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A study of plasma and urinary levels of free carnitine and short-chain acyl-carnitines in surgical patients showed that the septic state was associated with increased urinary excretion of free carnitine and lower plasma levels of short-chain acyl-carnitines [101]
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Clinical Features The key facts to ascertain from a patient presenting with melena are: Colour and texture of the stool best described as a jet black, tar-like, and sticky Associated symptoms including any haematemesis, abdominal pain, weight loss, dyspepsia, or dysphagia Past medical history including smoking and alcohol status Drug history use of steroids, NSAIDs, anticoagulants, or iron tablets* A digital rectal examination is essential to confirm the melena
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