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Clinical trials would need to assess both hemodynamic parameters and clinical outcomes including walking distance, pain scores, and amputation rates to establish therapeutic benefit

The elevated calcium levels also impair mitochondrial function, triggering the release of proapoptotic factors, including cytochrome c, and activating caspase-dependent apoptotic pathways ( tThe excitotoxicity induced by METH also triggers neuroinflammation and amplifies its neurotoxic effects

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There is no evidence from long-term use in patients with pernicious anemia that vitamin B12 is carcinogenic