tbuckley/cabot-search huggingface dataset:
Physician Time Spent Using the Electronic Health Record During Outpatient Encounters
Authors: Joseph A. Stankaitis
Journal: Annals of Internal Medicine (2020)

Letters6 October 2020Physician Time Spent Using the Electronic Health Record During Outpatient EncountersJoseph A. Stankaitis, MD, MPHJoseph A. Stankaitis, MD, MPHMonroe Plan for Medical Care and University of Rochester School of Medicine and Dentistry, Pittsford and Rochester, New York (J.A.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0275 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Overhage and McCallie's article (1) is a good start in assessing the use of EHRs for patient care. Of note, the study assumed that primary care providers had 12.3 patient encounters per day, with physicians spending an average of 16 minutes and 14 seconds per encounter actively using the EHR. This translates into approximately 3 hours and 20 minutes per day being spent with the EHR. One might have expected the rate of encounters in a general medicine practice over the course of an entire day to be higher. It would be helpful to know the breakdown ...Reference1. Overhage JM, McCallie D. Physician time spent using the electronic health record during outpatient encounters. A descriptive study. Ann Intern Med. 2020;172:169-74. [PMID: 31931523]. doi:10.7326/M18-3684 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Monroe Plan for Medical Care and University of Rochester School of Medicine and Dentistry, Pittsford and Rochester, New York (J.A.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0275. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPhysician Time Spent Using the Electronic Health Record During Outpatient Encounters J. Marc Overhage and David McCallie Jr. Physician Time Spent Using the Electronic Health Record During Outpatient Encounters Abigail Zuger Physician Time Spent Using the Electronic Health Record During Outpatient Encounters Kiyofumi Oya , Yuta Ishiyama , and Kashiwagi Hideyuki Physician Time Spent Using the Electronic Health Record During Outpatient Encounters J. Marc Overhage and David McCallie Physician Time Spent Using the Electronic Health Record During Outpatient Encounters John Weiser Metrics 6 October 2020Volume 173, Issue 7Page: 593KeywordsDietDisclosureDrugsElectronic medical recordsExerciseForecastingInfantsOutpatientsPatientsSystematic reviews ePublished: 6 October 2020 Issue Published: 6 October 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
SAT0227 An academic arthritis website is most frequently utilised for arthritis news and treatment information
Authors: JM White, JM Bathon, AK Matsumoto
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Medical and pseudo-medical information sites are the most heavily trafficked sites on the Worldwide Web. The Hopkins Arthritis Web Site was launched in late December 1998 to provide credible information about arthritis and its treatment to health care providers and patients. <h3>Objectives</h3> Our goal was to evaluate the topics most frequently accessed by visitors to the Site. <h3>Methods</h3> The information data base on the Site consists of a large body of ?static? information, as well as two interactive forums. The number of ?requests? for each page was monitored by Web Trends Enterprise Reporting Server. The number of requests per page was adjusted for number of months that the page was live, and sorted by topic into 1 of 6 categories. Requests were readjusted for number of pages per topic and calculated as a percent of total requests. Data were based on statistics compiled for the year 2000. <h3>Results</h3> The frequency of visits to the ?static? pages were as follows: news items (27%), pharmacologic treatment (21%), diagnostic/therapeutic guidelines (21%), event broadcasts (12%), disease-specific education (10%), and nonpharmacologic management (8%). Highlights of the ACR meetings were one of the most heavily accessed ?news item? postings on the Site. For the interactive forums, treatment related postings constituted the majority of postings: 55% of questions in ?Ask the Expert?, and 70% of postings to the Message Board. ?Hits? to the Site, and time spent on the Site, have increased steadily since launch, currently totalling 1,200,000 hits and 12 min per month, respectively. <h3>Conclusion</h3> The versatility of the Internet confers the unique ability to constantly update educational data bases. The desire for updated information is reflected on this Arthritis Web Site by the high frequency of visits to treatment and news related pages. Credible educational websites can effectively complement traditional on-site educational forums.
Automated digital reporting of clinical laboratory information to national public health surveillance systems, results of a EU/EEA survey, 2018
Authors: Katrin Claire Leitmeyer, Laura Espinosa, Eeva Kaarina Broberg, Marc Jean Struelens
Journal: Eurosurveillance (2020)

