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Studies show that this may reduce the chance of developing food allergy in babies with severe eczema or egg allergy discount super viagra american express erectile dysfunction treatment by yoga. If possible buy genuine super viagra online erectile dysfunction treatment uk, continue to breastfeed your baby while you are introducing solid foods order super viagra 160mg on-line erectile dysfunction drugs in bangladesh. Start to introduce solid foods around 6 months (not before 4 months) and when your baby is ready order super viagra 160 mg mastercard venogenic erectile dysfunction treatment. So you see the big obvious foods are eggplant, tomatoes, and peppers! Again, most people are fine, but if you only eat nightshades you may end up with leaky gut which can progress to other inflammatory diseases. If you continue to eat nightshades while you have an allergy/intolerance to them or you eat nightshades in abundance, the rick of developing leaky gut becomes prevalent. Not a top 8 allergen, but nightshade allergies can literally be toxic to some and cause a mass of inflammation throughout the body. Parents were once told to introduce one new food every five to seven days to determine if their child had an allergy; now, parents are encouraged to introduce food at whatever pace is most comfortable to them, says Goldhammer. The advice has really liberalized, and this includes what starter foods parents give a baby who is beginning solids.” For years, the American Academy of Pediatrics recommended children not have eggs until age 2 and peanuts until age 3. We told moms to stay away from allergens (like peanuts), only to find that there was no data to support this,” Natterson explains. Most babies start eating solid foods between ages 4 and 6 months. As your baby gets older, reintroduce foods one at a time. Babies outgrow most food allergies — especially dairy — in their first year to 18 months. Wheat flour can be replaced with a number of other flours, such as sorghum, buckwheat, almond flour, amaranth, quinoa flour, arrowroot and millet. Ideally, says Natterson, a breast-feeding mom would eliminate just about everything from her diet and slowly reintroduce one food at a time. If you suspect your baby might be sensitive or allergic to something in her diet, what are your options? When babies show signs of food sensitivity or allergy, parents need to become investigators. And while a breast-fed baby will have soft, sweet-smelling stools that are mustardy in color, a breast-fed baby with a food allergy might have constipation, diarrhea or foul-smelling stools that may be green with mucus, says Camie Goldhammer, the community health center project manager with the Breastfeeding Coalition of Washington. Symptoms of an allergy can also include rashes (eczema, but generally not hives in babies), vomiting, diarrhea, excessive fussiness, colic, chronic congestion or blood in the stool. Even though parents often equate food allergies with food sensitivities, the two are quite different. Find Out What Foods You Should Eat This Week. Sicherer SH. Manifestations of food allergy: evaluation and management. Perry CA, Dwyer J, Gelfand JA, Couris RR, McCloskey WW. Health effects of salicylates in foods adnd drugs. Kweon M-N, Takahashi I, Kiyono H. New insights into mechanism of inflammatory and allergic diseases in mucosal tissues. Helm RM, Burks AW. Mechanisms of food allergy. Andre F, Andre C, Feknous M, Colin L, Cavagna S. Digestive permeability to different-sized molecules and to sodium cromoglycate in food allergy. Ahmed T, Fuchs GJ. Gastrointestinal allergy to food: A review. These nutrient-dense foods have the power to help you look and feel your best, and they can provide long-term health benefits including reducing your risk of health problems. Choline provides nutritional support for a healthy mucous layer and is found in vegetables such as cauliflower and lettuce Choline can be obtained from lecithin (phosphatidylcholine) as well, which is high in eggs and soybeans Some foods also help combat or protect against the damage of Helicobacter pylori; these include catechins found in green tea, some spices such as cinnamon , carotenoids found in vegetables, and vitamin C , found in many fruits and vegetables. The gastrointestinal cell wall is the barrier between potentially toxic food molecules and the inside of your body; therefore, the integrity of this barrier is vital to your health. Hypochlorhydria is also associated with many diseases, such as asthma, celiac sprue, hepatitis, rheumatoid arthritis, osteoporosis, and diabetes melliThis. Low stomach acid (hypochlorhydria) is common, especially in older people since as we age, we make less stomach acid. Stomach acid is required for adequate breakdown of proteins, and without proper breakdown, all proteins are potential antigens and toxic food molecules. These synthetic food additives can cause food sensitivities and may promote the intensity of other symptoms you are experiencing. Especially if you suspect food sensitivities, you should avoid foods with pesticides, artificial colorings and preservatives. However, since there are so many types of food sensitivity responses, the Elimination Diet is considered the "gold-standard" for identifying food sensitivities. Healthcare practitioners sometimes use other clinical tests to