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WORLD GASTROENTEROLOGY NEWS www.worldgastroenterology.org
Official e-newsletter of the World Gastroenterology Organisation
VOL. 24, ISSUE 1 JULY 2019
Why You Should Attend the 2019
In this issue
World Congress in Istanbul?
Achalasia: New Insights in
Pathophysiology
Janette Furuzawa-Carballeda, MSc, PhD
Gonzalo Torres-Villalobos, MD, PhD
Miguel A. Valdovinos, MD 1. The World Congress of Gastroenterology is the premier biennial scientific meeting
for digestive diseases. In 2019, the World Gastroenterology Organsation (WGO) is
proud to partner with the Turkish Society of Gastroenterology (TSG).
2. Top class scientific program encompassing key areas in Gastroenterology, Hepatol-
ogy, GI Endoscopy and Surgery delivered by over 100 regional and international
leaders in the field.
3. An exceptional Postgraduate Course, featuring hot topics in gastroenterology, liver,
microbiota, and advances in GI pharmacology.
Updated Endoscope Disinfection and
New Pancreas Cystic Lesions Guidelines 4. Four concurrent sessions daily, hands-on workshops, both oral and poster presenta-
are Published tions, and exhibitions. Unmatchable platform to showcase your products. Sessions
Anton LeMair, MD
will offer simultaneous translation in Turkish and Russian!
5. Over 4,000 delegates from around the globe. This meeting will provide an op-
portunity for professionals in the field of gastroenterology, hepatology and related
disciplines to come together to learn about the latest research and advancements,
collaborate with colleagues and actively participate in this rapidly advancing field.
6. One of WGO’s pillars are Guidelines and Cascades. Featured in the scientific pro-
gram will be presentations on many of these, including: Celiac Disease, Diet and the
Gut, GERD, HCC, Hepatitis B, Hepatitis C, IBD, IBS, NASH and NAFL, and
Management of Strongyloidiasis.
7. Presentation of the Master of the WGO, the Henry L. Bockus Medal and Lecture to
be delivered by Prof. Richard Kozarek (USA) as well as the Georges Brohée Medal
and Lecture to be delivered by Prof. Michael Fried (Switzerland). These are among
the leading awards in gastroenterology.
8. Convenience of travel and stay: Getting to Istanbul is easy! Well-connected air flight
schedules – served by over 50 international airlines at a brand-new international air-
port in addition to two other airports. Whether you are traveling from Latin America,
Africa or Asia, the Istanbul International Airport has over 3,000 flights per day. Top
class hotels at affordable prices within walking distance from the congress venue.
Continued on page 4
WORLD GASTROENTEROLOGY NEWS JULY 2019
2
Contents
VOL. 24, ISSUE 1 WCOG 2019
Editors
World Congress of Gastroenterology 2019, Istanbul 5
Christina M. Surawicz, MD, MACG
Professor of Medicine Editorial
Division of Gastroenterology
Associate Dean for Faculty Development
University of Washington School of Medicine Message from the Editors 6
Seattle, Washington, USA Mário Reis Álvares-da-Silva, MD, PhD
Christina M. Surawicz, MD, MACG
Mário Reis Álvares-da-Silva, MD, PhD Expert Point of View
Professor of Hepatology
Hospital de Clinicas de Porto Alegre Achalasia: New Insights in Pathophysiology 7
Universidade Federal do Rio Grande do Sul Janette Furuzawa-Carballeda, MSc, PhD
Porto Alegre, Brazil Gonzalo Torres-Villalobos, MD, PhD
Miguel A. Valdovinos, MD
WDHD News
e-WGN Editorial Board
• Anita Afzali, USA Welcome to World Digestive Health Day (WDHD)
• Min-Hu Chen, China 2019! 11
• Dan Dumitrascu, Romania Kentaro Sugano, MD
• Sara Elfadil, Sudan Joseph Sung, MD, PhD, FRCP, MWGO
• Amy Foxx-Orenstein, USA Richard Hunt, FRCP, FRCPEd, FRCPC, MWGO
• Ernst Fredericks, South Africa
• Waseem Hamoudi, Jordan
• Nassir Alhaboob Arabi Mohammad, Sudan WGO & WGOF News
• VG Naidoo, South Africa
• Alejandro Piscoya, Peru
• Naoya Sakamoto, Japan The La Paz Training Center Revisited – the Legacy of
• Michael Schultz, New Zealand Guido Villa-Gomez MD MWGO 14
• C. Wendy Spearman, South Africa Eamonn M.M. Quigley, MD, FRCP, FACP, MACG, FRCPI
• Miguel Valdovinos, Mexico Henry Cohen, MD, FACG
• Haleh Vaziri, USA
• Lu Xia, China
18th WGO-RTC Post-Graduate Course at the
Managing Editor Rabat Training Center, Morocco 17
James Melberg, WGO Program Manager
Alan Barkun, MD,CM, FRCP(C), FACP, FACG, AGAF, MSc (Clinical
Art Production Epidemiology)
Jennifer Gubbin
Editorial Office WGO Train the Trainers Bucharest 2019 19
WGO Executive Secretariat
555 East Wells Street, Suite 1100
Milwaukee, WI 53202 USA Asian Pacific Digestive Week 2018 in Seoul, Korea 23
info@worldgastroenterology.org Khean-Lee Goh, MD
https://www.facebook.com/WorldGastroOrg 28th Annual Conference of the Asian Pacific Association
for the Study of the Liver 26
https://twitter.com/WorldGastroOrg
ISGCON 2018 — 59th Annual Conference of Indian
https://www.linkedin.com/company/world-gastro-
enterology-organisation-wgo-wgo-foundation Society of Gastroenterology 28
Naresh Bhat, MD, DM
www.worldgastroenterology.org Govind Makharia, MBBS, MD, DM, DNB
©2019 World Gastroenterology Organisation. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form without the prior permission of the copyright owner.
WORLD GASTROENTEROLOGY NEWS JULY 2019
3
Contents
26th UEG Week Vienna 2018 29 WGO Global Guidelines
UEG Week 2019 31 Updated Endoscope Disinfection and New Pancreas
Cystic Lesions Guidelines are Published 35
17th Egyptian Digestive Disease Week 2019 32 Anton LeMair, MD
Serag Zakaria, MD
Calendar of Events
Prof. Eamonn Quigley, WGO Past President, awarded
St. Patrick’s Day Medal 33 Calendar of Events 37
©2019 World Gastroenterology Organisation. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form without the prior permission of the copyright owner.
