{padding:1.25em 2.375em}:where(p.has-text-color:not(.has-link-color)) a{color:inherit}p.has-text-align-left[style*="writing-mode:vertical-lr"],p.has-text-align-right[style*="writing-mode:vertical-rl"]{rotate:180deg}.wp-block-post-author{display:flex;flex-wrap:wrap}.wp-block-post-author__byline{font-size:.5em;margin-bottom:0;margin-top:0;width:100%}.wp-block-post-author__avatar{margin-right:1em}.wp-block-post-author__bio{font-size:.7em;margin-bottom:.7em}.wp-block-post-author__content{flex-basis:0;flex-grow:1}.wp-block-post-author__name{margin:0}.wp-block-post-comments-form{box-sizing:border-box}.wp-block-post-comments-form[style*=font-weight] :where(.comment-reply-title){font-weight:inherit}.wp-block-post-comments-form[style*=font-family] :where(.comment-reply-title){font-family:inherit}.wp-block-post-comments-form[class*=-font-size] :where(.comment-reply-title),.wp-block-post-comments-form[style*=font-size] :where(.comment-reply-title){font-size:inherit}.wp-block-post-comments-form[style*=line-height] :where(.comment-reply-title){line-height:inherit}.wp-block-post-comments-form[style*=font-style] :where(.comment-reply-title){font-style:inherit}.wp-block-post-comments-form[style*=letter-spacing] :where(.comment-reply-title){letter-spacing:inherit}.wp-block-post-comments-form input[type=submit]{box-shadow:none;cursor:pointer;display:inline-block;overflow-wrap:break-word;text-align:center}.wp-block-post-comments-form input:not([type=submit]),.wp-block-post-comments-form textarea{border:1px solid #949494;font-family:inherit;font-size:1em}.wp-block-post-comments-form input:not([type=submit]):not([type=checkbox]),.wp-block-post-comments-form textarea{padding:calc(.667em + 2px)}.wp-block-post-comments-form .comment-form input:not([type=submit]):not([type=checkbox]):not([type=hidden]),.wp-block-post-comments-form .comment-form textarea{box-sizing:border-box;display:block;width:100%}.wp-block-post-comments-form .comment-form-author label,.wp-block-post-comments-form .comment-form-email label,.wp-block-post-comments-form .comment-form-url label{display:block;margin-bottom:.25em}.wp-block-post-comments-form .comment-form-cookies-consent{display:flex;gap:.25em}.wp-block-post-comments-form .comment-form-cookies-consent #wp-comment-cookies-consent{margin-top:.35em}.wp-block-post-comments-form .comment-reply-title{margin-bottom:0}.wp-block-post-comments-form .comment-reply-title :where(small){font-size:var(--wp--preset--font-size--medium,smaller);margin-left:.5em}.wp-block-post-date{box-sizing:border-box}:where(.wp-block-post-excerpt){margin-bottom:var(--wp--style--block-gap);margin-top:var(--wp--style--block-gap)}.wp-block-post-excerpt__excerpt{margin-bottom:0;margin-top:0}.wp-block-post-excerpt__more-text{margin-bottom:0;margin-top:var(--wp--style--block-gap)}.wp-block-post-excerpt__more-link{display:inline-block}.wp-block-post-featured-image{margin-left:0;margin-right:0}.wp-block-post-featured-image a{display:block;height:100%}.wp-block-post-featured-image img{box-sizing:border-box;height:auto;max-width:100%;vertical-align:bottom;width:100%}.wp-block-post-featured-image.alignfull img,.wp-block-post-featured-image.alignwide img{width:100%}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim{background-color:#000;inset:0;position:absolute}.wp-block-post-featured-image{position:relative}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-gradient{background-color:initial}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-0{opacity:0}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-10{opacity:.1}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-20{opacity:.2}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-30{opacity:.3}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-40{opacity:.4}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-50{opacity:.5}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-60{opacity:.6}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-70{opacity:.7}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-80{opacity:.8}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-90{opacity:.9}.wp-block-post-featured-image .wp-block-post-featured-image__overlay.has-background-dim-100{opacity:1}.wp-block-post-featured-image:where(.alignleft,.alignright){width:100%}.wp-block-post-navigation-link .wp-block-post-navigation-link__arrow-previous{display:inline-block;margin-right:1ch}.wp-block-post-navigation-link .wp-block-post-navigation-link__arrow-previous:not(.is-arrow-chevron){transform:scaleX(1)}.wp-block-post-navigation-link .wp-block-post-navigation-link__arrow-next{display:inline-block;margin-left:1ch}.wp-block-post-navigation-link .wp-block-post-navigation-link__arrow-next:not(.is-arrow-chevron){transform:scaleX(1)}.wp-block-post-navigation-link.has-text-align-left[style*="writing-mode: vertical-lr"],.wp-block-post-navigation-link.has-text-align-right[style*="writing-mode: vertical-rl"]{rotate:180deg}.wp-block-post-terms{box-sizing:border-box}.wp-block-post-terms .wp-block-post-terms__separator{white-space:pre-wrap}.wp-block-post-time-to-read,.wp-block-post-title{box-sizing:border-box}.wp-block-post-title{word-break:break-word}.wp-block-post-title a{display:inline-block}.wp-block-preformatted{box-sizing:border-box;white-space:pre-wrap}:where(.wp-block-preformatted.has-background){padding:1.25em 2.375em}.wp-block-pullquote{box-sizing:border-box;overflow-wrap:break-word;padding:4em 0;text-align:center}.wp-block-pullquote blockquote,.wp-block-pullquote cite,.wp-block-pullquote p{color:inherit}.wp-block-pullquote blockquote{margin:0}.wp-block-pullquote p{margin-top:0}.wp-block-pullquote