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Cymbalta (Duloxetine)

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Duloxetine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). This medication works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

Other names for this medication:
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Also known as: Duloxetine


{name} (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). Duloxetine affects chemicals in the brain that may be unbalanced in people with depression.

{name} is used to treat major depressive disorder in adults. It is also used to treat general anxiety disorder in adults and children who are at least 7 years old.

{name} is also used in adults to treat nerve pain caused by diabetes (diabetic neuropathy), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain).

{name} is also used to treat fibromyalgia (a chronic pain disorder) in adults and children at least 13 years old.


Usual Adult Dose for Depression:

Initial dose: 20 mg to 30 mg orally 2 times a day Maintenance dose: 60 mg per day, given either once a day OR 30 mg orally 2 times a day Maximum dose: 120 mg/day.

Usual Adult Dose for Fibromyalgia:

Initial dose: 30 mg orally once a day for at least 1 week Maintenance dose: 30 to 60 mg orally once a day.

Usual Adult Dose for Generalized Anxiety Disorder:

Initial dose: 60 mg orally once a day Maintenance dose: 60 to 120 mg orally once a day Maximum dose: 120 mg/day.

Usual Adult Dose for Pain:

Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day.

Usual Adult Dose for Neuropathic Pain:

Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day.

Usual Adult Dose for Chronic Pain:

Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day.

Usual Geriatric Dose for Generalized Anxiety Disorder:

Initial dose: 30 mg orally once a day for at least 2 weeks Maintenance dose: 60 mg orally once a day Maximum dose: 120 mg/day.

Usual Pediatric Dose for Generalized Anxiety Disorder:

7 to 17 years: -Initial dose: 30 mg orally once a day for at least 2 weeks -Maintenance dose: 30 to 60 mg orally once a day -Maximum dose: 120 mg/day.

Usual Pediatric Dose for Fibromyalgia:

13 years and older: -Initial dose: 30 mg orally once a day for at least 1 week -Maintenance dose: 30 to 60 mg orally once a day.

Detailed Cymbalta dosage information


If you take an overdose of Cymbalta, you should seek emergency medical attention or contact your healthcare provider immediately.


Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) and away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Cymbalta are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Do not take Cymbalta if you are allergic to Duloxetine, other SNRIs or to any of the medication's components. Do not take Cymbalta if you have taken recreational drugs such as ecstasy (MDMA), ketamine, LSD, poppers (amyl nitrate), narcotics or benzodiazepines. Do not take Cymbalta if you are taking other medications, including erythromycin, alpha-blockers, antifungal medications (ketoconazole and itraconazole), medications for HIV (ritonavir, saquinavir, nelfinavir and atazanavir), certain antibiotics (telithromycin), alprazolam (Xanax), anticoagulants (warfarin), antidepressants (Elavil, Asendin, Anafranil, Norpramin), MAOI antidepressants (Marplan, Nardil, Eldepryl, Emsam, Zelapar), SSRI antidepressants (fluvoxamine), herbal remedy St. John’s Wort, NSAIDs (Advil, Motrin, Aleve, Naprosyn), clopidogrel (Plavix), diazepam (Valium), digoxin (Lanoxin), diuretics ('water pills'), linezolid, flecainide (Tambocor), medications for diabetes, lithium (Eskalith, Lithobid), medications for anxiety and Parkinson's disease, methylene blue, medications for mental illness (Clozaril, Haldol), medications for migraine (Axert, Relpax, Frova, Amerge), medications for seizures (Tegretol, Dilantin), sedatives, sibutramine (Meridia), sleeping pills, tramadol (Ultram), tranquilizers, and vinblastine (Velban). Do not take Cymbalta if you experience seizures (convulsions or fits). Do not take Cymbalta if you suffer from or have history of cardiovascular disease, liver or kidney disorders, hypotension, leukemia, peptic ulcer disease, rhinitis, glaucoma, epilepsy. Do not take Cymbalta if you have a history of fainting, mania (feeling overexcited, irritable or not being able to think clearly) or severe depression. Do not take Cymbalta if you have recently undergone a surgery. Do not to consume alcohol, drive or operate machinery while using Cymbalta, as it can lower your blood pressure, causing dizziness, drowsiness. Cymbalta is not for use in patients under age 18 years.