determine suspected food allergies. If your symptoms are significant, you should consider working with a healthcare practitioner during the challenge period since re-introduction of a food to which you are extremely sensitive can result in more severe symptoms. A period of two to four days per food introduced should allow time for delayed-response symptoms to appear. For this reason, caffeine and alcohol are also typically excluded on an allergy avoidance diet. In the United States, beginning in 2004 with the passage of the Food Allergen Labeling and Consumer Protection Act (FALCPA), food labels have been required to identify the presence of any major food allergens. Whole, organically grown, brown rice is an excellent choice for an allergy avoidance diet. Have you ever kept track of what happens to you after you eat certain foods? Concentrated sources of calcium include: kelp , bok choy, spinach , greens collard , mustard , turnip ), nuts and seeds sesame seeds , almonds , chestnuts, walnuts , soy , tofu ). Foods from the cabbage family, kale and collards , also contain very absorbable calcium. Food allergies in children have also been associated with some forms of ear infections, such as recurring ear infections and inflammation, and with behavioral problems such as attention deficit disorder (e.g. ADD, ADHD). After staying on the diet for several weeks, you should begin to feel relief from symptoms and generally feel much better. Succumbing to food cravings to help alleviate symptoms is the beginning of a cycle of short term relief from symptoms and craving of the food as symptoms will increase again. Normal metabolism works to remove the food antigens and as the ratio of antibodies to antigens begins to rise, symptoms will begin to increase.

A substance that causes an allergic reaction is called an allergen buy super viagra uk impotence cure food. Anything can be an allergen if the immune system has an adverse reaction super viagra 160mg sale erectile dysfunction images. Allergies are hypersensitive responses from the immune system to substances that either enter or come into contact with the body order super viagra with a mastercard erectile dysfunction alcohol. Cold weather cheap super viagra 160mg visa erectile dysfunction qarshi, exposure to allergens, and respiratory infections can often trigger asthma attacks, and it is critical to avoid these situations when possible. Langford Allergy also offers newly FDA-approved medications such as Grastek and Ragwitek Dr. Langford works with patients to find a medication regimen that is doable logistically and financially. The allergy shot is given in the arm and contains a very small dose of the allergen. It is estimated that 20% of Americans suffer from allergic conjunctivitis, yet only a fraction of these people receive proper treatment. Management can include avoidance of environmental allergens such as pet dander and grass pollen and taking a combination of mast stabilizers and histamine blockers, he said. He encourages physicians to conduct a routine eye exam on patients suspected of allergy. Because allergy can be masked as a number of eye disorders, it is often misdiagnosed in children by pediatricians and in adults by primary care physicians. New multimodality drugs can provide the efficacy of mast-cell stabilization and histamine blockade together to combat allergy, according to Stefan D. Trocme, MD. In his research, Dr. Trocme found a majority of his patients reported satisfaction and improved quality of life after treatment with a combination of a dual-action drug, such as Alocril (nedocromil sodium, Allergan), with a “soft” steroid. D’Arienzo and Ober cite that only a small percentage of people who suffer from allergy symptoms are benefiting from appropriate therapy. With immunotherapy, you get shots containing tiny amounts of the allergen. Eye drops with both an antihistamine to relieve itchiness and a mast-cell stabilizer help prevent eye allergies. But they can make eyes dry and even worsen eye allergy symptoms. Treating eye allergies with eyedrops and medicine. Get to know this document, the cornerstone of personalized treatment for any person with a food allergy. An effective food allergy treatment plan includes the following: Learn more about how to treat severe allergic reactions. Because the symptoms of anaphylaxis can worsen quickly, reactions must be treated right away. The way that your body reacts to a food allergy one time cannot predict how it will react the next time. Whether you choose to advocate, volunteer, walk or donate, your support makes the world safer for people with food allergies. With food allergies, this would involve eliminating the allergen from your diet. Drops can treat more allergens than prescription tablets. The inhalant allergens that can be treated include everything that subcutaneous immunotherapy treats except for mold, cockroaches and certain animals. Allergy drops are made from the same liquids used for allergy shots. The drops can be used to treat inhalation allergies (as mentioned above) as well as food allergies. These allergy drops are often referred to as "sublingual immunotherapy" or "SLIT". Unlike allergy shots, however, sublingual allergy drops are not injected but instead are usually placed under the tongue. Although still rare, the risk of a systemic reaction is greater with allergy shots. Allergy shots