Critically ill patients admitted to the intensive care unit (ICU) are at risk of developing gastrointestinal (GI) bleeding owing to stress ulcers, which is associated with a prolonged length of stay (LOS) in the ICU and an increased risk of death.
- To prevent GI bleeding in these critically ill patients, ICU doctors frequently prescribe stress ulcers prophylaxis (SUP).
- Proton pump inhibitors (PPIs) and histamine type 2 receptor blockers (H2Bs) are the most commonly used SUP agents.
- Sepsis has been considered a risk factor for the development of stress ulceration and GI bleeding for many years, and SUP is recommended by the Surviving Sepsis Campaign guidelines for patients with sepsis or septic shock who have risk factors for GI bleeding.
- Although these guidelines further recommend either H2Bs or PPIs when SUP is indicated, there is limited evidence of the effects of H2Bs in comparison with PPIs when used as SUP in critically ill patients with sepsis.
- A recent meta-analysis of a general population of patients in the ICU suggested that PPIs are the most effective agents in preventing clinically important GI bleeding. However, two retrospective studies found that PPIs were associated with a higher rate of GI bleeding than H2Bs.
- In clinical practice, PPIs are more commonly prescribed by critical care providers, possibly because of their superior acid suppression capability in comparison with H2Bs.
- However, PPI use is not without risk. Some studies have shown that patients receiving PPIs have a higher risk of nosocomial pneumonia, Clostridium difficile infection(CDI), and myocardial infarction.
- Accordingly, it is reasonable to evaluate the comparative effects of SUP using PPIs and H2Bs on important outcomes in patients with severe sepsis or septic shock.
- A retrospective cohort study compares two strategies for SUP among adult patients with sepsis or septic shock who have risk factors for GI bleeding.
- Specifically, hypothesized that PPIs are associated with a lower occurrence of GI bleeding and in-hospital mortality than H2Bs but may increase the risk of pneumonia and CDI.
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Answer: Glucose and Oxygen
Explanation: The two products of the light dependent reactions in photosynthesis are glucose and oxygen and are produced through the reconstruction of water and CO2 in the air. The light independent reactions also known as cellular respiration is a process identical to the human cellular respiration where glucose is broken down and rearranged with oxygen to create mechanical energy leaving CO2 and H2O left over.
Answer:
They are: mutation, non-random mating, gene flow, finite population size (genetic drift), and natural selection.
Explanation:
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Ah, I'm not sure. I hope someone helps you!
Answer:
3. sexual selection
Explanation:
Because artificial selection is the one made by humans like dog breeds.
Disruptive selection is when extreme values for a trait in a population are favored like big and small sizes. Stabilizing is when the trait is pushed towards the average. Sexual selection is when the trait aids in competition among individuals for access to preferred mates.
