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News From The Literature Phosphate Enema Bowel Preparation Increases Anastomotic Leaks Findings in the latest issue of the British Journal of Surgery show that, compared with oral polyethylene, bowel preparations with a phosphate enema before elective colorectal surgery may increase the risk of anastomotic leakage, requiring re-operation. A recent meta-analysis has questioned the value of bowel preparation in patients undergoing colorectal resection. Investigators evaluated whether a single phosphate enema was as effective as oral polyethylene glycol solution in preventing anastomotic leakage. Patients were randomized to receive either a single phosphate enema or 3 liters of oral polyethylene glycol solution before surgery. The research team followed patients for a minimum of six weeks to detect anastomotic leakage. There were 147 patients in each group and the groups were evenly matched for putative risk factors at baseline. Patients in the enema group had more anastomotic leaks requiring re-operation, at 4 percent, with none occurring in the polyethylene glycol group. The researchers observed that the mortality rate was higher in the polyethylene glycol group, although this was not statistically significant. – Newsfeed from GastroHep.com British Journal of Surgery ; 2006: 93(4): 427-33
Liver Transplant Waiting List Mortality Highest for the Youngest The sobering reality that mortality on the waiting list remains highest for the youngest pediatric liver candidates frames our challenge for the next decade, reports this month's Liver Transplantation. During the last 10 to 15 years, medical and surgical innovations have established pediatric liver transplants as the optimal therapy for children suffering acute and chronic liver disease. Researchers from San Francisco investigated current pediatric liver transplant recipients, hypothesizing that the profile of current pediatric liver transplant recipients would differ significantly from that of an earlier era. The researchers collected and compared data regarding the characteristics of children undergoing liver transplantation alone in two eras separated by more than a decade from the Organ Procurement and Transplantation Network/United Network for Organ Sharing database; transplant recipients from 2002 to 2004 were compared to those from 1990 to 1992. The recipients from the later era tended to be more evenly distributed across age, race/ethnicity, and disease etiology. The team found a major shift toward utilization of partial grafts from both deceased and living donors. This shift occurred to achieve transplants for the youngest children in particular. However, the team noted only a modest increase in demand for pediatric liver transplantation. The researchers also observed that wait list times for both pediatric candidates and recipients have still increased between eras. – Newsfeed from GastroHep.com Liver Transplantation ; 2006: 12(4): 578-84
Satisfactory Quality of Life with Nissen Fundoplication for GERD Patients have a satisfactory quality of life with Nissen fundoplication for GERD, clinical results do not deteriorate over time, and this is predicted by postoperative esophageal clearance and gastric emptying, according to findings in this month's American Journal of Surgery. Long-term outcome of anti-reflux operations as well as pre- and postoperative parameters able to predict their clinical results are still controversial. Italian researchers evaluated long-term quality of life with open fundoplication for chronic GERD, investigating pre- and early postoperative functional parameters possibly related to persistence or recurrence of symptoms. The investigators reviewed 25 patients who underwent open Nissen fundoplications for GERD with an average follow-up of more than 10 years. Clinical evaluation was performed by using a symptom-specific score. The team used three health-related quality of life scores, including a GERD-specific health related quality of life score. In addition, two generic scores, such as the Short Form-36, were used to evaluate physical and psychological well-being. Subjective satisfaction grade of the patients was also investigated. A univariate analysis was undertaken, according to the long-term presence or absence of residual symptoms. The investigators took into account pre- and postoperative data of endoscopy, 24-hour pH monitoring, stationary manometry and gastric-emptying tests. The team found that persistence or recurrence of GERD-specific symptoms were reported by 32 percent of patients. About 8 percent of patients were re-operated on for