4
WORLD GASTROENTEROLOGY NEWS JULY 2019
Editorial | Expert Point of View | WCOG 2019 | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events
Continued from first page
9. Throughout the Congress, at-
tendees will have opportunities to
schedule tours and experience the
many historic sites in and around
Istanbul to learn about its tradi-
tions.
10. Istanbul, the only city in the world
built on two continents, has a
strategic setting forming the city’s
destiny as an imperial capital for
nearly 1600 years, for Roman,
Byzantine and Ottoman Empires.
This metropolis, proud of its rich
history and unequalled natural
beauty, offers a friendly welcome
and genuine hospitality. Seated on
the Bosphorus, some of the most
fascinating history will unfold
before your eyes as you visit this
magnificent city.
Don’t delay, register today! We
look forward to seeing you in
Istanbul!
5
WORLD GASTROENTEROLOGY NEWS JULY 2019
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Registration Now Open!
www.wcog2019.org
6
WORLD GASTROENTEROLOGY NEWS JULY 2019
Editorial | Expert Point of View | WCOG 2019 | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events
Message from the Editors
Mário Reis Álvares-da-Silva, MD, PhD
Professor of Hepatology
Hospital de Clinicas de Porto Alegre
Universidade Federal do Rio Grande do Sul
Porto Alegre, Brazil
Christina M. Surawicz, MD, MACG
Professor of Medicine, Division of Gastroenterology
Associate Dean for Faculty Development
University of Washington School of Medicine
Seattle, Washington, USA
2019 continues to be a busy and infection in some cases, the pathol- and Russian translations. They can be
productive year for us and our many ogy showing chronic inflammation, found on the WGO website at http://
member societies. You can see presence of organ specific antibodies, www.worldgastroenterology.org/
updates from several international association with autoimmune diseases, guidelines/global-guidelines.
meetings in this first issue. as well as improvement in symptoms Plan to attend the World Con-
We are proud to highlight the with immune suppressive therapy in gress of Gastroenterology (WCOG)
EPOV article “Achalasia: new some patients. Their excellent article meeting in Istanbul from 21-24
insights into Pathophysiology” by gives us a new way of thinking and September 2019. One important
Drs. Janette Furuzawa-Carbelleda, approaching this important disease. feature will be WGO Guidelines and
Gonzalo Torres-Villalobos and Miguel Cascades. Many will be highlighted
A. Valdovinos. (Instituto Nacional Note also that new Guidelines are as part of the robust Scientific Pro-
de Ciencias Médicas y Nutrición available! gram of the WCOG in Istanbul. Be
“Salvador Zubirán”, Mexico City). The new Pancreatic Cystic Lesions sure to attend the sessions featuring:
They state that “findings in molecular Guidelines as well as updated “En- Celiac Disease, Diet and the Gut,
pathology in patients with achalasia doscope disinfection update: a guide GERD, HCC, Hepatitis B, Hepatitis
have suggested the hypothesis that to resource-sensitive reprocessing” C, IBD, IBS, NASH and NAFL, and
achalasia is an autoimmune disorder.” Guidelines are now published. The Management of Strongyloidiasis.
They cite evidence of preceding viral new Diet and the Gut Guideline is
now available in Portuguese, Spanish
7
WORLD GASTROENTEROLOGY NEWS JULY 2019
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Achalasia: New Insights in Pathophysiology
latent or active neurotrophic viral
Janette Furuzawa-Carballeda, MSc, PhD or bacterial infections are associated
Department of Immunology and Rheumatology with achalasia. The proposed virus
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador candidates have included HSV-1, JC
Zubirán”. virus, bornavirus, VZV, measles, and
HPV.1 An epidemiological study and
genotype-phenotype analysis dem-
onstrated that patients with achalasia
Gonzalo Torres-Villalobos, MD, PhD
were frequently affected by viral
Department of Surgery and Experimental Surgery infections, especially by VZV, before
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador
Zubirán”.
achalasia onset, and that pregnancy
may stimulate the disease in females
who are carriers of the HLA-DQβ1
insertion.2 Achalasia patients have a
Miguel A. Valdovinos, MD significantly higher rate of oligoclonal
CD3+/CD8+ lymphocytic infiltrates
Department of Gastroenterology
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador in LES than healthy controls, and a
Zubirán”. deprived release of Th1-type cytokines
(IFN-Γ and IL-2) that may contribute
to establish the neuronal damage and
the HSV-1 latent state.1 Moreover,
HSV-1 DNA (viral infection), RNA
(active replication), and virus has been
Achalasia is an uncommon major 3. The presence of organ-specific detected in LES tissue from achala-
esophageal motility disorder charac- autoantibodies; sia patients by PCR, RT-PCR, and
terized by loss of esophageal peristalsis 4. The association of achalasia with immunohistochemistry, but not in
and incomplete relaxation of the well-established autoimmune control tissue.2
lower esophageal sphincter (LES). The diseases;
primary cause of achalasia is thought 5. Genetic factors and polymor- Inflammation
to be a loss of neurons in the myen- phisms that might play a role in Inflammatory infiltrates of varying
teric plexus of the distal esophagus the development and progression intensity around myenteric neurons
and LES. New findings in molecular of achalasia; and have been found in achalasia patients,
pathology in patients with achalasia 6. The improvement of achalasia contrasting with the non-infiltrate
have suggested the hypothesis that symptoms with immunosuppres- findings of control groups with
achalasia is an autoimmune disorder. sive agents. normal myenteric plexus.3,4 The
In this review we will focus on the characterization of the intraganglionic
evaluation of the several aspects that Infections infiltrate showed a predominance of
suggests that achalasia is an autoim- It has been hypothesized that the CD3+, CD4+, CD25+ and CD8+
mune inflammatory disease, including: infectious agent represents the trig- T lymphocytes, as well as CD20+ B
1. Evidence that the pathology is ger of an immune reaction in the cells and eosinophils but to a lesser
preceded by a viral infection; myenteric plexus. This immune degree, with detection of occasional
2. Chronic inflammatory infiltrates, response eventually overcomes the plasma cells along the nerve fascicles
predominantly enriched in lym- infectious insult, but only in geneti- and around the ganglion cells.5
phocytes that damage the ganglion cally predispose individuals may create Functional contact of mast cells with
cells of the myenteric plexus of the susceptibility to this disease and the interstitial cells of Cajal (ICC) has
LES; damage of ganglion cells. Several recently associated with nitrergic
studies have suggested that a chronic nerves, S-100-positive cells, ICC and
8
WORLD GASTROENTEROLOGY NEWS JULY 2019
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Continued from first page.
