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Neuroscience 213 , 7280 (2012)

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What also concerned me was evidence that elevated TMAO compromises the release of nitric oxide release in endothelial cells thereby interfering with the vasodilatory mechanism which can contribute to hypertension

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Alternatively, the spots may develop in response to a condition called Peutz-Jeghers syndrome or the darkening can accompany activities like vaping or smoking