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All patients provided their informed consent before the study and the protocol was approved by the Ethical Review Committee of Kursk State Medical University

Humans and other eukaryotic organisms lack the enzymatic machinery necessary for de novo Cbl synthesis and rely on external sources, such as diet or symbiotic bacteria, to obtain Cbl [85, 86]

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This underscores the urgent need for novel therapeutic strategies to mitigate residual cardiovascular risk in this high-risk population

Start slowly, patch test when trying a new product, and avoid applying to irritated or broken skin

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