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Here, we report the clinical and laboratory assessment and therapeutic approach of a series of three cases diagnosed (in order of) one week, three months and one and a half years after presentation of the first symptoms of the disease. Recently, Doppler echocardiography has been used to examine the different diastolic filling patterns of the left ventricle in health and disease, but confusion about diagnosis and treatment options has arisen because of the misinterpretation of these flow velocity curves. We demonstrate that T cell reconstitution after the initiation of insulitis precipitates the onset of diabetes through the recruitment of donor T cells to the autoimmune process. The results of our study indicated that pulsatile assist produced superior circulation in the kidney, and the microcirculation on the cell level was superior as well in early treatment of acute left heart failure. Our experience with Chinese MPCNL demonstrates that it is safe, feasible and efficient for managing the intrarenal calculi in solitary kidney with a low complication rate. This pathology is rare, but is important to diagnose because of the possible haemorrhagic complications encountered. To present the first repeat procedure and a simple way for management of balloon rupture during balloon vaginoplasty (BV) procedures.

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Development of and considerations on the future of gastrointestinal surgery in China. (2) Flupenthixol especially improves the ability to cope with stress, the ability to achieve something and feeling more relaxed. Suggestion of HCC should lead to early liver transplantation, which was successful without tumor recurrence in the two patients. The results of our investigation suggest that histological evidence of blood accumulation or of haemorrhages in thyroid cartilage is not a reliable criterion to distinguish between haemorrhagic lesions due to strangulation and other types of blood accumulation or artefacts. Subjects were instructed to pay covert attention and to respond to a frequency in a given hemifield ignoring all other stimuli. In support of the existence of an autocrine or paracrine platelet-derived growth factor (PDGF) loop, an early rise in expression of the PDGF A-chain gene and a subsequent rise in expression of the PDGF alpha-receptor gene were noted. We report the synthesis of three norpiperidine imidazoazepines representative of a new class of selective and nonsedating H(1) antihistamines. Glycation was further confirmed by the mass spectral analysis of the retained and unretained fractions from glycoaffinity chromatography of HSA from freeze-dried serum.

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A high index of suspicion is required when risk factors of CVT are present. Inhibition of the development of Q-bands on human chromosomes by netropsin. There are many reasons for this discrepancy, including difficulties in the appropriate interpretation of preclinical data and clinical trial design. FVL represents a common genetic trait that may protect against blood loss and transfusion in this population. This reinforces the need to consider differences between men and women in efforts to promote and support healthy weights among Canadians. Rheumatoid arthritis complicating adjuvant interferon-alpha therapy for malignant melanoma. Both of these promoters had functional IFN-stimulated response element and NF-kappaB binding sites. The association between adverse cardiovascular events and plasma homocysteine persists in older populations. Suspicion of a DCMA syndrome prompted sequencing of the human DNAJC19 gene. An easily sterilizable, flexible cassette with intensifying screens, designed for X-ray examination of operatively exposed kidneys.

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High-dose glucosamine associated with polyuria and polydipsia in a dog. The regions of highest V1a receptor density included the prefrontal, cingulate, pyriform, and entorhinal cortex, as well as the presubiculum and mamillary bodies. TMEP is a rare form of mastocytosis, which is localized to the skin, although systemic involvement has been reported. Findings highlight the importance of prospective multivariate models that specify potential selection, causation, socialization and reciprocal effects in order to fully examine complex relations among variables, including alcohol involvement, during major life-transition periods. Applications of the reaction to form a range of analogues by manipulation of the tether using both organolithium reagents and Diels-Alder cycloadditions are described.

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The isolates were found to be most closely related to the marine bacterial genera Alteromonas, Citreicella, Marinomonas, Marinovum, Pelagibaca, Rhodovulum, Sulfitobacter, Thalassobius, Thalassococcus, Thalassospira, and Tropicibacter. In this retrospective investigation 7 patients operated on for recurrent trigeminal neuralgia via a suboccipital enlarged burr hole trepanation were evaluated. Repeated reports of more than ten years postoperative survival in patients with glioblastoma multiforme (GM) have appeared in the literature over the last decades. Atherosclerosis is considered as a disease of the old and increases with the ageing process. The IR analyzer should be particularly useful for the diagnostic test of H.

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We have previously shown that high lung inflation increases wall stress in pulmonary capillaries. Animal model experiments have suggested that diabetes inhibits cell proliferation during fracture healing. Proximity effects in the palladium-catalyzed substitution of aryl fluorides. Trapped plasma before and after infusion of low molecular weight dextran. The patient presented with multiple fractures in the proximal humeri and femurs without osteopenia in the vertebrae. In populations with selection, EBVTA was more accurate and resulted in higher responses than selection on EBVRA. CD4 count and antiviral treatment were inversely correlated with the concentration of HIV in semen.

