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The American College of Rheumatology (ACR) guidelines.

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We did not evaluate factors that may have contributed to variance in topical drug absorption.

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In the latter circumstances a number of treatment options are available.

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Principle: Excess circulating corticosteroids (cortisol) spill into urine.

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Such changes may explain how a partial impairment of the GR, or rather an alteration in GR-dependent gene transcription, may lead to decreased HPA axis feedback inhibition and cause HPA axis hyperactivity without preventing the detrimental effects of glucocorticoids on brain plasticity.

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