Dr. Gray's Hospital is a district general hospital in Elgin, Moray, Scotland. It is managed by NHS Grampian.
Studies have compared proton pump inhibitors (PPI) with Histamine 2 receptor antagonists (H2RA) and placebo for upper gastrointestinal bleeding (UGIB) prophylaxis in mechanically ventilated patients. We conducted this meta-analysis to compare PPI with H2RA or placebo for UGIB prophylaxis in these patients. Our outcomes of interest were clinically important UGIB, overall UGIB, mortality, ventilator-associated pneumonia (VAP) and Clostridium difficile infection (CDI). We calculated pooled risk ratio (RR) with 95% confidence intervals (CI) for all outcomes. We included eight RCTs comprising 32,873 patients. Risk of clinically important UGIB was significantly lower in PPI group, RR (95%CI): 0.53 (0.32, 0.89). Risk of overall UGIB was also significantly lower in PPI group. There was no significant difference in mortality, VAP and CDI between groups. This meta-analysis demonstrates the superiority of PPI to H2RA and placebo for prophylaxis of UGIB in mechanically ventilated patients, without increasing the risk of adverse events.
OBJECTIVE:Refrigeration of food has been shown to mitigate environmental and dietary risk factors important in the pathogenesis of gastric cancer. Globally, the incidence of gastric cancer has decreased. This study aims to determine the relationship between refrigerator ownership and gastric cancer. METHODS:Gastric cancer data were obtained from the Global Burden of Disease study, and refrigerator ownership data were sourced from GlobalDataLab. Countries were excluded from the analysis if they lacked refrigerator ownership data for more than 10 years or had over 80% ownership at the start of data collection. The relationship between the two variables was assessed using Spearman's rank correlation coefficient. RESULT:Countries were screened using the inclusion criteria, and 85 countries from five continents were included in the study. Seventy-three countries demonstrated a negative correlation between refrigerator ownership and gastric cancer among their male populations, and 55 countries showed comparable results among their female populations. Thirteen countries exhibited a positive correlation between the two variables. CONCLUSION:Increasing refrigerator ownership appears to be associated with decreasing gastric cancer rates. Further research is needed to identify the specific risk factors involved in gastric cancer pathogenesis in the 13 countries where this association was not observed.