p:last-child{margin-bottom:0}.wp-block-pullquote.alignleft,.wp-block-pullquote.alignright{max-width:420px}.wp-block-pullquote cite,.wp-block-pullquote footer{position:relative}.wp-block-pullquote .has-text-color a{color:inherit}:where(.wp-block-pullquote){margin:0 0 1em}.wp-block-pullquote.has-text-align-left blockquote{text-align:left}.wp-block-pullquote.has-text-align-right blockquote{text-align:right}.wp-block-pullquote.is-style-solid-color{border:none}.wp-block-pullquote.is-style-solid-color blockquote{margin-left:auto;margin-right:auto;max-width:60%}.wp-block-pullquote.is-style-solid-color blockquote p{font-size:2em;margin-bottom:0;margin-top:0}.wp-block-pullquote.is-style-solid-color blockquote cite{font-style:normal;text-transform:none}.wp-block-pullquote cite{color:inherit}.wp-block-post-template{list-style:none;margin-bottom:0;margin-top:0;max-width:100%;padding:0}.wp-block-post-template.wp-block-post-template{background:none}.wp-block-post-template.is-flex-container{display:flex;flex-direction:row;flex-wrap:wrap;gap:1.25em}.wp-block-post-template.is-flex-container>li{margin:0;width:100%}@media (min-width:600px){.wp-block-post-template.is-flex-container.is-flex-container.columns-2>li{width:calc(50% - .625em)}.wp-block-post-template.is-flex-container.is-flex-container.columns-3>li{width:calc(33.33333% - .83333em)}.wp-block-post-template.is-flex-container.is-flex-container.columns-4>li{width:calc(25% - .9375em)}.wp-block-post-template.is-flex-container.is-flex-container.columns-5>li{width:calc(20% - 1em)}.wp-block-post-template.is-flex-container.is-flex-container.columns-6>li{width:calc(16.66667% - 1.04167em)}}@media (max-width:600px){.wp-block-post-template-is-layout-grid.wp-block-post-template-is-layout-grid.wp-block-post-template-is-layout-grid.wp-block-post-template-is-layout-grid{grid-template-columns:1fr}}.wp-block-post-template-is-layout-constrained>li>.alignright,.wp-block-post-template-is-layout-flow>li>.alignright{float:right;margin-inline-end:0;margin-inline-start:2em}.wp-block-post-template-is-layout-constrained>li>.alignleft,.wp-block-post-template-is-layout-flow>li>.alignleft{float:left;margin-inline-end:2em;margin-inline-start:0}.wp-block-post-template-is-layout-constrained>li>.aligncenter,.wp-block-post-template-is-layout-flow>li>.aligncenter{margin-inline-end:auto;margin-inline-start:auto}.wp-block-query-pagination>.wp-block-query-pagination-next,.wp-block-query-pagination>.wp-block-query-pagination-numbers,.wp-block-query-pagination>.wp-block-query-pagination-previous{margin-bottom:.5em;margin-right:.5em}.wp-block-query-pagination>.wp-block-query-pagination-next:last-child,.wp-block-query-pagination>.wp-block-query-pagination-numbers:last-child,.wp-block-query-pagination>.wp-block-query-pagination-previous:last-child{margin-right:0}.wp-block-query-pagination.is-content-justification-space-between>.wp-block-query-pagination-next:last-of-type{margin-inline-start:auto}.wp-block-query-pagination.is-content-justification-space-between>.wp-block-query-pagination-previous:first-child{margin-inline-end:auto}.wp-block-query-pagination .wp-block-query-pagination-previous-arrow{display:inline-block;margin-right:1ch}.wp-block-query-pagination .wp-block-query-pagination-previous-arrow:not(.is-arrow-chevron){transform:scaleX(1)}.wp-block-query-pagination .wp-block-query-pagination-next-arrow{display:inline-block;margin-left:1ch}.wp-block-query-pagination .wp-block-query-pagination-next-arrow:not(.is-arrow-chevron){transform:scaleX(1)}.wp-block-query-pagination.aligncenter{justify-content:center}.wp-block-query-title,.wp-block-quote{box-sizing:border-box}.wp-block-quote{overflow-wrap:break-word}.wp-block-quote.is-large:where(:not(.is-style-plain)),.wp-block-quote.is-style-large:where(:not(.is-style-plain)){margin-bottom:1em;padding:0 1em}.wp-block-quote.is-large:where(:not(.is-style-plain)) p,.wp-block-quote.is-style-large:where(:not(.is-style-plain)) p{font-size:1.5em;font-style:italic;line-height:1.6}.wp-block-quote.is-large:where(:not(.is-style-plain)) cite,.wp-block-quote.is-large:where(:not(.is-style-plain)) footer,.wp-block-quote.is-style-large:where(:not(.is-style-plain)) cite,.wp-block-quote.is-style-large:where(:not(.is-style-plain)) footer{font-size:1.125em;text-align:right}.wp-block-quote>cite{display:block}.wp-block-read-more{display:block;width:-moz-fit-content;width:fit-content}.wp-block-read-more:where(:not([style*=text-decoration])){text-decoration:none}.wp-block-read-more:where(:not([style*=text-decoration])):active,.wp-block-read-more:where(:not([style*=text-decoration])):focus{text-decoration:none}ul.wp-block-rss{list-style:none;padding:0}ul.wp-block-rss.wp-block-rss{box-sizing:border-box}ul.wp-block-rss.alignleft{margin-right:2em}ul.wp-block-rss.alignright{margin-left:2em}ul.wp-block-rss.is-grid{display:flex;flex-wrap:wrap;list-style:none;padding:0}ul.wp-block-rss.is-grid li{margin:0 1em 1em 0;width:100%}@media (min-width:600px){ul.wp-block-rss.columns-2 li{width:calc(50% - 1em)}ul.wp-block-rss.columns-3 li{width:calc(33.33333% - 1em)}ul.wp-block-rss.columns-4 li{width:calc(25% - 1em)}ul.wp-block-rss.columns-5 li{width:calc(20% - 1em)}ul.wp-block-rss.columns-6 li{width:calc(16.66667% - 1em)}}.wp-block-rss__item-author,.wp-block-rss__item-publish-date{display:block;font-size:.8125em}.wp-block-search__button{margin-left:10px;word-break:normal}.wp-block-search__button.has-icon{line-height:0}.wp-block-search__button svg{height:1.25em;min-height:24px;min-width:24px;width:1.25em;fill:currentColor;vertical-align:text-bottom}:where(.wp-block-search__button){border:1px solid #ccc;padding:6px 