persistent dysphagia, whereas 68 percent were asymptomatic. The GERD-health related quality of life and Short Form-36 scores displayed significant postoperative improvement, which continued in long-term follow-up. The investigative team observed that 80 percent of patients had repeat fundoplication. Among tested parameters, only postoperative mean supine esophageal clearance and gastric emptying half-time improved after the antireflux procedure. However, these parameters differed significantly in long-term asymptomatic and symptomatic subgroups. In long-term asymptomatic patients, the team noted that postoperative mean supine esophageal clearance was 0.8 minutes. In symptomatic patients, the mean supine esophageal clearance rate was two minutes. The investigators found that postoperative mean gastric emptying half-time of long-term asymptomatic patients was 93 minutes. However, in symptomatic patients it was 128 minutes. – Newsfeed from GastroHep.com American Journal of Surgery ; 2006: 191(4): 470-8
DNA Vaccine Induces Innate Immune Response against H. pylori A urease B subunit DNA reduces bacterial colonization in the stomach, even without antigen co-administration, suggesting a greater role for the innate immune responses against H. pylori, finds April's Helicobacter. Helicobacter pylori is recognized as a major risk factor for recurrent gastroduodenal inflammatory diseases and gastric adenocarcinoma and there is a high prevalence of H. pylori infection worldwide. The risks of side-effects from antibiotic therapy, and increasing resistance to antibiotics are the main primers for improved H. pylori vaccines. The antigenic potential of its urease enzyme, a critical virulence factor required for colonization of the gastric mucosa, has been shown in animal and human studies. An important but controversial issue in H. pylori vaccine studies is the type of immune response required to control infection. A new approach in H. pylori vaccinology is the administration of DNA vaccines, which has included heat-shock protein and catalase DNA vaccines. Researchers from England administered the H. pylori urease subunit B construct or vector alone to mice via the intranasal route. Spleens and stomachs were examined on day zero and weeks three, six, and 12 after immunization. The research team assessed proliferation of spleen cells using the carboxyfluorescein diacetate succinimidyl ester-based flow cytometry assay. Cytokine secretion from cultured spleen cells was detected by ELISA, after stimulation with the urease subunit B recombinant antigen. Total RNA was isolated from stomach and spleen tissue. The research team monitored the expression of β-defensin and cytokine genes by reverse transcription followed by polymerase chain reaction. Immunized mice were challenged with H. pylori and bacterial DNA quantified by TaqMan polymerase chain reaction. The team found that the urease B subunit DNA vaccine increased INF-γ secretion and splenocyte proliferation without adverse effects in the spleen. The research team observed an increase in gastric β-defensin 1. In addition, the team noted a marked induction in local interleuken-10 to INF-γ ratio up to 12 weeks post-immunization. These two observations suggest a potential role for local innate immune responses in protection at the site of infection. The researchers further observed significant bacterial reduction in the stomachs of urease B subunit DNA-immunized mice. However, intermediate reduction was also noted in the vector group. The team suggested that increased defensin expression and adjuvant effects of the cytosine preceding guanosine motifs may contribute to this phenomenon. – Newsfeed from GastroHep.com Helicobacter ; 2006: 11(2): 113
Noninvasive Markers of Liver Fibrosis in Drug Users with Hep C FibroSURE, alanine aminotransferase and aminotransferase-to-platelet-ratio index tests predict insignificant fibrosis in injection drug users with hepatitis C, reports this month's Hepatology. Most hepatitis C virus infections are acquired by injection drug use. U.S. researchers assessed prospective data on the progression of liver fibrosis, obtaining baseline liver biopsies from 1996 to 1998 on a random sample of 210 out of 1,667 hepatitis C virus-positive injection drug users. Subjects were followed biannually, with a second biopsy offered to those eligible. Among 119 prospectively followed injection drug users, 96 percent were African American, and 97 percent were hepatitis C virus genotype 1a/b. A further 27 percent were HIV-infected, with a median age of 42 years. Paired biopsies were scored from zero to six and the research team defined significant