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THE CLINICAL PROBLEM Acetaminophen (known as paracetamol outside the United States) is a commonly used analgesic and antipyretic agent, and its use is one of the most common causes of poisoning worldwide

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While skeletal muscle detoxifies ammonia, hyperammonemia decreases serum BCAA and increases myostatin levels, both of which result in inhibition of mammalian target of rapamycin signaling and decreased protein synthesis [41, 42]