10px}.wp-block-search__inside-wrapper{display:flex;flex:auto;flex-wrap:nowrap;max-width:100%}.wp-block-search__label{width:100%}.wp-block-search__input{-webkit-appearance:initial;appearance:none;border:1px solid #949494;flex-grow:1;margin-left:0;margin-right:0;min-width:3rem;padding:8px;text-decoration:unset!important}.wp-block-search.wp-block-search__button-only .wp-block-search__button{flex-shrink:0;margin-left:0;max-width:100%}.wp-block-search.wp-block-search__button-only .wp-block-search__button[aria-expanded=true]{max-width:calc(100% - 100px)}.wp-block-search.wp-block-search__button-only .wp-block-search__inside-wrapper{min-width:0!important;transition-property:width}.wp-block-search.wp-block-search__button-only .wp-block-search__input{flex-basis:100%;transition-duration:.3s}.wp-block-search.wp-block-search__button-only.wp-block-search__searchfield-hidden,.wp-block-search.wp-block-search__button-only.wp-block-search__searchfield-hidden .wp-block-search__inside-wrapper{overflow:hidden}.wp-block-search.wp-block-search__button-only.wp-block-search__searchfield-hidden .wp-block-search__input{border-left-width:0!important;border-right-width:0!important;flex-basis:0;flex-grow:0;margin:0;min-width:0!important;padding-left:0!important;padding-right:0!important;width:0!important}:where(.wp-block-search__button-inside .wp-block-search__inside-wrapper){border:1px solid #949494;box-sizing:border-box;padding:4px}:where(.wp-block-search__button-inside .wp-block-search__inside-wrapper) .wp-block-search__input{border:none;border-radius:0;padding:0 4px}:where(.wp-block-search__button-inside .wp-block-search__inside-wrapper) .wp-block-search__input:focus{outline:none}:where(.wp-block-search__button-inside .wp-block-search__inside-wrapper) :where(.wp-block-search__button){padding:4px 8px}.wp-block-search.aligncenter .wp-block-search__inside-wrapper{margin:auto}.wp-block[data-align=right] .wp-block-search.wp-block-search__button-only .wp-block-search__inside-wrapper{float:right}.wp-block-separator{border:none;border-top:2px solid}.wp-block-separator.is-style-dots{background:none!important;border:none;height:auto;line-height:1;text-align:center}.wp-block-separator.is-style-dots:before{color:currentColor;content:"···";font-family:serif;font-size:1.5em;letter-spacing:2em;padding-left:2em}.wp-block-site-logo{box-sizing:border-box;line-height:0}.wp-block-site-logo a{display:inline-block;line-height:0}.wp-block-site-logo.is-default-size img{height:auto;width:120px}.wp-block-site-logo img{height:auto;max-width:100%}.wp-block-site-logo a,.wp-block-site-logo img{border-radius:inherit}.wp-block-site-logo.aligncenter{margin-left:auto;margin-right:auto;text-align:center}.wp-block-site-logo.is-style-rounded{border-radius:9999px}.wp-block-site-title a{color:inherit}.wp-block-social-links{background:none;box-sizing:border-box;margin-left:0;padding-left:0;padding-right:0;text-indent:0}.wp-block-social-links .wp-social-link a,.wp-block-social-links .wp-social-link a:hover{border-bottom:0;box-shadow:none;text-decoration:none}.wp-block-social-links .wp-social-link a{padding:.25em}.wp-block-social-links .wp-social-link svg{height:1em;width:1em}.wp-block-social-links .wp-social-link span:not(.screen-reader-text){font-size:.65em;margin-left:.5em;margin-right:.5em}.wp-block-social-links.has-small-icon-size{font-size:16px}.wp-block-social-links,.wp-block-social-links.has-normal-icon-size{font-size:24px}.wp-block-social-links.has-large-icon-size{font-size:36px}.wp-block-social-links.has-huge-icon-size{font-size:48px}.wp-block-social-links.aligncenter{display:flex;justify-content:center}.wp-block-social-links.alignright{justify-content:flex-end}.wp-block-social-link{border-radius:9999px;display:block;height:auto;transition:transform .1s ease}@media (prefers-reduced-motion:reduce){.wp-block-social-link{transition-delay:0s;transition-duration:0s}}.wp-block-social-link a{align-items:center;display:flex;line-height:0;transition:transform .1s ease}.wp-block-social-link:hover{transform:scale(1.1)}.wp-block-social-links .wp-block-social-link.wp-social-link{display:inline-block;margin:0;padding:0}.wp-block-social-links .wp-block-social-link.wp-social-link .wp-block-social-link-anchor,.wp-block-social-links .wp-block-social-link.wp-social-link .wp-block-social-link-anchor svg,.wp-block-social-links .wp-block-social-link.wp-social-link .wp-block-social-link-anchor:active,.wp-block-social-links .wp-block-social-link.wp-social-link .wp-block-social-link-anchor:hover,.wp-block-social-links .wp-block-social-link.wp-social-link .wp-block-social-link-anchor:visited{color:currentColor;fill:currentColor}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link{background-color:#f0f0f0;color:#444}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-amazon{background-color:#f90;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-bandcamp{background-color:#1ea0c3;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-behance{background-color:#0757fe;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-codepen{background-color:#1e1f26;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-deviantart{background-color:#02e49b;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-dribbble{background-color:#e94c89;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-dropbox{background-color:#4280ff;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-etsy{background-color:#f45800;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-facebook{background-color:#1778f2;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-fivehundredpx{background-color:#000;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-flickr{background