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These changes culminated in a marked 30% decline in left ventricle ejection fraction by day 52, confirming substantial Dox-induced systolic dysfunction

This effect was shared by L-arginine, with an opposite effect seen by L-NAME, thereby portraying NO-system involvement in the healing of duodenal and skin defects, duodenocutaneous fistula closing and reinstated sphincter functions

However, controlled combination studies with clear statistical endpoints are rare, so synergistic effects remain largely hypothetical at present

They worsen symptoms when they relax the LES or increase stomach pressure

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