neuronal degeneration in achalasia. maintain homeostasis and avoid tissue or myasthenia gravis has led to the
The number of mast cells was higher damage. suggestion of a key role for autoanti-
in type I achalasia than type III. Ad- bodies in the etiopathogenesis of the
ditionally, patients with a history of Ganglion cell loss disease. However, their precise role is
autoimmune disease or viral infection Achalasia is known to be caused by still unclear. Nonetheless, serum from
had greater mast cell infiltration in the reduction of ICC but most impor- patients with achalasia can reproduce
the LES muscle. Mast cells express tantly to a selective loss of inhibitory functional and phenotypic changes of
the 3-O-sulphated heparan sulphate ganglion in the myenteric plexus of the disease in normal tissues.9
receptor that mediates the entry of the esophagus, which is associated Nuclear, nucleolar or cytoplasmic
HSV-1 but not HSV-2.4 with a decrease of nNOS, VIP, neural circulating myenteric anti-plexus an-
Serum profile studies has estab- proteins, S-100, substance P and tibodies were detected in 54.3-100%
lished that elevated concentrations of PGP9.5. The imbalance produced by of serum samples from patients with
proinflammatory cytokines (IL-22, loss of VIP and NO-secreting neurons achalasia versus 7.5-12% of healthy
IL-23, IL-17, TNF-α, IL-6, IFN-γ, as a result of the progressive destruc- subjects, especially in carriers of HLA
and IL-12), C4B5, C3, cyclin-de- tion of myenteric ganglion cells and DQA1*0103 and DQB1*0603 alleles
pendent kinase 5, α2-macroglobulin the occurrence of neural fibrosis (OR=3.17 and OR=5.82, respective-
and anti-GAD65 antibodies are would lead to the classic subtype of ly). The target antigens of circulating
up-regulated in achalasia patients, as achalasia.4 anti-myenteric autoantibodies are
compared with controls, supporting An underpinning pathogenic PNMA2 and GAD65 (69%-80%),
the hypothesis of immune-mediated mechanism in the early stage of recoverin (8%) and none with Hu,
reponse.6,7 achalasia is the esophageal myenteric CDR-62 (Yo), Nova-1 (Ri), SOX-1,
A significantly increased ratios immune-mediated response, inflam- titina or amphiphysin.2,3
of MMP-9/MMP-2 and activated matory state accompanied by T cell
MMP-9/proMMP-9 in sera of acha- infiltration, neuritis, ganglionitis and Autoimmunity and inflammatory
lasia patients has been determined neuronal degeneration with only mild diseases comorbidity
compared with controls. Moreover, to severe fibrosis in the smooth muscle Autoimmune diseases often occur in
extensive damage within the plexus layer. Moreover, achalasia patients association with one another, either
was found in the tissues with more have shown increased deposits of the involving a single individual or within
MMP-9-expressing cells. Addition- complement complex C5b-C9, C9 a family sharing autoimmune diseases,
ally, achalasia-associated autoantigens and of IgM within or proximal to and the presence of autoantibodies
PNMA2, GAD65, VIP and Ri are ganglion cells of myenteric plexus.6 without disease. Compared with the
substrates of MMP-9. Thus MMP-9 general population, patients with
Autoantibodies achalasia are 3.6-times more likely to
may contribute to the pathogenesis by
Antinuclear antibodies (ANAs) are have autoimmune diseases, including
cleaving achalasia-associated autoanti-
present in 56-68% of the patients uveitis (RR=259), Sjögren’s syndrome
gens into remnant epitopes generating
with achalasia. The most prevalent (RR=37), systemic lupus erythe-
autoimmunity (REGA paradigm).8
pattern observed is speckled, fol- matosus (RR=43), type I diabetes
An increased in some proinflam-
lowed by nucleolar, homogeneous (RR=5.4), hypothyroidism (RR=8.5),
matory/profibrogenic tissue and
and NuMA-1. Moreover, unusual rheumatoid arthritis (RR=2.4),
circulating CD4+ T cell subsets
staining patterns in the nuclei, such scleroderma, ankylosing spondylitis,
(Th22, Th17, Th2 and Th1) have
as the nuclear mitotic apparatus, and myasthenia gravis, Guillain-Barre
been characterized in patients with
cytoplasmic staining as in anti-Jo-1 syndrome, autoimmune acquired
achalasia compared with controls.2,3
positive polymyositis/dermatomyosi- hemophilia A, polyglandular autoim-
Furthermore, patients with achalasia
tis, and antimitochondrial antibodies mune syndrome type II, psoriasis and
have also shown a higher frequency
have been determined.2,3,9,10 asthma. Intriguingly, the younger
of immune regulatory cells in the
The increased prevalence of population of patients with achalasia
myenteric plexus of esophageal tis-
circulating IgG antibodies against was shown to have a higher prevalence
sue, as compared to controls. 2,3 The
cytoplasm and nucleus of neuronal of autoimmune comorbidities (RR =
concomitant presence of inflamma-
cells from myenteric plexus in most 3.3), compared with an older popula-
tory and regulatory cells suggests that
patients with achalasia compared tion of patients with achalasia.11
the proinflammatory and regulatory
with GERD, Hirschsprung’s disease, A recent cross-sectional study of 114
balance favors the former with the
esophageal cancer, peptic esophagitis, patients with achalasia showed that
incapacity of the latter in trying to
9
WORLD GASTROENTEROLOGY NEWS JULY 2019
Editorial | Expert Point of View | WCOG 2019 | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events
the presence of autoimmune disease DQB1*06:01) was characterized as TCR repertoire and react to HSV-
was found in 19 patients (16.7%), conferring the strongest risk for acha- 1 antigens. Am J Gastroenterol.
hypothyroidism was the main diag- lasia, and showed a particular geo- 2008;103:1598-1609.
nosis, and it was present in 52.6% spatial north-south gradient among Furuzawa-Carballeda J, Torres-Landa
of patients compared with 4.2% Europeans. The finding of this inser- S, Valdovinos MA, et al. New
in controls. Two patients had more tion being less common in northern insights into the pathophysiology
than one concomitant autoimmune European populations, as compared of achalasia and implications for
diseases (one hyperthyroidism/vitiligo with those from the southern regions future treatment. World J Gastro-
and one hypothyroidism/scleroderma/ mirrored the differential prevalence of enterol. 2016;22:7892-7907.
