There are several things to consider when trying to decide between gastric bypass surgery and gastric sleeve surgery. Unlike the laparoscopic adjustable gastric band (Lap Band), these two operations are both permanent, reduce hunger, and lead to the highest percentage of weight loss. To properly compare gastric sleeve surgery to gastric bypass surgery we will examine the following data : Expected weight loss. Speed of weight loss. Time of surgery. Gastric bypass benefits over sleeve. Gastric sleeve benefits over bypass. Risk of complications. Surgeon skill and preference.

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Physical assessment is taking an educated, systematic look at all aspects of an individual’s health status utilizing knowledge, skills and tools of health history and physical exam. To collect data- information about the client’s health, including physiological, psychological, sociocultural and spiritual aspects To establish actual and potential problems To establish the nurse-client relationship Method: The history is done first, then the physical examination focuses on finding data associated with the history. Health History- obtained through interview and record review. Physical exam- accomplished by tools and techniques ** A complete assessment is not necessarily carried out each time. A comprehensive assessment is part of a health screening examination. On admission, you will do an admission assessment (not necessarily including everything presented here) and document it on the admission form. You will do a daily shift assessment (patient systems review). And, if client has a specific problem, you may assess only that part of the body (focused). Data Collection: Information is organized into objective and subjective data: Subjective: Apparent only to person affected; includes client’s perceptions, feelings, thoughts, and expectations. It cannot be directly observed and can be discovered only asking questions. Objective: Detectable by an observer or can be tested against an acceptable standard; tangible, observable facts; includes observation of client behavior, medical records, lab and diagnostic tests, data collected by physical exam. ** To obtain data for the nursing health history, you must utilize good interview techniques and communications skills. Record accurately. DO NOT ASSUME. D. Frameworks for Health Assessment There are two main frameworks utilized in health assessment: Head to Toe- systematic collection of data starting with the head and working downward. Functional Health Assessment- Gordon’s 11 functional health patterns that address the behaviors a person uses to maintain health. PERSON is the ACC-ADN framework for assessment. It is similar to Gordon's functional health patterns.

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La palmitoiletanolamide (PeaVera, PeaPure, Palmidrol, Achille e altri PEA prodotti rappresenta una rivoluzione nel trattamento del dolore. Si tratta di un efficace analgesico naturale, senza effetti collaterali. La sua azione è stata documentata in molte centinaia di articoli scientifici. Il suo meccanismo è stato scoperto dalla professoressa Rita Levi Montalcini, premio Nobel per la medicina.

Qui è disponibile una breve introduzione su questa sostanza particolare. (Qui Informazioni per i medici) PEA è disponibile in Italia dal 2007 ed è stata classificata dal Ministero della Salute italiano come alimento dietetico per fini medici speciali.

Neuropathic pain: often difficult to treat. Palmitoylethanolamide (PEA) is a very special molecule, produced in our own body, against pain and chronic inflammation. PEA is available as supplement and as cream, and as dietfood for medical purposes in Italy and Spain. It has been explored since 1957 and has a clear analgesic and anti-inflammatory efficacy, and virtually no side effects. Meanwhile within the context of clinical trials 5000 patients have been using PEA, and its efficacy and safety has been documented in more than 400 scientific papers: http://palmitoylethanolamide4pain.com/about-2/ a website containing 400+ scientific articles on PEA in 6 different languages. The PEA datapool.

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poor posture (postural kyphosis) – slouching, leaning back in chairs and carrying heavy bags can stretch supporting muscles and ligaments, which can increase spinal curvature. abnormally shaped vertebrae (Scheuermann's kyphosis) – if the vertebrae don't develop properly, they can end up being out of position.

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