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Self-report instruments like the Eating Inventory and appetite visual analogue scales are useful but subjective, and are vulnerable to functional unblinding in a trial where the active drug produces obvious gastrointestinal effects and weight loss

It should not be used to self-diagnose, and it is not a substitute for a medical exam, cure, treatment, diagnosis, prescription, or recommendation

22,23 Historically, varicocele has been thought to cause infertility by reducing oxygenation and increasing oxidative stress in the testicular environment, but more recent evidence also implicates inflammatory and immune mechanisms

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