News from the Literature | Practice | Research | Journals & Publications
LEADING THE NEWS
Debt Ceiling Talks Continue
The talks on finding a deal to increase the debt ceiling will continue this week as President Obama becomes more personally engaged in the discussions. The Washington Post reports that cutting defense spending could be the compromise that Republicans are willing to make since they refuse to give on the issue of raising taxes. Democrats have been insisting that if domestic spending is to be slashed in any agreement, Republicans should give a little on tax increases and reducing the defense budget. Republicans typically view the defense budget as “off the table,” but in these tough budget times and with a new rank and file that want to reduce government spending, the defense budget is officially on the chopping block.
The Washington Post article quoted House Majority Leader Eric Cantor, R-VA, who quit the negotiations last week, as saying he prefers that the Appropriations Committee set the spending limits for defense, but wants an overall cap on spending “that leaves the door open to slashing the entire sum from domestic programs — such as education, … health research … — when lawmakers draft spending bills next spring.” However, since House Speaker John Boehner, R-OH, may need some Democratic votes to pass the debt limit increase, cutting the defense budget could garner some Democratic votes.
Also this week, Sens. Joe Lieberman, I-CT, and Tom Coburn, R-OK, unveiled a plan to save the Medicare program from financial insolvency and reduce the nation’s debt. The Lieberman-Coburn proposal would save $600 billion over ten years from Medicare by increasing cost-sharing for wealthier beneficiaries, incrementally increasing the eligibility age to 67 by 2025 and increasing the Part B and D premiums for wealthier beneficiaries. The plan would also provide a three-year sustainable growth rate formula fix that would be fully financed by savings from within the proposal. Many of the ideas in the proposal will be discussed during the ongoing budget ceiling talks and could be included in a final deal.
One thing is clear: every program is on the table for potential cuts. The AGA continues to advocate for sustained funding for the NIH and other federal programs that support medical research. If you haven’t already, please contact your legislators to urge them to provide adequate funding for research, since it not only creates jobs and triggers economic growth, but improves our nation’s quality of life.
Look for more updates on the budget negotiations and their impact on gastroenterology on the AGA Washington Insider.
NEWS FROM THE LITERATURE
Germline Mutations More Prevalent than Reported in CRC
Direct germline analysis could be used to screen high-risk patients for mutations in DNA mismatch repair genes associated with Lynch syndrome. In a population-based sample of young-onset colorectal cancer (CRC) cases, germline mutations in MLH1, MSH and/or MSH6 were more prevalent than reported for CRC patients overall. According to a study in Clinical Gastroenterology and Hepatology, because only about 5 percent of young-onset CRC cases had confirmed deleterious or suspected deleterious mutations, further comparative effectiveness research is needed to determine the most appropriate screening strategy for Lynch syndrome in this high-risk group.
Clinical Gastroenterology and Hepatology 2011; 9(6): 497-502
Patients with Chronic Nausea, Vomiting — Significant Medical Problem
Chronic nausea and vomiting with normal gastric emptying is a poorly understood syndrome. In a study appearing in Clinical Gastroenterology and Hepatology, doctors found that patients with nausea and vomiting with normal gastric emptying represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. This syndrome is not categorized in the medical literature — it might be a separate clinical entity.
Clinical Gastroenterology and Hepatology 2011; 9(7): 567-576.e4
Klothoß Variant Associates with Colon Transit in IBS-D
Bile acid malabsorption of moderate severity is reported in 32 percent of patients with chronic unexplained diarrhea, including IBS-D. Study results published in Gastroenterology suggest that a functional Klothoβ (KLB) gene variant mediating protein stability associates with colonic transit in IBS-D. This association is modulated by two genetic variants in fibroblast growth factor receptor 4 (FGFR4). The FGF19-FGFR4-KLB pathway links regulation of bile acid synthesis to colonic transit in IBS-D.
Gastroenterology 2011; 140(7): 1934-1942
Portal Pressure Predicts Outcome, Safety of Antiviral Therapy
There are limited data on the efficacy and safety of antiviral therapy in patients with hepatitis C virus (HCV)-related cirrhosis, particularly on the impact of portal hypertension. Data published in Clinical Gastroenterology and Hepatology suggest that hepatovenous pressure gradient (HVPG) is an independent predictor of response to antiviral therapy, with better predictive value than liver stiffness, baseline HCV RNA levels, HCV genotype or IL-28B polymorphism. The incidence and grade of thrombocytopenia during antiviral therapy are higher among patients with clinically significant portal hypertension. In evaluating cirrhotic HCV patients for antiviral treatment, measurement of HVPG should be considered.
Clinical Gastroenterology and Hepatology 2011; 9(7): 602-608.e1
PRACTICE
How to Get Started with EHR Incentive Payments
Did you know that providers have received more than $190 million in Medicare and Medicaid electronic health record (EHR) incentive payments through May? Do not be left behind; learn what you need to do to be eligible for an incentive. CMS is hosting a national provider call on Medicare and Medicaid EHR incentive program basics for eligible professionals on Thursday, July 14, from 1:30 to 3 p.m. ET.
Agenda
• Are you eligible?
• How much are the incentives and how are they calculated?
• How do you get started?
• What are major milestones regarding participation and payment?
• How do you report on meaningful use?
• Where can you find helpful resources?
• Question and answer session.
To register for this informative session, go to: http://www.eventsvc.com/palmettogba/071411. Registration will close at 1:30 p.m. ET on July 13, 2011, or when available space has been filled.
RESEARCH
Your AGA Research Foundation Gifts Support ...
Jan Dabritz, MD, who received the Moti L. and Kamla Rustgi International Travel Award in 2010.
"I am honored to be selected as a recipient of the 2010 AGA Rustgi Research Award for the second time, and I would like to thank Anil K. Rustgi, MD, AGAF, his family and the AGA Research Foundation for their support.”
“The overall aim of my work at the University of Münster, Germany, is to reveal novel insights into the pathogenesis of Crohn’s disease, and to identify mechanisms by which the modulation of innate immunity bears a potential of altering the natural history of this disease. Clinical trials showed that granulocyte macrophage-colony stimulating factor (GM-CSF) induces clinical response and remission in patients with active Crohn’s disease. Recent studies suggest a causal link between impaired inflammation and impaired bacterial clearance in Crohn’s due to alterations of monocytes/macrophages. As blood monocytes are the exclusive source of macrophages in inflamed intestinal mucosa, I therefore characterize GM-CSF-induced monocyte subsets in vitro and analyzed their role in experimental colitis in vivo.”
To make a donation, visit http://www.gastro.org/contribute.
| AGA Accepting Applications for Fellowship |
|---|
The AGA is accepting applications for fellowship, the organization’s highest level of membership. The application deadline is July 18. |
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 Anil K. Rustgi, MD, 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.
Deadline Extended for CGH Editor-in-Chief Applications
AGA has extended the deadline to receive applications for the editor-in-chief position of its official clinical practice journal Clinical Gastroenterology and Hepatology (CGH). 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 Aug. 1, 2011.
Qualified members should apply. Contact Thoba Khumalo Petrovic for additional information at tkhumalo@gastro.org or 301-941-9780.
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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.