are not as safe as sublingual immunotherapy. Numerous inhalant allergens can be treated, including pollens, dust mites, animal dander, molds and cockroaches. Although you can continue to receive your shots in our office, you may do maintenance immunotherapy at home as long as you do not have severe asthma or a history of anaphylaxis. Eating fewer processed foods and cooking whole foods at home lowers the risk of exposure to hidden food allergens. These filters trap allergens and other airborne irritants, which may reduce your symptoms. Here are some ways to avoid an allergic reaction before it requires treatment: The FDA has approved SLIT allergy tablets for allergies to grass pollen, dust mites, and ragweed. Allergy drops are also known as sublingual immunotherapy (SLIT). In children, it may prevent or slow down the progression from allergies to asthma.” It slows the progression of allergies, reduces symptoms, and hopefully eliminates the allergy,” says Dr. Bassett. Epinephrine is used to treat anaphylaxis — a severe, life-threatening allergic reaction — until emergency treatment can be administered. It is used to treat moderate to severe asthma that is caused by allergies in adults and children who are at least 6 years old. They are used to treat symptoms of asthma and, in the case of the drug Singulair (montelukast) , allergic rhinitis. Leukotrienes are chemicals the body releases as a response to allergens. It is prescribed alone or in combination with other medication to treat severe allergic reactions and many other conditions. If you have seasonal allergies, your doctor may advise that you start using nasal steroids about a week before you expect symptoms to begin. Perhaps the most commonly used remedies for certain allergy-related symptoms are nasal sprays. One of the most commonly used allergy remedies, nasal sprays can temporarily relieve sinus-related symptoms. Gradual doses may teach the body not to make reaction-producing antibodies after peanut exposure. Sanders notes that much of immunotherapy remains a mystery — and that food allergies have no known cure.

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The specimen should be frozen as soon as pos- detectable by tandem mass spectrometry and unexpected sible either at −70 °C super viagra 160 mg for sale erectile dysfunction and premature ejaculation, if feasible or at −20 °C buy super viagra no prescription erectile dysfunction weed. Am should not be fixed or otherwise treated with a preser- J Med Genet A 140:837–842 vative quality 160mg super viagra erectile dysfunction treatment penile injections. Ann Clin Biochem 32:190–192 results from the original newborn screening card order super viagra 160mg free shipping impotence drug, are National Newborn Screening Report – 1997, National Newborn available. Remaining indications include the identification of disorders of pterin metabolism in the differentiation of disorders of gluconeo- patients with unclear dystonic movement disorders, genesis from those with defective oxidation of in particular when Segawa syndrome is suspected. Divisions of Human Genetics and Clinical Genetics, Medical University Innsbruck, Schöpfstr. Following a careful selection of patients and under careful observation it can be never- Many metabolic disorders show biochemical abnor- theless carried out safely. It is often possible to pinpoint the site or at least the area of a Remember patient’s metabolic abnormality by the use of a prop- A fasting may cause life-threatening complications erly chosen challenge. A variety of in vivo function and should only be carried out with careful moni- tests are used to create conditions that allow the assess- toring in a specialized hospital setting, and only ment of metabolism in a controlled manner. Frequently, after other, less risky investigations have been com- this entails ingestion of specific substances that give pleted without a clear diagnosis. Most tests are fairly safe; many are inconvenient, but some (including the frequently performed fasting test) can lead to potentially serious complications and Fasting results in a series of hormonal and metabolic should only be carried out by experienced pediatri- responses to assure an endogenous supply of energy cians after other diagnostic options including mutation after cessation of exogenous intake. It is ing, nutrients are supplied via gastrointestinal absorp- essential to carefully plan the collection of samples tion. Depending on the amount and composition of the during the test and to prepare emergency measures in food, this absorption period can last for up to 6h in case complications occur. It is more often <4h in infants and small chil- Rapid advances in enzymatic, molecular, and other dren. With diminishing exogenous supply of glucose, diagnostic techniques permit an increasing number of plasma glucose concentrations fall and insulin levels diagnoses to be obtained without tests of tolerance. The decrease of insulin and However, functional studies may provide phenotypic increase of counteracting hormones diminishes glu- information that more closely reflects the metabolic cose consumption in muscle and peripheral tissues. In principle, hypoglycemia may be the consequence of endocrine or metabolic disease. The whole pic- ture can therefore only be obtained if insulin, cortisol, and growth hormone as well as metabolic