February 16, 2012 Home|Journals & Publications|  AGA eDigest
AGA eDigest

News from the Literature | Practice | GI Fellows | Research | Education & Meetings | Journals & Publications

LEADING THE NEWS

A Whirlwind Day on Capitol Hill

AGA Institute President C. Richard Boland, MD, AGAF, had an exhilarating day on Capitol Hill, meeting with seven congressmen to discuss several of AGA’s priorities: ensuring that our patients have unrestricted access to screening colonoscopy, high-quality generic injectable medications, the best biomedical research and a functioning Medicare program.

Dr. Boland believes that the best way for GIs and AGA members to have our voices heard and protect the strength of gastroenterology is to keep talking to legislators and let them hear — over and over — our concerns and the rationale for our requests.

Read more about Dr. Boland’s congressional meetings and his principal lessons learned on the AGA Washington Insider, a policy blog for GIs.

NEWS FROM THE LITERATURE

Smoking Increases Risk for Colorectal Adenomas in Lynch Syndrome

Individuals with Lynch syndrome have a high risk of developing colorectal carcinomas and adenomas at a young age, due to inherited mutations in mismatch repair genes. Among people with Lynch syndrome, current smokers have an increased risk of colorectal adenomas, according to data published in Gastroenterology. Former smokers have a lower risk than current smokers, but greater risk than never smokers. Individuals with Lynch syndrome should be encouraged to avoid smoking.

Gastroenterology 2012; 142(2): 241-247

Visceral Hypersensitivity: A New Target for Treatment?

In women presenting to gynecological clinics with lower abdominal pain, the cause is frequently attributed to endometriosis irrespective of whether it is found to be minimal or extensive at laparoscopy. IBS is also common in this setting, and it was speculated that the visceral hypersensitivity associated with this condition might be amplifying the symptoms of endometriosis. According to a study in Gut, visceral hypersensitivity is extremely common in endometriosis and could be intensifying the pain. This finding might explain why mildly affected individuals often complain of severe symptoms out of proportion to the extent of their disease. This study has introduced a completely new concept into the understanding of pain in endometriosis, and could open up new opportunities for treatment.

Gut 2012; 61: 367-372

Claudin-7 Has Non-Tight Junction Functions in Mice

Integrity of the intestinal epithelium is required for nutrition absorption and defense against pathogens. Claudins are cell-adhesion molecules that localize at tight junctions (TJs); many are expressed in the intestinal tract, but little is known about their functions. Claudin-7 is unique in that it has a stronger basolateral membrane distribution than other claudins, which localize primarily to apical TJs in the intestinal epithelium. Study results published in Gastroenterology suggest that in mice, claudin-7 has non-TJ functions, including maintenance of epithelial cell-matrix interactions and intestinal homeostasis.

Gastroenterology 2012; 142(2): 305-315

BMI Associated with Dysfunction of Gastroesophageal Barrier

The association between BMI and gastroesophageal pressure gradient is incompletely understood. The association between reflux and BMI may be largely explained by effects of increased intra-abdominal pressure, stated doctors in a study appearing in Gut. However, the reduced lower esophageal sphincter pressure associated with BMI may be mediated by another mechanism or effects of chronic rather than acute elevation of intra-abdominal pressure.
 
Gut 2012; 61: 337-343

PRACTICE

ICD-10 Implementation Date Will Be Delayed

HHS announced that it will initiate a process to postpone the date that health-care entities have to comply with International Classification of Diseases, 10th edition (ICD-10) diagnosis and procedure codes. HHS notes the delay is in response to the provider community’s concerns about the administrative burdens they face in the coming years.
 
The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of Oct. 1, 2013. The new implementation date has not been released.
 
AGA will monitor this development and will share more information once the new implementation date is released.

Counterfeit Version of Avastin in U.S. Distribution

The FDA is warning health-care professionals and patients about a counterfeit version of Avastin 400mg/16mL, which may have been purchased and used by some medical practices in the U.S. Avastin is an injectable medicine used to treat cancers of the colon, lung, kidney and brain, and is administered to patients in clinics, hospitals and doctors’ offices. The counterfeit version of Avastin does not contain the medicine’s active ingredient, bevacizumab, which may have resulted in patients not receiving needed therapy.

