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Many articles in this study indicated the patients included had adequately followed these guidelines, some indicating patients fasting well beyond the recommended guidelines, and still noted either increased residual gastric contents, aspiration events, or other GI-related symptoms in the perioperative setting (Santos et al

Rapid calorie restriction is one of the most common triggers of telogen effluvium

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If symptoms persist beyond 812 weeks despite appropriate management, or if they significantly impair quality of life, referral for further assessment may be warranted

The key is consistency rather than perfection