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These include Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE

The syringe itself does not affect stability, but the needle gauge and injection technique matter

2008 Therrien G, Rose C, Butterworth J, Butterworth RF: Protective effect of L-carnitine in ammonia-precipitated encephalopathy in the portacaval shunted rat