News from the Literature | Practice | Research | Education & Meetings | Journals & Publications | Announcements
LEADING THE NEWS
NIH, FDA, CDC Funding Closer to Being Cut
The House of Representatives has approved a bill funding the remainder of the current fiscal year that cuts funding to federal programs by $60 billion. This bill will have a devastating impact on many AGA priorities. The bill cuts NIH funding by $1.6 billion, which amounts to a 5 percent cut; FDA funding by $242 million, a 10 percent cut; and CDC funding, which includes the Colorectal Cancer Screening Program, by $1 billion, a 10 percent cut.
If you haven’t already, please contact your legislators and urge them not to cut NIH funding. It is critical that the new members of Congress learn about the importance of the NIH, FDA and CDC, not only for the promise research has for finding cures, but for our economy and global competitiveness.
NEWS FROM THE LITERATURE
Diagnostic Accuracy of CE Superior to That of MRE, CTE
Capsule endoscopy (CE) detects small bowel Crohn's disease with greater diagnostic yield than radiologic procedures, although there are concerns that CE has low specificity. Study results in Clinical Gastroenterology and Hepatology suggest that in suspected or newly diagnosed Crohn’s disease, MRI enterography and CT enterography have comparable sensitivities and specificities. In patients without endoscopic or clinical suspicion of stenosis, CE should be the first-line modality for detection of small bowel Crohn's disease beyond the reach of the colonoscope.
Clinical Gastroenterology and Hepatology; 2011: 9(2): 124-129.e1
Serum Bilirubin Associated with Lower Risk of Death
Serum total bilirubin levels in healthy patients reflect genetic and environmental factors that could influence the risk of developing respiratory disease. In a study published in the Journal of the American Medical Association, doctors reported that among patients with normal-range bilirubin levels in primary care practices, relatively higher levels of bilirubin were associated with a lower risk of respiratory disease and all-cause mortality.
Journal of the American Medical Association; 2011: 305(7): 691-97
Cirrhosis Patients Have Higher Risk for Malignant Neoplasms
It is not clear how cirrhosis affects the risks for hepatocellular carcinoma (HCC) and non-HCC cancers, which are rare among these patients. According to data in Clinical Gastroenterology and Hepatology, the overall risk for non-HCC malignancies is more than two-fold greater for patients with cirrhosis (mostly in biliary and gastrointestinal malignancies) than the general population. The risk for non-HCC cancers differs between patients with alcoholic liver disease (ALD) and non-ALD cirrhosis. The increased risk for HCC among patients with cirrhosis is associated with hepatitis C virus (HCV); it is the same among patients with HCV, with or without ALD.
Clinical Gastroenterology and Hepatology; 2011: 9(2): 168-174
Cdx2 Levels Modulate Paneth Cell Development
Caudal-related homeobox protein 2 (Cdx2) is an intestine-specific transcription factor that is important for intestinal development and intestine-specific gene expression. Cdx2 regulates intestinal cell-cell adhesion, proliferation, and the transcriptional activities of Wnt and β-catenin in cell culture systems. In a study published in Gastroenterology, doctors concluded that overexpression of Cdx2 in the small intestine is associated with reduced post-natal growth, early epithelial maturation, alterations in crypt base organization, and changes in Paneth and goblet cell lineages. Cdx2 is a critical regulator not only of intestine-specific genes, but also processes that determine epithelial maturity and function.
Gastroenterology; 2011: 140(2): 517-528.e8
PRACTICE
AGA Responds to NYT on Price of Colonoscopy
A letter to the editor published in the New York Times makes troubling assertions about colonoscopy and flexible sigmoidoscopy as screening strategies. In response, AGA Institute President Ian Taylor, MD, PhD, AGAF, submitted the following:
Letter writer Dr. John Abramson criticizes the higher absolute cost of colonoscopy when compared to flexible sigmoidoscopy for colorectal cancer screening. I challenge him to look at costs through the lens of patient lives, and he would see that colonoscopy is a cost-effective way to save lives. In fact, a New England Journal of Medicine article notes that colonoscopy reduces mortality at a cost savings to the health-care system.1
Abramson also questions the validity of national health reform legislation favoring colonoscopy over flexible sigmoidoscopy. Colonoscopy allows physicians to examine the entire colon, whereas flexible sigmoidoscopy provides only a partial view. Most patients, including myself and many of my physician colleagues, are loathe to undergo a screening test for colonic cancer that views only a very small fraction of the colon.
Sincerely,
Ian L. Taylor, MD, PhD, AGAF
President, American Gastroenterological Association Institute
1. Cohen et al., Does Preventive Care Save Money? Health Economics and Presidential Candidates. NEJM 2008; 358: 661-3.
Participate in Physician Quality Reporting, E-Prescribing Call
CMS will host a national provider conference call and webinar on physician quality reporting and the electronic prescribing incentive program. This toll-free call will take place from 1:30 to 3 p.m. ET on Tuesday, March 8.
