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However, it is also associated with the concept of 'integration', albeit with a low frequency

Durham said that he voted no because of poor characterization of the compound and the potential risk with carcinogenicity. William Zamboni, a pharmacologist at the University of North Carolina said that he voted no because he felt there was a significant lack of data on the safety of the product.

In the face of drug shortages and increased patient demand, a complicated set of foreign chemical manufacturers, middlemen distributors and repackagers, and compounding pharmacies offer cheaper versions of these drugs with less assurance of their quality