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The outer, rigid ring is titanium, while the inner is made of hygroscopic, compressed casein that swells as it absorbs pericardial fluid over the course of several weeks, ending in total occlusion
Fortunately, this potential side effect seems to be linked specifically to the largest doses of the drug, and all three people began to regain their zest for life after reducing their dosage
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The FDA has not formally studied this combination in controlled trials, so evidence comes from case reports and clinical experience rather than large randomized studies
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