American Gastroenterological Association - Advancing the Science and Practice of Gastroenterology

News from the Literature | Practice | Research | Education & Meetings | Journals & Publications | Announcements | Awards

LEADING THE NEWS

NEWS FROM THE LITERATURE

Low Doses of ASA Increase Risk of GI Bleeding

Doctors performed a meta-analysis of data from randomized trials to estimate the risk of all-cause mortality and bleeding (and especially GI bleeding) in patients treated with low doses of acetylsalicylic acid (ASA) (75–325 mg/d) alone or in combination with other medications. Study results published in Clinical Gastroenterology and Hepatology suggest that low doses of ASA increased the risk for GI bleeding; risk increased with accompanying use of clopidogrel and anticoagulant therapies, but decreased in patients who took PPIs.

Clinical Gastroenterology and Hepatology 2011: 9(9): 762-768.e6

Which Genetic Factors Influence IBD Risk?

There are many genetic factors that are associated with both ulcerative colitis and Crohn's disease. However, genetic factors that have distinct effects on ulcerative colitis and Crohn's disease have not been examined. The human leukocyte antigen-Cw*1202-B*5201-DRB1*1502 haplotype increases susceptibility to ulcerative colitis, but reduces risk for Crohn's disease, based on a genome-wide association study of a Japanese population published in Gastroenterology.

Gastroenterology 2011: 141(3): 864-871.e5

Policies Promoting Healthier Weight Have Economic Benefits

Rising prevalence of obesity is a worldwide health concern because excess weight gain within populations forecasts an increased burden from several diseases, most notably cardiovascular diseases, diabetes and cancers. In a report in The Lancet, doctors used a simulation model to project the probable health and economic consequences in the next two decades from a continued rise in obesity in two aging populations — the U.S. and the U.K. They stated that effective policies to promote healthier weight have economic benefits.

The Lancet 2011: 378(9793): 815-825

Laparoscopy, Fast-Track Care Lead to Faster Recovery

Postoperative ileus is characterized by delayed GI transit, and is a major determinant of recovery after colorectal surgery. Both laparoscopic surgery and fast-track multimodal perioperative care have been reported to improve clinical recovery. However, objective measures supporting faster GI recovery are lacking. In a study appearing in Gastroenterology, doctors found that colonic transit recovers significantly faster after laparoscopic surgery and the fast-track program. Laparoscopy and fast-track care lead to faster recovery of GI motility and improve clinical recovery.

Gastroenterology 2011: 141(3): 872-880

PRACTICE

CMS Releases Revised Advance Beneficiary Notice

During the July 13 hospital open-door forum call, CMS announced the release of a revised advance beneficiary notice (ABN) form (CMS-R-131) with the release date of March 20, 2011, printed in the lower left-hand corner. The new ABN form is available for immediate use. CMS only changed the format, not the substance, of the form.
 
The purpose of an ABN is to provide prior notice to a beneficiary (or his or her representative, in the event that the beneficiary is not competent) when the provider believes that Medicare will not pay for certain part B outpatient services because limitation on liability applies. Limitation on liability applies when part B outpatient services fall into one of three categories:

• The services do not meet Medicare’s medical necessity guidelines for that patient’s condition.
• The services are screening services that are being provided more frequently than Medicare provides a benefit for.
• The services are custodial.

Once the beneficiary knows that Medicare is not expected to pay for these services, he or she (or his or her representative) can decide whether to have these services performed, even though he or she is likely to end up paying for them. The ABN is designed to assist in that decision-making process by providing all the information necessary to make an informed decision.
 
Although the new ABN form is currently available, its use is not mandatory until Nov. 1, 2011. This transition period permits hospitals — and other providers and suppliers required to notify beneficiaries using the ABN form — to use up any stockpiles of the old forms. All ABNs with the release date of March 2008 that are issued on or after Nov. 1, 2011, however, will be considered invalid. Hospitals need to ensure that they utilize the new form for all ABNs issued on and after that date.

— Judith Kares, JD, regulatory specialist for HCPro, Inc.

GastroSlides Featured Image

Topic: Digestive Health and Disease in Women

These images illustrate important concepts in understanding gender-based differences — with a focus on women —  in digestive health and disease.

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.

Learn More About Changes to E-Prescribing Incentive Program

CMS will host a national provider call on the Physician Quality Reporting System and electronic prescribing incentive program on Tuesday, Sept. 13 from 1:30 to 3 p.m. ET. A Q-and-A session will follow the presentation.

Medical coders, physician office staff, provider billing staff, health records staff, vendors and all Medicare fee-for-service providers are encouraged to participate.

Register for this informative session. Registration will close at 1:30 p.m. ET on Sept. 12 or when available space has been filled.

RESEARCH

Your AGA Research Foundation Gifts Support ...

  ... Ian Maina, of the University of North Texas, who received a 2011 AGA-Stuart Brotman Student Research Fellowship Award.

