


X Fan et al. Gastroenterol 2021; 160: 455-458. Full text link: Effect of Acid Suppressants on the Risk of COVID-19: A Propensity Score-Matched Study Using UK Biobank
Among 9469 included participants, 1516 (16%) were regular users of acid suppressants, and 7953 (84%) were not…propensity score matching (PSM) was applied to match users of acid suppressants and nonusers.
Key findings:
My take: This study provides reassurance that acid blockers are unlikely to contribute to the risk of SARS-CoV-2 or to related complications.
Related blog post: PPIs Associated with Increased Risk of COVID-19
Other COVID-19 Information:
During the past week (as I write this), I came across two articles which focused on the subject of “attention.”
In the first, Toward a Medical “Ecology of Attention” (MJ Kissler et al. NEJM 2021; 384: 299-301), the authors assert that “in the clinical environment, the most important –and most limited–resource is attention.” They note that distraction contributes “to lapses in judgement, insensitivity to changing clinical conditions, and medication errors.” The article delves into modifications that can improve attention in clinical settings:
The second article, “The Internet Rewired Our Brains. This Man Predicted It Would,” (title online is “I Talked to the Cassandra of the Internet Age”) assesses how the “the attention economy” and the internet are changing the country.
A few excerpts:
My take: I frequently relate a quote from Jim Gaffigan. He stated that his wife is great at multi-tasking but that he is trying just to task. I try to focus on what’s in front of me.
ACG: 1Fact/1Myth: Dispelling Misinformation on COVID-19 Vaccine
Some of the slides:
Full set of Slides: ACG_COVID_Vaccine Slide Set PDF
Related blog posts:
NASPGHAN Webinar: (Link -requires registration to view): Changing the Dynamic: How to Enable EHRs to Work for You (if trouble with this link, go to https://learnonline.naspghan.org/webinar)
This webinar featured lectures by the following:
Since our group mainly uses Epic, I will summarize some of the tips from Steven Liu, who also is our group’s Epic Physician Champion. Anyone who listened to the webinar will realize how there are so many tricks available. Some of the material from the talk is at the bottom in the form of screenshots; however, much of the information in the webinar is proprietary to EPIC and cannot be shared without permission.
Here are some of the key points:
My take: Steven has helped everyone in our practice & listening to his talk makes me realize that I need to learn a good bit more and take some of his stuff. This EHR webinar provides a lot of tips to help good EHR users become better users. For those interested in research, understanding EHRs will be crucial going forward.
Related blog posts:
Link to 38 page guidance, last updated 2/2/21: AASLD EXPERT PANEL CONSENSUS STATEMENT:
VACCINES TO PREVENT COVID-19 INFECTION IN PATIENTS
WITH LIVER DISEASE
Key points:
JF Ludvigsson et al NEJM 2021; 384: 669-671. Full text: Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden In this letter to the editor, the authors report on outcomes in Sweden, which kept schools open during the pandemic; time period: from March 1-June 30, 2020 (schools end around June 10th). Key findings:
My take: This study suggests that school teachers are at similar risk for COVID-19 infection as other essential workers. In Sweden, during this timeframe, distancing but not masking was recommended. Thus, transmission rates could be lowered further.
Related article: SR Kadire et al. NEJM 2021; 384: DOI: 10.1056/NEJMclde2101987. Full text: Delayed Second Dose versus Standard Regimen for Covid-19 Vaccination This article provides rationale for both vaccine options.
Related blog posts:
It would seem intuitive that screening for melanoma in at-risk pediatric patients would be worthwhile. And, this has been recommended in pediatric patients with inflammatory bowel disease who have received medications which increase the risk. However, a recent article (HG Welch et al. NEJM 2021; 384: 72-79. The Rapid Rise in Cutaneous Melanoma Diagnoses) provides a lot of reason to question this practice;. This article did not focus on pediatrics but its message about overdiagnosis of melanoma is applicable to this population as well.
Key points:
My take: Routine visits to dermatology are difficult to justify in the absence of worrisome skin findings. “Although the conventional response has been to recommend regular skin checks, it is far more likely that more skin checks are the cause of the epidemic — not its solution.”
From BBC (1/25/21): Moderna vaccine appears to work against variants
An excerpt:
“For the Moderna study, researchers looked at blood samples taken from eight people who had received the recommended two doses of the Moderna vaccine. The findings are yet to be peer reviewed, but suggest immunity from the vaccine recognises the new variants. Neutralising antibodies, made by the body’s immune system, stop the virus from entering cells.
Blood samples exposed to the new variants appeared to have sufficient antibodies to achieve this neutralising effect, although it was not as strong for the South Africa variant as for the UK one. Moderna says this could mean that protection against the South Africa variant might disappear more quickly.”
Briefly noted: S Sultan, SM Siddique et al. Gastroenterol 2020; 159: 1935-1948. Full text: AGA Institute Rapid Review and Recommendations on the Role of Pre-Procedure SARS-CoV-2 Testing and Endoscopy
Table 1 provides a summary of the recommendations and indicates a threshold for which routine pre-procedure testing may not be needed:
My take: Particularly after the rollout of vaccination to health care providers, routine testing for SARS-CoV-2 is not likely to be needed once the prevalence drops to low levels.
Related blog posts: