American Gastroenterological Association - Advancing the Science and Practice of Gastroenterology

News from the Literature | Practice | Research | Journals & Publications | Announcements

LEADING THE NEWS

NEWS FROM THE LITERATURE

Telaprevir Improves Virological Response

In Phase II trials, telaprevir — a hepatitis C virus (HCV) genotype 1 protease inhibitor — in combination with peginterferon-ribavirin, as compared with peginterferon-ribavirin alone, has shown improved efficacy, with potential for shortening the duration of treatment in a majority of patients. In a study published in the New England Journal of Medicine, doctors found that this combination was associated with significantly improved rates of sustained virologic response in patients with HCV genotype 1 infection who had not received previous treatment, with only 24 weeks of therapy administered in the majority of patients.

New England Journal of Medicine 2011; 364:2405-2416

High Levels of Folate Not Associated with Increased CRC Risk

Folate intake has been inversely associated with colorectal cancer (CRC) risk in several prospective epidemiologic studies. However, no study fully assessed the influence of the high levels of folate that are frequently consumed in the U.S. as a result of mandatory folate fortification and the recent increase in use of folate-containing supplements. There is evidence that consumption of high levels of folic acid, the form of folate used for fortification and in supplements, has different effects on biochemical pathways than natural folates, and might promote carcinogenesis. According to a study in Gastroenterology, intake of high levels of total folate reduces risk of CRC; there is no evidence that dietary fortification or supplementation with this vitamin increases CRC risk.

Gastroenterology 2011: 141(1): 98-105.e1

Simplified Psychometric Evaluation Predicts Occurrence of Overt Hepatic Encephalopathy

The psychometric hepatic encephalopathy score, which includes five psychometric tests, is a standard for the diagnosis of minimal hepatic encephalopathy. Study results published in Clinical Gastroenterology and Hepatology suggest that a simplified psychometric hepatic encephalopathy score is as good as the psychometric hepatic encephalopathy score in diagnosing minimal hepatic encephalopathy and in predicting the occurrence of overt hepatic encephalopathy.

Clinical Gastroenterology and Hepatology 2011: 9(7): 613-16

Diet, Lifestyle Associated with Long-Term Weight Gain

Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy “eat less and exercise more” for preventing long-term weight gain. According to data appearing in the New England Journal of Medicine, specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity.

New England Journal of Medicine 2011; 364: 2392-04

PRACTICE

Your Responses Are Crucial to GI Reimbursement

At the request of CMS, AGA, ASGE, ACG and the Society of American Gastrointestinal and Endoscopic Surgeons are conducting surveys on physician work for the following endoscopy procedures:

• 43239; esophagogastroduodenoscopy with biopsy.
• 45330; diagnostic flexible sigmoidoscopy.
• 45380; colonoscopy with biopsy.
• 45385; colonoscopy with snare.

Our societies participate in the AMA/Specialty Society Relative Value Update Committee (RUC) process. CMS has requested that the RUC review the work values of these codes to ensure that the procedures are valued properly.

You may have received an e-mail from gastro.org@softekdc.com asking for your participation in these surveys. This e-mail contains a link and instructions for your access to four separate surveys for these codes. If you received this e-mail, it is imperative that we obtain your responses to all of these surveys. The surveys must be filled out by the physician and should not be filled out by your staff, administrator or other health personnel.

View a slide presentation outlining the survey process and steps to completing the surveys.

Please look for an e-mail from gastro.org@softekdc.com that may have arrived on June 14, June 27 or July 5. Depending on your computer/e-mail provider settings, the e-mail might have been delivered to your spam folder, so please check there as well. The surveys are due no later than July 15.

If you have any questions, please contact Adam Borden at aborden@gastro.org or 301-941-2629. Thank you for your participation and dedication to the specialty.

Educational Resources for Incentive Programs Available

To assist practices in successful participation in the 2011 electronic (eRx) prescribing incentive program and the 2011 Physician Quality Reporting System, new educational resources are now available from CMS.

