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Although not documented in Keshan disease, it is possible that selenium deficiency may increase the virulence of viruses with the potential to invade and damage the heart muscle (57)

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68 However, in a population using GLP-1 RAs for obesity management without history of diabetes, increased risk of pancreatitis associated with the GLP-1 RAs was found compared to bupropion-naltrexone (HR 9.1, 95%CI 1.2566.0) suggesting the risk benefit ratio of these medications is influenced by underlying disease state