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This impairment of DNA synthesis affects the rapidly dividing cells of the bone marrow earlier than other cells, resulting in the production of large, immature, hemoglobin-poor red blood cells (macrocytosis), as well as effects on white blood cells, including abnormal (hypersegmented) neutrophils and reduced overall cell counts (pancytopenia)

The study population may have differed in meaningful ways

Implement dietary strategies for nausea (smaller meals, lower fat, adequate protein)

For Medicare, anesthesia reimbursement uses the Anesthesia Conversion Factor (ACF), which is adjusted annually and varies by geographic practice cost index (GPCI)