• eRx incentive program made simple fact sheet: provides step-by-step advice for participating in the program.
• eRx incentive program made simple quick reference chart: provides a quick reference to assist with participating in the program.
• Satisfactorily reporting measures — claims and registry fact sheet: provides guidance on claims-based and registry-based reporting, and describes steps that eligible professionals/practices should take prior to undertaking Physician Quality Reporting System reporting. It also provides helpful tips for eligible professionals and their billing staff.
• Reporting the preventive care measures group fact sheet: provides quick, easy-to-understand instructions for eligible professionals on how to satisfactorily participate in the reporting system using the preventive care measures group.
• Reporting periods for 2011 fact sheet: explains the two reporting periods for the 2011 Physician Quality Reporting System: 12 months (Jan. 1, 2011, to Dec. 31, 2011) and six months (July 1, 2011, to Dec. 31, 2011).

To access all available eRx incentive program educational resources, visit http://www.cms.gov/ERxIncentive on the CMS website. To access all available Physician Quality Reporting System educational resources, visit http://www.cms.gov/PQRS. On either page, select the educational resources tab. Then, scroll down to the downloads section to select the publication title.

CGH Image of the Month

Mega-Intestine After Subtotal Colectomy for Constipation
Johanna Iturrino, Michael Camilleri, Jarred M. Orrock

A 26-year-old male with multiple endocrine neoplasia type 2B presented with chronic abdominal distention and constipation. He had previously undergone total thyroidectomy for medullary thyroid carcinoma, and a subtotal colectomy with ileosigmoidostomy for megacolon. Examination revealed a marfanoid body habitus, neuromas on the tip of the tongue, pectus excavatum and severe abdominal distention. Laboratory studies were unremarkable, including negative urine catecholamines screening for pheochromocytoma. Abdominal X-ray showed multiple dilated loops of small bowel (figure).

Read more in Clinical Gastroenterology and Hepatology.

UpToDate^® Free Topic of the Month

Produced in cooperation with the AGA Institute, UpToDate^® is a subscription-based clinical information resource available on the Web, CD-ROM and pocket PC handheld devices. Each month, a free topic is made available on the AGA website. This month's free topic is:

• Nutrition and dietary interventions in adults with IBD.

Nearly 232 physicians write more than 673 topic reviews for UpToDate in gastroenterology and hepatology alone. UpToDate provides gastroenterologists with access to more than 60,000 pages of original, peer-reviewed text, 160,000 MEDLINE abstracts, drug information and drug interactions databases, and hundreds of patient information handouts across 12 specialties. Moreover, UpToDate is used by tens of thousands of clinicians in more than 110 countries and by hundreds of premier medical institutions worldwide.

Order your subscription to UpToDate.

RESEARCH

Your AGA Research Foundation Gifts Support ...

 ... Andrea Todisco, MD, who received the 2011 R. Robert and Sally D. Funderburg Research Award in Gastric Biology Related to Cancer.

“I am deeply honored I was chosen to receive the Funderburg award. My laboratory has had a long-standing interest in the elucidation of the mechanisms that regulate the growth and differentiation of the gastric epithelium. The bone morphogenetic proteins (BMPs), in particular, are peptides produced by gastrointestinal tissues that have been shown to regulate gastrointestinal growth and development. Interestingly, members of the BMP family of proteins have also been shown to inhibit inflammation in the gut.”

“Accordingly, the overall goal of the studies funded by the Funderburg award will be to examine the function and the mechanisms of actions of the BMPs in the regulation of the inflammatory response in the stomach. These investigations will help us gain new insight into the mechanisms involved in the pathophysiology of gastric inflammation and carcinogenesis.”

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

Grants Available for Fellows, Junior Faculty, Experienced Investigators

Investigators at all stages of their careers are invited to apply for research funding from the AGA Research Foundation.

For fellows:
GI fellows who are interested in independent research careers are invited to apply for the Fellowship to Faculty Transition Award, which provides salary support to further research training in gastrointestinal, liver function or related diseases. The additional two years of research training provided by this award should broaden and expand the scope of investigative tools available to the recipient, generally in basic disciplines such as cell or molecular biology or immunology. Applications are due Sept. 2.

