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Thus far, 2 distinct microbial enzyme systems have been identified in vitro that can produce TMA from either choline or carnitine as substrate ( 75 , 77 )

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No statistically significant differences were observed for wound infection, cellulitis, wound disruption, hemorrhage, hypertrophic scarring, need for additional Mohs stages, or several rare complications

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There are also signs that some medical institutions are allowing individuals to purchase the medicine through their health insurance programs, which would be against the law