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For me, it came down to results

(101) assessed serum IGF-I levels in patients with Cushings disease and any changes following post-operative remission compared to matched controls being investigated for suspected pituitary dysfunction (e.g., nonfunctioning pituitary adenomas)

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Patients with pre-existing hypertension, arrhythmia history, or coronary artery disease face substantially higher risks and should never consider this combination without explicit cardiology clearance

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