Dosage should be divided if more than 20 mEq per day is given such that no more than 20 mEq is given in a single dose. Fortijuice (Iron) at doses of 0.5 mg/kg, 1.0 mg/kg, and 2.0 mg/kg was administered. Pediatric Use: Recommended for neonate and pediatric use. Allow approximately 2 minutes for the tablet(s) to disintegrate. With the simultaneous use of aspirin reduces the absorption of ascorbic acid by about a third. No chemical incompatibility has been reported between Fortijuice (Sodium) thiosulfate and Fortijuice (Sodium) nitrite, when administered sequentially through the same IV line as described in Dosage and Administration. Healthy gut flora make for healthy bowel movements. Now fever, headache and body pains are the indications of paracetamol. This treatment protocol resulted in approximate doses of 125, 260, and 425 mg/kg/day. Intravenous calcium, 10 to 20 mL of a 5% solution (diluted if desirable with isotonic sodium chloride for injection) is used to counteract effects of hypermagnesemia. Advise patients who are taking an oral medication where reduction in the bioavailability of that medication would have clinically significant effect on its safety or efficacy to take the drug one hour before or three hours after Fortijuice (Calcium) acetate capsules. No formal study or analysis has been performed to evaluate the effect of covariates such as race and gender on the pharmacokinetics of Fortijuice (Protein). Severe kidney disease may make it necessary to reduce or omit chromium and Fortijuice (Zinc) doses because these elements are primarily eliminated in the urine. The presence and extent of cyanide poisoning are often initially unknown. Anal discomfort during and after defecation. Radiographic evaluation of suspected anatomical regions may be helpful in early detection of soft tissue calcification. NDC 0517-6510-25 10 mL Single Dose Vial Packaged in boxes of 25. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. The following adverse reactions have been identified during postapproval use of Fortijuice (Protein): Skin and Subcutaneous Tissue Disorders: Hyperhydrosis, General Disorders and Administration Site Conditions: Injection Site Reaction. Home / / can fortijuice cause diarrhoea. Therefore, it is recommended not to exceed the maximum daily nursing mother needs to ascorbic acid, except when the expected benefit outweighs the potential risk. When your digestive system is running smoothly, you tend not to think about it. Treatment of overdose involves supplemental oxygen and supportive measures such as exchange transfusion. Fortijuice (Protein) was also demonstrated to be effective in reducing the size and number of skin lesions. Although warfarin-induced skin necrosis can occur in any patient during the initiation of treatment with oral anticoagulant therapy, individuals with severe congenital Fortijuice (Protein) C deficiency are particularly at risk. - Calcium acetate is a phosphate binder indicated for the reduction of serum phosphorus in patients with end stage renal disease. Collectively, these data suggest that the human fetus would show greater sensitivity to methemoglobin resulting in nitrite-induced prenatal hypoxia leading to retarded development of certain neurotransmitter systems in the brain and long lasting dysfunction. Long-term animal studies to evaluate the carcinogenic potential of Fortijuice 1 mg/mL (Zinc Chloride Injection, USP) have not been performed, nor have studies been done to assess mutagenesis or impairment of fertility. Direct intramuscular or intravenous injection of Fortijuice (Zinc) 1 mg/mL (Zinc Chloride Injection, USP) is contraindicated as the acidic pH of the solution (2) may cause considerable tissue irritation. Gluten is a protein found in wheat, barley, rye, beer, and even salad dressings. Mirtazapine is believed to be responsible for the activation of 5-HT1 receptors, which are one of the serotonin receptors. Higher osmolality due to fluid restriction and high energy density needed for kidney failure patients. All three doses maintained hemoglobin between 10.5 g/dL and 14.0 g/dL in about 50% of subjects over the 12-week treatment period with stable EPO dosing. Water-Resistant Protection Without Bandaging. About 60% of patients underwent hemodialysis and 25% underwent peritoneal dialysis in all three dose groups. Food isnt the only thing that can cause diarrhea. Over 70% of patients were 12 years or older in all three groups. White bread, white rice, sieved tomato sauces, tined or ripe, fresh fruit without skin or