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Some experts feel that the increase in relative risk for venous thromboembolism conferred by tamoxifen for breast cancer prophylaxis does not differ much from that seen with oral contraceptives or hormone replacement therapy

Furthermore, some patients may adopt ketogenic or low-carbohydrate diets to enhance weight loss, which can produce ketones that impart a distinctive, sometimes sweet or fruity odour to urine

More efforts are necessary to establish the therapeutic window for cancer without contributing to other NAD-derived illness or toxicity