May 03, 2012 Home|Journals & Publications|  AGA eDigest
AGA eDigest

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

LEADING THE NEWS

Hand-Picked Sessions Useful in Day-to-Day Practice

In an effort to help GIs working in community-based practice to navigate DDW®, the AGA Institute Council has developed AGA Practitioner Picks, a selection of DDW sessions that will be useful in day-to-day practice.

The picks include sessions that cover general gastroenterology as well as updates and state-of-the-art information relevant to clinical practice. While many AGA-sponsored sessions are included, the recommendations include programming from other societies.

The council’s goal in identifying the practitioner picks is to help busy clinicians choose from the numerous options offered by the four societies. This track will provide clinicians with information on new research, ways to improve their practice based on new guidelines and new diagnostic techniques. Although the track was designed for clinicians, anyone with an interest in general gastroenterology may find it useful, including fellows who are trying to expand their general knowledge base, and basic scientists who do not have time to keep up with clinical information.

To get more information about these sessions and add them to your DDW itinerary, log in to MyDDW. After logging in, choose "Search Scientific Sessions" from the menu on the left. On the right, you will see "By Special Interest." Choose "AGA Practitioner Picks" from the menu and select the search button. You will be able to select the session name to view presentation details, including full-text abstracts. Choose the "Add" button on the left to add the session to your DDW itinerary.

NEWS FROM THE LITERATURE

Telbivudine Prevents Hepatitis B Transmission

Telbivudine reduces hepatitis B virus DNA and normalizes levels of alanine aminotransferase in patients with chronic hepatitis B (CHB). A study in Clinical Gastroenterology and Hepatology found that women with CHB given telbivudine during the second or third trimester of pregnancy have reduced rates of perinatal transmission. Telbivudine produced no adverse events in mothers or infants by 28 weeks.

Clinical Gastroenterology and Hepatology 2012; 10(5): 520-526

Familial Diarrhea Syndrome Caused by GUCY2C

Familial diarrhea disorders are, in most cases, severe and caused by recessive mutations. According to a study in the New England Journal of Medicine, increased guanylate cyclase C (GC-C) signaling disturbs normal bowel function and appears to have a proinflammatory effect, either through increased chloride secretion or additional effects of elevated cellular guanosine monophosphate. Further investigation of the relevance of genetic variants affecting the GC-C-cystic fibrosis transmembrane regulator pathway to conditions such as Crohn's disease is warranted.
 
New England Journal of Medicine 2012; 366: 1586-1595

Antimicrobial Antibodies Associated with Crohn's-Like Phenotype

Pouchitis and Crohn's disease-like (CDL) complications of the pouch occur at rates near 50 percent and 20 percent, respectively, after colectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis. Data published in Clinical Gastroenterology and Hepatology suggest that antimicrobial antibodies and perinuclear antineutrophil cytoplasmic antibody are associated with inflammatory complications of the pouch. The CDL phenotype is associated with factors that characterize Crohn's disease, including smoking, anti-CBir1 and antibodies against Saccharomyces cerevisiae.

Clinical Gastroenterology and Hepatology 2012; 10(5): 507-512.e1

Bariatric Surgery Results In Better Glucose Control

Roux-en-Y gastric bypass and biliopancreatic diversion can markedly ameliorate diabetes in morbidly obese patients, often resulting in disease remission. Prospective, randomized trials comparing these procedures with medical therapy for the treatment of diabetes are needed. In severely obese patients with type 2 diabetes, bariatric surgery resulted in better glucose control than did medical therapy, stated researchers in a study in the New England Journal of Medicine. Preoperative BMI and weight loss did not predict the improvement in hyperglycemia after these procedures.

New England Journal of Medicine 2012; 366:1577-1585

GI FELLOWS

AGA Members Provide Nearly 300 Free Colonoscopies

During Colorectal Cancer Awareness Month, AGA successfully partnered with the CDC and its Colorectal Cancer Control Program (CRCCP) to match gastroenterologists willing to provide free colonoscopies to uninsured patients throughout the country. The CDC is currently compiling statistics, which will allow us to quantify the reach of the program. However, preliminary information indicates that it was a great success, with more than 50 AGA members screening almost 300 uninsured patients across the country. Thank you to everyone who participated.

