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The Gastric Sleeve became the initial step in the management of superobese or in patients with high operative risk or multiple prior operations

It works by blocking 2 calcium channels and inhibiting the release of excitatory neurotransmitters from presynaptic vesicles

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Now we get to the heart of the matter

MMA levels are generally low under normal physiological conditions, but increased levels can come from different sources, such as vitamin B12 deficiency, genetic mutations in enzymes related to the propionate pathway, the gut microbiota, and aggressive cancers 1