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         Central Pontine Myelinolysis:     more detail
  1. Thiamine Deficiency and Associated Clinical Disorders (Contemporary Clinical Neuroscience) by David W. McCandless, 2009-09-15

41. P991029c - Hyponatremia - Central Pontine Myelinosis
Initially named central pontine myelinolysis, this disease is nowknown to also affect extrapontine brain areas. Manifestations
http://www.emory.edu/WHSCL/grady/amreport/litsrch99/p991029c.html
Hyponatremia - Central Pontine Myelinosis 10/29/99 (Walker) Question: What are the best ways to avoid central pontine myelinosis as a consequence of therapy for hyponatremia? Link Directly to Fulltext article in Ovid Unique Identifier: 97127952 Authors: Laureno R. Karp BI. Institution: Washington Hospital Center, Washington, D.C., USA. Title: Myelinolysis after correction of hyponatremia [see comments]. [Review] [49 refs] Source: Annals of Internal Medicine. 126(1):57-62, 1997 Jan 1. Fulltext Available in EBSCO using HEALTH SOURCE PLUS and the search term: Hyponatremia: focus on therapy Unique Identifier: 95064213 Authors: Oster JR. Singer I. Institution: Department of Veterans Affairs Medical Center, Miami, Fla. Title: Hyponatremia: focus on therapy [see comments] [published erratum appears in South Med J 1995 Sep;88(9):927]. [Review] [51 refs] Source: Southern Medical Journal. 87(12):1195-202, 1994 Dec. Morning Report Emory University School of Medicine 1999 Edition Participating Faculty: Daniel Stephens MD / Donald Brady MD dbrady@emory.edu

42. OA
Abstract The central pontine myelinolysis was first described by Adams et al in1959 .It is usually associated with hyponatremia or rapid correction of this
http://www.cmj.org/luobenyan2.htm
Pontine and extrapontine myelinolysis caused by hyponatremia: Report of two cases LUO Benyan ZHANG Minming , RUAN Lingxiang , JIN Haiqing , WANG Qidong , ZHANG Kan Deparments of Neurology (Luo BY, Jin QH and Zhang K) and Radiology (ZhangMM, Ruan LX and Wang QD). First Hospital Zhejiang Uniersity.HangZhou 310009,China Key words hyponatremia myelinolysis Chin Med J 2002;115(6):987-988 Abstract: The central pontine myelinolysis was first described by Adams et al in 1959 .It is usually associated with hyponatremia or rapid correction of this condition. It is an uncommon complication in sick patients with severe underlying disorders such as chronic alcoholism, malignancy, malnutrition, hyponatraemia , hyperhydrated postoperatively, and in other clinical situations .We report two cases of myelinolysis caused by hyponatremia and cyclosporine. They are characterized by mental status changes, one of which had quadriplegia and pseudobulbar palsy. Brain MRI shows hyperintens