"I've always believed I was meant to contribute to humanity as a health professional,  and the tremendous honor of receiving this prestigious award will give me much more insight into the various ways I can do so. The award will be of great assistance in the completion of my project analyzing a new enzyme assay, a-GST, in patients with acute liver failure under the mentorship of William Lee, MD, at the University of Texas Southwestern Medical Center."

"I am very excited, as this is my first research opportunity in the field of medicine. Also, gastroenterology is relatively new to me, but I am eager to walk in the lab every day to gain knowledge and contribute as much as I can. I must thank Corron Sanders, MD, Lafaine Grant, MD, Shawna Nesbitt, MD, and most importantly, Dr. Lee. They worked with me throughout the application process and have been exemplary mentors. I could not have done it without them."

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

EDUCATION & MEETINGS

Clinical Congress Offers Valuable Information for Clinicians

Those who are in clinical practice or are thinking of going into clinical practice should not miss the AGA Clinical Congress of Gastroenterology and Hepatology: Practice, Evidence and Quality in 2012, which will be held Jan. 20 and 21, 2012, in Miami Beach, FL. More relaxed than larger clinical meetings, the congress offers a comprehensive review of key clinical issues that arise in everyday practice. Attendees will take away immediately applicable, case-based information that will enhance their clinical decision-making skills and improve patient care.

Led by congress director, Marcia R. Cruz-Correa, MD, PhD, AGAF, and co-director, David A. Lieberman, MD, AGAF, this multi-faceted program highlights six areas most important to the practicing clinician: intestinal disorders, liver disease, endoscopy, biliary/pancreatic disorders, esophageal diseases and colorectal cancer/colonoscopy. While the didactic lectures will expand attendees’ clinical knowledge, the small-group breakouts will explore these six areas in greater detail and offer more time for questions and further discussion with the expert faculty.

One of the most interesting aspects of the program is a review of difficult patient cases, which are submitted by attendees and chosen by the faculty. Attendees are encouraged to submit a case to be considered for review. Prizes will be awarded to those whose cases are selected.

Trainees can submit an abstract and present their research at the congress, providing a valuable opportunity to receive feedback from both faculty and peers. Selected abstracts will be published in Clinical Gastroenterology and Hepatology. The deadline to submit an abstract is Oct. 12.

The congress also features the following events:

• AGA Practice Management Course
• AGA Practice Skills Workshop
• AGA Maintenance of Certification (MOC) Course 

Special incentives are available for AGA member trainees, including free registration and trainee scholarships for attending both the congress and the corresponding practice skills workshop, which follows on Jan. 22.

Congress registrants can register for the practice management course or the MOC course at a discount. Those who register for the congress on or before Oct. 31 will receive free access to the 2012 congress online sessions.

Learn more and register.

Toolkit Series Delivers Essential Nutrition, Obesity Information

With obesity rates in the U.S. quickly rising, and increasing reports and studies identifying a link between obesity and GI diseases, it is critical that health-care providers understand the role of nutrition and obesity in treating and managing patients with digestive disorders. The AGA’s nutrition toolkit series, a collection of online self-assessment modules, covers the latest information for the effective management of nutrition and obesity in the GI practice. Modules include:

• Nutrition in Short Bowel Syndrome.
• 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 module features 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. Participants can earn up to 0.75 AMA PRA Category 1 Credits™ per module.

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 of the AGA website. Additional modules on the nutritional management of fiber and the gastrointestinal and nutritional complications of bariatric surgery are in development, and will be available in the fall.

*Sponsored by the General Mills Bell Institute of Health and Nutrition.

UC Virtual Clinic Helps Improve Patient Care

The Ulcerative Colitis (UC) Virtual Clinic is a two-part, interactive, case-based activity that follows a virtual UC patient through two office visits. Designed to improve clinical outcomes and enhance quality of life for UC patients, this activity examines guideline-recommended approaches to the management of recurrent or refractory UC, with emphasis on first- and second-line pharmacologic therapies and the factors that affect adherence to treatment regimens.

• Patient visit one: a 34-year-old woman with onset of bloody diarrhea in established UC.
• Patient visit two: a 34-year-old woman with refractory UC.

Each visit is a CME-accredited activity (0.5 AMA PRA Category 1 credit). This activity is supported by an educational grant from Centocor Ortho Biotech Services, Inc. and Abbott Laboratories.

JOURNALS & PUBLICATIONS

Download 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 cover:

• Changes in Postprandial Lipid Clearance and Blood Glucose Homeostasis Following Vertical Sleeve Gastrectomy in Rats.
• Durability of Radiofrequency Ablation in Barrett's Esophagus with Dysplasia.
• Fruit, Vegetables and Folate: The Evidence for Cancer Prevention.

Recent podcasts from CGH cover:

• Immune Dysfunction and Infections in Cirrhosis.
• Early Fluid Resuscitation in Acute Pancreatitis — Strategies and Reduced Morbidity.
• Prevalence of Primary Biliary Cirrhosis — Autoimmune Hepatitis Overlap Syndrome.