rheumatoid arthritis). Most of the the disease between populations.12 Fi- Furuzawa-Carballeda J, Aguilar-León
patients with concomitant autoim- nally, the HLA-DRB1*14:54:01 and D, Gamboa-Domínguez A, et
mune disease (79%) had the autoim- DQB1*05:03:01 and the extended al. Achalasia--An Autoimmune
mune disease established before the haplotype were characterized as risk Inflammatory Disease: A Cross-
diagnosis of achalasia (median: 14.6 factor for achalasia in mixed-ancestry Sectional Study. J Immunol Res.
years). For 10.5% of the patients Mexican individuals suggesting that 2015;2015:729217.
the autoimmune disease was estab- the haplotype was introduced by ad- Liu ZQ, Chen WF, Wang Y, et al.
lished after the diagnosis of achalasia mixture with European and/or Asian Mast cell infiltration associated
(median: 2 years) and 10.5% had the populations.13 with loss of interstitial cells of
diagnosis occurring simultaneously Cajal and neuronal degeneration
for both conditions. Thirteen of the Immunosuppressive therapies in achalasia. Neurogastroenterol
19 achalasia patients (68.4%) with Finally, there are some reports of Motil. 2019;31:e13565.
autoimmune disease had history of achalasia patients under treatment Sodikoff JB, Lo AA, Shetuni BB, et al.
familial autoimmunity (6 with hypo- with corticosteroids (prednisolone, Histopathologic patterns among
thyroidism, one with hyperthyroid- methylprednisolone or beclometha- achalasia subtypes. Neurogastroen-
ism, and 6 with rheumatoid arthritis). sone) alone or combined with other terol Motil. 2016;28:139-45.
Compared with GERD, the achalasia immunosuppressive drugs (metho- Im SK, Yeo M, Lee KJ. Proteomic
group was 3.8-times more likely to trexate, azathioprine or cyclophos- identification of proteins sugges-
have an autoimmune disease includ- phamide) with dramatic clinical tive of immune-mediated response
ing, thyroidopathies (RR=3), and improvement and complete recovery or neuronal degeneration in serum
chronic inflammatory disease includ- of peristalsis corroborated by HRM, of achalasia patients. Gut Liver.
ing allergic rhinitis, asthma, rosacea lending further credence to the notion 2013;7:411-416.
and gout (RR=3.02).10 that this disease has an autoimmune Clayton S, Cauble E, Kumar A, et
component.14 al. Plasma levels of TNF-α, IL-
Human Leukocyte Antigen 6, IFN-γ, IL-12, IL-17, IL-22,
Association Conclusion
and IL-23 in achalasia, eosinophi-
Associations between achalasia and The initial event that triggers achalasia
licesophagitis (EoE), and gastro-
HLA-DQB1*05:03 and HLA- may be the result of a repetitive insult
esophageal reflux disease (GERD).
DQB1*06:01; HLA-DQA1*01:03; produced by neurotropic virus infec-
BMC Gastroenterol. 2019;19:28.
and HLA-DQB1*03:01 and HLA- tion, likely HSV-1, which induces a
Furuzawa-Carballeda J, Boon L, Tor-
DQB1*03:04 have been determined. conspicuous and persistent inflam-
res-Villalobos G, et al. Gelatinase
In fact, many studies have also mation at the perineural level, in the
B/Matrix Metalloproteinase-9 as
shown a positive association with myenteric plexus. Not all infected
Innate Immune Effector Molecule
DQw1, DQA1*0103, DQB1*0601, patients will develop achalasia, on
in Achalasia. Clin Transl Gastroen-
DQB1*0602, DQB1*0603, account of a genetic predisposition to
terol. 2018;9:208.
DQB1*0601, DQB1*0502, and develop a chronic auto-inflammatory
Bruley des Varannes S, Chevalier J,
DQB1*0503 alleles, in Caucasians. response that has the potential to
Pimont S, et al. Serum from acha-
In a study of 1068 cases of acha- progress to the disease.
lasia patients alters neurochemical
lasia from central Europe, Spain coding in the myenteric plexus
References
and Italy, an 8-residue insertion at and nitric oxide mediated motor
Facco M, Brun P, Baesso I, et al. T
position 227-234 in the cytoplas- response in normal human fundus.
cells in the myenteric plexus of
mic tail of HLA-DQβ1 (encoded Gut. 2006;55:319-326.
achalasia patients show a skewed
by HLA-DQB1*05:03 and HLA-
10 WORLD GASTROENTEROLOGY NEWS JULY 2019 Editorial | Expert Point of View | WCOG 2019 | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events Romero-Hernández F, Furuzawa- Furuzawa-Carballeda J, Zuñiga J, Carballeda J, Hernández-Molina Hernández-Zaragoza DI,et al. G, et al. Autoimmune comorbid- An original Eurasian haplotype, ity in achalasia patients. J Gastro- HLA-DRB1*14:54-DQB1*05:03, enterol Hepatol. 2018;33:203-208. influences the susceptibility to Booy JD, Takata J, Tomlinson G, idiopathic achalasia. PLoS One. Urbach DR. The prevalence of au- 2018;13:e0201676. toimmune disease in pa- Savarino E, Gemignani L, Zentilin P, tients with esophageal achalasia. De Bortoli N, Malesci A, Mas- Dis Esophagus. 2012;25:209-13. tracci L, Fiocca R, Savarino V. Becker J, Haas SL, Mokrowiecka A, Achalasia with dense eosinophilic et al. The HLA-DQβ1 insertion is infiltrate responds to steroid ther- a strong achalasia risk factor and apy. Clin Gastroenterol Hepatol displays a geospatial north-south 2011; 9: 1104-1106. gradient among Europeans. Eur J Hum Genet 2016;24:1228-1231.
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Welcome to World Digestive
Health Day (WDHD) 2019!
• Promote a multidisciplinary and
Kentaro Sugano, MD personalized treatment of digestive
Jichi Medical University, Japan cancers to achieve better clinical
Co-Chair World Digestive Health Day 2019 outcomes
• Increase the awareness of the pub-
lic on the benefit of screening and
early detection of digestive cancers
• Provide gastroenterologists,
Joseph Sung, MD, PhD, FRCP, MWGO
hepatologists, their patients, and
The Chinese University of Hong Kong, Hong Kong the lay public with an understand-
Co-Chair World Digestive Health Day 2019
ing of the latest basic and clinical
research on the early detection,
screening, and treatment of diges-
tive cancers.