-color:#0461dd;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-foursquare{background-color:#e65678;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-github{background-color:#24292d;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-goodreads{background-color:#eceadd;color:#382110}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-google{background-color:#ea4434;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-gravatar{background-color:#1d4fc4;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-instagram{background-color:#f00075;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-lastfm{background-color:#e21b24;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-linkedin{background-color:#0d66c2;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-mastodon{background-color:#3288d4;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-medium{background-color:#02ab6c;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-meetup{background-color:#f6405f;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-patreon{background-color:#000;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-pinterest{background-color:#e60122;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-pocket{background-color:#ef4155;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-reddit{background-color:#ff4500;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-skype{background-color:#0478d7;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-snapchat{background-color:#fefc00;color:#fff;stroke:#000}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-soundcloud{background-color:#ff5600;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-spotify{background-color:#1bd760;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-telegram{background-color:#2aabee;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-threads,.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-tiktok{background-color:#000;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-tumblr{background-color:#011835;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-twitch{background-color:#6440a4;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-twitter{background-color:#1da1f2;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-vimeo{background-color:#1eb7ea;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-vk{background-color:#4680c2;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-wordpress{background-color:#3499cd;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-whatsapp{background-color:#25d366;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-x{background-color:#000;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-yelp{background-color:#d32422;color:#fff}.wp-block-social-links:not(.is-style-logos-only) .wp-social-link-youtube{background-color:red;color:#fff}.wp-block-social-links.is-style-logos-only .wp-social-link{background:none}.wp-block-social-links.is-style-logos-only .wp-social-link a{padding:0}.wp-block-social-links.is-style-logos-only .wp-social-link svg{height:1.25em;width:1.25em}.wp-block-social-links.is-style-logos-only .wp-social-link-amazon{color:#f90}.wp-block-social-links.is-style-logos-only .wp-social-link-bandcamp{color:#1ea0c3}.wp-block-social-links.is-style-logos-only .wp-social-link-behance{color:#0757fe}.wp-block-social-links.is-style-logos-only .wp-social-link-codepen{color:#1e1f26}.wp-block-social-links.is-style-logos-only .wp-social-link-deviantart{color:#02e49b}.wp-block-social-links.is-style-logos-only .wp-social-link-dribbble{color:#e94c89}.wp-block-social-links.is-style-logos-only .wp-social-link-dropbox{color:#4280ff}.wp-block-social-links.is-style-logos-only .wp-social-link-etsy{color:#f45800}.wp-block-social-links.is-style-logos-only .wp-social-link-facebook{color:#1778f2}.wp-block-social-links.is-style-logos-only .wp-social-link-fivehundredpx{color:#000}.wp-block-social-links.is-style-logos-only .wp-social-link-flickr{color:#0461dd}.wp-block-social-links.is-style-logos-only .wp-social-link-foursquare{color:#e65678}.wp-block-social-links.is-style-logos-only .wp-social-link-github{color:#24292d}.wp-block-social-links.is-style-logos-only .wp-social-link-goodreads{color:#382110}.wp-block-social-links.is-style-logos-only .wp-social-link-google{color:#ea4434}.wp-block-social-links.is-style-logos-only .wp-social-link-gravatar{color:#1d4fc4}.wp-block-social-links.is-style-logos-only .wp-social-link-instagram{color:#f00075}.wp-block-social-links.is-style-logos-only .wp-social-link-lastfm{color:#e21b24}.wp-block-social-links.is-style-logos-only .wp-social-link-linkedin{color:#0d66c2}.wp-block-social-links.is-style-logos-only .wp-social-link-mastodon{color:#3288d4}.wp-block-social-links.is-style-logos-only .wp-social-link-medium{color:#02ab6c}.wp-block-social-links.is-style-logos-only .wp-social-link-meetup{color:#f6405f}.wp-block-social-links.is-style-logos-only .wp-social-link-patreon{color:#000}.wp-block-social-links.is-style-logos-only .wp-social-link-pinterest{color:#e60122}.wp-block-social-links.is-style-logos-only .wp-social-link-pocket{color:#ef4155}.wp-block-social-links.is-style-logos-only .wp-social-link-reddit{color:#ff4500}.wp-block-social-links.is-style-logos-only .wp-social-link-skype{color:#0478d7}.wp-block-social-links.is-style-logos-only .wp-social-link-snapchat{color:#fff;stroke:#000}.wp-block-social-links.is-style-logos-only .wp-social-link-soundcloud{color:#ff5600}.wp-block-social-links.is-style-logos-only .wp-social-link-spotify{color:#1bd760}.wp-block-social-links.is-style-logos-only .wp-social-link-telegram{color:#2aabee}.wp-block-social-links.is-style-logos-only .wp-social-link-threads,.wp-block-social-links.is-style-logos-only .wp-social-link-tiktok{color:#000}.wp-block-social-links.is-style-logos-only .wp-social-link-tumblr{color:#011835}.wp-block-social-links.is-style-logos-only .wp-social-link-twitch{color:#6440a4}.wp-block-social-links.is-style-logos-only .wp-social-link-twitter{color:#1da1f2}.wp-block-social-links.is-style-logos-only .wp-social-link-vimeo{color:#1eb7ea}.wp-block-social-links.is-style-logos-only .wp-social-link-vk{color:#4680c2}.wp-block-social-links.is-style-logos-only .wp-social-link-whatsapp{color:#25d366}.wp-block-social-links.is-style-logos-only .wp-social-link-wordpress{color:#3499cd}.wp-block-social-links.is-style-logos-only .wp-social-link-x{color:#000}.wp-block-social-links.is-style-logos-only .wp-social-link-yelp{color:#d32422}.wp-block-social-links.is-style-logos-only .wp-social-link-youtube{color:red}.wp-block-social-links.is-style-pill-shape .wp-social-link{width:auto}.wp-block-social-links.is-style-pill-shape .wp-social-link a{padding-left:.66667em;padding-right:.66667em}.wp-block-social-links:not(.has-icon-color):not(.has-icon-background-color) .wp-social-link-snapchat .wp-block-social-link-label{color:#000}.wp-block-spacer{clear:both}.wp-block-tag-cloud{box-sizing:border-box}.wp-block-tag-cloud.aligncenter{justify-content:center;text-align:center}.wp-block-tag-cloud.alignfull{padding-left:1em;padding-right:1em}.wp-block-tag-cloud a{display:inline-block;margin-right:5px}.wp-block-tag-cloud span{display:inline-block;margin-left:5px;text-decoration:none}.wp-block-tag-cloud.is-style-outline{display:flex;flex-wrap:wrap;gap:1ch}.wp-block-tag-cloud.is-style-outline a{border:1px solid;font-size:unset!important;margin-right:0;padding:1ch 2ch;text-decoration:none!important}.wp-block-table{overflow-x:auto}.wp-block-table table{border-collapse:collapse;width:100%}.wp-block-table thead{border-bottom:3px solid}.wp-block-table tfoot{border-top:3px solid}.wp-block-table td,.wp-block-table th{border:1px solid;padding:.5em}.wp-block-table .has-fixed-layout{table-layout:fixed;width:100%}.wp-block-table .has-fixed-layout td,.wp-block-table .has-fixed-layout th{word-break:break-word}.wp-block-table.aligncenter,.wp-block-table.alignleft,.wp-block-table.alignright{display:table;width:auto}.wp-block-table.aligncenter td,.wp-block-table.aligncenter th,.wp-block-table.alignleft td,.wp-block-table.alignleft th,.wp-block-table.alignright td,.wp-block-table.alignright th{word-break:break-word}.wp-block-table .has-subtle-light-gray-background-color{background-color:#f3f4f5}.wp-block-table .has-subtle-pale-green-background-color{background-color:#e9fbe5}.wp-block-table .has-subtle-pale-blue-background-color{background-color:#e7f5fe}.wp-block-table .has-subtle-pale-pink-background-color{background-color:#fcf0ef}.wp-block-table.is-style-stripes{background-color:initial;border-bottom:1px solid #f0f0f0;border-collapse:inherit;border-spacing:0}.wp-block-table.is-style-stripes tbody tr:nth-child(odd){background-color:#f0f0f0}.wp-block-table.is-style-stripes.has-subtle-light-gray-background-color tbody tr:nth-child(odd){background-color:#f3f4f5}.wp-block-table.is-style-stripes.has-subtle-pale-green-background-color tbody tr:nth-child(odd){background-color:#e9fbe5}.wp-block-table.is-style-stripes.has-subtle-pale-blue-background-color tbody tr:nth-child(odd){background-color:#e7f5fe}.wp-block-table.is-style-stripes.has-subtle-pale-pink-background-color tbody tr:nth-child(odd){background-color:#fcf0ef}.wp-block-table.is-style-stripes td,.wp-block-table.is-style-stripes th{border-color:#0000}.wp-block-table .has-border-color td,.wp-block-table .has-border-color th,.wp-block-table .has-border-color tr,.wp-block-table .has-border-color>*{border-color:inherit}.wp-block-table table[style*=border-top-color] tr:first-child,.wp-block-table table[style*=border-top-color] tr:first-child td,.wp-block-table table[style*=border-top-color] tr:first-child th,.wp-block-table table[style*=border-top-color]>*,.wp-block-table table[style*=border-top-color]>* td,.wp-block-table table[style*=border-top-color]>* th{border-top-color:inherit}.wp-block-table table[style*=border-top-color] tr:not(:first-child){border-top-color:initial}.wp-block-table table[style*=border-right-color] td:last-child,.wp-block-table table[style*=border-right-color] th,.wp-block-table table[style*=border-right-color] tr,.wp-block-table table[style*=border-right-color]>*{border-right-color:inherit}.wp-block-table table[style*=border-bottom-color] tr:last-child,.wp-block-table table[style*=border-bottom-color] tr:last-child td,.wp-block-table table[style*=border-bottom-color] tr:last-child th,.wp-block-table table[style*=border-bottom-color]>*,.wp-block-table table[style*=border-bottom-color]>* td,.wp-block-table table[style*=border-bottom-color]>* th{border-bottom-color:inherit}.wp-block-table table[style*=border-bottom-color] tr:not(:last-child){border-bottom-color:initial}.wp-block-table table[style*=border-left-color] td:first-child,.wp-block-table table[style*=border-left-color] th,.wp-block-table table[style*=border-left-color] tr,.wp-block-table table[style*=border-left-color]>*{border-left-color:inherit}.wp-block-table table[style*=border-style] td,.wp-block-table table[style*=border-style] th,.wp-block-table table[style*=border-style] tr,.wp-block-table table[style*=border-style]>*{border-style:inherit}.wp-block-table table[style*=border-width] td,.wp-block-table table[style*=border-width] th,.wp-block-table table[style*=border-width] tr,.wp-block-table