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When caloric restriction is present, mammals synthesise less IGF-1 and its synthesis in the liver is refractory to GH stimulation [128130]

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Dynamic proctography is indi- cated for fecal incontinence when clinical features suggest excessive perineal descent, a clinically significant rectocele (eg, in patients who splint the vagina to facilitate rectal emptying), an enterocele, or internal rectal intussusception

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