For additional call details and to register, go to http://www.eventsvc.com/palmettogba/030811.
RESEARCH
Your AGA Foundation Gifts Support ...
... Christie M. Gutierrez, who received an AGA Student Research Fellowship Award in 2008.
“I am extremely thankful and honored to have been selected as a recipient of the AGA Student Research Fellowship Award. As a rising pre-med senior, my positive lab experience last summer not only introduced me to biomedical research, but it also made an MD/ PhD program a serious option for me in the future. By enabling me to continue my research investigating cell adhesion and invasion in the tumor microenvironment, the AGA Foundation Student Research Fellowship Award has not only provided me with funding, but has also fueled my passion to pursue a career that incorporates both research and medicine.”
To make a donation, visit www.gastro.org/contribute.
EDUCATION & MEETINGS
Short Bowel Syndrome Focus of New Module
The AGA Institute's nutrition toolkit series has released a new online module, Nutrition in Short Bowel Syndrome. The module offers expert insight on supporting patients with this condition, including the process of intestinal adaptation, recognizing the role of diet, glutamine, growth hormones and GLP-II, and when to consider surgery.
Participants can earn up to 0.75 AMA PRA Category 1 creditsTM.
Additional modules in the toolkit series include:
- Nutritional Management of Celiac Disease.
- Nutrition Therapy in Acute Pancreatitis.
- Nutrition and IBD.
- Obesity for the Gastroenterologist.
- Nutrition in the Patient with Liver Disease.
Each online module includes slides with corresponding audio delivered by subject-matter experts as well as pre- and post-test questions. A score report will be provided upon completion.
The nutrition toolkit series is an online education component of the AGA Institute's nutrition and obesity initiative. The initiative includes access to AGA Institute obesity-related educational materials located under the nutrition and obesity topic area of the practice resource library. Additional modules on obesity- and nutrition-related issues are in development and will be made available throughout the year.
Pre-Order Postgraduate Course Resources
The 2011 AGA Spring Postgraduate Course will examine the latest science behind recent clinical advances, current diagnostic methods and the best approaches for handling controversial management issues. This year’s course offers valuable reference tools for purchase, including a syllabus, DVD and online subscription to the sessions. Orders placed on or before March 23 will receive a 10 percent discount.
The course syllabus, which is available at DDW® and free to course attendees, contains comprehensive details of all sessions, including abstracts, key points, references, slides, graphs, charts and tables. Learning objectives and reference lists are also included.
The lectures and clinical challenge sessions have been captured online and on DVD to provide the audio, slides and videos as heard and seen at the meeting. The DVD and online sessions are fully searchable by topic or author and the online sessions offer up to 22.75 AMA PRA Category 1 Credits™. These sessions will be available online and on DVD by June 15. Buyers can save with a special offer that gives them access to the online sessions for just $10 with their DVD purchase.
While supplies last, the CD-ROM and syllabus from last year’s Spring Postgraduate Course, Managing Digestive Diseases in the Next Decade: Controversies and New Developments, are available at a discounted price.
To order, visit www.gilearn.org/pgresources. For more information about this year’s Spring Postgraduate Course, visit www.gilearn.org/pgcourse.
New DDW® Programming for Trainees and Young GIs
AGA's new trainee and young GI track at DDW® features exciting new sessions that provide trainees and young GIs with the necessary tools and information for a successful clinical practice career. Led by course director, Michelle K. Kim, MD, the track consists of the following:
Mentor and Advisor Networking Reception (May 7) — presents an opportunity for attendees to network and interact with peers and colleagues. Sponsored by the AGA Mentor and Advisor Program and the AGA Women’s Committee.
Board Review Session (May 8) — will prepare attendees for the board certification exam using AGA’s popular Digestive Disease Self-Education Program® (DDSEP) 6. DDSEP editors and authors will cover select questions, answers and critiques from the book. Participants will receive a 40 percent discount coupon for DDSEP 6 to use at the AGA Store or at the AGA Booth during DDW.
Career- and Professional-Related Issues (May 8) — provides practical advice on how to address common career and professional issues. Topics include choosing a practice type and location, developing an effective CV, learning how to interview successfully, negotiating contracts, and maintaining a healthy work-life balance.
Immediate Advancement in Skills for Teaching (May 10) — offers expert insight on how to successfully pursue a teacher/clinician educator career path; uses questions and vignettes to engage attendees in discussions about how to deliver effective presentations, use team-building learning techniques and manage small-group dynamics.
Advance Your Leadership Skills: How to Rise to a Position of Leadership in Gastroenterology or Hepatology (May 10) — will help participants develop a leadership growth plan, learn how to recognize steps for success and avoid issues, improve interpersonal communication skills, practice challenging decision-making and more.
