Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
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Review
Fast-track recovery after major liver and pancreatic resection from the nursing point of view.
Postoperative fast-track recovery protocols combine various methods to support immediate care of patients who undergo major surgery. These protocols include control of postoperative pain and early beginning of oral diet and mobilization. The combination of these approaches may reduce the rate of postoperative complications and facilitate hospital discharge. ⋯ Reports focusing on the implementation of a fast-track protocol in the postoperative recovery of patients after major hepatectomy or pancreatectomy were selected. Fast-track protocols may be applicable to patients recovering after major liver or pancreatic resection. Future research should be focused on particular parameters of the fast-track protocol separately.
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Celiac disease is an autoimmune disease affecting individuals at any time across the developmental lifespan. The only treatment for celiac disease is lifelong adherence to a gluten-free diet to prevent future complications and malignancies. The ratio of occurrence between children and adolescents is 1:104. ⋯ An abundance of both qualitative and quantitative studies from the Netherlands, Europe, and Canada focusing on adolescents with celiac disease and adherence to the gluten-free diet was found in the literature. Conversely, in the United States, there was a dearth of literature examining adolescents diagnosed with celiac disease, their adherence to a gluten-free diet, and their lived experience of having celiac disease. The relevance to nursing practice and recommendations for future research are discussed in light of these findings.
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The sedative-hypnotic propofol (2,6-diisopropylphenol) is being increasingly used for sedation during painful diagnostic and therapeutic procedures in adults and children. The purpose of this article is to present a general overview of the use of propofol for endoscopic sedation. Advantages and disadvantages of using propofol for sedation, as well as its pharmacokinetics, preparation for use, dosing for endoscopic sedation, auxiliary sedative and analgesic medication options, methods of administering, adverse effects with interventions, recovery, and patient-physician satisfaction are discussed. Finally, next steps necessary to optimize future use of propofol are suggested.
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A 2007 survey of members of the Society of Gastroenterology Nurses and Associates identified a need for more evidence regarding sedation medications including propofol. Therefore, the Cochrane Database of Systematic Reviews, Cochrane Database of Randomized Clinical Trials, MEDLINE, CINAHL, EMBASE, and the National Guideline Clearinghouse (http://www.guideline.gov) databases were individually searched using the term propofol, limited to human, English, 2000-2009, review articles, and randomized clinical trials. ⋯ These minor adverse events included four studies reporting hypoxemia requiring occasional intervention, three studies reporting hypotension, and two studies reporting bradycardia. No patients required tracheal intubation, and no deaths were reported.