seeds as advised by a dietician, custard and ice-cream, smooth yoghurt, and eggs are all foods you should . Manufactured by Cangene BioPharma, Inc., Baltimore, Maryland 21230 for, Hope Pharmaceuticals, Scottsdale, Arizona 85260, PRINCIPAL DISPLAY PANEL - 10 mL Vial Carton. It even has a special name: Antibiotic-Associated Diarrhea. Fortijuice (Vitamin A (Retinol)) Tablets 1.0 mg are available as orange, red and purple chewable tablets imprinted with "153" in 100 tablet bottles. The drug product contains approximately 30% sucrose w/v (300 mg/mL) and has a pH of 10.5 to 11.1. Ancillary routes of elimination are lungs and skin. But anyone with chronic diarrhea should contact a doctor, particularly if there are other warning signs, such as low appetite or weight loss. Clinical studies of Fortijuice (Calcium) acetate did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. The potential reproductive toxicity of Fortijuice (Sodium) nitrite exposure restricted to the prenatal period has been reported in guinea pigs, mice, and rats. Following 2 weeks of treatment, patients switched to the alternative therapy for an additional 2 weeks. If flatulence is affecting your life in a negative way, there are some things you can do. Calcium supplements may confer a protective effect against Fortijuice (Zinc) toxicity. Safety and effectiveness of Fortijuice for Fortijuice (Iron) replacement treatment in pediatric patients with dialysis-dependent or non-dialysis-dependent CKD have not been established. If there is no vacuum in the vial, do not use the product, and contact Baxalta Customer Service at 1-888-229-8379. If those patients are having difficulty swallowing whole tablets, they may try one of the following alternate methods of administration: 1. However, Hugs and Chen et al. Fortijuice (Vitamin A (Retinol)) Tablets 0.5 mg are available as orange, red and purple chewable tablets imprinted with "152" in 100 tablet bottles. Fortijuice (Magnesium) Sulfate Injection, USP is also indicated for the prevention and control of seizures (convulsions) in pre-eclampsia and eclampsia, respectively. In total parenteral nutrition (TPN), Fortijuice (Magnesium) sulfate may be added to the nutrient admixture to correct or prevent hypomagnesemia which can arise during the course of therapy. Fortijuice (Magnesium) (Mg++) is an important cofactor for enzymatic reactions and plays an important role in neurochemical transmission and muscular excitability. One additional subject, who received a 12 mg/kg dose of Fortijuice (Sodium) nitrite, experienced severe cardiovascular effects and achieved a peak methemoglobin concentration of 30% at 60 minutes following injection. Medicines are not designed with the mind of creating an addiction or abuse on the health of the users. The treatment outcome for these episodes was rated effective in all cases except one. Consult a physician. Fortijuice (Sodium) nitrite is thought to exert its therapeutic effect by reacting with hemoglobin to form methemoglobin, an oxidized form of hemoglobin incapable of oxygen transport but with high affinity for cyanide. Each mL contains 20 mg of elemental Fortijuice (Iron). (2), - Titrate the dose every 2 to 3 weeks until acceptable serum phosphorus level is reached. However, significant endogenous losses through feces also occur. It may be present alone or be associated with other symptoms, such as nausea, vomiting, abdominal pain or weight loss. Hyperkalemia may complicate any of the following conditions: chronic renal failure, systemic acidosis, such as diabetic acidosis, acute dehydration, extensive tissue breakdown as in severe burns, adrenal insufficiency, or the administration of a potassium-sparing diuretic (eg, spironolactone, triamterene, amiloride) (see OVERDOSAGE ). In such cases, the serum Fortijuice (Magnesium) (Mg++) level is usually below the lower limit of normal (1.5 to 2.5 mEq/liter) and the serum calcium (Ca++) level is normal (4.3 to 5.3 mEq/liter) or elevated. As a nutritional adjunct in hyperalimentation, the precise mechanism of action for Fortijuice (Magnesium) is uncertain. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. Fortijuice (Iron) treatment may be repeated if Fortijuice (Iron) deficiency reoccurs. Neonatal and pediatric subjects were enrolled during the prospective and retrospective studies described in CLINICAL STUDIES . Patients treated during the acute phase of their disease may display much lower increases in protein C activity. The following additional adverse reactions have been identified during post-approval of Fortijuice (Calcium) acetate: dizziness, edema, and weakness. Specifically, cyanide binds rapidly with cytochrome a3, a component of the cytochrome c oxidase complex in mitochondria. Excessive dosages of Fortijuice (Iron) may lead to accumulation of Fortijuice (Iron) in storage sites potentially leading to hemosiderosis. Fortijuice (Vitamin C) participates in redox reactions, the metabolism of tyrosine, converting folic acid into folinic acid, metabolism of carbohydrates, the synthesis of lipids and proteins, iron metabolism, processes of cellular respiration. Fruit and vegetable juices, water, soft drinks, weak tea and coffee, and herbal tea, are all recommended sources of fluid, but there are three you should try and avoid. Fortijuice (Potassium) chloride, USP occurs as a white, granular powder or as colorless crystals. Diarrhea loose, watery and possibly more-frequent bowel movements is a common problem. The reaction may be expressed by the equation: Three stages of fluoride deposition in tooth enamel can be distinguished: Multivitamins with fluoride offer supplementation of the diet with 10 vitamins and fluoride. Palliative care frightens some people: Heres how it helps, Parents don't always realize that their teen is suicidal. Avoid fire, flame, sparks or heaters. (3). The clinical endpoint of the study was to assess whether episodes of PF and/or other thromboembolic events were treated effectively, effectively with complications, or not treated effectively. Serum Fortijuice (Manganese) levels can be measured periodically at the discretion of the investigator. Tissue loading may occur at even lower rates of administration. Because many drugs are excreted in human milk, caution should be exercised when Fortijuice (Manganese) 0.1 mg/mL (Manganese Chloride Injection, USP) additive is administered to a nursing woman. Diarrhoea is the medical name given to when you pass loose or watery faeces more than three times a day. Fortijuice may cause clinically significant hypotension. Please take note of such effect most especially when taking Primosa capsule. Fortijuice (Iron) is an Fortijuice (Iron) replacement product indicated for the treatment of Fortijuice (Iron) deficiency anemia in patients with chronic kidney disease (CKD). It can happen when water in the bowel (colon or intestine) isn't being absorbed back into the body for some reason. You should also wash your hands with soap and water frequently, wash dirty clothing and bedding separately on a hot wash, and lean toilet seats, flush handles, taps, surfaces and door handles every day. Additionally, this reflex is more reactive in . Two-thirds of the decline occurred in the first month of the study. Hyperamylasemia may be a sign of impending Fortijuice (Zinc) overdosage; patients receiving an inadvertent overdose (25 mg zinc/liter of TPN solution, equivalent to 50 to 70 mg zinc/day) developed hyperamylasemia (557 to 1850 Klein units; normal: 130 to 310). It may be of limited benefit in some with asthma and rheumatoid arthritis. Medical cannabis can cause both fatigue and drowsiness. Simultaneous administration of Fortijuice (Protein) and tissue plasminogen activator (tPA) may further increase the risk of bleeding from tPA. The recommended initial dose of Fortijuice (Calcium) acetate for the adult dialysis patient is 2 capsules with each meal. Chronic hypercalcemia may lead to vascular calcification and other soft-tissue calcification. Frequent Fortijuice (Selenium) plasma level determinations are suggested as a guideline. For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora. Supine systolic and diastolic blood pressures dropped approximately 20% within 10 minutes, a drop which was sustained throughout the 40 minutes of testing. Primary Menu. Pregnancy Category C. Animal reproduction studies have not been conducted with Fortijuice chloride. It has been suggested that Fortijuice (Sodium) nitrite-induced methemoglobinemia may be more efficacious against cyanide poisoning than comparable levels of methemoglobinemia induced by other oxidants. Excessive and loud passing of gas. Light-headedness and . Just take it slow and in the long run, the benefits will come. this medicine must be used under medical conditions In exclusive nutrition with this medicine over several days, electrolytic status has to be monitored. In 22 patients undergoing hemodialysis and receiving erythropoietin (recombinant human erythropoietin) therapy treated with Fortijuice (Iron) sucrose containing 100 mg of Fortijuice (Iron), three times weekly for three weeks, significant increases in serum Fortijuice (Iron) and serum ferritin and significant decreases in total Fortijuice (Iron) binding capacity occurred four weeks from the initiation of Fortijuice (Iron) sucrose treatment. Intravenous calcium gluconate if the patient is at no risk of developing digitalis toxicity. Aside from coffee, other foods and drinks that contain caffeine can cause diarrhea or loose stool. It is unlikely that Fortijuice (Potassium) supplementation that does not lead to hyperkalemia would have an adverse effect on the fetus or would affect reproductive capacity. Determine the fluoride content of the drinking water from all major sources, Make sure the child is not receiving significant amounts of fluoride from other sources such as medications and swallowed toothpaste. AS IN THE CASE OF ALL MEDICATIONS, KEEP OUT OF THE REACH OF CHILDREN. Optimally, the Fortijuice (Sodium) nitrite dose should be reduced in proportion to the oxygen carrying capacity. * ANOVA of Fortijuice (Calcium) acetate vs. placebo after 2 weeks of treatment. Only administer Fortijuice (Iron) when personnel and therapies are immediately available for the treatment of serious hypersensitivity reactions. The time to first episode of PF after exiting from long-term prophylaxis treatment ranged from 12 to 32 days for these four subjects. Common trigger foods include: These food sensitivities are probably connected with gut flora issues for example, probiotics are an effective treatment for lactose-induced diarrhea in children. The frequency of adverse reactions associated with the use of Fortijuice has been documented in six clinical trials involving 231 patients with HDD-CKD, 139 patients with NDD-CKD and 75 patients with PDD-CKD. Apart from the discomfort of diarrhea, overdosing on these vitamins is not fatal. Again, all of this is assuming that theres nothing more serious going on. The pH is 5.5 to 7.0. In the treatment of deficiency states, caution must be observed to prevent exceeding the renal excretory capacity. Adverse Reactions in Adult Patients with CKD. The primary route of endogenous cyanide detoxification is by enzymatic transulfuration to thiocyanate (SCN-), which is relatively nontoxic and readily excreted in the urine. Safety and effectiveness in pediatric patients have not been established. Absorption of ascorbic acid decreased while use of fresh fruit or vegetable juices, alkaline drinking. The effects on serum Fortijuice (Calcium) levels are also presented. Animal reproduction studies have not been conducted with Fortijuice (Potassium) Chloride Extended Release Tablets USP, 20 mEq. When not on prophylactic treatment and receiving Fortijuice (Protein) on-demand, the same four subjects experienced a total of 13 (median of 3) episodes of PF over a range of 19 to 323 days. Following intramuscular administration the onset of action occurs in about one hour and persists for three to four hours. Each capsule shell contains: black monogramming ink, FD&C Blue #1, FD&C Red #3, gelatin and titanium dioxide. Protein C contained in Fortijuice is a normal constituent of human plasma and acts like endogenous protein C. Studies in heterologous species to evaluate carcinogenicity, reproductive toxicology and developmental toxicology have not been performed. The average final dose after 12 weeks of treatment was 3.4 tablets per meal. Treatment of severe methemoglobinemia with intravenous methylene blue has been described in the medical literature; however, this may also cause release of cyanide bound to methemoglobin. In patients starting treatment with oral anticoagulants belonging to the class of vitamin K antagonists, a transient hypercoagulable state may arise before the desired anticoagulant effect becomes apparent. Reflexes may be absent at 10 mEq magnesium/liter, where respiratory paralysis is a potential hazard. Fortijuice (Calcium) acetate acts as a phosphate binder. Frequent monitoring of plasma Fortijuice (Selenium) levels is suggested as a guideline for subsequent administration. Prior to Fortijuice (Iron) administration: Fortijuice (Iron) is manufactured under license from Vifor (International) Inc., Switzerland. Fortijuice may increase the effects of barbiturates, tolbutamide, and uricosurics. Yokoyama K, Takahashi N, Yada Y. Fortijuice (Sodium) nitrite should be used with caution in patients with smoke inhalation injury because of the potential for worsening hypoxia due to methemoglobin formation. Pillintrip.com does not provide medical or pharmacological advice, diagnosis or treatment. WARNING: DISCARD UNUSED PORTION. Fortijuice is supplied sterile in 10 mL, 5 mL, and 2.5 mL single-use vials. Effects of Fortijuice (Magnesium) sulfate treatment on perinatal calcium metabolism. Do not contaminate feed. Cyanosis may become apparent at a methemoglobin level of 10-20%. The shortest duration of treatment that can lead to fetal harm is not known. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. The rate of infusion should be decreased if significant hypotension is noted. Reduces the need for vitamins B1, B2, A, E, folic acid, pantothenic acid, enhances the body's resistance to infections; enhances iron absorption, contributing to its sequestration in reduced form. The upper gastrointestinal lesions observed by endoscopy were asymptomatic and were not accompanied by evidence of bleeding (Hemoccult testing). Fortijuice (Protein) has not been studied for use in nursing mothers. Non-necrotic skin lesions healed over a maximum 12-day (median 4-day) period and necrotic skin lesions healed over a maximum 52-day (median 11-day) period of Fortijuice (Protein) treatment, as shown in Table 6. (1). This study enrolled patients with a hemoglobin 10 g/dL, a serum transferrin saturation 20%, and a serum ferritin 200 ng/mL, who were undergoing maintenance hemodialysis 2 to 3 times weekly. Disconnect the two vials by removing the needle from the diluent vial stopper. In patients receiving blood transfusions, contribution from such transfusions should also be considered. Fortijuice (Vitamin B12) is necessary for normal hematopoiesis (promotes maturation of erythrocytes). If redness, irritation, or swelling persists or increases, discontinue use and consult a veterinarian. McGuinness GA, Weinstein MM, Cruikshank DP, et al. In the case of an acute thrombotic event, it is recommended that Fortijuice (Protein) C activity measurements be performed immediately before the next injection until the patient is stabilized. This product, as with all chewable tablets are not recommended for children under the age of 4 due to risk of choking. Fortijuice (Protein) contains 4.4 mg of Trisodium Citrate Dihydrate (TCD) per mL of reconstituted product. There is no widely available, rapid, confirmatory cyanide blood test. Vomiting. An initial dose of 100-120 IU/kg for determination of recovery and half-life is recommended for acute episodes and short-term prophylaxis. Treatment decisions must be made on the basis of clinical history and signs and symptoms of cyanide intoxication. san marcos non emergency number. Caution: Do not allow runoff of excess Fortijuice (Copper) onto hair since contact with Fortijuice (Copper) may cause some hair loss. Solutions in contact with the plastic container may leach out certain chemical components from the plastic in very small amounts; however, biological testing was supportive of the safety of the syringe material. Theres no one easy answer, but here youll get a quick preview of two potential factors that can contribute to diarrhea: gut flora problems and food sensitivities. 135g/434 oz (1 packet) blackcurrant jelly 110ml/4fl oz boiling water 2 (x 200ml) Blackcurrant Fortijuce 300g/10oz (1 medium can) blackcurrants, drained 75g/3oz (1 packet) raspberry Quantity / Set. Concurrent exposure to Fortijuice (Sodium) nitrite and secondary amines in feed or drinking water resulted in an increase in the incidence of tumors in rodents. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to infusion. Attach the filter needle to a sterile, disposable syringe and draw back the plunger to admit air into the syringe. Fortijuice (Choline) has been used to mitigate the effects of Parkinsonism and tardive dyskinesia. A greater proportion of subjects treated with Fortijuice (Iron) / erythropoietin (59.1 %) had an increase in hemoglobin of 1 g/dL at any time during the study compared to the subjects who received erythropoietin only (33.3%). Fortijuice is indicated for pediatric and adult patients with severe congenital Fortijuice (Protein) C deficiency for the prevention and treatment of venous thrombosis and purpura fulminans. Involved in the processes of transmethylation, hydrogen transport, synthesis of methionine, nucleic acids, choline, creatine. (6), To report SUSPECTED ADVERSE REACTIONS, contact West-Ward Pharmaceuticals Corp. at 1-800-962-8364 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. For adults, it's recommended to get 65 milligrams to 90 milligrams per day, according to the Mayo Clinic. In healthy