For junior faculty:
Research Scholar Awards provide $60,000 per year for two years to young faculty (not fellows) working toward independent careers in gastroenterology, hepatology or related areas. The awards’ objective is to enable young investigators to develop independent and productive research careers in digestive diseases by ensuring that a major proportion of their time is protected for research. Applications are due Sept. 9.

For established investigators:
Established investigators may apply for the R. Robert and Sally Funderburg Research Award in Gastric Biology Related to Cancer. Investigators working in the fields of gastric mucosal cell biology, regeneration and regulation of cell growth (not as they relate to peptic ulcer disease or repair), inflammation (including Helicobacter pylori) as precancerous lesions, genetics of gastric carcinoma, oncogenes in gastric epithelial malignancies, epidemiology of gastric cancer, etiology of gastric epithelial malignancies, or clinical research in the diagnosis or treatment of gastric carcinoma are eligible. Applications are due Sept. 2.

Complete eligibility requirements and application information are available on the AGA’s website.

JOURNALS & PUBLICATIONS

Download the Latest Journal Podcasts

Listen in to the latest journal podcasts on popular articles from Gastroenterology and Clinical Gastroenterology and Hepatology (CGH).

Recent podcasts from Gastroenterology include:

• Fruit, Vegetables and Folate: The Evidence for Cancer Prevention.
• Functions of Autophagy in Hepatic and Pancreatic Physiology and Disease.
• Aspirin or NSAID Use Increases Risk for Diverticulitis and Diverticular Bleeding.

Recent podcasts from CGH include:

• Primary Biliary Cirrhosis, Autoimmune Hepatitis Overlap Syndrome.
• Treatment of Ulcerative Colitis to Achieve Mucosal Healing.
• Symptoms May Not Indicate Failure of Anti-Tumor Necrosis Factor Therapy in Crohn's Disease.

Each podcast lasts approximately 10 to 15 minutes and can be downloaded to an iPod or any other media player. Podcasts are available through iTunes. Subscription to the podcasts is free and you will receive automatic updates on your iPod as new podcasts are added.

ANNOUNCEMENTS

AGA Fellowship Application Deadline Approaching

The deadline is approaching to apply for fellowship in the AGA. The application and other supporting documentation must be received by Monday, July 18 in order to be considered for fellowship starting in 2012.

The prestigious designation of fellow is awarded to members based on their superior personal and professional achievements in either clinical practice or basic/clinical research. To date, 1,694 members have been honored as AGA fellows.

Fellowship in the AGA is by application only and applicants must meet certain criteria in order to apply. One such criterion is membership in the AGA for at least seven years.

As an AGA fellow, you will have the use of the letters “AGAF” in your professional activities. You will also receive a recognition pin and certificate upon acceptance and be listed as a fellow on the AGA website. During DDW^® 2012, you will be recognized with a ribbon denoting your fellowship status and your name will be printed in the recognition and research awards booklet.

The review and selection process for this program falls under the oversight of the Fellowship Recognition Committee, with final approval by the AGA Governing Board. Fellows will be selected based on superior achievements in clinical practice or in research. Applicants will be notified of their acceptance by Jan. 31, 2012. Fellowship will commence upon notification of acceptance.
 
Learn more about the eligibility requirements and apply online.

Classifieds

Place GI Position Listings and Activity Announcements

For as little as $82.50, you can place a classified ad of 100 words or less in AGA's weekly e-mail newsletter, AGA eDigest, or AGA's bi-monthly magazine, AGA Perspectives. If you place ads in both AGA Perspectives and AGA eDigest, you will receive a 10 percent discount. Advertising in either includes a free online classified listing. Learn more.

