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In hemodialysis patients, due to reduced renal clearance, carnitine depletion and acylcarnitine accumulation become significant, resulting in an abnormal increase in the ratio of acylcarnitine to free carnitine in plasma, which in turn inhibits cardiac fatty acid metabolism [261]

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She is the founder of the Cleveland Clinic Specialized Womens Health Fellowship and is currently the Professor and Director of the Center for Specialized Womens Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University

Multiple injections are usually required to achieve optimal outcomes