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Patients should be reviewed 812 weeks after commencing treatment to assess: Symptomatic improvement, particularly resolution of fatigue and neurological symptoms Haematological response (normalisation of haemoglobin and mean cell volume) Reticulocyte count typically rises within one week, indicating bone marrow response Repeat serum B12 testing is generally not useful after starting parenteral therapy, as levels remain elevated for months

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The activation of focal adhesion signaling through phosphorylation of FAK and paxillin is also posited to assist cell attachment and movement within the extracellular matrix and thereby facilitate repair

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