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Step-down and interval-extension protocols are clinical adjustments that require provider experience and a relationship

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Depletion of PAPS due to lack of inorganic sulfate or due to genetic defects of enzymes participating in PAPS synthesis may lead to reducing of sulfonation capacity which could affect the metabolism of xenobiotics or disrupt the equilibrium between synthesis and degradation of active endogenous compounds

Alternatively, in HDBR studies, swimming goggles were demonstrated to increase intraocular pressure, which could help to normalise the pressure gradient across the posterior eye and alleviate SANS [107]

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