• Translate research into clinical
Richard Hunt, FRCP, FRCPEd, FRCPC, MWGO
practice to inform physicians,
McMaster University Health Science Centre, United Kingdom pharmacists, allied health profes-
Co-Chair World Digestive Health Day 2019
sionals, healthcare payers, and the
public of the risk factors, causes,
and treatment of digestive cancers
• Stimulate international collabora-
tions that foster improved diges-
tive cancer education, research,
and training especially in the
Join WGO in Increasing Awareness the World Gastroenterology Organisa- developing world
of the Benefits of Early Diagnosis tion (WGO), The WGO Foundation • Increase awareness of digestive
and Promoting Multidisciplinary (WGOF), WGO Member Societies, cancers by providing a better un-
Treatment of Digestive Cancers in WGO Training Centers, WGO Re- derstanding and recognition of the
2019 gional Affiliate Associations, and other GI cancers as a global burden
The celebration of World Diges- WGO partners worldwide. How to Get Involved
tive Health Day (WDHD) began on Campaign Information If you have not started planning your
29 May 2019 and is in full swing. The WDHD 2019 campaign theme is WDHD 2019 event we invite you to
The success of WDHD, a yearlong, “Early Diagnosis and Treatment of GI start today! While the official date of
worldwide, public health campaign, is Cancer.” By participating in WDHD WDHD is 29th May, many events
derived from the combined efforts of 2019, you will help to:12
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take place throughout 2019. WGO Plan Your Own WDHD Event Co-Chair World Digestive Health
challenges you to get involved in the WGO and The WGO Foundation Day 2019
campaign by creating exciting ways to encourage all members to participate Richard Hunt, FRCP, FRCPEd, FR-
raise awareness around the benefits of in World Digestive Health Day 2019 CPC, MWGO
the early diagnosis and treatments of by organizing events in their regions McMaster University Health Science
digestive cancers all year long, to im- to observe this day. We hope that this Centre
prove the standards of practice, and to year’s campaign will help increase United Kingdom
educate the public. WGO is pleased awareness of the importance of the
to provide you with a few ways that Early Diagnosis and Treatment of GI Chair, WGO Foundation
you can TAKE ACTION and CEL- Cancer worldwide. Naima Amrani, MD
EBRATE World Digestive Health Have you started planning your Mohamed V University – Rabat
Day in your respective community event? Past events include public Morocco
(see the breakout boxes). WGO and campaigns, courses and lectures on
Members
The WGO Foundation are apprecia- treatments of the current theme,
Han-Mo Chiu, MD
tive of all campaign participants and walkathons, national meetings, press
National Taiwan University
for the ongoing efforts in supporting conferences, radio and television
Taiwan
the WDHD 2019 campaign. We look interviews, developing a country’s
forward to a successful year! own WDHD Day, publications, and Henry Cohen, MD
much more! University of the Republic Uruguay
TAKE ACTION In the coming months, you will Uruguay
• Host an academic conference or find available a variety of tools and Francesco Di Mario, MD
symposium featuring scientific resources, which may benefit your University of Palma
programs, plenaries, posters pre- physicians, allied healthcare profes- Italy
sentations, and forums. sionals, patients and the general
public, by visiting www.worldgastro- Takuji Gotoda, MD
• Create prevention toolkits for Nihon University
healthcare professionals and the enterology.org/wgo-foundation/wdhd/
wdhd-2019. Japan
general public.
• Organize a public awareness cam- WDHD 2019 Steering Committee David Graham, MD, MACG
paign and disseminate campaign The World Digestive Health Day Baylor College of Medicine
materials through blogs, podcasts, 2019 campaign is led by the following United States
videos, and brochures. individuals representing a global view Abdel Meguid Kassem, MD
• How will you TAKE ACTION to and expertise on the Early Diagnosis Cairo University
support WDHD? and Treatment of GI Cancer. They are Egypt
guiding the course of the campaign,
and are leading in the development of Nayoung Kim, MD, PhD
CELEBRATE tools and resources throughout 2019 Seoul National University
• Host a walk-a-thon to rally and beyond. Korea
your community in support of Ernst Kuipers, MD, PhD
WDHD. Co-Chair World Digestive Health Erasmus University, Rotterdam
• Generate awareness by developing Day 2019 Netherlands
a social media campaign. Kentaro Sugano, MD
• Engage your local media with pub- Jichi Medical University Yi-Chia Lee, MD, PhD
lic service announcements, press Japan National Taiwan University
releases, radio advertisements, and Taiwan
TV interviews. Co-Chair World Digestive Health Wai Keung Leung, MD
• How are you planning to CEL- Day 2019 Hong Kong University
EBRATE WDHD? Joseph Sung, MD, PhD, FRCP, Hong Kong
To submit an event to the WGO MNGO
The Chinese University of Hong Brigette Ma, MD
Meetings & Events Calendar please
Kong The Chinese University of Hong
visit www.worldgastroenterology.org/
Hong Kong Kong
forms/submit-event.php.
Hong Kong13
WORLD GASTROENTEROLOGY NEWS JULY 2019
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Peter Malfertheiner, MD Jesús Kazuo Yamamoto-Furusho, MD Join the WDHD Conversation on
Otto Von Guericke University Mag- National Institute of Medical Sciences Social Media
deburg and Nutrition Salvador Zubirán WGO and The WGO Foundation
Germany Mexico want to hear from you! Join the con-
Wojciech Marlicz, MD, PhD, DSci, Graeme Young, MD versation in support of WDHD 2019,
FACG Flinder University Adelaide tag WGO on Facebook (World Diges-
Pomeranian Medical University Australia tive Health Day - WDHD), Twitter
Poland (@WGOF_WDHD), or LinkedIn
To learn more about WDHD we wel- (www.linkedin.com/company/world-
Simon Ng, MD come you to visit any of the following gastroenterology-organisation-wgo-
The Chinese University of Hong WDHD 2019 webpages: wgo-foundation). Be sure to include
Kong • WDHD 2019 Homepage #WDHD2019 and #GICancer in
Hong Kong • Message from the Co-Chairs your post.
Arnoldo Riquelme Pérez, MD • Tools and Resources
Pontifical Catholic University of Chile • Supporting WGO Global Guide- Like @WGOFWDHD on
Chile lines and Cascades Facebook
Email info@worldgastroenterology.org
Prateek Sharma, MD with any WDHD related questions. Follow @WGOF_WDHD on
University of Kansas Medical Center To officially submit your event for Twitter
United States inclusion on the WGO Meetings and
Shunji Tanaka, MD Events calendar, please visit www. Follow WGO/WGO Founda-
Hiroshima University worldgastroenterology.org/forms/ tion on LinkedIn
Japan submit-event.php and complete the
online form.
