Advancing Clinical Science in Pediatric Gastroparesis

推进小儿胃轻瘫的临床科学

• 批准号: 10319415
• 负责人: Bruno Pedro Chumpitazi
• 金额: $ 38.06万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-25 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10319415
• 关键词: Adolescence; Adolescent; Adult; Affect; Anxiety; Caring; Categories; Child; Childhood; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Data; Development; Diabetes Mellitus; Dietitian; Disease; Distress; Duodenum; Dyspepsia; Eating Behavior; Epidemiology; Epigastrium; Equipment and supply inventories; Etiology; Food; Functional Gastrointestinal Disorders; Functional disorder; Future; Gastric Emptying; Gastritis; Gastroparesis; General Population; Goals; Hospital Costs; Hospitalization; Hypersensitivity; Incidence; Intestinal permeability; Knowledge; Link; Measures; Mechanics; Mental Depression; Methodology; Methods; Morbidity - disease rate; National Institute of Diabetes and Digestive and Kidney Diseases; Natural History; Nausea and Vomiting; Obstruction; Operative Surgical Procedures; Outcome; Pain; Parents; Patients; Population; Prevalence; Psychologist; Quality of life; Questionnaires; Radionuclide Imaging; Registries; Research; Role; Sample Size; Satiation; Severities; Severity of illness; Site; Stomach; Symptoms; Testing; Toddler; Treatment outcome; Validation; Visceral; Vomiting; Water; Work; age group; age related; anxiety states; children' s depression inventory; cohort; common symptom; comorbidity; dietary; disability; early satiety; eosinophil; field study; functional disability; gastrointestinal; improved; innovation; insight; interdisciplinary approach; mast cell; mortality; neuropathology; novel; pain catastrophizing; pediatric patients; prospective; psychosocial; recruit; tool; trait

Gastroparesis (GP) in children and adults is characterized by delayed gastric emptying in the absence of mechanical obstruction. GP is associated with significant morbidity and mortality yet little is known regarding its incidence, prevalence, and natural history in children. This knowledge gap in pediatric GP is exacerbated by the overlap in symptoms and pathophysiology with functional dyspepsia (FD), a common disorder in adults and children. The limited data suggests significant differences between clinical symptoms and pathophysiology of GP and FD in children vs adults. Thus, data regarding GP and FD in adults is unlikely to provide insight and fill the knowledge gaps regarding GP and FD in children. These issues (among others) underscore need for childhood GP- and FD-specific research strategies. Thus, the goals of this renewal application are to build on and extend our previous Pediatric Registry work as part of the NIDDK Gastroparesis Consortium (GpCRC) (e.g., recruitment into the Registry, development of a pediatric Quality of Life and Symptom GP Module; PedsQL/Symptom GP Module), ultimately, to determine the factors contributing to disease severity measured by quality of life and symptoms. Our Specific Aims are: Aim 1 – Complete validation of the PedsQL/Symptom GP Module via field testing and develop an analogous module for pediatric FD using qualitative measures followed by field testing. Aim 2- Determine the role of the following potential contributors to disease severity in pediatric GP and FD: 2a - Pathophysiologic: a) Visceral hypersensitivity (via water load satiety testing); b) Gastric accommodation (via intragastric meal distribution); c) Gastric emptying rate (scintigraphy); d) Duodenal/gastric inflammation (mast cells and eosinophils); e) Gastric/proximal gut barrier function (gut permeability). 2b - Psychosocial distress: Engage with psychologists to assess a) Somatization (Children’s Somatization Inventory); b) Depression (Children’s Depression Inventory) c) Anxiety (State-Trait Anxiety Inventory); d) Disability (Functional Disabilities Inventory); e) Catastrophizing (Pain Catastrophizing Scale). 2c - Dietary intolerances: Engage with dietitians, patients, and parents to determine self-identified food intolerances and eating behaviors in children with GP and FD. Aim 3 - To accomplish the above, expand Registry recruitment by including more pediatric centers, with some linked to adult GpCRC sites in order to begin to explore barriers to transition from pediatric to adult care. This innovative multidisciplinary approach will prospectively begin to fill the vast knowledge void regarding GP and FD in children. The current proposal is responsive to RFA-DK-20-504 by achieving among other goals, to: build on our previous gains, enlist expertise of psychologists and dietitians, expand recruitment sites, and study pediatric to adult care transition.

儿童和成人中的胃轻瘫（GP）的特征是胃排空延迟在没有的情况下 机械目标。 GP与显着的发病率和死亡率有关，但知之甚少 儿童的发病率，患病率和自然历史。小儿GP中的这种知识差距会因 症状和病理生理学与功能性消化不良（FD）的重叠，成人的常见疾病和 孩子们。有限的数据表明临床症状与病理生理学之间的显着差异 儿童与成人的GP和FD。这就是成人中有关GP和FD的数据，不太可能提供洞察力并填补 关于儿童GP和FD的知识差距。这些问题（除其他问题）强调了需求 儿童时期的GP和FD特定研究策略。这是此更新应用的目标是建立 并扩展我们以前的小儿注册表工作，作为NIDDK胃肉食联盟（GPCRC）的一部分 （例如，招募注册表，开发儿科质量和症状GP模块； PEDSQL/症状GP模块），最终确定导致疾病严重程度的因素 通过生活质量和符号。我们的具体目的是： AIM 1 - 通过现场测试对PEDSQL/症状GP模块的完全验证并开发 小儿FD的类似模块，使用定性测量，然后进行现场测试。 目标2-确定以下潜在疾病严重程度在小儿GP中的作用 和FD： 2A-病理生理学：a）内脏超敏反应（通过水负荷饱腹感测试）； b）胃 住宿（通过胃内饭菜分布）； c）胃排空率（闪烁显像）； D）十二指肠/胃 炎症（肥大细胞和嗜酸性粒细胞）； e）胃/近端肠道屏障功能（肠道渗透率）。 2B-社会心理困扰：与心理学家互动以评估a）躯体化（儿童的躯体化 存货）; b）抑郁症（儿童抑郁量表）c）焦虑症（州特征焦虑清单）； d） 残疾（功能残疾库存）； e）灾难性（疼痛灾难性量表）。 2C-饮食饮食：与营养师，患者和父母互动以确定自我识别的食物 GP和FD儿童的肠胃和饮食行为。 目标3-要完成上述内容，通过包括更多的儿科中心来扩展注册表的招聘，其中一些 与成人GPCRC站点有关，以开始探索从小儿过渡到成人护理的过渡障碍。 这种创新的多学科方法可能会开始填补有关的广泛知识空白 GP和FD儿童。当前的提案通过实现其他目标，对RFA-DK-20-504的反应， 到：以我们以前的收益为基础，吸引心理学家和营养师的专业知识，扩大招聘场所以及 研究小儿到成人护理过渡。