43. OA
. 1. Laureno R. central pontine myelinolysis followingrapid correction of hyponatremia. central pontine myelinolysis.
http://www.cmj.org/luobenyan1.htm
LUO Benyan ZHANG Minming , RUAN Lingxiang , JIN Haiqing , WANG Qidong , ZHANG Kan C hin Med J 2002;115(6):994-996 1959ÄêAdamsµÈÊ×ÏÈèÊöÁËÖÐÑëÇÅÄÔËèÇÊÈܽ⡣¸²¡Í¨³£ÓëµÍÄÆѪ֢ºÍµÍѪÄƵĿìËÙ¾ÀÕýÏà¹Ø¡£ÕâÊÇÒ»ÖÖº±¼ûµÄ²¢·¢Ö¢£¬¶àÔÚ»¼Õß·¢ÉúÒÔÏÂÑÏÖصļ²²¡Ê±³öÏÖ£ºÈçÂýÐԵľƾ«Öж¾£¬¶ñÐÔÖ×Áö£¬ÓªÑø²»Á¼£¬µÍѪÄÆÖ¢£¬ÊõºóÊäÒº¹ý¶àµÈ¡£ÎÒDZ¨µÀÁ½ÀýÓɵÍѪÄƺͻ·æß¹ËØÒýÆðµÄËèÇÊÈܽâÖ¢¡£ËûǶ¼¾ßÓо«Éñ״̬¸Ä±äµÄÌص㣬ÆäÖÐÒ»Àý³öÏÖËÄ̱֫»¾ºÍ¼ÙÐÔÑÓËèÂé±Ô¡£»¼Õßͷ­MRI±íÏÖΪÔÚÇÅÄÔºÍÇÅÄÔÍâ³öÏÖT2ÏñµÄ¸ßÐźźÍT1ÏñµÄµÍÐźš£ »¼Õß74ËêÅ®ÐÔ£¬ÔÚ°òë×Ö×ÁöÍâ¿ÆÇгýÊõºó³öÏÖ¾«ÉñÒì³££¬²¢°éÓеÍѪÄÆÖ¢ºÍÓªÑø²»Á¼¡£ÊõºóµÚ15Ìì²âµÑª½¬ÄÆÀë×ÓŨ¶ÈΪ118mmol/L¡£ÊõºóµÚ17ÌìµÍÄÆѪ֢±»¿ìËÙ¾ÀÕýºó³öÏÖ¾«Éñ״̬µÄ½øÒ»²½¶ñ»¯£¬±íÏÖΪ¾«Éñ´íÂÒ¡¢¿ÞЦÎÞ³£¡¢Ê§Óï¡¢ÍÌÑÊÀ§ÄѺÍËÄ̱֫»¾¡£ MRI³ÉÏñδÏÔʾÒì³££¨Í¼1£©£¬µ«ÑªÄƾÀÕýºóµÚ20Ììͷ­MRI¸´²é£¬ÏÔʾΪÖÐÑëÇÅÄÔËèÇÊÈܽ⣨ͼ2¡¢3£©¡£ÁÙ´²±íÏÖºÍͷ­MRI³ÉÏñÖеIJ¡±ä·Ö²¼Ö¤÷ÒÔÉÏÉñ¾­²¡±äµÄ³öÏÖÊÇÓÉÓÚµÍÄÆѪ֢ºÍµÍÄÆѪ֢±»Ñ¸ËÙ¾ÀÕýÔì³ÉµÄ¡£ »¼Õß17ËêÄÐÐÔ£¬Òò»¼ÂýÐÔÁ£Ï¸°ûÐÔ°×Ѫ²¡½øÐйÇËèÒÆÖ²£¬ÔÚÊõºóµÚ15ÌìͻȻ³öÏÖÍ·Í´£¬Ñ£ÔΣ¬ÑÛÇòÕð²ü£¬¹¹ÒôÕÏ°­ºÍÖ«ÌåÕð²üµÈ±íÏÖ¡£ÊµÑéÊÒ¼ì²é½á¹ûÌáʾÑÏÖصĵÍÄÆѪ֢£¨ÑªÄÆˮƽΪ108mmol/L£©£¬¿¼ÂÇÊÇÓÉÓÚ»¯ÁÆËùÖµĿ¹ÀûÄò¼¤Ëز»Êʵ±·ÖÚÒýÆð¡£µÍÄÆѪ֢¾ÀÕýºóÉÏÊö±íÏÖÈÔ³ÖÐøÁË10ÓàÌì¡£ÄÔ¼¹ÒºÉú»¯¼ì²éºÍϸ¾úÅàÑø½ÔΪÒõÐÔ¡£ÑÛµ×¼ì²éÕý³£¡£·¢²¡ºóµÚ20Ì컼Õßͷ­MRI³ÉÏñÏÔʾ²àÄÔÊÒÖÜΧ°×ÖÊ¡¢ÇðÄÔ¡¢»ùµ×½ÚµÈ´¦µÄT2¼ÓȨÏñ³öÏÖ°ßµã×´¸ßÐźÅÓ°£¨Í¼4¡¢5£©£¬¶ø»¼ÕßÒÆֲǰµÄͷ­MRI³ÉÏñÏÔʾÕý³££¨Í¼6£©¡£ MRIͼÏó 1959ÄêAdams µÈµÚÒ»´ÎèÊöÖÐÑëÇÅÄÔËèÇÊÈܽ⣬40¶àÄêÀ´ÒÑÓÐÊý°ÙÀýÇÅÄÔËèÇÊÈܽⱻ±¨µÀ¡£Ä¿Ç°Æä·¢²¡»úÖÆÉÐΪ÷È·£¬Ò»°ãÈÏΪ¸²¡³£ÓëµÍÄÆѪ֢ºÍµÍÄÆѪ֢µÄѸËÙ¾ÀÕýÜÇÐÏà¹Ø

44. ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Central Pontine M
Table of content. central pontine myelinolysis. There is no known cure for centralpontine myelinolysis and treatment is focused on relieving symptoms.
http://www.enlmedical.com/article/000775.htm

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... Table of content
Central pontine myelinolysis
Causes and Risks:
The destruction of the myelin sheath inhibits impulse conduction along the nerve cell. The most common cause of this condition is rapid correction of low sodium levels in the body (hyponatremia).
Risks include hyponatremia from any cause. Alcoholism Wernicke-Korsakoff syndrome , and general ill health and malnutrition associated with serious illnesses (cachexia) increase the risk of central pontine myelinolysis. This condition does not occur spontaneously but results from other conditions that cause the damage.
Prevention:
Gradual controlled correction of hyponatremia may reduce the risk of damage to the nerves of the pons.
Symptoms:

45. ThirdAge - Adam - Central Pontine Myelinolysis
central pontine myelinolysis. Alternative Names CPM. Symptoms WeaknessIn the face, arms, and/or legs; Usually affecting both sides of the body.
http://www.thirdage.com/health/adam/ency/article/000775sym.htm
document.write(''); document.write(''); document.write('<'); document.write('/SCRIPT>'); document.write(''); document.write(''); document.write('<'); document.write('/A>'); document.write('<'); document.write('/NOSCRIPT>'); document.write('<'); document.write('/IFRAME>'); Activities Computers Family Tree Health ... Prevention
Central pontine myelinolysis
Alternative Names: CPM
Symptoms:

46. NEJM -- Osmotic Demyelination Syndrome Following Correction Of Hyponatremia
The treatment of hyponatremia is controversial some authorities have cautioned thatrapid correction causes central pontine myelinolysis, and others warn that
http://content.nejm.org/cgi/content/abstract/314/24/1535
HOME SEARCH CURRENT ISSUE PAST ISSUES ... HELP Previous Volume 314:1535-1542 June 12, 1986 Number 24 Next Osmotic demyelination syndrome following correction of hyponatremia
RH Sterns, JE Riggs, and SS Schochet Table of Contents Find Similar Articles in the Journal Notify a friend about this article Add to Personal Archive ... Related Articles in Medline Articles in Medline by Author: Sterns, R. H. Schochet, S. S. Medline Citation Abstract
This article has been cited by other articles:
  • Sugimoto, T, Murata, T, Omori, M, Wada, Y (2003). Central pontine myelinolysis associated with hypokalaemia in anorexia nervosa. J. Neurol. Neurosurg. Psychiatry [Abstract] [Full Text]
  • Saeed, B O, Beaumont, D, Handley, G H, Weaver, J U (2002). Severe hyponatraemia: investigation and management in a district general hospital. J Clin Pathol [Abstract] [Full Text]
  • Polster, T, Hoppe, M, Ebner, A (2001). Transient lesion in the splenium of the corpus callosum: three further cases in epileptic patients and a pathophysiological hypothesis. J. Neurol. Neurosurg. Psychiatry

47. Directory :: Look.com
central pontine myelinolysis (3) EMedicine central pontine myelinolysis An introduction,clinical features, differencials, work up, treatment and follow up.
http://www.look.com/searchroute/directorysearch.asp?p=526797

48. Periodic Paralysis Association
The rapid correction of hyponatremia may cause central pontine myelinolysis, a disorderinitially associated with alcoholism or malnutrition but now more often
http://www.periodicparalysis.org/PPRC/DietAndNutrition/DietNutritionView.asp?die

