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While alternative administration routes, such as intravenous, intramuscular, nasal, percutaneous, and transdermal delivery, have shown promise in certain conditions, these methods can be invasive and uncomfortable for patients

14 , 20 A history of autoimmune disease or malignancy may further raise suspicion for an alternative diagnosis, especially if the initial presentation occurs after age 65

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Furthermore, OCR determinations in response to succinate, malonate, and rotenone demonstrated no differences between uninfected and HIV infected conditions, with the OCR recovering to control levels