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If the vial is exposed, keeping it in a dark area of the refrigerator is a simple precaution

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[3] The British Society for Haematology guidelines emphasise that the response to treatment should be monitored through clinical assessment and blood count testing, rather than routine measurement of B12 levels after treatment has started

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We cannot take a sick passenger on an excursion that represents a potential risk for that passenger and for the integrity of the group (this can be evaluated by the guide at the beginning of the tour)