Kaichun Wu, MD
Xijing Hospital
China14
WORLD GASTROENTEROLOGY NEWS JULY 2019
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The La Paz Training Center Revisited – the Legacy of
Guido Villa-Gomez MD MWGO
Eamonn M.M. Quigley, MD, FRCP, FACP, MACG,
FRCPI
Past President of WGO (2005-2009)
Houston, Texas
Henry Cohen, MD, FACG
Past President of WGO (2011-2013)
Montevideo, Uruguay
In February 2019 we participated in in mind when the concept of training America and also provided extended
the 15th international course at the centers was proposed. Accordingly, periods of training (for up to a year)
WGO Training Center in La Paz, La Paz presented a yearly course on in selected areas of the specialty to
Bolivia. It was an experience that gastroenterology and gastrointes- smaller numbers. Over the 15 years of
was, on the one hand, exhilarating tinal endoscopy delivered by local its existence over 400 “trainees” have
and, on the other, tinged with a little and international experts to young attended the La Paz center courses. In
sadness. The exhilaration came from gastroenterologists from across Latin looking through photographs from
witnessing at first hand and in all its
glory the success story that is the La
Paz Training Center; sadness on the
realization that the individual who
developed and has guided the center
for the past 15 years is stepping down
on the occasion of his retirement
from the University.
We were both privileged to have
been there on the occasion of the
inauguration of the center in 2005
as the first WGO Training Center
in Latin America and paid further
visits since then. The La Paz center
was always exactly what WGO had
The La Paz Center was
always exactly what WGO
had in mind when the
concept of training centers
was proposed. Unveiling of the La Paz Training Centerin 2005.15
WORLD GASTROENTEROLOGY NEWS JULY 2019
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On every front the La Paz Training
Center has been an undoubted suc-
cess and has exceeded any and all ex-
pectations. Why did a Training Cen-
ter located in a somewhat inaccessible
city (“on the roof of the world” where
oxygen is at a premium) and in one of
the poorest nations in the continent
work and work so well? Several fac-
tors contributed to this success – the
wholehearted support of the uni-
versity, its medical school and their
leaderships, and of the municipality
of La Paz and national government
Trainees and trainers at the 2019 course agencies. The Japanese International
Cooperation Agency (JICA), the
the very first course, one can identify included the rapt attention of the overseas development authority of the
“trainees” who have since gone on young gastroenterologists at each ses- Japanese government, provided sub-
to hold leadership roles in gastroen- sion, their enthusiastic participation stantial funding for the establishment
terology in their home nations. The in panel discussions and the sheer joy of the Bolivian-Japanese Institute of
La Paz Center has clearly served to that they brought to the entire event; Gastroenterology in La Paz which has
galvanize the training and practice of joy at the opportunity to listen to and housed the training center and hosted
gastroenterology in the region and, in interact with a who’s who of Latin its courses and continues to provide
so doing, fostered the emergence of American gastroenterology and sheer ongoing support. Crucial also has
a group of young gastroenterologists delight at being together and sharing been the unswerving commitment of
who share a commitment to the high- a common mission. This exuberance the Bolivian Society of Gastroenterol-
est standards in clinical practice and a overflowed in the talent show where ogy to the center; its members have
dedication to training and education. “trainees” from the various nations selflessly contributed to the courses.
Those who remained in La Paz for competed with each other in front of Over the years, a host of expert
longer periods of “hands-on” train- the entire attendance. The Bolivian gastroenterologists and endoscopists
ing returned to their home base with group who presented a fully costumed from around the globe have willingly
new skills to the great benefit of their representation of the famed Carna- given of their time and expertise at
patients and their community. val de Oruro won in an event that the courses and local and national
Throughout its 15 years under the showcased the diverse talents of these industry have provided invaluable
leadership of Guido Villa-Gomez, young physicians. financial and in-kind support. As one
the courses at La Paz always adhered of its accredited centers, WGO has
to the highest standards of ethical also provided funding and faculty and
practice and educational principles – the center has attracted the endorse-
evidence-based presentations, critical ment and support of GI societies
assessment (in terms of knowledge from North and South America.
gained by the attendees and their
critical assessment of the educational
experience), experienced faculty with There is an additional
known reputations in teaching and factor, the X-factor, that
an atmosphere of critical analysis
and open interactivity. Interactions
has been absolutely
between the “trainees” was further fundamental to the success
fostered by social activities that pro- of the La Paz Training
moted bonding among the group as Center: its director – Guido
well as interchange with faculty. Villa Gomez.
Highlights from the 2019 course
that illustrated how well it worked La Paz from the Teleferico16
WORLD GASTROENTEROLOGY NEWS JULY 2019
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Their time in La Paz will be rendered
memorable by engaging in the course,
coming to appreciate how unique and
wonderful La Paz and Bolivia are, and
by the unrivalled hospitality of Guido,
his team and his colleagues. Why else
do the same faces reappear year after
year to experience dyspnea, see their
finger-tips go a little blue as they teach
on the La Paz courses? There is also
no doubt that his decades at the top
in gastroenterology in Bolivia and the
continent facilitate the ongoing and
essential support of the pharmaceuti- La Paz Training Center director, Guido Villa
cal, instrument and device industries. Gomez
Many, many tributes were appropri-
illustrates what can be achieved when
ately paid to Guido at this this year’s
those dedicated to a clear goal and
Tiwanaku event, his last as he retires from the
under outstanding leadership can
University and relinquishes director-
There is an additional factor, the achieve. Guido, the world of gastro-
ship of the center. Each he greeted,
X-factor, that has been absolutely fun- enterology owes you a profound debt
surrounded by his supportive family,
damental to the success of the La Paz of gratitude. We thank you for getting
with complete modesty and always
training center: its director – Guido to know La Paz, Bolivia and its people
emphasizing the roles of all of those
Villa Gomez. It is appropriate that we and the wealth of ideas, talent and
who have worked with him.
should acknowledge his unique and potential that the young gastroenter-
The La Paz Training Center, under
profound contributions to gastroen- ologists of the continent possess. We
the directorship of Guido Villa–
terology in the region through this wish you success and happiness in the
Gomez, provides a template for a
leadership of the center. An interna- next phase of your career. Your legacy
successful training center; his profes-
tionally recognized gastroenterologist, will be the continued success of the
sional and personal qualities have
wizard endoscopist and renowned center with ongoing support from
been critical to this success. Its success
educator, Guido brought a reputation JICA, WGO, industry and all the
and gravitas to the center that provid- friends of La Paz.
