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Most clinics cluster around two areas: the Mainstrasse and Roebling Point district near the riverfront, and the medical offices along Dixie Highway heading toward Florence

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The decision not to take serum methylnalonic acid and homocysteine concentrations into account as diagnostic markers and outcome variables was made bearing in mind that these are not normally determined, either at diagnosis or during follow-up, in patients with a vitamin B12 deficiency

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It minimizes the risk of attributing disease-related changes to medication effects and allows for clearer assessment of treatment safety once the patient's condition improves

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