49. Central Pontine Myelinolysis
central pontine myelinolysis. The most common cause of central pontine myelinolysisis a rapid, drastic change in sodium levels in the body.
http://www.umm.edu/ency/article/000775.htm
Disease Nutrition Surgery Symptoms Injury ... Encyclopedia (English)
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Central pontine myelinolysis
Overview Symptoms Treatment Prevention Definition: Central pontine myelinolysis is a condition characterized by nerve damage caused by the destruction of the covering layer ( myelin sheath) of nerve cells in the brainstem (pons).
Alternative Names: CPM
Causes, incidence, and risk factors: The destruction of the myelin sheath that coats nerves inhibits impulse conduction within the cell and thus decreases its ability to communicate with other cells. The most common cause of central pontine myelinolysis is a rapid, drastic change in sodium levels in the body. Most commonly, this occurs when someone is being treated for low levels of sodium ( hyponatremia ) and the levels rise too fast, but it can occasionally occur when high levels of sodium in the body (hypernatremia) are corrected too quickly. This condition does not occur spontaneously; it is a complication of either treatment for other conditions or the other conditions themselves. Risks include hyponatremia from any cause.

50. Resourses
central pontine myelinolysis .. Central PontitneMyelinolysis Central Pontitne Myelinolysis Central Pontine
http://sargon.mmu.ac.uk/RESORCE3.HTM
Health and Disability-Related Web Sites Page 3 of 26 Updated 11/08/97

51. New Document
Much has been written about treatment of hyponatremia and the potentialadverse outcome of central pontine myelinolysis. This condition
http://www.trirats.org/hypo_article.html
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I'm writing this to "the big list", the PA Buzzards, Virginia Happy Trails Running Club, the Montgomery County Road Running Club (in Maryland) and a few others to say THANK YOU SO VERY MUCH for the Get Well Wishes, Cards, Flowers, and overall concern and support. Wow! I have a lot of wonderful friends! I am writing to so many people for a few reasons - first, I have received many inquires about how I am doing after the Vermont 100 miler. Also, many people heard about what happened (which I'll explain below) but only got parts of the story. So you'll get the story here - as best I know it, from me, Michele Burr - the person who got a severe case of hyponatremia at VT100. The people who do know about my getting hyponatremia have urged me to post something so that people are aware of this very serious problem. I must admit, I don't remember much because I had a seizure and went into a coma but I have pieced together many things from people who saw me at the end of the race and from talking with my husband, who thank God, was there at the finish line and with me during my 5 day stay at two hospitals in Vermont and then New Hampshire. WHAT ARE THE SYMPTOMS? The answer to this question is the scary part and why this is such a medical emergency when it occurs. ****Many of the symptoms are NEUROLOGICAL in origin.**** Level of alertness can range from agitation to a coma state. Variable degrees of cognitive impairment (eg, difficulty with short-term recall; loss of orientation to person, place, or time; frank confusion or depression). Other symptoms include seizure activity and irrational behavior. In patients with acute severe hyponatremia, signs of brainstem herniation, including coma; fixed, unilateral, dilated pupil; decorticate or decerebrate posturing; and respiratory arrest. Coma and seizures usually occur only with acute reduction of the serum sodium concentration to less than 120 mEq/L. (Remember my sodium level was at 113 mEq/L.)

52. Abstract
Case Report. central pontine myelinolysis secondary to cytomegalovirus hepatitisin a 10month-old child. central pontine myelinolysis - CMV - MRI - Infant,
http://link.springer-ny.com/link/service/journals/00247/contents/02/00722/s00247
Case Report
Central pontine myelinolysis secondary to cytomegalovirus hepatitis in a 10-month-old child
N. Cagla Tarhan , Ali Firat , Arzu Otken , A. Muhtesem Agildere and Fulya Demirceken Fevzi Cakmak Cad. 10. Sok. No:45, 06490 Bahcelievler, Ankara, Turkey Sami Ulus Children's Hospital, Department of Paediatrics, Ankara, Turkey Abstract. We present a 10-month-old child with central pontine myelinolysis (CPM) secondary to chronic active hepatitis due to cytomegalovirus (CMV) infection. A total of 35 paediatric cases of pontine and/or extrapontine myelinolysis are reported and, to our knowledge, CPM secondary to CMV hepatitis in an infant has not been previously reported. The MRI findings are highlighted. Keywords. Central pontine myelinolysis - CMV - MRI - Infant E-mail: caglat@baskent-ank.edu.tr
E-mail: itarhan@isbank.net.tr
Phone: +90-312-2126868
Fax: +90-312-223-7333

