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It was presumed that this was an additional adulterant in patients who presented with opioid withdrawal because local data in Philadelphia, where the study took place, showed 98% of all non-medical opioid samples tested contained both fentanyl and xylazine

In summary, oxidative stress plays a pivotal role in male infertility, primarily through its deleterious effects on spermatozoa, which manifest as diminished motility, reduced fertilization capabilities, and compromised genetic integrity

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However, against this hypothesis of a primary defect in lymphatic tissue as the proximal cause of lipedema is that lymphatic vessel function as determined by lymphangioscintigraphy appears normal in many women with early stages of lipedema and only later can reductions in lymphatic flow rate or function be detected in many women with late stage lipedema (54,63,64)