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Patients with a personal or family thyroid cancer history need additional thyroid assessment, and cardiac history may warrant an EKG or cardiology consultation where clinically indicated

Reported cases have occurred primarily in diabetic patients with significant renal insufficiency, including both intrinsic renal disease and renal hypoperfusion, often in the setting of multiple concomitant medical/surgical problems and multiple concomitant medications

Addressing these challenges requires systemic reform of the patent system, expanded insurance coverage, and a commitment to equitable access

However, some users report shedding in real-world settings