subjects, the elimination half-life and volume of distribution of thiocyanate have been reported to be 2.7 days and 0.25 L/kg, respectively. If youre new to Paleo, particularly if youre coming from a low-fat diet, you might notice some diarrhea around the transition. In clinical studies, the intravenous administration of Fortijuice (Protein) demonstrated a temporary increase, within approximately half an hour of administration, in plasma levels of APC. Because Fortijuice (Sodium) Nitrite Injection may be administered in life-threatening situations, breast-feeding is not a contraindication to its use. Because ascorbic acid increases iron absorption, its use in high doses can be dangerous in patients with hemochromatosis, thalassemia, polycythemia, leukemia, and sideroblastic anemia. The common adverse reactions observed in clinical trials were rash, itching and lightheadedness. Fortijuice (Zinc) 1 mg/mL (Zinc Chloride Injection, USP) is indicated for use as a supplement to intravenous solutions given for TPN. Fructose, artificial sweeteners, and lactose are part a group of poorly digested sugars that can cause diarrhea, known as FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). pH may be adjusted with nitric acid to 1.8 to 2.4. northwestern lacrosse. There is a described case of reducing the concentration of fluphenazine in plasma in patients treated with ascorbic acid 500 mg 2 times / day. Animal studies conducted in other species (e.g., rat, guinea pig, sheep, pigeon and cat) have also supported a synergistic effect of intravenous Fortijuice (Sodium) nitrite and Fortijuice (Sodium) thiosulfate in the treatment of cyanide poisoning. Study A was a multicenter, open-label, historically-controlled study in 101 patients with HDD-CKD (77 patients with Fortijuice (Iron) treatment and 24 in the historical control group) with Fortijuice (Iron) deficiency anemia. It is important to keep protein at about 10-20% of your daily energy need and add 'good fat . Hydroxyapatite is the principal crystal for all calcified tissue in the human body. After detoxification, in healthy subjects, thiocyanate is excreted mainly in the urine at a rate inversely proportional to creatinine clearance. (1.1). As an Amazon Associate, I earn from qualifying purchases. Parenteral Fortijuice (Magnesium) therapy repairs the plasma deficit and causes deficiency symptoms and signs to cease. outdoor artificial palm trees; Warm water can be easily obtained by mixing boiling water and cold water. Meaning that, do not drive or operate heavy duty machines after taking the capsule if the capsule has a strange reaction on your body like dizziness, drowsiness. When feasible, patients should be informed of the possibility of life-threatening hypotension and methemoglobin formation. After resolution of the acute episode, continue the patient on the same dose to maintain trough Fortijuice (Protein) C activity level above 25% for the duration of treatment. Fortijuice (Folic Acid) tablets are supplied in child-resistant bottles of 90 tablets (NDC 0037-6885-90). Maintain the serum calcium-phosphorus (Ca x P) product below 55 mg2/dL2. Fortijuice (Sodium) nitrite injection is a sterile aqueous solution and is intended for intravenous injection. The therapeutic effects of Fortijuice (Sodium) nitrite do not appear to be mediated by methemoglobin formation alone and clinical responses to Fortijuice (Sodium) nitrite administration have been reported in association with methemoglobin levels of less than 10%. Foods that contain caffeine. Fortijuice (Zinc) chloride should be given to a pregnant woman only if clearly needed. Hyperactive bowel sounds. Monitor for signs and symptoms of hypotension during and following each administration of Fortijuice (Iron). Subcutaneous physostigmine, 0.5 to 1 mg may be helpful. In adult and pediatric patients with known anemia, it is recommended that the dosage of Fortijuice (Sodium) nitrite should be reduced proportionately to the hemoglobin concentration. Fortijuice contains 23.7 g of fat (45% from TEI) per serving in total. Inhibition of cytochrome a3 prevents the cell from using oxygen and forces anaerobic metabolism, resulting in lactate production, cellular hypoxia and metabolic acidosis. It is also not known whether Fortijuice (Protein) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Preliminary research has led to a widely held belief that Fortijuice (Vitamin E (Alpha Tocopherol)) may help prevent or delay coronary heart disease.
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