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Ethanol metabolism produces toxic molecules such as acetaldehyde and ROS ( + /NADH ratio, changes in redox state, increased fat synthesis, hepatocellular damage, and other associated malfunctioning of metabolic activities ( Betaine supplementation was demonstrated to alleviate the alcohol-induced fatty liver in rats by improving hepatic lipid metabolism (i.e., decreasing the synthesis and increasing the catabolism) via suppression of diacylglycerol acyltransferases: DGAT1, DGAT2, sterol regulatory element binding proteins: SREBP-1c, SREBP-2, fatty acid synthase, and HMG-CoA reductase and overexpression of peroxisome proliferator-activated receptor coactivator (PGC)-1 in the liver and preventing the decline of adiponectin concentrations in serum and adipose tissue (Yang et al., 2017)

Fanning and Anderson, 1996

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Monitoring: Follow fracture healing with serial X-rays (typically 2-4 week intervals standard care)