Curēus
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Standard preparation for a surgical procedure requires patients to fast (nulla per os [NPO]) after midnight before their operation. Unfortunately, given the unpredictable nature of operating room scheduling and unavoidable delays, patients may find themselves anxiously waiting and fasting much longer than expected. In recent years, the usefulness of prolonged fasting to prevent pulmonary aspiration has been questioned. ⋯ The study revealed significantly prolonged NPO times caused by delays in the scheduling of operation times. An analysis of delays revealed that prior surgical procedures running longer than scheduled were the most common reason for a delay in starting an operation and, subsequently, prolonging patient fasting time. Significantly prolonged fasting times warrant the need for institutional management strategy changes and a revamping of clinical education curriculums.
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Diverticulitis is a common ailment that is prevalent in the developed world. As such, the management of diverticulitis places a substantial economic burden on healthcare. Research is ongoing to further elucidate both the pathogenesis of the disease, as well as ways to reduce associated expenditures. ⋯ The consensus among the studies reviewed challenges the current practice guidelines issued by the American Gastroenterological Association. However, given the geographical difference in diverticular disease and inherent bias found in these studies, we cannot recommend a modification of the guidelines. Based on this literature review, we feel compelled to suggest, and strongly recommend, further research be conducted in the United States in order to bolster the already significant evidence against antibiotic therapy in acute uncomplicated diverticulitis.