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Additional evidence of multiplication of the sowthistle yellow vein virus in an aphid vector--serial passage. Nonetheless, six large clinical trials designed to demonstrate such effects in patients at high cardiovascular risk, comparing ARB with placebo, failed to demonstrate any cardiovascular protection by ARB. Increases in leukostasis/monocyte adhesion to the capillary endothelium (leukostasis) and decreases in retinal blood flow may be causally associated and are implicated in the pathogenesis of diabetic retinopathy. Quantitative estimates such as these can be used to support individual informed choices about screening. Estrogens regulate the bone metabolism, adversely affecting peak bone mass and prohibiting the bone loss. gingivalis serotype or ribotype is directed mainly against antigens that are not shared by other potentially infective clonal types. Label-free quantitative proteomic analysis reveals dysfunction of complement pathway in peripheral blood of schizophrenia patients: evidence for the immune hypothesis of schizophrenia. Incubation with ox-LDL led to intense contractile and electrophysiological effects including prolongation of action potential duration, depolarization of resting membrane potential, spontaneous activity, generation of afterdepolarizations, and modification of transmembrane ion currents (e.g.

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While these findings may be due to chance, in particular where differing associations were seen between males and females, they do provide evidence of early life associations with telomere length much later in life. MALDIquant is an R package providing a complete and modular analysis pipeline for quantitative analysis of mass spectrometry data. A total of 40 sequentially treated pemphigus vulgaris patients, diagnosed using clinical, histological and immunofluorescence criteria, were evaluated for laryngeal manifestations using endoscopic examination. Surprisingly few studies described the value of Doppler parameters in patients from the community. Retinal detachment with macular hole following combined photodynamic therapy and intravitreal bevacizumab injection.

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In this focused review, we summarize the status of serum protein biomarkers in bTBI in the context of the classification and pathological changes of other forms of TBI. Females are more prevalent in cranial dystonia and there is a preponderance of males in the dystonias with a lower location. Effect of endothelin-1 receptor antagonists on histological and ultrastructural changes in the pancreas and trypsinogen activation in the early course of caerulein-induced acute pancreatitis in rats. Late cutaneous fistulae represent a complication that is difficult to deal with as their treatment has yet to be clearly identified. Association of Food Premises Inspection and Disclosure Program with retail-acquired foodborne illness and operator noncompliance in Toronto.

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We screened all exons of the E-cadherin gene for mutations in 101 Japanese patients having an intense family history of gastric cancers. Inductively coupled plasma-mass spectrometry (ICP-MS) and inductively coupled plasma-atomic emission spectrometry (ICP-AES) analysis showed elevated levels of As, Cd, Cr, Mn, and Pb in all biological samples taken from populations living close to the mine compared to controls. BRCA1 plays an important role in DNA damage and repair, homologous recombination, cell-cycle regulation and apoptosis. These advantages make it useful for stereo viewing or for quantitative stereomicroscopy provided necessary consideration is given to errors that may result from the technique. Young (9 weeks) and old (20 months) male Wistar rats, maintained under a light:dark cycle regimen of 12:12, were assigned randomly to either a single subcutaneous (s.c.) injection of saline or ghrelin (1 microg/rat or 15 microg/rat) 1 h before sacrifice in the middle of the dark phase, or repeated s.c. Nineteen patients (twenty-one knees) with chronic patellofemoral instability who had failed conservative treatment underwent this procedure and were assessed clinically and radiologically at an average of 23 months post-operation.

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All these ligands induced tyrosine phosphorylation of proline-rich tyrosine kinase 2 (Pyk2) and its substrate paxillin, an integrin-associated focal adhesion adaptor protein, in the macrophages. In this study, we investigated the effect of PRV on peritoneal transport characteristics. Isolates from surgical drainage of pericardial fluid showed Acinetobacter baumannii exhibiting multiple antibiotics resistance. Problems faced in conducting a blindness survey in a developing country. Molecular biological study of aloe vera in the treatment of experimental allergic rhinitis in rat. In particular, the protein is found at tissues providing a barrier or secretory function. Rod-cone interaction in human scotopic visiion--III: Rods influence cone increment thresholds. The questionnaire dealt with UADS relating to voice and swallowing symptoms and sought to quantify their severity. Mast cells (MCs) and nerves can induce cutaneous inflammatory responses, both independently and by interacting with each other. This study evaluates the health effects of mold-contaminated schools on students and teachers.

