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According to a 2017 systematic review in the Journal of Clinical Nursing confirming that aspiration before subcutaneous injection does not reduce adverse events, subcutaneous injections carry a distinct pharmacokinetic profile that intramuscular delivery disrupts, which is why correct angle and depth matter for predictable results

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The stereospecific nature of the isomerization determines that the CO 2 lost, as isocitrate is oxidized to succinyl-CoA, is derived from the oxaloacetate used in citrate synthesis

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