ed the foundation to its success. Yet
he, as a person, brings so much more
– why else would some of the world’s
busiest clinician-educators make the
trek to a city perched over 12,000 feet
up in the Andes? He is universally
respected, knows the worlds of gastro-
enterology and gastrointestinal endos-
copy intimately and can identify those
teachers who will best fulfill his goals. The Bolivian Altiplano with Illimani in the
background17
WORLD GASTROENTEROLOGY NEWS JULY 2019
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18th WGO-RTC Post-Graduate Course at the
Rabat Training Center, Morocco
MY ALL-TOO-SHORT STAY IN MOROCCO AT THE YEARLY FRENCH AFRICA POST-GRADUATE COURSE
Alan Barkun, MD,CM, FRCP(C), FACP, FACG, AGAF, The WGO Rabat Training Cen-
MSc (Clinical Epidemiology) ter offers a ten day course which
Division of Gastroenterology, McGill University and the McGill is open to all Francophone gas-
University Health Centre troenterologists (with preference
Montreal, Quebec, Canada to those from Africa) who wish
to improve their knowledge in
hepatology, gastroenterology and
digestive oncology. The 2019
edition was held from 24 Janu-
WOW! What an experience! Indeed, openness of mind and genuine thirst
ary – 2 February.
my involvement as a speaker at this for learning that in my experience is
yearly Post-Graduate Course in Gas- both unusual and extremely gratifying
troenterology and Hepatology – the for all present – both speakers and at-
oldest and most respected, targeting tendees. This is my fourth course and
French-speaking Africa - transcends I still exchange WhatsApp and e-mail
the usual faculty engagement. It is correspondence with some whom I
truly a life-changing event for both had been privileged to meet at past
participants and faculty. But why? courses.
What makes this such a special edu- Next, the speakers who span
cational few days? designated parts of the 10-day cur-
First and foremost, the partici- riculum. All were carefully chosen for
pants: a highly motivated, multina- their expertise, lecturing skills, and Training models
tional and multicultural group of endorsement of the course philosophy
colleagues who bring with them an that focuses on extensive interactions
with the attendees during both didac-
tic and organized social events – all in
The entire group becomes essentially a family whose an effort to help mentor participants
members – trainees and faculty – learn continuously about knowledge, procedural skills,
and career goals. The entire group
together and from each other, in a multitude of learning becomes essentially a family whose
sessions that include didactic, small group, and hands-on members – trainees and faculty –
opportunities. learn continuously together and from
each other, in a multitude of learning
sessions that include didactic, small
group, and hands-on opportunities.
An additional reason for the success
is no doubt in part the exotic, beauti-
ful setting of Rabat, the capital of
Morocco.
But perhaps most crucial to the
continued popularity of this wonder-
ful educational event is the unending
Course at the Rabat TC Participants and faculty
dedication, hard work, vision and18
WORLD GASTROENTEROLOGY NEWS JULY 2019
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But perhaps most crucial to
the continued popularity of
this wonderful educational
event is the unending
dedication, hard work,
vision and generosity of its
organizers led by Professor
Hands-on training Naima Amrani. More hands-on training
generosity of its organizers led by Pro- tively addressing critical adult medical
fessor Naima Amrani. An intelligent, education needs in French-speaking
insightful and veritable leader with Africa.
endless generosity who has remained This continued initiative is a tribute
true to the Course’s aims and origins. to the larger multifaceted efforts un-
As a busy international speaker, it is dertaken by the World Gastroenterol-
my honest opinion that this yearly ogy Organisation in fulfilling its truly
program is quite unique, achieving global educational mandate.
significant impact by boldly and effec-
The entire group becomes essentially a family19
WORLD GASTROENTEROLOGY NEWS JULY 2019
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WGO Train the Trainers Bucharest 2019
the Romanian Society of Gastroenter-
ology & Hepatology (SRGH), with
support from the American College of
Gastroenterology. It was made up of
17 modules, included lectures, small
group discussions, and hands-on ses-
sions while creating the opportunity
for everyone to engage in an open Opening session led by Prof. Jean-Christophe
Saurin, Chair of the TTT Committee
discussion on many topics related to
teaching and training.
TTT is a highly successful program
designed to disseminate teaching
skills to those gastroenterologists who
hold training positions in their own
WGO is proud to announce that its countries. Delegates are equipped
latest Train the Trainers workshop with both skills and tools which they
was a success! Since Train the Trainers can then implement on their home 26 countries spanning the globe were repre-
began in 2001, over 1,000 educators ground. Not only has this workshop sented at TTT Bucharest!
have attended this unique program to been enthusiastically received by
hone their skills in adult education. all WGO member societies around
The 28th WGO Train the Trainers the world, it continues to provide The 2019 TTT Bucharest work-
(TTT) workshop took place this an excellent forum for the exchange shop was a notable addition as it was
past 1 – 4 April 2019 in Bucharest, of ideas and the establishment of the first Train the Trainers workshop
Romania. This interactive workshop contacts between various countries, in in Eastern Europe in many years.
was organized by the World Gastro- an environment which is conducive to Romania welcomed participants and
enterology Organisation (WGO) and learning and interaction. faculty from 26 countries including
several participants from WGO Mem-
ber Society countries (Madagascar and
Puerto Rico) that had never before
participated in a Train the Trainers
workshop.
In particular, TTT Bucharest 2019
was an intensive four-day course
focused on improving the abilities
and educational skills of trainers in
the field of gastroenterology. The
workshop brought together renowned
faculty members from WGO (the
trainers) and participants (the train-
ees) from those different countries
and settings around the world, in an
enabling environment to improve
their potential for teaching.
Going beyond the seminars, the
workshop also sought to bring the
Thanks to our gracious hosts from the SRGH! participants and faculty together20
WORLD GASTROENTEROLOGY NEWS JULY 2019
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through a variety of teambuilding and
small group activities that highlighted
the beauty and history of Romanian
culture. All attendees were treated to
the best of Bucharest by their kind
Romanian hosts.
Participants and faculty TTT Report Back Session
TTT Bucharest: A Global “United Train the Trainers, Bucharest: A
Nations” Gathering Romanian Perspective
Wai-Kay Seto, MD Carmen Monica Preda, MD
The University of Hong Kong, Hong Kong Bucharest, Romania
The World Gastroenterology Organisation Train the Trainers Bucharest 2019 was for
TTT Workshop is a great course to equip me a great opportunity to improve my
oneself in the philosophies and concepts of teaching educational skills in gastroenterology, hepatology and
and training. endoscopy.