Immediate Advancement in Skills for Clinical Practice (May 10) — presents practice management and managerial skills for building a successful clinical practice career. Topics cover how to deal with support staff, understanding the financial stresses and benefits of clinical practice, and more.
The above sessions are free; however, participants must be registered for DDW to attend the sessions. Learn more about these sessions by visiting www.gilearn.org/traineetrack. To register for DDW, visit www.ddw.org.
| AGA Spring Postgraduate Course at DDW® |
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Take away practical advice on a variety of GI and liver topics that you can apply directly to your practice. Trainees may register at a reduced fee. |
JOURNALS & PUBLICATIONS
CGH Editor-in-Chief Needed
AGA seeks applications for editor-in-chief of its official clinical practice journal Clinical Gastroenterology and Hepatology (CGH) from qualified members. CGH is the go-to resource on a broad spectrum of themes in clinical gastroenterology and hepatology, providing the best, most actionable information in the field.
This exciting and challenging position requires an energetic and passionate individual to direct the intellectual content of the journal, ensuring its quality and relevancy to clinical investigators and practicing physicians. To keep pace with the rapidly evolving field of medical publishing, candidates must be forward thinking, creative and open to change. Interested candidates must be AGA members and board certified in gastroenterology and hepatology; past experience on a journal editorial board is desirable.
The term of this position is five years and begins July 1, 2012. Completed applications are due April 1, 2011.
For additional information, contact Thoba Khumalo Petrovic at tkhumalo@gastro.org or 301-941-9780.
ANNOUNCEMENTS
FDA Approves Wider Use of LAP-BAND®
The FDA approved the wider use of Allergan's LAP-BAND® stomach-restricting device for adults with obesity who have failed more conservative weight-reduction alternatives, have a BMI of 30 to 40 and have at least one obesity-related comorbid condition. Candidates for the procedure must have previously attempted to lose weight by other methods such as diet and exercise.
Currently, approximately 37 million Americans have a BMI of 30 to 40 and at least one comorbid condition. Obesity is the second-leading cause of preventable death in the U.S., second only to smoking.
In December 2010, the FDA gastroenterology-urology devices panel debated Allergan’s request to expand the wider use of LAP-BAND. After reviewing evidence from a clinical trial and public testimony, the panel voted to recommend to the FDA that the expanded use the device met the requirements for safety and effectiveness, and the benefits outweighed the risks.
Maintain Your Certification in Pediatric GI
This year’s certifying exam in pediatric gastroenterology will take place on Nov. 15. Registration for first-time applicants is open now until May 2; registration for re-registrants opens on March 15.
All applicants must complete applications online during the registration periods. Visit the American Board of Pediatrics website to learn more about eligibility requirements and register for the exam.
| Take Your Exam Preparation A Step Further |
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The Digestive Disease Self-Education Program® (DDSEP) 6 — the field most comprehensive review of gastroenterology, hepatology and nutrition — features expertly written content on important GI topics, including pediatric gastroenterology. Order your copy today. |
Participate in Upcoming AGA Election
Next month, members will be asked to vote in AGA’s 2011 elections. You are strongly encouraged to participate in this important activity.
The election, March 11 through April 10, will provide voting members the opportunity to vote for AGA councillors and elected members of the 2011–2012 AGA Nominating Committee. Members without e-mail addresses will receive a paper ballot. Those with e-mail addresses will receive, via e-mail, a link to AGA’s voting website. Stay tuned to future issues of AGA eDigest for additional information.
UCSF Honors Former AGA President
Former AGA President and Julius Friedenwald Medal recipient, Marvin H. Sleisenger, MD, was recently awarded the University of California, San Francisco (UCSF) medal for his extraordinary contributions to human health and well-being. Awarded annually, the UCSF medal replaces the granting of honorary degrees and is bestowed on individuals who have attained preeminence in an area that is in support of UCSF's mission.
Please join us in congratulating Dr. Sleisenger, and learn more about this remarkable achievement.
Dress in Blue on March 4
Wear blue to show your support for Dress in Blue Day. Help raise awareness about colon cancer and encourage others to get their colon checked by wearing blue on Friday, March 4.
Why do we need to raise awareness of colon cancer?
- Colon cancer is the second leading cause of cancer deaths in the U.S.
- Approximately 150,000 Americans will be diagnosed with colon cancer each year.
- Colon cancer often has no symptoms at all until it is at an advanced stage.
- Colon cancer is 80 percent preventable when detected early.
- You can reduce your risk through regular screenings.
- Beginning at age 50 (or earlier if you have a family history), everyone should get their colon checked.
AGA members can use discount code VOICES20 to receive 20 percent off Dress in Blue Day materials from the Colon Cancer Alliance.
Learn how you can get involved and make a difference.
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