parame- D8. Patients with hyperinsulinism often have the shortest and sometimes variable fasting D8. After 8–10 h of fasting, free fatty acids begin to sub- Monitored fasting is a powerful tool in unraveling stitute glucose as the primary energy source in muscle, the nature of metabolic disorders of energy metabo- while it often takes 17–24h to deplete ordinary stores lism. Two central metabolic adaptations to pro- potentially dangerous, and should only be carried out longed fasting are initiated in the liver. Glucose is syn- after other, less risky investigations have been com- thesized via glyconeogenesis from alanine and from pleted without a clear diagnosis. Fasting can cause oxaloacetate derived from amino acids as well as from life-threatening cardiac complications particularly in glycerol resulting from fatty acid oxidation; and most patients with long-chain fatty acid oxidation defects. D8 Function Tests 341 may completely disappear with restoration of glucose Remember homeostasis. Patients with defects of glycogenolysis (glycogen storage disorders) often become hypoglycemic directly after the absorption period. Patients with Remember defects of gluconeogenesis may become hypoglyce- mic after 10–20 h of fasting, while those with defects Fatty acid oxidation defects should be ruled out of ketogenesis or ketolysis develop hypoglycemia at before a diagnostic fast by urinary organic acids and 15–24 h. In prolonged fasting, the body finally draws selectively on its lipid resources to spare vitally needed In fatty acid oxidation disorders, acylcarnitine profiles proteins. Depending on the nutritional state, an adult usually remain abnormal in the nonfasting state. Some patients with electron transport defects follow Analysis of fatty acid oxidation enzymes can be carried the prolonged pattern, because fatty acid oxidation out in leukocytes or fibroblasts. Determination of fasting tolerance through a moni- The fasting test has lost some importance with the tored fast is indicated in patients with recurrent episodes advent of acylcarnitine analyses in dried blood spots of apparently fasting-related symptoms, such as epi- and is now largely irrelevant if not contraindicated for sodes of decreased consciousness or especially recur- the diagnosis of fatty acid oxidation defects. These rent documented hypoglycemia or Reye-like disease in disorders frequently show clinical symptoms only at whom other analyses (including acylcarnitines) were times of fasting when there may be marked hypoke- inconclusive. CoA synthase, an isolated disorder of ketogenesis, may The single most important investigation is the deter- show a normal acylcarnitine profile even during hypo- mination of free fatty acids (elevated) and ketone bod- glycemic episodes. A fasting test may reveal the typi- ies (no sufficient rise) in a serum or plasma sample cal, hypoketotic hypoglycemia and a unique spectrum at the time of symptomatic hypoglycemia. Primary mutation analysis is problems arise when the acute hypoglycemic illness the method of choice to confirm the diagnosis. Zschocke gluconeogenesis from those with defective oxidation everybody involved in advance. It is controlled fasting include the following: advisable to fill out the forms and assemble and label all the tubes including day and timing of the samples • Recurrent episodes of symptomatic ketonemia. The aim, nature, and possible adverse effects of the • Recurrent intermittent metabolic acidosis. Informed consent must only to fine-tune the therapy of metabolic disorders, be obtained from the parents prior to the test. Caloric intake for ketone bodies (acetoacetate and 3-hydroxybutyrate) the last 3 days should have been adequate for age. The blood sugar and urinary organic acids, fasting is con- test must be postponed in case of even minor intercur- ducted with careful bedside monitoring of the concen- rent illness. What is especially important is a detailed trations of glucose in blood and ketones in urine. The history with respect to the individual fasting tolerance, patient is allowed to drink water and unsweetened tea, and events and time courses of adverse reactions to but no juices or soft drinks including “diet” beverages. Under normal conditions, ketogenesis is brisk may be scheduled according to the age of the child and especially after 15–17 h concentrations of acetoac- (Table D8. In general, it is usually safe to allow neogenesis occurs preserving normoglycemia. The fasting at night as long as the child usually goes with- fast is stopped at any time for the development of out eating, but the period beyond should take place hypoglycemia, and with close monitoring it is usually during the daytime. Blood samples should be obtained at 15, 20, and 24 h A monitored fast should be undertaken only in set- and always at a time of hypoglycemia when the fast is tings in which the entire staff is experienced with the stopped. The following basic laboratory parameters procedure, with close clinical supervision and well set should be measured: blood sugar, free fatty acids and out guidelines as to response to hypoglycemia or other ketone bodies (acetoacetate, 3-hydroxybutyrate), lactate, adverse events. Necessary details must be explained to electrolytes, blood gases, transaminases, and creatine kinase. In addition, dried blood spots must be obtained for the analysis of the acylcarnitine profile.

