The field of general surgery has changed dramatically over the last
ten years with the acceptance of laparoscopy as an extension of the scalpel.
Once ridiculed by most academic centers, laparoscopy has revolutionized
the management of biliary tract disease and has led to a critical
reassessment of how patients with other general surgical problems are
managed. The rapid advancement and acceptance of laparoscopy as a
part of general surgery is apparent today since most academic centers
have laparoscopic sections and many offer laparoscopic fellowships....
Before deciding whether to buy a good or service, consumers often have the opportunity to gather
information or simply spend time thinking about how much they would enjoy the good. Gathering or
processing information is costly, in terms of money, time, and e¤ort. A rm, through its advertising,
product design, and marketing strategies, can a¤ect these costs and make it easier or harder for
consumers to assess whether a product is a good match for their needs or preferences.
Further, Le Trong Trai et al. (2001) described that payments from these national
forestry programs have provided benefits to villagers in the short term, and Acacia
spp. and pine plantations established under these programs are growing reasonably
well. However, villagers brought attention to a number of problems they had to
face in response to the needs of the national forestry programs.
The unprecedented prospect of human-induced (rapid) changes to the global
climate has prompted a large international scientiﬁc effort to assess the evidence.
The IPCC, established within the UN framework in 1988, was charged with advis-
ing national governments on the causes and processes of climate change; likely
impacts and their associated costs; and ways to lessen the impacts. The IPCC’s
Third Assessment Report (2001) projects an increase in average world surface
temperature ranging from 1.4 to 5.8°C over the course of the twenty-ﬁrst
century (see Figure 1.1).
It is common practice to recommend nutritional supplementation, such as multi-vitamins and
iron, following bariatric surgery for all patients. However, evidence is scarce regarding specific
recommendations for pregnant women. We did not identify any randomized studies assessing
this question of efficacy of management strategies. Studies evaluating pregnancy following
laparoscopic adjustable gastric banding or gastric bypass have shown minimal nutritional
adverse events; however, most of these studies monitored and ensured that the women complied
with vitamin supplementation.
We did not identify any prospective cohort studies, which would be the strongest study
design to assess this question of risk. Consequently, our conclusions are tempered by the limited
available evidence. Based on these data, gastric bypass and laparoscopic adjustable band seem
to confer minimal if any risk for nutrient problems, as long as maternal nutrition is maintained.
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