BackgroundTimely reporting of microbiology test results is essential for infection management. Automated, machine-to-machine (M2M) reporting of diagnostic and antimicrobial resistance (AMR) data from laboratory information management systems (LIMS) to public health agencies improves timeliness and completeness of communicable disease surveillance.AimWe surveyed microbiology data reporting practices for national surveillance of EU-notifiable diseases in European Union/European Economic Area (EU/EEA) countries in 2018.MethodsEuropean Centre for Disease Prevention and Control (ECDC) National Microbiology and Surveillance Focal Points completed a questionnaire on the modalities and scope of clinical microbiology laboratory data reporting.ResultsComplete data were provided for all 30 EU/EEA countries. Clinical laboratories used a LIMS in 28 countries. LIMS data on EU-notifiable diseases and AMR were M2M-reported to the national level in 14 and nine countries, respectively. In the 14 countries, associated demographic data reported allowed the de-duplication of patient reports. In 13 countries, M2M-reported data were used for cluster detection at the national level. M2M laboratory data reporting had been validated against conventional surveillance methods in six countries, and replaced those in five. Barriers to M2M reporting included lack of information technology support and financial incentives.ConclusionM2M-reported laboratory data were used for national public health surveillance and alert purposes in nearly half of the EU/EEA countries in 2018. Reported data on infectious diseases and AMR varied in extent and disease coverage across countries and laboratories. Improving automated laboratory-based surveillance will depend on financial and regulatory incentives, and harmonisation of health information and communication systems.
Immune checkpoint inhibitor associated reactivation of primary membranous nephropathy responsive to rituximab
Authors: Jamie S Lin, Daniel Y Wang, Omar Mamlouk, William F Glass, Maen Abdelrahim, Cassian Yee, Ala Abudayyeh
Journal: Journal for ImmunoTherapy of Cancer (2020)

The same mechanisms that mediate antitumor immunity from checkpoint inhibitors (CPIs) can also lead to unintended targeting of normal tissues, characterized as immune-related adverse events (irAEs). Those with pre-existing autoimmune disease are believed to be particularly vulnerable for exacerbating underlying autoimmunity or inducing severe irAEs. We report the first case of CPI-associated reactivation of primary membranous nephropathy (MN) in a patient with pleural mesothelioma responding to immunotherapy. Due to its specificity in targeting B-lymphocytes, rituximab was used to treat primary MN with the expectation that this would not interfere with the benefits gained from T cell-mediated antitumor immunity. Rituximab was effective in treating CPI-associated reactivation of MN, and the patient was successfully rechallenged with nivolumab and maintained stable kidney function and sustained clinical antitumor effect. While exacerbation of pre-existing autoimmune diseases from CPIs is common, therapy for autoimmune reactivation can be rationally directed by an understanding of the immunosuppressive mechanism with goals of cancer treatment.
Serial autoantibody detection in interstitial lung diseases: should they be repeated at follow-up?
Authors: P. Cameli, D. Plataroti, G.D. Rana, L. Bergantini, M. d'Alessandro, E. Bargagli
Journal: Pulmonology (2020)

Serial autoantibody detection in interstitial lung diseases: should they be repeated at follow-up?Interstitial lung diseases (ILDs) are a heterogeneous group characterized by progressive thickening of the lungs; they include a wide variety of lung pathologies of known and unknown cause.Idiopathic pulmonary fibrosis (IPF) and non-specific idiopathic pneumonia (NSIP) are the most common idiopathic ILDs. 1 The 2018 ATS/ERS international guidelines for the diagnosis of IPF recommend analysis of autoantibodies to exclude ILDs associated with connective tissue lung diseases (CTD-ILD). 1The diagnosis of IPF requires exclusion of other ILDs and serological evaluation of C-reactive protein, erythrocyte sedimentation rate, antinuclear antibodies, rheumatoid factor, myositis panel, and anti cyclic citrullinated peptide in newly diagnosed ILDs.Many biomarkers have been proposed in the literature for differential diagnosis but they are not yet approved for clinical use. 2 The guidelines also underline that there is no clear agreement on the serological tests to perform in the initial screening. 1Autoantibody determination is mainly required in cases with atypical IPF features, including women under 60 years of age, where interstitial lung involvement may be the first manifestations of CTD-ILD. 3 We therefore wondered whether autoantibody determination should be repeated regularly under specific conditions in patients with UIP pattern and negative serological test at onset, in order to verify the initial diagnosis of IPF, since some patients develop CTD manifestations months or years after the initial diagnosis. 3The question mainly concerns UIP and NSIP radiological patterns, i.e. the most frequent radiological features associated with rheumatoid arthritis, systemic sclerosis and Sjogren syndrome. 4e retrospectively evaluated a cohort of 91 patients (71 males, age 68.46 ± 7.70 years) diagnosed with IPF and treated with pirfenidone between August 2011 and January 2019: we selected patients who had undergone assay of serum autoantibodies.Five of them (2 males, age 69,8 ± 13,1 years) developed clinically evident CTD (2 Sjogren syndrome and 3 rheumatoid arthritis), that was confirmed by rheumatological tests and clinical evaluation.Concerning systemic manifestations of CTD, two patients reported sicca syndrome, one patient showed rheumatic nodules of the elbow and two patients complained of diffuse joint pain and stiffness.Mean time to CTD onset after
Transcatheter arterial chemoembolization-induced bile duct necrosis with hemobilia in hepatocellular carcinoma: endoscopic visualization and repair
Authors: Chi Hyuk Oh
Journal: Endoscopy (2020)