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Others have theorized that the abnormal origin and course of the coronary artery creates abnormal flow patterns during exercise buy super viagra 160 mg low cost erectile dysfunction treatment singapore. Arrow indicates retrograde flow from left coronary artery into main pulmonary artery creating a left to right shunt and coronary steal buy generic super viagra pills erectile dysfunction treatment in vadodara. Low pulmonary arterial pressure causes coronary blood flow to reach the left main coro- nary artery in a retrograde fashion from the right coronary artery blood supply then escape into the main pulmonary artery casting coronary blood flow “steal” mechanism buy 160mg super viagra with amex best erectile dysfunction vacuum pump, the presumed clinical effect in these cases is that relative ischemia results in ventricular arrhythmias or electromechanical dissociation discount super viagra 160mg otc impotence news. Autopsy results in patients with a coronary artery arising from the incorrect sinus do not show significant scar in the heart muscle in the vast majority of cases. In the case of anomalous left coronary arising from the pulmonary artery, oxygen supply to the myocardium is compromised due to both delivery of deoxy- genated blood and decreased perfusion pressures. During fetal life, the coronary blood supplied from the anomalous pulmonary connection is at high pressure and is appropriately saturated so that myocardial perfusion is normal. At birth, the blood in the pulmonary artery quickly becomes desaturated and pressure drops dramatically. Accordingly, both pressure and oxygenation of the blood in the left coronary artery decreases causing inadequate oxygen delivery to the myocar- dium. Over time, in an attempt to increase oxygen delivery, the left coronary vessels dilate and collaterals form to the right coronary system, which arises normally from the aorta. However, since the left coronary arises from the low- pressure pulmonary artery and the right coronary from the high-pressure aorta, collateral flow from the right coronary system passes into the left coronary sys- tem and then retrogrades through the left main coronary artery to the pulmonary artery. These collaterals effectively bypass the myocardial tissue and create a pulmonary artery steal from the coronary artery with resultant ischemia of the left ventricular myocardium, which leads to progressive left ventricular dysfunction and dilation in most cases. Felten Presentation/Clinical Manifestations Patients with an anomalous coronary artery that passes between the two great vessels may present with chest pain, dizziness, palpitations, or syncope during or immedi- ately after exercise. As mentioned above, the course of the coronary between the great vessels results in diminished coronary flow to the myocardium during exercise. This diminished flow can result in relative ischemia of that part of the heart, with resultant pain, ventricular arrhythmias (tachycardia or fibrillation), or diminished myocardial contractility. Ultimately, if the ischemia is significant enough, the patient will experience a sudden and dramatic drop in cardiac output. However, the majority of patients experience symptoms during exercise that lead them to seek medical attention. It should also be noted that many of the victims of sudden death have been athletes, so it is important that all individuals being evaluated for participation in sports be asked about the history of chest pain, dizziness, palpitations, syncope, or other symptoms associated with exer- cise. Those individuals who have a positive history should undergo further evaluation for potential anomalous coronary artery. It is interesting to note that there are patients who present with anomalous coronary between the great vessels as an incidental find- ing, apparently having had no previous symptoms. It is unclear why individuals with the same anatomic abnormalities can have such disparate outcomes. The presentation of anomalous left coronary artery arising from the pulmonary artery is quite different. Symptoms typically develop within the first 2–3 months of age, corresponding with the normal fall in pulmonary vascular resistance and resul- tant reversal of flow from the left coronary into the pulmonary artery. They may also be noted to have transient respira- tory distress, appear pale and sweaty, and may appear syncopal. It is thought that these symptoms are related to myocardial ischemia and associated angina. Signs and symptoms include the failure to thrive, tachypnea, lethargy, tachycardia, and diaphoresis. On examination, these patients may have poor perfusion, a