Right at the start of the workshop, my first impres- On this occasion I met extraordinary professionals
sion was: if only this were taught in medical school! I from these domains and colleagues from all over the
have been working in an academic institution in Hong world. Here is a summary of the sessions:
Kong for more than 6 years, teaching medical students, Professor Naima Amrani taught me how to write a
postgraduate students, junior doctors and gastroenter- presentation and good ways to deliver to my students.
ology trainees on a regular basis. And yet, after going The technique of teaching someone endoscopy was
through the course, I feel there is so much more one explained to us by Professor Damon Bizos, which is
can improve in teaching and education. The workshop very useful for my daily practice.
adopts a real-life perspective on gastroenterology teach- Trial design, presented by Professor David Bjork-
ing and training in the classroom, in the clinical setting man has had a great importance for me, which makes
and during endoscopies and procedures. The breakout me want to improve myself further in epidemiology.
continued... continued...
Four Days of Intense Work and Fun in Train the Trainers Bucharest:
Bucharest, Romania! Tremendous Power of Active
Nancy Fanous, MD Learning
Cairo, Egypt Lidia Ciobanu, MD
In 2013, I had the honor to join the Cluj-Napoca, Romania
WGO Cairo Training Center (CTC) My name is Lidia Ciobanu (Munteanu)
through its director, Prof. Ibrahim Mostafa. I was much and I am one of the attendees of the WGO Train the
impressed by the vision, mission and the great work it Trainers Workshop recently held in Bucharest from
carried on its shoulders to promote medical services in 1-4 April 2019.
Africa in the field of gastroenterology, hepatology and This meeting joined gastroenterologists from
endoscopy. Since its start in 2004, about 300 of my many countries and cultures, with different levels of
fellow African doctors have been trained through the practice, with very different scientific and educational
WGO CTC & gone back to serve their people with the careers. The topics were also very diverse: Education,
knowledge they gained. Teaching Procedural Skills, e-Learning, Preparation of
I knew about the TTT courses provided by WGO a an Abstract, Professionalism, Evidence Based Medi-
few years before through CTC and always appreciated cine, Critical Appraisal, Publications, Trial Design,
their caliber. In October 2018, and upon request from Assessment, Appraisal and Credentialing, Writing
WGO for nomination, I was nominated by CTC direc- Multiple Choice Questions, Interpersonal Skills and
tor, Prof. Ibrahim Mostafa to join the TTT in Bucha- Team Working. When I first saw the attendees and
continued... continued...21
WORLD GASTROENTEROLOGY NEWS JULY 2019
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Continued from: TTT Bucharest: A Global “United Nations” Gathering throughout the sessions, made the sessions very interactive
sessions put what we have learned into practice and solidi- and has shared many of his ideas about gastroenterology
fied our teaching concepts. There were concise sessions on and endoscopy.
different aspects of research. I really found the sections on I have to note our Romanian teachers Professors Anca
appraisal and credentialing useful, as these are relevant to my Trifan, Carol Stanciu and Catalin Sfarti who delivered
daily clinical practice. And tips on setting multiple choice great presentations about evidence-based medicine and
questions: I finally have guidance! publications.
The content of this workshop can be potentially very Professor Emmanuelle Williams spoke to us about assess-
impactful for gastroenterologists in China and Asia. China ment and appraisal and she did a wonderful job moderat-
is in the midst of modernizing its medical teaching and ing the breakout session.
training methods up to international standards. Gastroen- Last, but not least, Professor Cihan Yurdaydin, with
terology is one of the fastest-growing specialties in China, his impressive experience as editor, gave us an interesting
and the content of this workshop will be highly useful for presentation of critical appraisal of an article, followed by a
Chinese institutions aspiring to improve their teaching and very useful teamwork in the breakout session.
training standards. Hopefully WGO can take a leading Finally, I have to emphasize how successful the social
role in this. In addition, this workshop was truly a global side of the event was organized by the Romanian Profes-
“United Nations” gathering with participants from all six sors Trifan, Stanciu and Sfarti. Many participants appreci-
continents. It was great to meet new gastroenterology friends ated it as superlative and will keep many, many wonderful
from Argentina, Croatia, Madagascar, Guatemala, and of memories.
course Romania! Professor Harshit Khara organized a WhatsApp group
I would like to wholeheartedly thank the faculty members for all TTT attendees which we used to exchange photos,
of this workshop for the enlightening learning experience, films and ideas. Thank you very much Harshit!
including Drs. Jean-Christophe Saurin, Damon Bizos, Guil- Thank you very much WGO! Thank you very much
herme Macedo, David Bjorkman, Emmanuelle Williams, SRGH!
Harshit Khara and Kelly Burak. Thoroughly impressed by
their wholehearted dedication to education! And of course a Continued from: Four Days of Intense Work and Fun in Bucharest,
Romania!
million thanks to the Romanian Society of Gastroenterology
for being the best host possible and providing an enriching rest, Romania that was planned to take place from 1-4 April,
dose of Romanian culture! I fully support the conducting 2019 in partnership with Romanian Society of Gastroenter-
of similar TTT workshops in the future and the devotion of ology and Hepatology (SRGH).
WGO to improving gastroenterology educational standards From the very beginning, the event was highly organized.
worldwide. All details were perfectly taken care of so precisely and care-
fully, thanks to the highly skilled organizing team who made
Continued from: Train the Trainers, Bucharest: A Romanian Perspective our task an easy one. The warm welcome provided to me,
Also this concept of intensive and interactive workshops, along with the wonderful hand-made Romanian souvenir
practicing teamwork, gave me a great opportunity for me upon my arrival to Bucharest seemed so promising with a
to learn better. unique event to come.
I was impressed by the concept of a flipped classroom The TTT had a unique structure, mixing hard work with
and the presentation how to make multiple choice ques- fun. A total of 50 participants from all over the world, mak-
tions, given by Professor Kelly Burak. I will definitely try ing it a cosmopolitan event, first met during the welcome
to implement these techniques in my department. dinner on the first day of arrival and never imagine how we
Professor Harshit Khara talked to us about credentialing, would feel on the last day!
interpersonal skills and team working, which was a very Dividing the group into smaller working groups was a
interesting presentation. very effective idea which allowed people to interact in a
Professor Guilherme Macedo made a very good presen- friendly and professional manner, breaking geographical,
tation about professionalism, which many will definitely language and cultural boundaries.
remember for a long time now. The content of the course was extraordinarily practical and
Professor Chris Mulder explained publications and highly focused on the skills we need to encounter everyday,
publication politics, which gave us a lot of clues to why the challenges in the training field. Shorter lectures, longer
somebody is published and why they are not. breakout sessions and small group workshops made the long
Professor Jean-Christophe Saurin was our principal chair days so interesting and interactive. Very rich topics wereYou can also read