53. SpringerLink: Acta Neuropathologica - Abstract Volume 96 Issue 5 (1998) Pp 537-5
case report central pontine myelinolysis in AIDS. Key words Central pontinemyelinolysis · AIDS · Magnetic resonance imaging · Autopsy.
http://link.springer-ny.com/link/service/journals/00401/bibs/8096005/80960537.ht
Acta Neuropathologica
ISSN: 0001-6322 (printed version)
ISSN: 1432-0533 (electronic version) Table of Contents Abstract Volume 96 Issue 5 (1998) pp 537-540
case report : Central pontine myelinolysis in AIDS
R. F. Miller (1), Michael J. G. Harrison (2), Margaret A. Hall-Craggs (3), Francesco Scaravilli (4)
(1) Division of Pathology and Infectious Diseases, University College London Medical School, Mortimer Market Centre, London WC1E 6AU, UK e-mail: rmiller@gum.ucl.ac.uk, Tel.: +44-171-380-9945, Fax: +44-171-380-9669
(2) Department of Neurology, University College London Medical School, London W1P 6DB, UK
(3) Department of Imaging, University College London Hospitals, London W1N 8AA, UK
(4) Department of Neuropathology, Institute of Neurology, London WC1N 3BG, UK
Received: 6 March 1998 / Revised, accepted: 11 May 1998 Abstract Central pontine myelinolysis (CPM) is an uncommon complication in sick patients with severe underlying disorders such as chronic alcoholism, malignancy, malnutrition and hyponatraemia. We report two patients with advanced HIV infection who developed CPM. In one case the diagnosis was not suspected in life, in the other the diagnosis was made just before death, on the basis of magnetic resonance (MR) imaging appearances. At post mortem there was a close correlation between the MR abnormalities and the anatomic changes in the pons. Key words Article in PDF-Format (414 KB) Online publication: September 25, 1998

54. Ask Jeeves: Search Results For "Nervous System Figure"
http//gwis2.circ.gwu.edu/~atkins/Neuroweb/autonomic.html 3. central pontine myelinolysiscentral pontine myelinolysis A condition characterized by damage to
http://webster.directhit.com/webster/search.aspx?qry=Nervous System Figure

55. Michele Burr's Vermont 100 Hyponatremia
QUICKLY). Much has been written about treatment of hyponatremia and thepotential adverse outcome of central pontine myelinolysis. This
http://www.ultrarunner.org/vt100micheleburr.htm
From: Michele Burr
To: "'ultra@LISTSERV.DARTMOUTH.EDU'
Subject: hyponatremia/ VT100/ Michele Burr
Date: Tue, 30 Jul 2002 21:03:20 Hi everyone, I'm writing this to "the big list", the PA Buzzards, Virginia Happy Trails Running Club, the Montgomery County Road Running Club (in Maryland) and a few others to say THANK YOU SO VERY MUCH for the Get Well Wishes, Cards, Flowers, and overall concern and support. Wow! I have a lot of wonderful friends! I am writing to so many people for a few reasons - first, I have received many inquires about how I am doing after the Vermont 100 miler. Also, many people heard about what happened (which I'll explain below) but only got parts of the story. So you'll get the story here - as best I know it, from me, Michele Burr - the person who got a severe case of hyponatremia at VT100. The people who do know about my getting hyponatremia have urged me to post something so that people are aware of this very serious problem. I must admit, I don't remember much because I had a seizure and went into a coma but I have pieced together many things from people who saw me at the end of the race and from talking with my husband, who thank God, was there at the finish line and with me during my 5 day stay at two hospitals in Vermont and then New Hampshire.