Central Pennsylvania
Excellent opportunity for BC/BE gastroenterologist. Well-established, seven-physician practice with state-of-the-art ASC, fully operational EMR and soon-to-open new office with growth potential. Outstanding salary, benefits and incentive compensation plan. Learn more about our practice at www.gicare.com. Fax curriculum vitae to 717-761-0465, attention: Lisa Scicchitano or e-mail lscicchitano@gicare.com. 

Pennsylvania
Medical Director of GI Services — Good Samaritan Gastroenterology Associates, a hospital-employed physician group, is seeking a progressive GI physician for this exciting opportunity to “jump start” an existing program. Pioneer the expansion of this program by introducing new GI procedures and techniques, and growing the program through community outreach.

The hospital collaborates with medical directors, ensuring that improvements and investments in technology are ongoing.

Lebanon, PA, offers access to culture and activities of metropolitan centers as well as numerous historic attractions, beautiful scenery, friendly faces and a relaxed way of life.

For details, contact Jennifer Westford: 412-364-8200 or jwestford@corazoninc.com.

Kentucky
BC/BE GI wanted to join a growing, well-respected five-person group providing the full range of GI services, including ERCP. Endoscopy suite located next door to office. Join the St. Elizabeth Physicians GI team and enjoy it all — a competitive compensation and benefits package, a great place to live and work, and a very substantial referral base.

This opportunity allows you to enjoy Kentucky’s natural charm and all that metropolitan greater Cincinnati has to offer. Northern Kentucky is on the banks of the Ohio River and boasts affordable costs of living, award-winning schools, college and professional sports, exceptional fine arts, and is sixth in the nation for its number of Fortune 500 company headquarters.

St. Elizabeth Physicians is the multi-specialty group of St. Elizabeth Healthcare, a regional health-care provider continually recognized as one of the nation’s best. With close to 200 doctors and 50 mid-level providers, St. Elizabeth Physicians delivers quality medical care to residents of Northern Kentucky and Greater Cincinnati.

CONTACT: Kathy Robinson, kathyrobinson@stelizabeth.com, 859-212-4112.

Texas
Full-time gastroenterologist. Position requires an individual with the ability to work as part of a collaborative team consisting of physicians, physician assistants, medical assistants and clerical staff. The qualified physician will provide comprehensive care to patients requiring both acute and chronic gastrointestinal management — in both inpatient and outpatient clinical settings. All documentation is maintained electronically within our GI-specific electronic health record.

Digestive & Liver Disease Consultants, P.A. dba DLDC, established in North Houston, has been providing outstanding gastrointestinal and liver care for patients in the Harris and Montgomery counties for the past 23 years. The highly acclaimed group of gastroenterologists, board certified in internal medicine, gastroenterology and liver diseases, has a superb reputation in the community. The practice is serving patients at three convenient locations in North Houston, Humble/Kingwood and the Woodlands/Conroe areas. From consultative services and diagnostic procedures and, most importantly, endoscopic procedures, the physicians at DLDC have achieved a seamless integration of services by providing them under one roof. DLDC boasts a state-of-the-art, modern gastrointestinal diagnostic center and a fully accredited endoscopy and surgery center. Every detail is attended with meticulous care at the center in an effort to transform each patient’s care into a gratifying experience. The team approach at DLDC, with its university-trained physicians, skilled medical assistants and quality nursing staff, makes each patient’s experience further unique and memorable. Ancillary services such as CT (fully accredited by the American College of Radiology), ultrasound, manometry, capsule endoscopy, Helicobacter pylori breath tests, etc. are all offered at our main campus. E-mail shodgesdldc@gmail.com.

Virginia
Hospital-employed group practice seeking gastroenterologist with ERCP skills. This is an established four-person group located at the campus of Augusta Health. This entity is part of a larger 50 physician multi-specialty group affiliated with Augusta Health, Inc. This is a dynamic physician-driven organization serving the cities of Staunton and Waynesboro, and a large surrounding area consisting of a population of approximately 200,000. August Health is a sole community provider and holds the majority market share position for many services. Very competitive salary and benefits. No J-1 available. Contact: Arlene Macellaro, director, physician recruitment/practice development, 540-332-4462.