Transcatheter arterial chemoembolization (TACE) has been widely used as a palliative treatment for patients with unresectable hepatocellular carcinomas (HCCs) [1]. TACE is a relatively safe procedure, with a complication rate of < 1 % [2]. Hemobilia after TACE has very occasionally been reported [3], but endoscopic visualization of hemobilia has not been reported.
SARS Coronavirus-2 variant tracing within the first Coronavirus Disease 19 clusters in northern Germany
Authors: Susanne Pfefferle, Thomas Günther, Robin Kobbe, Manja Czech-Sioli, Dominic Nörz, René Santer, Jun Oh, Stefan Kluge, Lisa Oestereich, Kersten Peldschus, Daniela Indenbirken, Jiabin Huang, Adam Grundhoff, Martin Aepfelbacher, Johannes K. Knobloch, Marc Lütgehetmann, Nicole Fischer
Journal: Clinical Microbiology and Infection (2020)
Long‐term effectiveness of dupilumab up to 52 weeks in atopic dermatitis in 253 adult patients
Authors: E. Nettis, G. Fabbrocini, M. Ortoncelli, G. Pellacani, G. Argenziano, E. Di Leo, C. Patruno, L. Stingeni, C. Foti, F. Rongioletti, L. Macchia, S. Tavecchio, M. Napolitano, S. Ribero, L. Bonzano, G. Calabrese, D. Di Bona, S.P. Nisticò, K. Hansel, P. Romita, V. Piras, M. Carbonara, A. Detoraki, S.M. Ferrucci
Journal: British Journal of Dermatology (2020)

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (vol 74, pg 1376, 2019)
Authors: DK Arnett, RS Blumenthal, MA Albert, AB Buroker, ZD Goldberger, EJ Hahn, CD Himmelfarb, A Khera, D Lloyd-Jones, JW McEvoy, ED Michos, Miedema, D Munoz, Smith, SS Virani, KA Williams, J Yeboah, B Ziaeian
Journal: Journal of the American College of Cardiology (2020)
Notes from the Field: Botulism Type B After Intravenous Methamphetamine Use — New Jersey, 2020
Authors: Michelle A. Waltenburg, Valerie A. Larson, Elinor H. Naor, Timothy G. Webster, Janet Dykes, Victoria Foltz, Seth Edmunds, Deepam Thomas, Joseph Kim, Leslie Edwards
Journal: MMWR Morbidity and Mortality Weekly Report (2020)
Mechanisms of resistance to selective RET tyrosine kinase inhibitors in RET fusion-positive non-small-cell lung cancer
Authors: J.J. Lin, S.V. Liu, C.E. McCoach, V.W. Zhu, A.C. Tan, S. Yoda, J. Peterson, A. Do, K. Prutisto-Chang, I. Dagogo-Jack, L.V. Sequist, L.J. Wirth, J.K. Lennerz, A.N. Hata, M. Mino-Kenudson, V. Nardi, S.-H.I. Ou, D.S.-W. Tan, J.F. Gainor
Journal: Annals of Oncology (2020)