56. Hyponatremia And Myelinolysis, Annals 15 Jul 97
1991;1975862. 3. Tien R, Arieff AI, Kucharczyk W, Wasik A, Kucharczyk J. Hyponatremicencephalopathy is central pontine myelinolysis a component? Am J Med.
http://www.acponline.org/journals/annals/15jul97/letter1.htm
Annals of Internal Medicine Current Issue Past Issues Library for Internists Subscriptions ... Email this page Annals of Internal Medicine LETTERS
Hyponatremia and Myelinolysis
Annals of Internal Medicine 15 July 1997.
Related Article
To the Editor: Annals in which their review appears. In summary, brain damage from hyponatremic encephalopathy due to delayed onset of therapy is at least 24 times more likely than brain damage due to improper therapy. Most patients who have brain damage secondary to hyponatremic encephalopathy are young (menstruant) women (4), whereas those who have brain damage from a change in plasma sodium concentration usually have end-stage liver disease. J. Carlos Ayus, MD
Baylor College of Medicine
Houston, TX 77024 Allen I. Arieff, MD
University of California Medical Center
San Francisco, CA 94143
References
Laureno R, Karp BI. Myelinolysis after correction of hyponatremia. Ann Intern Med. 1997;126:57-62.
2. Sarnaik AP, Meert K, Hackbarth R, Fleischmann L.

57. Myelinolysis After Correction Of..., Annals 1 Jan 97
weighted magnetic resonance imaging scan showing a symmetrical area of increasedsignal in the center of the pons consistent with central pontine myelinolysis.
http://www.acponline.org/journals/annals/01jan97/myelout.htm
Annals of Internal Medicine Current Issue Past Issues Library for Internists Subscriptions ... Email this page Annals of Internal Medicine
Myelinolysis after Correction of Hyponatremia
Article Outline
Figures
  • Figure 1 : T2-weighted magnetic resonance imaging scan showing a symmetrical area of increased signal in the center of the pons consistent with central pontine myelinolysis. Figure 2 : Section of pons with central pontine myelinolysis. Figure 3 : Comparison of the histopathology of myelinolysis and multiple sclerosis.
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58. Volume 95 January - December 1972
central pontine myelinolysis a clinical and pathological study of 10 cases.HH . Goebel and PHB . Zur. Pages 495 - 504. Part of the OUP Brain WWW service.
http://www3.oup.co.uk/jnls/supplements/braini/hdb/Volume_95/Issue_03/950495.sgm.
Volume 95: January - December 1972
Issue 3: September 1972
Abstract
  • Central pontine myelinolysis - a clinical and pathological study of 10 cases
  • HH Goebel and PHB Zur Pages: Part of the OUP Brain WWW service
    General Information
    Click here to register with OUP. This page is maintained by OUP admin Last updated 14 May 97 Part of the OUP Journals World Wide Web service Oxford University Press, 1997

    59. La Imagen Del Mes
    Translate this page central pontine myelinolysis a hitherto undescribed disease occurring in alcoholicand malnourished patients. Is central pontine myelinolysis a component?
    http://www.rochelink.roche.com.ar/pub/rnarg/med/revista1/imagen.htm

    60. Central Pontine Myelinolysis In A Patient With AIDS [letter]
    Click here to return to AIDSLINE main menu central pontine myelinolysisin a patient with AIDS letter J Neurol Neurosurg Psychiatry.
    http://www.aegis.com/pubs/aidsline/1992/nov/M92B0785.html
    Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
    Central pontine myelinolysis in a patient with AIDS [letter] J Neurol Neurosurg Psychiatry. 1992 Jul;55(7):631-2. Unique Identifier : AIDSLINE MED/92349099
    Holmes AH; Esiri M; Morris CS; Edwards A Keywords: AIDS Dementia Complex/*PATHOLOGY Case Report Demyelinating Diseases/*PATHOLOGY Human Male Middle Age Myelin Sheath/PATHOLOGY Pons/*PATHOLOGY Water-Electrolyte Balance/PHYSIOLOGY LETTER JOURNAL ARTICLE
    National Library of Medicine
    . Reproduced under license with the National Library of Medicine, Bethesda, MD. AEGiS is made possible through unrestricted grants from Boehringer Ingelheim iMetrikus, Inc. , the National Library of Medicine , and donations from users like you. Always watch for outdated information. This article first appeared in 1992. This material is designed to support, not replace, the relationship that exists between you and your doctor. AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

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