Though events took place throughout the month, the majority of the CRCCP screenings occurred the weekend of March 29–31, with gastroenterologists performing free colonoscopies in Arizona, California, Colorado, Florida, Massachusetts, New Hampshire and Nevada.

AGA member Carla Ginsburg, MD, MPH, AGAF, spearheaded the program, which began in 2009 in Boston and has grown to include the partnership with CDC. AGA is pleased that we were able to help create partnerships between members and the CRCCP, many of which have led to the beginnings of longer-term partnerships resulting in agreements for year-round screening programs and educational opportunities.

If you participated in this program, please contact Aimee Frank at afrank@gastro.org to share more about your experience.

In Case You Missed It ...

The latest studies in AGA's journals were shared by many of our followers on Twitter. Here are some highlights from last week:

  • 2012 special issue of Gastro is now online with latest updates on viral #hepatitis research and treatment: ow.ly/azfKh.
  • Gastro: What is the prevalence of #celiac disease among patients with non-constipated #IBS? Find out now: ow.ly/avVGf.
  • April is IBS Awareness Month: #IBS patients differ in cerebral responses to standardized rectal distensions. ow.ly/assGc.
  • Read about how to initiate azathioprine for Crohn’s in this FREE education practice article from CGH: ow.ly/assbq.

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:

PRACTICE

CGH Image of the Month

Isolated Jejunal Varices: A Cause of Occult GI Hemorrhage in a Cirrhotic Patient with Mild Portal Hypertension

A 60-year-old woman with hepatitis C cirrhosis and a history of lymphoma was admitted to a medical center because of recurrent melena. Although hemodynamically stable, she required frequent blood transfusions. Upper and lower endoscopies failed to reveal the source of hemorrhage. Capsule endoscopy showed an isolated bleeding jejunal varix.

Read more in Clinical Gastroenterology and Hepatology.

Pursuit of Happiness: Choosing a GI Practice, Post Fellowship

Many GI fellows are finally looking to secure a position within their chosen practice. After years of rigorous training, under financially challenging circumstances and often in locations dictated to them by a mysterious algorithm (better known as “the match”), they have reached one of the most important decisions of their careers. So, what do GI fellows look for in a practice and how do they actually go about their search? Andrew Tinsley, MD, a fellow in gastroenterology at the Mt. Sinai School of Medicine in New York helps answer these crucial questions using a two-pronged approach. Find out what he learned by reading the full article in AGA Quarterly: Practice.

GastroSlides Images Illustrate Liver Disease

Topic: Autoimmune Liver Disease

These images illustrate the causes, diagnosis and management of autoimmune injury to the liver and biliary tree, and are separated into the following sections:

  • Part I: Primary Sclerosing Cholangitis
  • Part II: Primary Biliary Cirrhosis
  • Part III: Autoimmune Hepatitis
  • Part IV: Overlap Syndromes
  • Part V: Illustrative Cases

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.

Special offer: get your free download of GastroSlides unit on liver cancer (revised).

RESEARCH

Your AGA Research Foundation Gifts Support …

 … Akanksha Mishra, for research conducted at the Cincinnati Children’s Hospital Medical Center, who received the 2011 AGA-Eli & Edythe Broad Foundation Student Research Fellowship Award.

"This award will enhance my basic understanding of the biology of eosinophils and their role in experimental systems in mice, and help me develop a proper framework to establish a direct translation of my findings to human esophageal disease. I strongly believe that my proposed research work will give me a new understanding of the medical research, and hope that my work will provide future direction to understand the mechanistic aspects of the esophageal disease, termed as eosinophilic esophagitis. I also hope that this AGA-Broad Student Research Award will provide me with the opportunity to define the immunological mechanisms involved in gastrointestinal allergy. In summary, the award will shape my career goal to work hard and get my data published to help me obtain an MD, PhD degree."