Rearranged during transfection (RET) gene fusions are a validated target in non-small-cell lung cancer (NSCLC). RET-selective inhibitors selpercatinib (LOXO-292) and pralsetinib (BLU-667) recently demonstrated favorable antitumor activity and safety profiles in advanced RET fusion-positive NSCLC, and both have received approval by the US Food and Drug Administration for this indication. Insights into mechanisms of resistance to selective RET inhibitors remain limited.This study was performed at five institutions. Tissue and/or cell-free DNA was obtained from patients with RET fusion-positive NSCLC after treatment with selpercatinib or pralsetinib and assessed by next-generation sequencing (NGS) or MET FISH.We analyzed a total of 23 post-treatment tissue and/or plasma biopsies from 18 RET fusion-positive patients who received an RET-selective inhibitor (selpercatinib, n = 10; pralsetinib, n = 7; pralsetinib followed by selpercatinib, n = 1, with biopsy after each inhibitor). Three cases had paired tissue and plasma samples, of which one also had two serial resistant tissue specimens. The median progression-free survival on RET inhibitors was 6.3 months [95% confidence interval 3.6-10.8 months]. Acquired RET mutations were identified in two cases (10%), both affecting the RET G810 residue in the kinase solvent front. Three resistant cases (15%) harbored acquired MET amplification without concurrent RET resistance mutations, and one specimen had acquired KRAS amplification. No other canonical driver alterations were identified by NGS. Among 16 resistant tumor specimens, none had evidence of squamous or small-cell histologic transformation.RET solvent front mutations are a recurrent mechanism of RET inhibitor resistance, although they occurred at a relatively low frequency. The majority of resistance to selective RET inhibition may be driven by RET-independent resistance such as acquired MET or KRAS amplification. Next-generation RET inhibitors with potency against RET resistance mutations and combination strategies are needed to effectively overcome resistance in these patients.
Capturing respiratory syncytial virus season in Belgium using the influenza severe acute respiratory infection surveillance network, season 2018/19
Authors: Lorenzo Subissi, Nathalie Bossuyt, Marijke Reynders, Michèle Gérard, Nicolas Dauby, Marc Bourgeois, Bénédicte Delaere, Sophie Quoilin, Steven Van Gucht, Isabelle Thomas, Cyril Barbezange
Journal: Eurosurveillance (2020)

Background Respiratory syncytial virus (RSV) is a common cause of severe respiratory illness in young children (&lt; 5 years old) and older adults (≥ 65 years old) leading the World Health Organization (WHO) to recommend the implementation of a dedicated surveillance in countries. Aim We tested the capacity of the severe acute respiratory infection (SARI) hospital network to contribute to RSV surveillance in Belgium. Methods During the 2018/19 influenza season, we started the SARI surveillance for influenza in Belgium in week 40, earlier than in the past, to follow RSV activity, which usually precedes influenza virus circulation. While the WHO SARI case definition for influenza normally used by the SARI hospital network was employed, flexibility over the fever criterion was allowed, so patients without fever but meeting the other case definition criteria could be included in the surveillance. Results Between weeks 40 2018 and 2 2019, we received 508 samples from SARI patients. We found an overall RSV detection rate of 62.4% (317/508), with rates varying depending on the age group: 77.6% in children aged &lt; 5 years (253/326) and 34.4% in adults aged ≥ 65 years (44/128). Over 90% of the RSV-positive samples also positive for another tested respiratory virus (80/85) were from children aged &lt; 5 years. Differences were also noted between age groups for symptoms, comorbidities and complications. Conclusion With only marginal modifications in the case definition and the period of surveillance, the Belgian SARI network would be able to substantially contribute to RSV surveillance and burden evaluation in children and older adults, the two groups of particular interest for WHO.
A Phase Ib Study of Onvansertib, a Novel Oral PLK1 Inhibitor, in Combination Therapy for Patients with Relapsed or Refractory Acute Myeloid Leukemia
Authors: Amer M. Zeidan, Maya Ridinger, Tara L. Lin, Pamela S. Becker, Gary J. Schiller, Prapti A. Patel, Alexander I. Spira, Michaela L. Tsai, Errin Samuëlsz, Sandra L. Silberman, Mark Erlander, Eunice S. Wang
Journal: Clinical Cancer Research (2020)

The Polo-like kinase 1 (PLK1) is a master regulator of mitosis and overexpressed in acute myeloid leukemia (AML). We conducted a phase Ib study of the PLK1 inhibitor, onvansertib, in combination with either low-dose cytarabine (LDAC) or decitabine in patients with relapsed or refractory (R/R) AML.Onvansertib was administered orally, in escalating doses, on days 1-5 in combination with either LDAC (20 mg/m2; days 1-10) or decitabine (20 mg/m2; days 1-5) in a 28-day cycle. The primary endpoint was to evaluate first-cycle dose-limiting toxicities and the MTD. Secondary and exploratory endpoints included safety, pharmacokinetics, antileukemic activity, and response biomarkers.Forty patients were treated with onvansertib (12-90 mg/m2) in combination with LDAC (n = 17) or decitabine (n = 23). Onvansertib was well tolerated with most grades 3 and 4 adverse events related to myelosuppression. In the decitabine arm, the MTD was established at 60 mg/m2, and 5 (24%) of the 21 evaluable patients achieved complete remission with or without hematologic count recovery. Decrease in mutant circulating tumor DNA (ctDNA) during the first cycle of therapy was associated with clinical response. Engagement of the PLK1 target, TCTP, was measured in circulating blasts and was associated with greater decrease in bone marrow blasts.The onvansertib and decitabine combination was well tolerated and had antileukemic activity particularly in patients with target engagement and decreased mutant ctDNA following treatment. This combination will be further investigated in the ongoing phase II trial.
Regulation of tumor growth by leukocyte-specific protein 1 in T cells
Authors: Riri Kwon, Bong-Ki Hong, Kang-Gu Lee, Eunbyeol Choi, Laurent Sabbagh, Chul-Soo Cho, Naeun Lee, Wan-Uk Kim
Journal: Journal for ImmunoTherapy of Cancer (2020)