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To determine the efficacy of radiation treatment in elimination of foodborne pathogens, seeds inoculated with 4 log CFU/g of Salmonella Typhimurium were treated with radiation doses of 1 and 2 kGy. Although mechanisms of kinetochore signaling and SAC inhibitor assembly and function have received the bulk of attention in the past two decades, recent work has focused on the principles of SAC silencing. Such models are suitable for many complex diseases, where there are gene-interactions. Effect of hypertension on cell proliferation and apoptosis in benign prostatic hyperplasia. The high uptake of Mn into the brain of neonatal rats may be due to high levels of Mn in the blood, which may be supplied from the liver. Contagious caprine pleuropneumonia in the Thrace region of Turkey. 5-Fluorouracil derivatives were isolated from the marine sponge Phakellia fusca collected around the Yongxing Island of the Xisha Islands in the South Sea of China. We report the first case of polyneuropathy induced by levetiracetam, an anti-epileptic medication. Strikingly, in all six patients who received markedly decreased numbers of SSC(lo)ALDH(br) cells, this was associated not only with almost complete loss of CFU-GM potential but also with delayed establishment/permanent absence of full hematopoietic donor cell chimerism, whereas all other patients showed early complete donor chimerism. Multi-channel Si-liquid crystal filter with fine tuning capability of individual channels for compensation of fabrication tolerances.

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The muscle was originating from the thick fascia around the popliteal vessels. Four new, highly oxygenated nortriterpenoids with unique schisanartane skeletons, micrandilactones D-G (1-4), have been isolated from the leaves and stems of Schisandra micrantha, and their structures have been elucidated on the basis of extensive spectral studies. Enhanced functional capacity of the peritoneal macrophages as antigen presenting cells after aclacinomycin treatment in mice. The neoplasms described developed in guinea pigs, aged over 4 years, and they are referred to as mostly common tumors in this species of animals. A fixed combination of the whole, blooming, fresh plant with clear seed formation ( Iberis amara totalis) is used in a phytotherapeutical product (Iberogast). Using optical microscopy, it was demonstrated qualitatively that fragmentation of the large drug particles was occurring during tablet compression. Antiviral therapy has demonstrated clear evidence of efficacy in vasculitis related to the HBV and, to a lesser degree, the HCV. Thus under incubation conditions where ET18-OCH3 inhibited the proliferation of MCF-7 cells, the ether lipid potently inhibited the activity of PKC in intact cells. This requires continuous intervention and raises a natural question: Can origami arise through self-organization?.

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Difficulties in establishing the correct diagnosis may be caused by a lack of awareness of the condition among physicians. A review of maximum dose of amaryl rating scales for measuring behavior change due to frontal systems damage. The angle between prism rows and the enamel-dentin junction increased from 44 degrees to 48 degrees, while the angle of decussation increased from 60 degrees to 70 degrees. However, high levels of Ezh2 remained present in differentiating oligodendrocytes until myelinating. Two types of lipid-containing cells were found in diet-induced atheromata of rabbits. In a prospective, nonrandomized study, 120 patients have been switched from oral anticoagulants to LMWH because of bleeding complications or other severe side effects during treatment with vitamin K antagonists. IL-10-dependent suppression of experimental allergic encephalomyelitis by Th2-differentiated, anti-TCR redirected T lymphocytes.

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Effect of positive external pressure on calf volume and local venous haemodynamics. To examine clinical outcomes associated with optional beta blockade in a population of patients with evidence of heart failure after myocardial infarction. The high prevalence of thrombophilic defects in the population, the association of defects with venous thromboembolism and the special considerations for management make it a widely debated subject. Patients who have an inpatient report filed for SCAN are often of high medical acuity, less likely to have physical findings, and may present with injuries or illnesses unrelated to the SCAN. Evaluation of PMPs in BALF may be useful in evaluating strategies for lung-protective ventilator treatment. Study of the phenomenon of splenic cell migration inhibition in experimental ascariasis. When PDGF and HGF were simultaneously added, HGF inhibited the prolonged activation of ERK, which suggests that early inactivation of PDGF-induced ERK may be involved in the inhibitory effect of HGF on mesangial cell proliferation.

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The identification of an STI in a child imitrex 6 mg injection , in addition to medical implications, can have serious legal implications. Effect of uncouplers on the transport of anions in rat-liver mitochondria. Autonomic phenomena of temperature regulation in temporal lobe epilepsy. The genetically engineered catalytically active homodimeric bifunctional DHFR-TS was expressed, purified and characterized. E-cadherin expression in human epithelial ovarian cancer and normal ovary. Laparoendoscopic single-site surgery has been recently applied in several surgical procedures. Despite preclinical in vivo activity in ATC, pazopanib has minimal single-agent clinical activity in advanced ATC. China is very rich in cavefishes and some detailed studies on their taxonomy and biology have been carried out, but many other aspects such as genetics and evolution need further investigation. The elderly in 2021 need an additional of 60 to 70 percent more internists than the elderly of 2009. Cytogenetic and clinicopathological analysis of soft-tissue leiomyosarcomas.

