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Finally, as detailed clinical indications were not consistently available in the national administrative dataset, future research should employ a nested casecontrol design to enable more precise characterization of these variables

If an infection is suspected because of the history and a tender, hot bursa with purulent drainage is found on examination, fluid for Gram stain and culture may be obtained by aspiration

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Patients with hyperadrenergic POTS often suffer from severe "adrenaline surges," causing intense tremors, anxiety, and tachycardia