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Risk may be increased in patients with predisposing factors (e.g., renal disease, severe respiratory disorders, status epilepticus, diarrhea, surgery, ketogenic diet)

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Studies suggest proficiency in POEM is gained after approximately 25 procedures for those with advanced endoscopy experience

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A recent study reported a reduction in Akt/PKB kinase activity in the dorsolateral and ventrolateral subregions of the prefrontal cortex in a large cohort of patients with bipolar disorder compared with unaffected controls [140]