Read the full drug safety alert.

Overcoming Obstacles to Quality Measurement

Are quality measures for colorectal cancer screening effective? In the February/March issue of AGA Perspectives, Douglas O. Faigel, MD, AGAF, and Philip Schoenfeld, MD, MSEd, MSc (Epi), discuss the stumbling blocks to quality measurement.

Do you agree with their perspectives? Post your comments or questions to Drs. Faigel and Schoenfeld on our discussion board. You will need to log on using your e-mail address and password.

Evaluating GIs on Performance Is Gaining Momentum

How we evaluate and treat patients directly influences the quality and cost of health care. In a recent article in the AGA’s quarterly practice newsletter, Lawrence Kosinski, MD, MBA, AGAF, and Joel Brill, MD, AGAF, CHCQM, note that the selection of quality and resource use measures is a critical task for practices striving to improve health care. They say it is important for measures to:

  • Improve outcomes that are meaningful to patients.
  • Identify a significant gap between optimal and current clinical practice, which is amenable to improvement.
  • Hold the potential for substantial impact on the health status, health outcomes and satisfaction of the patient.
  • Be relevant to physicians and their patients.
  • Have significant severity and prevalence to justify targeting the condition for improvement.
  • Have the potential to improve the value of health services (AHRQ, Massachusetts Medical Society).

The article provides important guidance on what the average practice should be measuring. Read the full article, which is part of AGA’s efforts to help practitioners succeed in the new health-care environment.

What Is This Month's GastroSlides Image?

Topic: Viral Hepatitis

These images focus on hepatitis caused by hepatotropic viruses.

Order these slides individually as you need them or purchase a one-year subscription and have access to the entire GastroSlides library of more than 4,000 images. Preview and order slides.

GI FELLOWS

Barrett Appointed President-Elect of APS

Congratulations to Kim E. Barrett, PhD, AGAF, who was elected as president-elect of the American Physiological Society. Dr. Barrett obtained her BSc and PhD degrees from the Department of Chemistry at University College London. Following a post-doctoral fellowship at the NIH, she joined the faculty of UC San Diego School of Medicine in 1985, and rose to her current rank of professor of medicine in 1996.

Dr. Barrett has also been very actively involved in the AGA, previously serving as an elected member of the AGA Institute Council from the intestinal disorders section and on the AGA Institute Governing Board as the basic science councillor. Currently, she serves on the leadership cabinet as chair of the AGA Institute Ethics Committee and AGA Institute Audit Committee.

Source: UC San Diego Office of Graduate Studies

New Job? Promotion? Share Your News

AGA members are invited to send news of promotions, appointments and awards to communications@gastro.org.

C. Difficile-Associated Diarrhea Associated with PPIs

Many of you retweeted last week's news of PPI use and its association with Clostridium difficile-associated diarrhea. Here is what else our Twitter followers retweeted most often last week:

  • C. Difficile-Associated Diarrhea Associated with Stomach Acid Drugs: ow.ly/9062v.
  • AGA says much more needs to be known about #gluten sensitivity before official guidelines can be devised: on.wsj.com/y89Q9C via @WSJ.
  • Gastro Comment from Editor—Dr. Lieberman discusses key quality endpoints, surrogate quality indicators for #colonoscopy ow.ly/8ZBCY.
  • Colonic malakoplakia with invasive adenocarcinoma in this FREE CGH Image of the Month: ow.ly/8ZU2D.

Have any news that you would like us to share with our AGA members? Please send them to communications@gastro.org or share them on our social media channels:

RESEARCH

President Unveils FY 2013 Budget, NIH Flat Funded

President Obama unveiled his fiscal year 2013 budget that sets funding priorities. In his budget, the NIH received $30.7 billion, which represents level funding. The president stated that although the funding is flat, new management policies will be put in place to increase the number of new grants by 7 percent. Of interest to gastroenterology, NIDDK is funded at $1.94 billion, which represents a $2.7 million cut to the institute. NIDDK also continues to prioritize obesity research, especially in children and adolescents, and how bacteria in the gut impact this growing epidemic.

