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If you have a vagina/front hole the doctor or nurse may ask if its ok if they carry out an internal examination and they may swab the cervix, if you have one, to test for infection

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Cigarette smoke disrupts gutlung axis communication through microbial metabolite alterations driving pulmonary inflammation and cancer progression Interestingly, accumulating investigations demonstrate that cigarette smoke distorts gutlung axis communication by altering microbial metabolite profiles, creating a pro-inflammatory milieu that fuels pulmonary deterioration in COPD and promotes oncogenic niches in lung adenocarcinoma (LUAD)