fibrosis was as score three or greater. Progression of fibrosis was defined as an increase two or more units or clinical evidence of end-stage liver disease. The team's predictive values of blood markers include FibroSURE, aspartate aminotransferase-to-platelet-ratio index and alanine aminotransferase. The researchers assessed the detection of contemporaneous and future liver fibrosis. The team noted that 91 percent did not have significant liver fibrosis at first biopsy. The researchers' predictive value for detecting insignificant fibrosis at first biopsy was greater than 95 percent for FibroSURE. The predictive value for aminotransferase-to-platelet-ratio index and alanine aminotransferase specificities were 73 percent. After four years median follow-up, 21 percent had progression of fibrosis. The researchers observed that this was significantly associated with serum level of hepatitis C virus RNA and alanine aminotransferase. No serological test had a predictive value greater than 40 percent for contemporaneous or future significant fibrosis. Initial biopsy result had only a 30 percent value for predicting future significant fibrosis. – Newsfeed from GastroHep.com Hepatology ; 2006: 43(4): 788-95
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Policy Update CMS Announces Preliminary Estimates for 2007 Physician Payment Update In a letter to the Medicare Payment Advisory Commission (MedPAC), the Centers for Medicare and Medicaid Services (CMS) released its current estimates for the 2007 physician fee schedule update and conversion factor and the data used in making the estimates. Each year, CMS uses the sustainable growth rate (SGR) formula to update the Medicare “conversion factor.” For 2007, CMS estimates a -4.6 percent update which equates to a conversion factor of $36.1542. The AGA will fight against this payment reduction, and continue to advocate that Congress enact a long-term fix to the flawed SGR formula. In the letter, CMS outlines the preliminary data used to calculate their estimates. According to the agency, physician fee schedule expenditures for 2005 increased by approximately 11.4 percent. The vast majority of the 2005 spending growth is attributable to the following areas: evaluation and management services, particularly higher-level visits (31 percent of overall spending growth), minor procedures such as physical therapy, podiatry and dermatology procedures (29 percent of overall spending growth), imaging services (27 percent of overall spending growth) and lab and other tests (15 percent of overall spending growth). Spending on physician-administered drugs decreased, accounting for -0.3 percent of overall spending growth. As noted above, these are preliminary findings based on currently available data; however, CMS will continue to evaluate these trends. In addition, CMS again confirms its intent to begin linking payment to quality in what is known as “pay for performance” (P4P):
Unfortunately, the agency indicates that the President’s budget supports linking quality reporting and improvement to Medicare payment in a budget-neutral manner. The AGA, along with the Alliance of Specialty Medicine, and the rest of the medical community, continue to express concern with the integration of P4P into the currently unsustainable physician payment system. We will continue to follow the agency’s activities, advocate that the payment system be overhauled and keep you updated. Click here to view a copy of the CMS letter to MedPAC.
The House failed to pass its fiscal year 2007 budget resolution due to the inability of the Republican controlled House to reach consensus. With no Democratic support, the Republicans were divided with conservatives urging more spending cuts and moderates pushing for increased spending in health and education programs. The House was scheduled to debate the budget resolution passed by the House Budget Committee. which mirrors President Bush’s budget blueprint except for cuts to the Medicare program. Also, a controversial amendment, offered by moderate Rep. Mike Castle (R-DE), would have added $7 billion to the Labor, Health and Human Services and Education budget, which includes funding for NIH. However, the Republican leadership pulled the entire budget bill when they realized they did not have enough votes to secure passage. It is uncertain whether the House will try to work out a budget resolution when they return from the April recess. The AGA will continue to advocate for adequate funding for digestive disease research, through continued support of the Castle amendment, and fair reimbursement for gastroenterologists under Medicare.
