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Red flags requiring immediate evaluation include severe abdominal pain (possible pancreatitis), persistent vomiting leading to dehydration, suicidal thoughts, development of new eating disorder behaviors, syncope, chest pain, hematemesis/melena, severe constipation/obstipation, orthostatic hypotension, or marked electrolyte abnormalities

[8] Tardiolo G, Bramanti P, Mazzon E

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Metabolic reprogramming of glycolysis and glutamine metabolism are key events in myofibroblast transition in systemic sclerosis pathogenesis

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