How researchers and public health officials perceive the risk-benefit ratio of rolling out vaccines to under 5s varies around the world and depends on the impact covid-19 has had on that country. Sweden has had just a handful of fatalities in those aged under 18,6 and vaccines are still not available to children aged 5-11 years. But in Brazil the virus has killed an average of two children under the age of 5 each day7—a rate which equates to around one in every five deaths among under 5s worldwide. Understandably, doctors are keen to boost protection levels, fearful of the impact that future variants might have.
BMJ 2022;378:o1892 — https://doi.org/10.1136/bmj.o1892 (Published 23 August 2022)
BMJ
Covid-19: is omicron less lethal than delta?
This study provides the most conclusive evidence to date that infection with the omicron subvariant BA.1 was inherently less deadly than delta when controlling for a number of key covariates. Combining death certification records with molecular surveillance is the main advantage of this study, which avoids previous biases in covid-19 death designations. Accounting for a broad array of standardised covariates, including sociodemographic variables, pre-existing health conditions, and previous immunity, is another strength.
BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1806 (Published 02 August 2022)
Quote from the BMJ editorial. Here’s the link to the study:
Risk of covid-19 related deaths for SARS-CoV-2 omicron (B.1.1.529) compared with delta (B.1.617.2): retrospective cohort study — BMJ 2022; 378 doi: https://doi.org/10.1136/bmj-2022-070695
PPI’s and Gastric Cancer Risk
Objective The association between proton pump inhibitor (PPI) use and gastric cancer related to Helicobacter pylori eradication has not been fully investigated in geographical regions with high risk of gastric cancer. We aimed to evaluate the association between PPIs and gastric cancer in Korea.
Design This study analysed the original and common data model versions of the Korean National Health Insurance Service database from 2002 to 2013. We compared the incidence rates of gastric cancer after 1-year drug exposure, between new users of PPIs and other drugs excluding PPIs, by Cox proportional hazards model. We also analysed the incidence of gastric cancer among PPI users after H. pylori eradication.
Results The analysis included 11 741 patients in matched PPI and non-PPI cohorts after large-scale propensity score matching. During a median follow-up of 4.3 years, PPI use was associated with a 2.37-fold increased incidence of gastric cancer (PPI≥30 days vs non-PPI; 118/51 813 person-years vs 40/49 729 person-years; HR 2.37, 95% CI 1.56 to 3.68, p=0.001). The incidence rates of gastric cancer showed an increasing trend parallel to the duration of PPI use. In H. pylori-eradicated subjects, the incidence of gastric cancer was significantly associated with PPI use over 180 days compared with the non-PPI group (PPI≥180 days vs non-PPI; 30/12 470 person-years vs 9/7814 person-years; HR 2.22, 95% CI 1.05 to 4.67, p=0.036).
Conclusion PPI use was associated with gastric cancer, regardless of H. pylori eradication status. Long-term PPIs should be used with caution in high-risk regions for gastric cancer.
Association between proton pump inhibitor use and gastric cancer: a population-based cohort study using two different types of nationwide databases in Korea — https://gut.bmj.com/content/early/2021/05/11/gutjnl-2020-323845?rss=1
- Prevacid 24HR
- Nexium 24HR
- Prilosec OTC
- Zegerid OTC
OTC PPIs are only intended for a 14-day course of treatment and can be used up to three times per year.
Over-The-Counter (OTC) Heartburn Treatment — https://www.fda.gov/drugs/information-consumers-and-patients-drugs/over-counter-otc-heartburn-treatment
I was thinking of a snarky comment but decided against posting any snark.
But if you routinely pop a PPI before and/or after chowing down on a meat lover’s pizza you can’t say you weren’t advised that maybe it might be a better idea to give up the pizza.
Trends in excess mortality associated with atrial fibrillation over 45 years (Framingham Heart Study)
Conclusions
We found no evidence of a temporal trend in hazard ratios between newly diagnosed atrial fibrillation and all cause mortality. The hazard ratios for non-cardiovascular death declined over time but no evidence of a temporal trend for cardiovascular death was found. Mortality associated with newly diagnosed atrial fibrillation remained high compared with individuals without atrial fibrillation, despite showing some improvements over the past 45 years. More than 10 years after a diagnosis of atrial fibrillation, individuals with atrial fibrillation lose about two years of life compared with matched referents.
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2724 (Published 11 August 2020)
Cite this as: BMJ 2020;370:m2724
lifeunderwriter.net 