Senate Plans to Debate Health Care in May Senate Republicans have designated the first week of May as “Health Week” and plan to debate medical liability reform as well as legislation to help make it easier for small businesses to purchase health care for their employees. Sen. John Ensign (R-NV) announced that the Senate would debate a new medical liability reform bill that caps non-economic damages at $750,000, rather than the $250,000 limit that has passed the House several times over the past few years. However, a claimant could collect only $250,000 per provider. This new medical liability reform bill may not garner the 60 votes needed to prevent a filibuster. The Senate will also debate S. 1955, the Health Insurance Marketplace Modernization Act, that passed the Senate Health, Education, Labor and Pensions (HELP) Committee by a party-line vote. The legislation would enable small business health plans to purchase health insurance coverage that would not be required to meet state health insurance requirements, as long as the plans also offer an alternative that contains benefits matching those offered in a state employee health plan in one of the most five populous states (California, New York, Texas, Illinois and Florida). The AGA has serious concerns with the bill since it preempts state laws that require health plans to provide screening benefits such as colorectal cancer. The Senate may also bring up legislation to expand tax credits for people to purchase health savings accounts as a means of buying health insurance.
AGA Issues Legislative Annual Report A review of the major activities of the Public Affairs and Advocacy Committee and the AGA Public Policy Department in 2005 is now available online. Virtually every day that Congress is in session, AGA representatives are on Capitol Hill advocating for initiatives to advance the science and practice of gastroenterology. While 2005 was a tough year for health policy issues, specialty physicians and the AGA can count successes, including:
For more information on AGA’s public policy work, visit the Advocacy section of the AGA Web site. To get involved, e-mail policy@gastro2.org or call the AGA at (240) 482-3221 and ask to speak with Michael Kalutkiewicz.
Democrats Highlight Need for Increased NIH Funding During a hearing of the House Appropriations Subcommittee on Labor, Health and Human Services, and Education, Democratic members of the committee stated that the President’s and Republicans’ proposal for funding the National Institutes of Health (NIH) for fiscal year (FY) 2007 is insufficient and announced they will propose a $18 billion increase for public health programs over the next five years. It is not certain how much of the $18 billion would be allocated to NIH. The President proposed $28.3 billion for NIH for FY 2007 — the same amount as last year — which will result in 650 fewer grants, including reductions at 22 of the 27 institutes and centers at NIH. NIH Director Elias Zerhouni testified at the hearing that since the NIH’s budget was doubled from 1998 to 2004, more than 3,000 new technologies using NIH research have been brought to market and advances in genomics and genetics have led to developments in less invasive treatments. The AGA will continue to monitor the budget and appropriations process and advocate for adequate funding for NIH and digestive disease research.
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News For Clinicians Register for the Physician Voluntary Reporting Program Gastroenterologists can now register online to participate in the Centers for Medicare & Medicaid Services’ (CMS) Physician Voluntary Reporting Program (PVRP). Registering your intent to participate does not obligate physicians to participate in the program. However, this registration is necessary to get the confidential feedback reports once a physician begins reporting on measures. Although there are currently no Gastroenterology/Hepatology specific measures in the 2006 starter set of PVRP measures, it is expected that gastroenterology specialty measures will be included in the PVRP over time. To register go to http://www.qualitynet.org For more information see: http://www.cms.hhs.gov/pvrp/
Regional CME Workshop CD-ROM on Its Way The AGA Regional CME Workshop CD-ROM, on Nocturnal Reflux and Colorectal Cancer Prevention and Detection has been mailed to all AGA members. This CD-ROM, featuring slides and presentations from the workshop recently held in Santa Monica, CA, was created to give you practical information on nocturnal reflux and colorectal cancer (CRC) to use in everyday practice. The CD-ROM contains discussions from internationally renowned experts on the latest advances in research, screening and diagnosis, and clinical management of these conditions. The program explores the prevalence and treatment of nocturnal reflux, which, if left untreated, may lead to complications such as Barrett’s esophagus and esophageal cancer. It also focuses on CRC, the second-leading cause of cancer death in the U.S. Contact Kimberly Wise, Manager of Educational Initiatives at kwise@gastro.org with any questions. This CD-ROM is supported by an educational grant from Santarus, Inc.
