Objective: To determine whether the risk of upper gastrointestinal bleeding in patients taking low dose aspirin (≤ 325 mg/day) is increased in people with Helicobacter pylori infections. Study design: A systematic search for all publications since 1989 (when H. pylori was named) using search term equivalents for “upper gastrointestinal haemorrhage” and “aspirin”. Articles were assessed individually for inclusion of data on H. pylori infection, as not all relevant papers were indexed with this term. Data that could be pooled were then subjected to meta‐analysis, using a random effects model. Data sources: MEDLINE, Embase, Scopus, the Cochrane Library. Data synthesis: Of 7599 retrieved publications, reports for seven case–control studies contained data suitable for meta‐analysis; four were deemed high quality on the Newcastle–Ottawa scale. Upper gastrointestinal haemorrhage was more frequent in aspirin users infected with H. pylori than in those who were not (odds ratio [OR], 2.32; 95% CI, 1.25–4.33; P = 0.008). The heterogeneity of the studies was significant (Q = 19.3, P = 0.004; I2 = 68.9%, 95% CI, 31.5–85.9%), but the pooled odds ratio was similar after removing the two studies that contributed most to heterogeneity (OR, 2.34; 95% CI, 1.56–3.53; P < 0.001). The number needed to treat to prevent one bleeding event annually was estimated to be between 100 and more than 1000. Conclusions: The odds of upper gastrointestinal bleeding in patients taking low dose aspirin is about twice as great in those infected with H. pylori. Testing for and treating the infection should be considered in such patients, especially if their underlying risk of peptic ulcer bleeding is already high.

This paper examines economic, sociocultural, and behavioral risk factors that influence the compensating price difference (premium paid) between sex with and without a condom for female sex workers (FSWs) in U.S.-Mexico border cities. Field data collected in Ciudad Juarez on the price of sex with and without a condom for the same FSW respondent allowed calculation of the price premium for unprotected sex based on these paired prices, holding unobservable characteristics constant. A Tobit model was used to identify the factors determining the price premium. Key predictors of a larger price premium for sex without a condom included: length of time as a FSW; number of male clients; and participation in HIV education. Key predictors of a decrease in the price premium for unprotected sex included: age; a bad financial situation; frequent alcohol consumption before or during sex; and frequent drug use before or during sex.

Background and Aim The prevalence of primary biliary cholangitis (PBC) reported in different countries varies significantly and in some parts of the world appears to be increasing. The aim of this study was to determine the 2013 prevalence of PBC in Victoria, Australia, and to determine the time trend by comparing it with previous studies undertaken in 1991 and 2002. Methods Four case‐finding methods were used to identify cases of PBC in Victoria: (1) physicians' survey; (2) tertiary hospital search; (3) liver transplant database search; and (4) private pathology antimitochondrial antibody search. Results The prevalence of PBC in Victoria, Australia, is 189.0 per million using all four methods. The average annual increase in prevalence from 1991 to 2013 was 7.7 per million per year. Using the same case‐finding methods as the 1991 Victorian prevalence study (methods 1 and 2), the prevalence of PBC increased from 19.1 per million in 1991 to 49.4 per million in 2002 (P < 0.001) and to 80.7 per million in 2013 (P < 0.001). Conclusions The current prevalence of PBC in Victoria is significantly higher than previously reported. The use of private pathology‐based case‐finding methods is important in identifying the maximum number of PBC cases.

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