BMJ : British medical journal
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To determine, in critically ill patients, the relative impact of proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), sucralfate, or no gastrointestinal bleeding prophylaxis (or stress ulcer prophylaxis) on outcomes important to patients. ⋯ PROSPERO CRD42019126656.
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Comment
Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline.
What is the role of gastrointestinal bleeding prophylaxis (stress ulcer prophylaxis) in critically ill patients? This guideline was prompted by the publication of a new large randomised controlled trial. ⋯ In most critically ill patients, the reduction in clinically important gastrointestinal bleeding from gastric acid suppressants is closely balanced with the possibility of pneumonia. Clinicians should consider individual patient values, risk of bleeding, and other factors such as medication availability when deciding whether to use gastrointestinal bleeding prophylaxis. Visual overviews provide the relative and absolute benefits and harms of the options in multilayered evidence summaries and decision aids available on MAGICapp.
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To estimate the risks of daily hospital admissions for cause specific major cardiovascular diseases associated with short term exposure to ambient fine particulate matter (aerodynamic diameter ≤2.5 μm; PM2.5) pollution in China. ⋯ These data suggest that in China, short term exposure to PM2.5 is associated with increased hospital admissions for all major cardiovascular diseases except for haemorrhagic stroke, even for exposure levels not exceeding the current regulatory limits.
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Observational Study
Bend it like Beckham or fix them like Florence-proportional representation of healthcare in New Year honours: an observational study.
To compare the proportional representation of healthcare workers in receipt of New Year honours (NYHs) with workers in other industries and to determine whether the NYH system has gender or geographical biases. ⋯ In relation to the size of its workforce, a career in healthcare is not as "honourable" as careers in certain other industries. Geographical and gender biases might exist in the honours system.