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.

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.

ANNOUNCEMENTS

Did You Miss Last Week's Tweets?

Some of our favorite and popular news items of interest featured via Twitter last week include:

• RT @Rndubois: US may be facing a serious shortage of physicians in the future: tinyurl.com/3sveh24.
• NIH is welcoming proposals for innovative approaches to major challenges in biomedical or behavioral research. http://ow.ly/6dCyJ.
• Dr. William Wolff, 94, Colonoscopy Co-Developer, Dies: nyti.ms/rlwSrW via @RyanMadanickMD.
• CGH video abstract: quality of life for pediatric patients after total pancreatectomy or islet autotransplant: http://ow.ly/6hwjY.
• Remembering Emmet B. Keeffe, world-renowned hepatologist who will be missed by friends, colleagues, students, patients: http://ow.ly/6dCJC.

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:

• Become an AGA fan on Facebook.
• Join our LinkedIn group.
• Follow us on Twitter @AmerGastroAssn.
• Check out our videos on YouTube.

AWARDS

Final Call for Nominations: Friedenwald Medal

Nominations are due Sept. 23 for the Julius Friedenwald Medal, the highest honor the AGA bestows on a member. This award recognizes an individual who has made lifelong contributions to the field of gastroenterology. All AGA members are encouraged to nominate their colleagues for this prestigious award.

To submit a nomination, send a letter summarizing the nominee’s career and achievements in gastroenterology, a curriculum vitae and a bibliography to awards@gastro.org. Complete instructions and selection criteria are available on AGA's website.

Nominations are due Nov. 11 for other AGA member recognition prizes, including:

• The William Beaumont Prize in Gastroenterology, which recognizes an individual who has made a major contribution (a single accomplishment or series of accomplishments) that has significantly advanced gastroenterological basic or clinical research.
• The Distinguished Clinician Awards, which recognize two individuals, one in private practice and one in clinical academic practice, who have exemplified leadership and excellence in the practice of gastroenterology.
• The Distinguished Educator Award, which recognizes an individual for his or her achievements as an outstanding educator over a lifelong career.
• The Distinguished Mentor Award, which recognizes an individual for his or her achievements as an outstanding mentor over a lifelong career.
• The AGA Research Service Award, which recognizes an individual who has dedicated an extraordinary effort to advocacy for the advancement of gastroenterological science and research.

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.

Colorado
GASTROENTEROLOGIST: Denver Health Medical Center, nationally recognized as the premier safety net provider in the country, is actively recruiting faculty with clinical interests in luminal gastroenterology who will be using the strengths of our integrated delivery and information systems to provide, understand, evaluate and improve the delivery of digestive health care to all who live in the Denver metro area. Our program is fully integrated with the University of Colorado School of Medicine GI division, including appropriate academic rank and a combined fellowship. Please contact Joel Levine, MD, GI chief at Joel.Levine@dhha.org for further information.

GASTROENTEROLOGISTS/CLINICAL HEAD OF GI: The division of gastroenterology and hepatology at the University of Colorado Denver is seeking talented and energetic clinical academicians. The university serves as a tertiary referral center for the Rocky Mountain region, and the division has outstanding programs in endoscopy, transplantation, early detection and chemoprevention of colon cancer, and other clinical research. Applications are sought from individuals with strong clinical academic and leadership skills. Salary is based on the academic level of entry and individual qualifications and responsibilities. The Denver area provides a beautiful outdoor-oriented environment to complement the opportunities provided through the university. CVs and applications will be processed via www.jobsatcu.com, position number 811902.

Maryland
Large multi-specialty practice serving Montgomery County, MD seeks a BE/BC gastroenterologist. Excellent opportunity to join a large private practice with an integrated referral system. Please forward your CV to elliotrgoldstein@yahoo.com.

North Dakota
Procedure-Oriented Practice

Sanford Health Fargo has immediate openings for BC/BE gastroenterologists in a procedure-oriented practice. Call 1:8. 100 percent hospitalist coverage; hospital consults only. Procedures performed include: ERCP, EUS and capsule endoscopy. ERCP and EUS skills are desirable, but not necessary. Opportunity to teach medical students and IM residents. Level II 583-bed trauma center with electronic medical records and PACS. Sanford Health Fargo consists of 585+ physicians located in Fargo and 32 regional primary care clinics.

Fargo, ND, with a metro population of 190,000, is a diverse, stimulating and family-oriented city with all the amenities that make for a satisfying and fulfilling life. We offer exceptional K-12 and higher education systems, world-class health care, affordable housing, low cost of living, and myriad cultural and entertainment opportunities.

Jean Keller, physician recruiter
Sanford Physician Placement
Phone: 701-280-4853
E-mail: jean.keller@sanfordhealth.org
www.sanfordhealth.org

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.