murmur of mitral insufficiency, a gallop rhythm, or hepatomegaly. A small number of individuals improve with time and escape diagnosis as an infant. They may have transient shortness of breath and chest pain with exercise and continue to be at risk for sudden death. Chest Radiography Plain film X-rays are not useful in the diagnosis of an anomalous coronary artery arising from the wrong aortic sinus. Patients with anomalous origin of the left coronary artery from the pulmonary artery have X-ray findings consistent with dilated cardiomyopathy, 26 Congenital Abnormalities of Coronary Arteries 309 namely, cardiomegaly with left atrial and ventricular enlargement, and associated pulmonary edema. Echocardiography Echocardiography is the mainstay for the diagnosis of anomalous coronary arteries. An echocardiogram is recommended for all patients who present with syncope or chest pain associated with exercise to evaluate for the possibility of anomalous coronary arteries, as well as other cardiac abnormalities. It is important that Doppler color flow interrogation of the coronary arteries also be performed. Color flow can help to demonstrate the origins of the coronary arteries from the aortic sinuses and can also help to show a coronary artery passing between the two great vessels. The coronary flow can also be identified by Doppler color flow in the pul- monary artery as an abnormal diastolic flow signal at the point where the anoma- lous coronary artery enters. Echocardiography can also demonstrate other important findings in patients with anomalous coronary arteries, including ventricular size and function, the presence of atrioventricular valve insufficiency, and the presence of other congenital heart disease. Cardiac Catheterization Cardiac catheterization is typically only used in the diagnosis of anomalous coro- nary artery when other imaging modalities are inconclusive. Coronary angiography may help in demonstrating the anomalous origin of a coronary artery, but proving 310 R. Hemodynamic evaluation performed at cardiac catheterization can be useful in the management of certain patients with anomalous coronary arteries to evaluate cardiac output, filling pres- sures, and measurement of shunts, but in most cases these measurement are not necessary. Treatment/Management The treatment of an anomalous coronary passing between the great vessels or of anomalous origin of the left coronary from the pulmonary artery is predominately surgical. In the case of an anomalous coronary passing between the great vessels, surgical reimplantation of the abnormal coronary into the correct sinus can some- times be performed if the anomalous coronary artery arises as a separate origin from the abnormal sinus. In cases where a portion of the anomalous coronary courses in the wall of the aorta, the coronary may be “unroofed” such that the intra- mural portion of the coronary is opened to the lumen of the aorta so as to widen the origin and minimize tension or compression effects that may result from the coro- nary passing between the two great vessels. In the case of anomalous left coronary from the pulmonary artery, several surgical approaches have been used historically. If adequate collaterals have formed, one straightforward approach is to ligate the anomalous origin from the pulmonary artery to eliminate the pulmonary–coronary steal. This procedure has also been performed in association with a bypass graft to augment coronary flow if collaterals were not sufficient. Currently, however, the most accepted approach is direct excision and reim- plantation of the anomalous coronary from the pulmonary artery into the aorta. In these cases, an aortopulmonary window can be created and a baffle placed in the pulmonary artery to tunnel coronary flow from the aorta (Takeuchi procedure). It is generally accepted that surgical intervention should be undertaken in these patients at the time of presentation. Patients with significant cardiac dysfunction or heart failure may require acute medical management of these symptoms before proceeding to surgery. Long-Term Follow-Up and Prognosis It remains unclear as to what extent surgical intervention in cases of anomalous coronary passing between the great vessels minimizes the risk of sudden death. It is widely felt, though, that surgical intervention should be undertaken in any patient with the finding of an anomalous left coronary between the great vessels. The finding of an anomalous right coronary passing between the great vessels is more controversial, but surgical intervention is frequently undertaken, particularly in patients who are symptomatic in any way.

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