The AGA will continue to follow the budget and appropriations process with respect to the NIH and other federal funding of biomedical research. The AGA will continue to advocate for increased funding for NIH and argue that investing in NIH not only improves our nation’s health, but also increases our global competitiveness and grows our economy.

Your AGA Research Foundation Gifts Support ...

 … Evelyn Covés-Datson, of University of Michigan, who received the 2011 AGA- Horizon Pharma Student Abstract Prize.

"I extend many warm thanks to the AGA for the exciting opportunity to attend my first DDW® conference last year, indeed my first ever conference, with such generous financial support. As an undergraduate student, it means a great deal to me to be a recipient of the student abstract prize in the company of many exemplary researchers. I feel truly welcomed by the gastroenterological community and will be indebted to this award for many years to come for funding the foundation of the conference-going phase of my scientific career. Having learned much about the power of presenting one's work to peers in the context of a national forum, I look forward to attending more conferences in the future, perhaps DDW 2012 or beyond. In addition to defraying the costs of my travel to DDW 2011, the award inspired in me the drive to further the research that I was fortunate enough to present."

To make a donation, visit http://www.gastro.org/contribute.

EDUCATION & MEETINGS

AGA Spring Postgraduate Course: Register Early and Save

Early bird registration is open for the 2012 AGA Spring Postgraduate Course, Practical Solutions for Your Everyday Clinical Management Problems, which will be held May 19 and 20 in conjunction with DDW® in San Diego, CA.

Do not wait to register — you will save $75 by registering on or before the early registration deadline of April 11. Registration is online at DDW’s newly redesigned website, www.ddw.org.

The course will improve your clinical knowledge of and ability to manage common GI and liver disorders. After attending the course, you will be able to:

  • Identify areas of controversy in the management of eosinophilic esophagitis, refractory heartburn, Barrett’s esophagitis, functional dyspepsia and acute gastrointestinal bleeding.
  • Learn to implement new treatments in hepatitis C and nonalcoholic fatty liver disease.
  • Learn the different diagnostic modalities to examine the biliary system and pancreas.
  • Increase your knowledge of the newest screening and surveillance tools for gastrointestinal cancers.
  • Review the latest therapies on IBD and functional bowel disorders.
  • Gain an understanding of the present issues for imaging the small intestine and colon.

In addition to understanding the science behind new developments, attendees will benefit from practical, take-home points that they can immediately apply to practice.

This activity has been approved for up to 10.75 AMA PRA Category 1 Credits™. For complete course information, visit www.gilearn.org/pgcourse.

JOURNALS & PUBLICATIONS

Call for Papers on Clinical Trials: Gastroenterology

Gastroenterology is committed to advancing clinical practice in the field of digestive disease. Recognizing that clinical trials generally have the greatest impact of all studies on clinical practice, Editor Bishr Omary, MD, PhD, and his associate editors strongly encourage authors to submit their manuscripts on clinical trials (diagnostic validation, therapeutic efficacy) of drugs, biological materials and devices in digestive, liver and pancreatic diseases, including studies at Phases I, II and especially III, to Gastroenterology for consideration. The journal is also interested in publishing trials in endoscopic and imaging modalities.

There are several important reasons to submit clinical trial research for publication in Gastroenterology:

  • With an impact factor of 12.9, Gastroenterology is the premier journal in the field.
  • Gastroenterology is the journal that will directly reach the largest portion of physicians who care for and make treatment decisions for patients with GI or liver disease.
  • Authors who submit their manuscripts to Gastroenterology typically will receive decisions within three weeks or fewer.
  • Accepted manuscripts will be published online and indexed on PubMed within 10 days of acceptance.

To submit your manuscript to Gastroenterology, go to www.editorialmanager.com/gastro.

For important information on how to report clinical trials, go to www.gastrojournal.org/authorinfo. To review the current and past issues of the journal, go to www.gastrojournal.org.

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