Annual DDW Luncheon Showcases Women in GI The annual Women in Gastroenterology Luncheon will be held Tuesday, May 23 at this year’s DDW meeting in Los Angeles. This long-standing, popular event, presented by the AGA Institute Governing Board, provides a venue for women to network and learn about opportunities to get involved with the AGA. According to Gail Hecht, MD, Governing Board basic science councilor and liaison for women and underrepresented minority issues, the luncheon will focus on facilitating the professional growth and development of women in the field, especially trainees. “Since there are fewer women in the field of gastroenterology, we want to provide an opportunity for female trainees to meet role models,” said Dr. Hecht, professor of medicine and chief of the Digestive Diseases and Nutrition Section at the University of Illinois, Chicago. “Trainees often have questions regarding how to develop successful carees in GI and how to get involved with the AGA, so it’s important for them to meet women who’ve achieved these goals, establish a support system for their careers and get advice about how to find balance.” The luncheon will take place at the Wilshire Grand Hotel in San Gabriel B from 12:30 – 2:00 p.m. All DDW attendees are welcome to attend. To RSVP for the luncheon, contact Mary Kozlowski at mkozlowski@gastro.org.
New Review Articles Available Daily from Gastrohep.com Gastrohep.com is the global online tool for clinicians and researchers, presenting the latest news and information on key topics in gastroenterology, hepatology and endoscopy. One of Gastrohep.com's most popular features is its review articles section which offers a collection of more than 850 online review articles. New articles are added each day and can be easily searched by topic. Recent articles discuss managing primary sclerosing cholangitis , dysplasia in Barrett's esophagus and traditional medical therapies for chronic constipation . Gastrohep.com also features a library of more than 5,000 abstracts, including slides of various procedures or diseases related to gastroenterology and other educational tools. There is also a growing bank of text books and online books, including Peter Cotton’s Advanced Digestive Endoscopy, a series of five well-illustrated multi-authored books that have been newly updated. In addition, subscribers have access to the Gastrohep.com book club which offers discounts on titles in gastroenterology and other GI-related subjects. Published by Blackwell Publishing Ltd., AGA Members can access the entire Gastrohep.com database free of charge, courtesy of an unrestricted grant from Novartis Pharmaceuticals Corporation. Click here to activate your free subscription. Follow the instructions and complete the e-subscription form online. Your next visit simply requires you to login with the username and password chosen at registration.
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News For Academic Clinicians & Researchers Match Deadline Approaches; GI Enrolls in ERAS After a six-year hiatus, gastroenterology reentered the Match administered by the National Resident Matching Program (NRMP) in January 2006 for positions to begin July 1, 2007. To date, a total of 138 programs have enrolled and committed 284 clinical and research track positions. It is not too late to register; programs may do so by May 24, 2006. This is the Quota Deadline by which programs must submit the final number of positions offered per track. For more information on how the Match works and the various tracks available, please click here. To enroll online in the GI Match, training directors should visit the NRMP Web site at www.nrmp.org. Match results for programs and applicants will be posted to the NRMP Web site on June 21, 2006, at noon Eastern. As a joint statement, the American Association for the Study of Liver Diseases (AASLD), the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA) and the American Society for Gastrointestinal Endoscopy (ASGE) have endorsed a “Resolution Regarding Gastroenterology Fellowship Applicants, Including all Research and Clinical Fellowship Applicants and Positions.” The resolution concerns the conditions surrounding GI fellowship offers to applicants, acceptances and participation in the GI Match by applicants and programs. The resolution serves to foster an environment in which applicants are encouraged to consider all options before making haste or early decisions. The resolution will be distributed to both the gastroenterology and internal medicine communities. Gastroenterology will also enroll this year in the Electronic Residency Application Service (ERAS) for positions to begin July 1, 2008. Independent of the GI Match, this service is an excellent companion to the fellowship application process. It allows both applicants and programs to use the latest in technology to facilitate an efficient and streamlined application process. Training directors can use the customizable program to select applicants for interviews based upon a number of criteria and manage the entire application process electronically, from filing material to scheduling and ranking applicants. ERAS allows applicants to create and submit application material far more efficiently than the traditional paper application process. For more information on ERAS, please visit our Web site or www.aamc.org/eras.