table[style*=border-width]>*{border-style:inherit;border-width:inherit}:where(.wp-block-term-description){margin-bottom:var(--wp--style--block-gap);margin-top:var(--wp--style--block-gap)}.wp-block-term-description p{margin-bottom:0;margin-top:0}.wp-block-text-columns,.wp-block-text-columns.aligncenter{display:flex}.wp-block-text-columns .wp-block-column{margin:0 1em;padding:0}.wp-block-text-columns .wp-block-column:first-child{margin-left:0}.wp-block-text-columns .wp-block-column:last-child{margin-right:0}.wp-block-text-columns.columns-2 .wp-block-column{width:50%}.wp-block-text-columns.columns-3 .wp-block-column{width:33.33333%}.wp-block-text-columns.columns-4 .wp-block-column{width:25%}pre.wp-block-verse{overflow:auto;white-space:pre-wrap}:where(pre.wp-block-verse){font-family:inherit}.wp-block-video{box-sizing:border-box}.wp-block-video video{vertical-align:middle;width:100%}@supports (position:sticky){.wp-block-video [poster]{object-fit:cover}}.wp-block-video.aligncenter{text-align:center}.wp-block-video figcaption{margin-bottom:1em;margin-top:.5em}.editor-styles-wrapper,.entry-content{counter-reset:footnotes}a[data-fn].fn{counter-increment:footnotes;display:inline-flex;font-size:smaller;text-decoration:none;text-indent:-9999999px;vertical-align:super}a[data-fn].fn:after{content:"[" counter(footnotes) "]";float:left;text-indent:0}.wp-element-button{cursor:pointer}:root{--wp--preset--font-size--normal:16px;--wp--preset--font-size--huge:42px}:root .has-very-light-gray-background-color{background-color:#eee}:root .has-very-dark-gray-background-color{background-color:#313131}:root .has-very-light-gray-color{color:#eee}:root .has-very-dark-gray-color{color:#313131}:root .has-vivid-green-cyan-to-vivid-cyan-blue-gradient-background{background:linear-gradient(135deg,#00d084,#0693e3)}:root .has-purple-crush-gradient-background{background:linear-gradient(135deg,#34e2e4,#4721fb 50%,#ab1dfe)}:root .has-hazy-dawn-gradient-background{background:linear-gradient(135deg,#faaca8,#dad0ec)}:root .has-subdued-olive-gradient-background{background:linear-gradient(135deg,#fafae1,#67a671)}:root .has-atomic-cream-gradient-background{background:linear-gradient(135deg,#fdd79a,#004a59)}:root .has-nightshade-gradient-background{background:linear-gradient(135deg,#330968,#31cdcf)}:root .has-midnight-gradient-background{background:linear-gradient(135deg,#020381,#2874fc)}.has-regular-font-size{font-size:1em}.has-larger-font-size{font-size:2.625em}.has-normal-font-size{font-size:var(--wp--preset--font-size--normal)}.has-huge-font-size{font-size:var(--wp--preset--font-size--huge)}.has-text-align-center{text-align:center}.has-text-align-left{text-align:left}.has-text-align-right{text-align:right}#end-resizable-editor-section{display:none}.aligncenter{clear:both}.items-justified-left{justify-content:flex-start}.items-justified-center{justify-content:center}.items-justified-right{justify-content:flex-end}.items-justified-space-between{justify-content:space-between}.screen-reader-text{border:0;clip:rect(1px,1px,1px,1px);-webkit-clip-path:inset(50%);clip-path:inset(50%);height:1px;margin:-1px;overflow:hidden;padding:0;position:absolute;width:1px;word-wrap:normal!important}.screen-reader-text:focus{background-color:#ddd;clip:auto!important;-webkit-clip-path:none;clip-path:none;color:#444;display:block;font-size:1em;height:auto;left:5px;line-height:normal;padding:15px 23px 14px;text-decoration:none;top:5px;width:auto;z-index:100000}html :where(.has-border-color){border-style:solid}html :where([style*=border-top-color]){border-top-style:solid}html :where([style*=border-right-color]){border-right-style:solid}html :where([style*=border-bottom-color]){border-bottom-style:solid}html :where([style*=border-left-color]){border-left-style:solid}html :where([style*=border-width]){border-style:solid}html :where([style*=border-top-width]){border-top-style:solid}html :where([style*=border-right-width]){border-right-style:solid}html :where([style*=border-bottom-width]){border-bottom-style:solid}html :where([style*=border-left-width]){border-left-style:solid}html :where(img[class*=wp-image-]){height:auto;max-width:100%}:where(figure){margin:0 0 1em}html :where(.is-position-sticky){--wp-admin--admin-bar--position-offset:var(--wp-admin--admin-bar--height,0px)}@media screen and (max-width:600px){html:where(.is-position-sticky){--wp-admin--admin-bar--position-offset:0px}}#smartbanner{position:absolute;left:0;top:-82px;border-bottom:1px solid #e8e8e8;width:100%;height:78px;font-family:'Helvetica Neue',sans-serif;background:-webkit-linear-gradient(top, #f4f4f4 0%,#cdcdcd 100%);background-image:-ms-linear-gradient(top, #F4F4F4 0%, #CDCDCD 100%);background-image:-moz-linear-gradient(top, #F4F4F4 0%, #CDCDCD 100%);box-shadow:0 1px 2px rgba(0,0,0,0.5);z-index:9998;-webkit-font-smoothing:antialiased;overflow:hidden;-webkit-text-size-adjust:none}#smartbanner,html.sb-animation{-webkit-transition:all .3s ease}#smartbanner .sb-container{margin:0 auto}#smartbanner .sb-close{position:absolute;left:5px;top:5px;display:block;border:2px solid #fff;width:14px;height:14px;font-family:'ArialRoundedMTBold',Arial;font-size:15px;line-height:15px;text-align:center;color:#fff;background:#070707;text-decoration:none;text-shadow:none;border-radius:14px;box-shadow:0 2px 3px rgba(0,0,0,0.4);-webkit-font-smoothing:subpixel-antialiased}#smartbanner .sb-close:active{font-size:13px;color:#aaa}#smartbanner .sb-icon{position:absolute;left:30px;top:10px;display:block;width:57px;height:57px;background:rgba(0,0,0,0.6);background-size:cover;border-radius:10px;box-shadow:0 1px 3px rgba(0,0,0,0.3)}#smartbanner.no-icon .sb-icon{display:none}#smartbanner .sb-info{position:absolute;left:98px;top:18px;width:44%;font-size:11px;line-height:1.2em;font-weight:bold;color:#6a6a6a;text-shadow:0 1px 0 rgba(255,255,255,0.8)}#smartbanner #smartbanner.no-icon .sb-info{left:34px}#smartbanner .sb-info strong{display:block;font-size:13px;color:#4d4d4d;line-height:18px}#smartbanner .sb-info>span{display:block}#smartbanner .sb-info em{font-style:normal;text-transform:uppercase}#smartbanner .sb-button{position:absolute;right:20px;top:24px;border:1px solid #bfbfbf;padding:0 10px;min-width:10%;height:24px;font-size:14px;line-height:24px;text-align:center;font-weight:bold;color:#6a6a6a;background:-webkit-linear-gradient(top, #efefef 0%,#dcdcdc 100%);text-transform:uppercase;text-decoration:none;text-shadow:0 1px 0 rgba(255,255,255,0.8);border-radius:3px;box-shadow:0 1px 0 rgba(255,255,255,0.6),0 1px 0 rgba(255,255,255,0.7) inset}#smartbanner .sb-button:active, #smartbanner .sb-button:hover{background:-webkit-linear-gradient(top, #dcdcdc 0%,#efefef 100%)}#smartbanner .sb-icon.gloss:after{content:'';position:absolute;left:0;top:-1px;border-top:1px solid rgba(255,255,255,0.8);width:100%;height:50%;background:-webkit-linear-gradient(top, rgba(255,255,255,0.7) 0%,rgba(255,255,255,0.2) 100%);border-radius:10px 10px 12px 12px}#smartbanner.android{border-color:#212228;background:#3d3d3d url('data:image/gif;base64,R0lGODlhCAAIAIABAFVVVf///yH5BAEHAAEALAAAAAAIAAgAAAINRG4XudroGJBRsYcxKAA7');border-top:5px solid #88B131;box-shadow:none}#smartbanner.android .sb-close{border:0;width:17px;height:17px;line-height:17px;color:#b1b1b3;background:#1c1e21;text-shadow:0 1px 1px #000;box-shadow:0 1px 2px rgba(0,0,0,0.8) inset,0 1px 1px rgba(255,255,255,0.3)}#smartbanner.android .sb-close:active{color:#eee}#smartbanner.android .sb-info{color:#ccc;text-shadow:0 1px 2px #000}#smartbanner.android .sb-info strong{color:#fff}#smartbanner.android .sb-button{min-width:12%;border:1px solid #DDDCDC;padding:1px;color:#d1d1d1;background:none;border-radius:0;box-shadow:none;min-height:28px}#smartbanner.android .sb-button span{text-align:center;display:block;padding:0 10px;background-color:#42B6C9;background-image:-webkit-gradient(linear,0 0,0 100%,from(#42B6C9),to(#39A9BB));background-image:-moz-linear-gradient(top,#42B6C9,#39A9BB);text-transform:none;text-shadow:none;box-shadow:none}#smartbanner.android .sb-button:active, #smartbanner.android .sb-button:hover{background:none}#smartbanner.android .sb-button:active span, #smartbanner.android .sb-button:hover span{background:#2AC7E1}#smartbanner.windows .sb-icon{border-radius:0px}/*]]>*/
Transplantation rénale: ce qui bloque - Algerie360
Dans cette interview, le professeur Farid Haddoum fait un véritable plaidoyer pour le développement de la greffe rénale. Il estime que c’est là un choix stratégique que doivent prendre les autorités sanitaires pour réduire le coût de la prise en charge de l’hémodialyse et donner un confort de vie aux malades.
Liberté : Vous dressez un bilan sans complaisance de l’état de la prise en charge des insuffisants rénaux en Algérie. Pouvez-vous nous en dire davantage ?
Pr Haddoum : Le lecteur peut s’interroger légitimement sur les raisons objectives qui nous poussent à tirer la sonnette d’alarme quant à la dérive actuelle en matière de prise en charge des patients algériens atteints d’insuffisance rénale chronique terminale. La quasi-totalité de nos patients sont “parqués” dans des centres d’hémodialyse, véritables prisons modernes, ils y restent ad vitam æternam…
Le constat est accablant pour nous néphrologues, nous le reconnaissons et nous réagissons. La célébration de la Journée mondiale du rein 2014 est, nous semble-t-il, une excellente occasion pour informer les autorités sanitaires, les professionnels de la santé, les médias, les familles des patients et les citoyens sur les différents moyens thérapeutiques dont nous disposons en Algérie pour soigner les insuffisants rénaux, et leur offrir ce qu’il y a de meilleur ! Comment à l’avenir éviter cette dérive, inverser la tendance, mettre fin au monopole de l’hémodialyse, sortir nos patients du “ghetto” de la dialyse, réduire les dépenses colossales de santé consacrées à la seule hémodialyse, intégrer harmonieusement toutes les méthodes de dialyse et de transplantation ? Certes, il s’agit là d’un vaste programme (certes ambitieux !) qui mettra du temps à se mettre en place, d’autant qu’il faudra lutter contre les vieux réflexes, les énormes bénéfices réalisés par l’importation massive des consommables et équipements pour hémodialyse (ils se chiffrent en centaines de millions d’euros), pour ne citer que ces contraintes !… La vente des consommables et équipements pour hémodialyse est l’un des marchés les plus florissants en Algérie. Il génère des profits faramineux.
Depuis 2004, le volume de vente est en pleine croissance avec une progression annuelle des ventes de 10%, un record inégalé. Nous espérons beaucoup de la future loi sanitaire (l’actuelle date de 1985) pour encadrer par des textes l’activité de transplantation, l’activité de dialyse, la répartition harmonieuse et obligatoire de toutes les méthodes, l’obligation de tout proposer aux patients, le recours obligatoire aux spécialistes de néphrologie pour la primo prescription, les barrières légales pour éviter les dérives actuelles.
Nous ne pouvons rester les bras croisés devant cette situation, silencieux (donc complices !), indifférents au sort de nos patients, témoins passifs de la dilapidation des deniers publics, en acceptant la disparition pure et simple de la dialyse péritonéale et de la transplantation rénale. Mettre fin au “tout-hémodialyse” en Algérie : mission impossible pour les néphrologues algériens ?