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We report on a female with lymphedema, facial anomalies, intestinal lymphangiectasia, and moderate mental retardation consistent with the diagnosis of Hennekam syndrome. MFV in the MCA of the undamaged hemisphere 1 month after admission correlated negatively with FIM scores during inpatient rehabilitation. Colic is the single most important cause of mortality in horses and there is evidence that a proportion of colic cases are associated with infection with the intestinal cestode Anoplocephala perfoliata. Five to ten ml maternal serum was obtained from 24 pregnant women with 16 male fetuses and 8 female fetuses (including 4 carriers with X-linked diseases). The increased DNA content of the L-2 cells indicates transformation and may be associated with the inability to synthesize surfactant.

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Potentiality of a new compound for in vitro differentiation between halophilic and non-halophilic vibrios. In clinical practice, the emergence of zyrtec 10 mg price mutations at position Q148 should be monitored whenever possible. Phagocytosis increased when Syk activity and expression were reduced, suggesting that normally Syk down regulates CR3-mediated myelin phagocytosis. Effect of alpha-trinositol on interstitial fluid pressure, oedema generation and albumin extravasation in experimental frostbite in the rat. Beta-lactam antibiotics are reported to exhibit time-dependent bactericidal activity.

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Improving relationships with commercial supporters of medical education. To assess the practice of BSE and its correlated factors and particularly barriers amongst urban women in Malaysia. One of the main problems in multimodal cancer treatment is the lack of prognostic parameters for the individual patient. In particular, the development of standard exchange and archive formats for crystallographic data has allowed the editorial office to conduct automated analyses of structural data supporting articles submitted for publication and these analyses assist the scientific editors in careful and critical peer review. TSA-IL6 tumours were significantly less metastatic than TSA-neo tumours. Generation of cyanide ion by the reaction of phenol with nitrous acid in wastewater. Periventricular leucomalacia and preterm birth have different detrimental effects on postural adjustments.

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One method through which the ACE on survival can be estimated involves appropriately averaging over Cox-regression-based fitted survival functions. The inhibitory actions of ten trichothecene antibiotics were investigated, in reticulocyte cell-free systems synthesizing protein in vitro, by studying polyribosome profiles and kinetics of amino acid incorporation in the presence or absence of the drugs. It is plausible to see the scientific community as a whole having such a fiduciary obligation to the broader public in virtue of the technical complexity of the issues and owing to the public funding and institutional support for scientific research. This should be taken into account in studies of the genetics of ischemic stroke. In terms of dental arch alignment, a quad helix can achieve in 3 to 4 months what would otherwise take a great deal longer and at least a series of arch changes. The patient recovered slowly thereafter, but later developed a gastric stricture and pulmonary embolism. These autoantibodies also serve to predict type 1 diabetes in nondiabetic individuals. The pulse energy reaches 3.13 nJ, surpassing the conventional power limit in the dispersion-managed soliton regime. These sites are determined by structure and polarity of the cyclohexapeptides. Adrenocortical cancer (ACC) is a rare and aggressive tumor often diagnosed at the late stage of its development.

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The nodules are enriched in iron and depleted in manganese relative to Atlantic Ocean averages. Of the risk factors examined, only agricultural work and rural residence were significant. To identify the glycosphingolipid(s) which participates in the fusion process, we have analyzed the interaction of HIV-1 gp120 (X4 and R5X4 isolates) with reconstituted membrane microdomains of human erythrocyte glycosphingolipids. Addition of type II secretory phospholipase A2 (sPLA2), a PLA2 isoform that is detected in microg flagyl dosage to treat c diff /ml levels in inflammatory exudates, to NGF-stimulated CTMC significantly augmented delayed, but not immediate, PGD2 generation, and this augmentative effect was mediated in part by the enhancement of COX-2 expression by sPLA2. The time to mobilisation, degree of pain relief, blood pressure, respiration and motor function were recorded at regular intervals postoperatively for 40 h. The temperature-dependent K(d) values for cap analogues were markedly lower, indicating tighter binding, with the eIF4E(K119A) mutant compared with wild-type eIF4E.

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