Plan to Attend the Women in GI Luncheon at DDW The annual Women in Gastroenterology Luncheon will be held Tuesday, May 23 at this year’s DDW meeting in Los Angeles. This long-standing, popular event, presented by the AGA Institute Governing Board, provides a venue for women to network and learn about opportunities to get involved with the AGA. According to Gail Hecht, MD, Governing Board basic science councilor and liaison for women and underrepresented minority issues, the luncheon will focus on facilitating the professional growth and development of women in the field, especially trainees. “Since there are fewer women in the field of gastroenterology, we want to provide an opportunity for female trainees to meet role models,” said Dr. Hecht, professor of medicine and chief of the Digestive Diseases and Nutrition Section at the University of Illinois, Chicago. “Trainees often have questions regarding how to develop successful carees in GI and how to get involved with the AGA, so it’s important for them to meet women who’ve achieved these goals, establish a support system for their careers and get advice about how to find balance.” The luncheon will take place at the Wilshire Grand Hotel in San Gabriel B from 12:30 – 2:00 p.m. All DDW attendees are welcome to attend. To RSVP for the luncheon, contact Mary Kozlowski at mkozlowski@gastro.org.
Gastrohep.com Offers New Review Articles Daily Gastrohep.com is the global online tool for clinicians and researchers, presenting the latest news and information on key topics in gastroenterology, hepatology and endoscopy. One of Gastrohep.com's most popular features is its review articles section which offers a collection of more than 850 online review articles. New articles are added each day and can be easily searched by topic. Recent articles discuss managing primary sclerosing cholangitis , dysplasia in Barrett's esophagus and traditional medical therapies for chronic constipation . Gastrohep.com also features a library of more than 5,000 abstracts, including slides of various procedures or diseases related to gastroenterology and other educational tools. There is also a growing bank of text books and online books, including Peter Cotton’s Advanced Digestive Endoscopy, a series of five well-illustrated multi-authored books that have been newly updated. In addition, subscribers have access to the Gastrohep.com book club which offers discounts on titles in gastroenterology and other GI-related subjects. Published by Blackwell Publishing Ltd., AGA Members can access the entire Gastrohep.com database free of charge, courtesy of an unrestricted grant from Novartis Pharmaceuticals Corporation. Click here to activate your free subscription. Follow the instructions and complete the e-subscription form online. Your next visit simply requires you to login with the username and password chosen at registration.
CD-ROM on Nocturnal Reflux and CRC Now Available The AGA Regional CME Workshop CD-ROM, on Nocturnal Reflux and Colorectal Cancer Prevention and Detection has been mailed to all AGA members. This CD-ROM, featuring slides and presentations from the workshop recently held in Santa Monica, CA, was created to give you practical information on nocturnal reflux and colorectal cancer (CRC) to use in everyday practice. The CD-ROM contains discussions from internationally renowned experts on the latest advances in research, screening and diagnosis, and clinical management of these conditions. The program explores the prevalence and treatment of nocturnal reflux, which, if left untreated, may lead to complications such as Barrett’s esophagus and esophageal cancer. It also focuses on CRC, the second-leading cause of cancer death in the U.S. Contact Kimberly Wise, Manager of Educational Initiatives at kwise@gastro.org with any questions. This CD-ROM is supported by an educational grant from Santarus, Inc.