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

JOURNALS & PUBLICATIONS

Researchers Discuss Gastro, CGH Studies

Watch Michael J.Levy, MD, discuss his Gastroenterology manuscript, "Comparison of Methods to Detect Neoplasia in Patients Undergoing Endoscopic Ultrasound-Guided Fine-Needle Aspiration." Provide your thoughts and comments on this important study via the YouTube comments tool.


Watch Guo-Rong Han, MD, discuss her Clinical Gastroenterology and Hepatology manuscript, "Telbivudine Prevents Vertical Transmission from HBeAg-Positive Women with Chronic Hepatitis B." Provide your thoughts and comments on this important study via the YouTube comments tool.

View our comprehensive library of video abstracts and educational videos on the AGA YouTube channel.

Gastroenterology Publishes Special Issue on Viral Hepatitis

The editors of Gastroenterology are pleased to announce the publication of this year’s highly anticipated special 13th issue on viral hepatitis. Viral hepatitis is a field that has grown rapidly over the last 15 years and it affects more than 500 million patients worldwide, so this special issue is particularly timely. Titled “Viral Hepatitis: A Changing Field,” the supplement includes the latest updates on the evolution of viral hepatitis research and treatment, as well as important commentary on the remaining challenges the field faces.
 
In conjunction with Editor-in-Chief M. Bishr Omary, PhD, MD, the issue was developed by Senior Associate Editor Anna S. Lok, MD, AGAF, and Associate Editor Jean-Michel Pawlotsky, MD, and debuts a compelling new format. Classic review articles are interspersed with insightful commentaries that address critical unresolved issues and fundamental questions for the future. The content is organized into four sections, mainly related to hepatitis B and C virus infections, including:

  • Epidemiology and Pathophysiology.
  • Diagnostic and Prognostic Tools.
  • Therapy and Prevention.
  • Hepatitis E Virus.

The editors make clear the mission of this supplement: “Our goals in this special issue of Gastroenterology are to give the readers an up-to-date insight into the tremendous progress made over the past few years in viral hepatitis research and care, and to guide them through complex challenges and expected future developments with the help of an outstanding group of thoughtful expert international leaders.”

Access this high-quality and compelling issue now.

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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.

Illinois
Feinberg School of Medicine Northwestern University
Associate Professor or Professor and Chief, Division of Gastroenterology and Hepatology

Northwestern University seeks an exceptional individual to direct the division of gastroenterology/hepatology. The division currently is comprised of over 40 faculty members, with broad interests in basic and clinical research, education and clinical care. Patient care is provided through Northwestern Memorial Hospital, Northwestern Medical Faculty Foundation and the Jesse Brown VA Medical Center, as well as associated hospitals of the McGaw Medical Center (Children's Memorial Hospital and The Rehabilitation Institute of Chicago). The division works in close collaboration with many departments, institutes and centers across the Feinberg School of Medicine in a variety of areas related to gastroenterology/hepatology.

The ideal candidate should be a nationally recognized leader with an established record of academic accomplishment in research, education and clinical care. The selected candidate will also be committed to shaping and growing a division that sets the standards of a 21st century department of medicine and medical school. These standards include advanced leadership ability, a demonstrated commitment to collaboration and interdisciplinary activities, and a passion for success in all areas of the tripartite mission.

A medical degree and board certification are required. This is a full-time faculty position. Salary will be commensurate with experience. The successful candidate will be tenured at the rank of associate or full professor. The proposed start date is Sept. 1, 2012. To ensure full consideration, interested candidates should submit a curriculum vitae by June 1, 2012, to:

Gastroenterology/Hepatology Search Committee
c/o Diane B. Wayne, MD
Vice – Chair, Department of Medicine
251 E Huron St. Galter 3-150
Chicago, IL 60611
dwayne@northwestern.edu

The Feinberg School of Medicine is an affirmative action/equal opportunity employer. Women and minorities are encouraged to apply. Hiring is contingent upon eligibility to work in the United States.