Expliquez-nous les raisons qui privilégient le choix de la greffe ou de la dialyse péritonéale sur l’hémodialyse ?
Qui d’entre nous ne souhaiterait pas ce qu’il y a de meilleur à un parent malade, à un ami, à un collègue qui souffre d’insuffisance rénale ? Qui de nous ne fera pas tout ce qui est possible pour son prochain, pour lui “offrir” le meilleur de la néphrologie ? Le recours systématique et unique à l’hémodialyse est considéré par les experts mondiaux comme l’expression ou le synonyme de l’échec de la médecine et de la néphrologie….
L’hémodialyse en centre représente moins de 30% dans la majorité des pays occidentaux, elle est quasiment interdite au Mexique, au Canada, à Cuba, en Afrique du Sud, en Corée du Sud, à Singapour, à Hong-Kong, pour ne citer que ces pays.
Sans rentrer dans le discours des spécialistes, la supériorité de la transplantation rénale est maintenant confirmée depuis 40 ans et elle est suivie par la dialyse péritonéale. Cette dernière méthode est le gold standard des pays riches car elle offre de très nombreux avantages pour les enfants, les personnes âgées, les personnes en attente de greffe rénale, les diabétiques, les patients cardiaques.
C’est la dialyse la plus physiologique, elle se fait à domicile, loin des structures à risque nosocomial, elle confère une grande autonomie, elle maintient la diurèse, elle permet d’éviter les hépatites virales B et C (véritable fléau en hémodialyse), il n’y a pas de recours aux transfusions sanguines contrairement à l’hémodialyse (les transfusions sont de véritables barrières à la transplantation rénale), pour ne citer que ces immenses qualités….
La transplantation rénale est tout simplement le retour à la vie normale au prix de quelques précautions et de la prise de médicaments pour prévenir un éventuel rejet du greffon.
Les recommandations des sociétés savantes sont claires, elles sont connues, et largement publiées ! Nous avons l’obligation morale de les appliquer à nos patients et de préserver les équilibres financiers de nos dépenses de santé ! L’hémodialyse en centre coûte, en Algérie, 3 fois plus cher que la dialyse péritonéale et 5 fois plus cher que la transplantation rénale. Avec plus de 300 millions d’euros en 2013 pour la seule hémodialyse, les finances de santé de notre pays sont gravement menacées, d’autant qu’elles ne font qu’augmenter d’année en année.
Nous devons réagir sans tarder et dénoncer cet état de fait ! Nous sommes conscients des réticences et des réactions qui suivront et qui s’exprimeront lorsque nos souhaits de réorienter nos choix vers la greffe rénale et la dialyse péritonéale se mettront en place dans notre pays. Ils défendront naturellement leurs intérêts financiers et feront tout pour poursuivre l’importation du consommable pour l’hémodialyse. Nous sommes déterminés à défendre la santé de nos patients, à leur offrir ce qui est bon pour eux, tout en préservant les équilibres financiers.
Quelles solutions la corporation préconise-t-elle pour booster la greffe rénale ?
Parmi les solutions proposées, la plus importante reste la loi. La transplantation d’organes, tissus et cellules est une activité médicale qui nécessite un encadrement légal pour de multiples raisons. Elle doit devenir obligatoire en Algérie pour tous les professionnels de santé, mais pas seulement ! La transplantation est une activité qui implique de nombreux secteurs comme les différents ministères de la Santé, de l’Enseignement supérieur, des Affaires religieuses, de l’Éducation, de l’Intérieur, les agences de santé, les compagnies de transport, les secours publics, pour ne citer que quelques-uns.
L’effort sera national, interministériel, intersectoriel pour transformer cette activité trop marginalisée en devoir national. La mutualisation des compétences est nécessaire et la seule garante d’une réussite d’un programme national pérenne. Les structures hospitalières existantes, les équipements existants, les ressources humaines existantes, les laboratoires spécialisés existants, les services d’imagerie existants sont très largement suffisants pour développer toutes sortes de transplantation, dès lors que la loi sera promulguée. Nous n’avons nul besoin de nouvelles structures et nul besoin d’équipements ultrasophistiqués pour réaliser les 500 greffes rénales annuelles en 2014/2015.
En revanche, l’activité de transplantation nécessite d’être également soutenue financièrement, toujours grâce à la loi, qui affectera des budgets spéciaux aux équipes médico-chirurgicales, aux laboratoires de biochimie, de microbiologie-virologie, d’immunologie, d’anatomo-pathologie, aux services d’imagerie médicale, aux pharmacies hospitalières, aux centres de transfusion et d’hémobiologie et enfin aux équipes de garde de transplantation qui continuent à travailler bénévolement, contrairement aux équipes de garde en hémodialyse qui sont, elles, rémunérées.
Quels en sont les principaux obstacles ?
Clairement, les sommes colossales affectées pour le développement et l’instauration systématique dans toute l’Algérie du tout-hémodialyse. Ce sont les bénéfices astronomiques générés par l’importation massive et la mise en vente des consommables et équipements pour l’hémodialyse depuis 2004, ainsi que leur très coûteuse maintenance, qui sont en grande partie à l’origine de cette dérive. La néphrologie algérienne est devenue “unijambiste”, s’appuyant complètement sur l’hémodialyse, abandonnant la très précieuse prévention des maladies rénales, la dialyse péritonéale et la transplantation rénale.
L’image est forte car elle souligne le “surplace” opéré par notre spécialité, et nous appelons tous nos collègues néphrologues à un sursaut et une prise de conscience pour nos patients et notre système de santé. Nous ne pouvons pas continuer à nous taire à la vue de centaines de jeunes patients dialysés sans espoir de greffe rénale et ne rien dire.
Avec seulement 10 millions d’euros en 2014/2015, l’activité de greffe rénale peut-être boostée par 5 ou par 6. Une goutte d’eau comparée aux 300 millions d’euros affectés pour la seule hémodialyse en 2013.