Proton-pump inhibitors adverse effects: a review of the evidence and position statement by the Sociedad Española de Patología Digestiva

Introduction: In the last few years a significant number of papers have related the use of proton-pump inhibitors (PPIs) to potential serious adverse effects that have resulted in social unrest. Objective: The goal of this paper was to provide a literature review for the development of an institutional position statement by Sociedad Española de Patología Digestiva (SEPD) regarding the safety of long-term PPI use. Material and methods: A comprehensive review of the literature was performed to draw conclusions based on a critical assessment of the following: a) current PPI indications; b) vitamin B12 deficiency and neurological disorders; c) magnesium deficiency; d) bone fractures; e) enteric infection and pneumonia; f) interactions with thienopyridine derivatives; e) complications in cirrhotic patients. Results: Current PPI indications have remained unchanged for years now, and are well established. A general screening of vitamin B12 levels is not recommended for all patients on a PPI; however, it does seem necessary that magnesium levels be measured at therapy onset, and then monitored in subjects on other drugs that may induce hypomagnesemia. A higher risk for bone fractures is present, even though causality cannot be concluded for this association. The association between PPIs and infection with Clostridium difficile is mild to moderate, and the risk for pneumonia is low. In patients with cardiovascular risk receiving thienopyridines derivatives it is prudent to adequately consider gastrointestinal and cardiovascular risks, given the absence of definitive evidence regardin potential drug-drug interactions; if gastrointestinal risk is found to be moderate or high, effective prevention should be in place with a PPI. PPIs should be cautiously indicated in patients with decompensated cirrhosis. Conclusions: PPIs are safe drugs whose benefits outweigh their potential side effects both short-term and long-term, provided their indication, dosage, and duration are appropriate.

Invisible, therefore isolated: comparative effects of team virtuality with task virtuality on workplace isolation and work outcomes

The new standards of technological and flexible arrangements have made virtual work prevalent for almost everyone in all levels of an organization. Whether in a virtual or traditional setting, current working conditions allow anyone to collaborate, work and interact with others through electronic means of communication, thereby creating a lack of face-to-face contact. Even though the dynamics of virtuality have been widely elaborated at the team level, there are still many unknowns about the impacts of virtuality experienced at an individual level. This paper aims to shed light on the relationship between workplace social isolation, job satisfaction, perceived performance and turnover intention comparing individual responses to team virtuality and task virtuality. Our findings propose that there are statistically significant relations between individual task virtuality, workplace social isolation, satisfaction, perceived performance and turnover intention in organizations. The results also reveal that task virtuality is a better predictor than team virtuality in estimating workplace social isolation and turnover intention.