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These data, together with the observation from the meta analysis that the benefit of adjuvant chemotherapy appears to diminish with increasing age, led us to hypothesise that it may be a failure to deliver drug dose and or dose intensity in the older adjuvant breast cancer patient that results in its apparent reduced efficacy buy priligy 30mg These high rates may be related to the limited engagement of TGW with effective sexual health services for example, regular HIV STI screening and underutilization of pre exposure prophylaxis 137, 138

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