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News for Trainees DDW 2006 to Host Annual Women in GI Luncheon The annual Women in Gastroenterology Luncheon will be held Tuesday, May 23 at this year’s DDW meeting in Los Angeles. This long-standing, popular event, presented by the AGA Institute Governing Board, provides a venue for women to network and learn about opportunities to get involved with the AGA. According to Gail Hecht, MD, Governing Board basic science councilor and liaison for women and underrepresented minority issues, the luncheon will focus on facilitating the professional growth and development of women in the field, especially trainees. “Since there are fewer women in the field of gastroenterology, we want to provide an opportunity for female trainees to meet role models,” said Dr. Hecht, professor of medicine and chief of the Digestive Diseases and Nutrition Section at the University of Illinois, Chicago. “Trainees often have questions regarding how to develop successful carees in GI and how to get involved with the AGA, so it’s important for them to meet women who’ve achieved these goals, establish a support system for their careers and get advice about how to find balance.” The luncheon will take place at the Wilshire Grand Hotel in San Gabriel B from 12:30 – 2:00 p.m. All DDW attendees are welcome to attend. To RSVP for the luncheon, contact Mary Kozlowski at mkozlowski@gastro.org.
Find New Review Articles Daily at Gastrohep.com Gastrohep.com is the global online tool for clinicians and researchers, presenting the latest news and information on key topics in gastroenterology, hepatology and endoscopy. One of Gastrohep.com's most popular features is its review articles section which offers a collection of more than 850 online review articles. New articles are added each day and can be easily searched by topic. Recent articles discuss managing primary sclerosing cholangitis , dysplasia in Barrett's esophagus and traditional medical therapies for chronic constipation . Gastrohep.com also features a library of more than 5,000 abstracts, including slides of various procedures or diseases related to gastroenterology and other educational tools. There is also a growing bank of text books and online books, including Peter Cotton’s Advanced Digestive Endoscopy, a series of five well-illustrated multi-authored books that have been newly updated. In addition, subscribers have access to the Gastrohep.com book club which offers discounts on titles in gastroenterology and other GI-related subjects. Published by Blackwell Publishing Ltd., AGA Members can access the entire Gastrohep.com database free of charge, courtesy of an unrestricted grant from Novartis Pharmaceuticals Corporation. Click here to activate your free subscription. Follow the instructions and complete the e-subscription form online. Your next visit simply requires you to login with the username and password chosen at registration.
Check Your Mailbox for the Regional CME Workshop CD-ROM The AGA Regional CME Workshop CD-ROM, on Nocturnal Reflux and Colorectal Cancer Prevention and Detection has been mailed to all AGA members. This CD-ROM, featuring slides and presentations from the workshop recently held in Santa Monica, CA, was created to give you practical information on nocturnal reflux and colorectal cancer (CRC) to use in everyday practice. The CD-ROM contains discussions from internationally renowned experts on the latest advances in research, screening and diagnosis, and clinical management of these conditions. The program explores the prevalence and treatment of nocturnal reflux, which, if left untreated, may lead to complications such as Barrett’s esophagus and esophageal cancer. It also focuses on CRC, the second-leading cause of cancer death in the U.S. Contact Kimberly Wise, Manager of Educational Initiatives at kwise@gastro.org with any questions. This CD-ROM is supported by an educational grant from Santarus, Inc.
Place GI position listings and activity announcements in eDigest. For only $82.50, you can place an ad of 100 words or less in two consecutive issues and for $165 in four consecutive issues. Ads can also be placed in AGA Perspectives, AGA¹s bi-monthly magazine. If you place ads in both AGA Perspectives and AGA eDigest, you will receive a 10 percent discount. For more information, contact Vivian Hayward at vhayward@gastro.org or (301) 654-2055. California Michigan Nebraska Academic Gastroenterologists :Expanding group with opportunities for clinical scholars in inflammatory bowel disease, motility, endoscopy and intestinal failure. The University of Nebraska Medical Center seeks BC/BE gastroenterologists with commitment to excellence in research, teaching, patient care. Rank/salary DOQ, Send CV: Mark Mailliard, M.D., Chief, Division of Gastroenterology/Hepatology, 982000 NMC, Omaha, NE 68198-2000. AA/EOE, women/minorities encouraged to apply. New York Oregon
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