Clinical efficacy of T cell-based cancer immunotherapy is limited by the lack of T cell infiltration in the tumor mass, especially in solid tumors. Our group demonstrated previously that leukocyte-specific protein 1 (LSP1), an intracellular signal regulator, negatively regulates T cell infiltration in inflamed tissues. To determine the immuno-regulatory effects of LSP1 in T cells on tumor progression, we investigated the growth of B16 melanoma in Lsp1 knockout (KO) mice and T cell-specific Lsp1 transgenic (Tg) mice. The immune cell subpopulation infiltrated into the tumor mass as well as the expression of interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) in T cells was assessed by flow cytometry and/or immunohistochemistry. Chemotactic migration was assayed with Lsp1 KO and Lsp1 Tg T cells. Adoptive transfer of Lsp1 KO or Lsp1 Tg T cells was performed in B16 melanoma-challenged Rag1 KO mice. Lsp1 KO mice showed decreased growth of B16 melanoma and increased infiltration of T cells in the tumor mass, which were completely reversed in T cell-specific Lsp1 Tg mice. Lsp1 KO CD8+ T cells also exhibited elevated migratory capacity in response to CXCL9 and CXCL10, whereas Lsp1 Tg CD8+ T cells did the opposite. LSP1 expression was increased in tumor-infiltrating T cells and could be induced by T cell receptor activation. Intriguingly, gene expression profiling of Lsp1 KO T cells suggested enhanced cytotoxicity. Indeed, expression of IFN-γ and TNF-α was increased in tumor-infiltrating CD4+ and CD8+ T cells of Lsp1 KO mice, while it was markedly reduced in those of Lsp1 Tg mice. Adoptive transfer of Lsp1 KO T cells to Rag1 KO mice was more effective in suppressing melanoma growth than transfer of Lsp1 Tg T cells. Of note, when treated with antiprogrammed cell death protein 1 (PD-1) antibody, inhibition of melanoma growth was more pronounced in Lsp1 KO mice than in Lsp1-sufficient mice, suggesting that Lsp1 depletion additively increases the antitumor effects of anti-PD-1 antibody. LSP1 in T cells regulates the growth of B16 melanoma in mice, possibly by affecting migration and infiltration of T cells into the tumor and by modulating production of antitumor effector cytokines by CD8+ T cells. These findings provide evidence that LSP1 can be a target to improve the efficacy of T cell-based immunotherapy.
Pathogenesis of persistent lymphatic vessel hyperplasia in chronic airway inflammation Journal of Clinical Investigation
Authors: P Baluk, T Tammela, E Ator, N Lyubynska, Mg Achen, Dj Hicklin, M Jeltsch, Tv Petrova, B Pytowski, Sa Stacker, S Yla-Herttuala, H Jackson, K Alitalo, Mcdonald
Journal: Journal of Clinical Investigation (2005)
Covid-19: Prevalence has quadrupled in England since start of September, study shows
Authors: Gareth Iacobucci
Journal: BMJ (2020)

Researchers have estimated that one in 200 people in England are currently infected with SARS-CoV-2, a near fourfold increase from a month ago.

One of the preliminary findings from the fifth round of the government funded Real-Time Assessment of Community Transmission (REACT-1) study is that between 18 and 26 September 2020 the prevalence of SARS-CoV-2 in England increased in all regions and age groups. There was a sevenfold increase in the number of infections in people aged 65 or older when compared with the previous round of testing between 22 August and 7 September.

The study, published as a preprint by Imperial College London,1 analysed 84 610 samples taken over nine days (18-26 September) from people who had carried out polymerase chain reaction swab tests for SARS-CoV-2 themselves at home. Participants also submitted questionnaire data online.

The data, which have not been peer reviewed, suggest that the R number has reduced from 1.7 (95% …