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Although colonoscopy has been available in clinical practice for more than 40 years, only in the past 15 years has awareness developed that the success of colonoscopy in preventing colorectal cancer and minimizing complications is very dependent on the skill and competence of the colonoscopist. Other possible physical symptoms related to depression include heart palpitations, premenstrual syndrome, dizziness, or numbness. Vet said listening to him she believed it was congestive heart failure. This syndrome usually presents with circumstantialities, excessive talking, chronic compulsive writing hypergraphia , intensified mental life with deepened cognitive and emotional responses to certain events, hyper-religiosity, hyper-morality, and hyposexuality. The Diabetic Foot in 2008: an update from the 12th Malvern Diabetic Foot Meeting. 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