Microvascular disease, statins, ACE-inhibitors and post-operative SBO

微血管疾病、他汀类药物、ACE 抑制剂和术后 SBO

基本信息

批准号：
8534778
负责人：
Frank Irving Scott
金额：
$ 15.46万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8534778
关键词：
Abdomen Abscess Address Adhesions Admission activity Adult Affect American Angiotensin Receptor Angiotensin-Converting Enzyme Inhibitors Animal Model Animals Award Barrier Contraception Biometry Biostatistical Methods Case-Control Studies Clinical Clinical Research Code Cohort Studies Colon Comorbidity Data Data Set Databases Development Development Plans Diabetes Mellitus Diabetic Angiopathies Diagnosis Diagnostic Disease Disease Association Doctor of Philosophy Epidemiologic Methods Epidemiologic Studies Epidemiology Evaluation Exposure to Foreign Bodies Foundations Future Gastroenterology Gastrointestinal Diseases General Practitioners Goals Gold Health Health Care Costs Hospitals Human Hyperlipidemia Hypertension Hypoxia In Vitro Incidence Infertility Inflammation Integration Host Factors Intestinal Obstruction Intra-abdominal Knowledge Laboratories Laparoscopy Measures Medical Medical History Medical Records Medicine Mentors Meta-Analysis Modeling Modification Morbid Obesity Morbidity - disease rate Mus Nicotine Operative Surgical Procedures Outcome Pathogenesis Patients Pennsylvania Peripheral Vascular Diseases Peritoneum Pharmaceutical Preparations Pharmacoepidemiology Play Population Postoperative Period Powder dose form Predictive Value Procedures Property Prospective Studies Questionnaires Recommendation Research Resources Risk Risk Factors Role Small Intestines Surgical Mesh Surveys Techniques Testing Thiazide Diuretics Time Tissues Tobacco use Translating Trauma Universities Validation Woman base career career development case control cohort cytokine design disorder risk epidemiology study experience follow-up instructor mortality novel population based prevent professor prospective response skills tool

项目摘要

DESCRIPTION (provided by applicant): This is an application for a K08 award for Dr. Frank I. Scott, who will be an Instructor at the University of Pennsylvania starting July 1, 2011. This K08 will provide the candidate with the necessary support to launch a successful career in epidemiologic research in post-operative adhesion-related complications. To achieve his goals, Dr. Scott has proposed a comprehensive career development plan: (1) to implement advanced epidemiologic and biostatistical methods to conduct observational research~ (2) to develop a new research tool for the study of complications of abdominal surgery and post-surgical small bowel obstruction (SBO)~ (3) to conduct research on host-related risk factors and modifiers of adhesion-related SBO~ and (4) to develop an independent research career in epidemiologic and clinical research. Dr. Scott has assembled a mentoring team to assist him in achieving these goals. Dr. James D. Lewis, MD, MSCE, Professor of Medicine and Epidemiology in the Division of Gastroenterology at the University of Pennsylvania, will serve as the candidate's primary mentor. Dr. Lewis is a world-renowned expert in pharmacoepidemiology and gastrointestinal disease epidemiology. Dr. Gary D. Wu, MD, Professor of Medicine and Associate Chief of Research in the Gastroenterology Division will serve as an advisor. Dr. Najjia N. Mahmoud, MD, Associate Professor of Surgery, who has collaborated with Dr. Scott and Dr. Lewis on prior adhesion-related research, will continue to provide invaluable input as an advisor. Dr. Wensheng Guo, PhD, in the department of Biostatistics and Epidemiology, will share his expertise in longitudinal analyses. Post-operative adhesions are responsible for a significant amount of morbidity and mortality, and are the leading cause of SBO in adults. Little is currently known about which host-related factors may impact the risk of post-operative SBO, although hypoxia appears to play a role in animal models. Dr. Scott's research will examine the impact of co-morbid medical conditions associated with microvascular disease on the incidence of post-operative SBO utilizing data from The Health Improvement Network (THIN). Prior research efforts have been limited by the lack of valid medical data from a large population undergoing abdominal surgery. The proposed research will validate diagnostic codes for abdominal surgery and SBO within THIN, thereby generating a novel dataset for such research (AIM 1). The candidate will then conduct a case-control study to assess the association between several common medical conditions, such as hypertension, hyperlipidemia, and diabetes, with the risk of SBO after an intra-abdominal surgery using THIN (AIM 2). Finally, he will assess the effects of statins and ACE-inhibitors, which have known pleiotropic anti-fibrotic effects, on the incidence of post-operative SBO (AIM 3). This research will serve as the foundation for future prospective evaluation of the effect of risk factor modification and medication use to prevent adhesion-related SBO.

描述（由申请人提供）：这是弗兰克·斯科特（Frank I. 将为候选人提供必要的支持，以启动与术后相关并发症的流行病学研究成功事业。为了实现自己的目标，斯科特博士提出了一项全面的职业发展计划：（1）实施先进的流行病学和生物统计学方法，以开发观察性研究〜（2）开发一种新的研究工具，以研究腹部手术并发症的研究，并进行手术后的小肠阻塞（SBO）〜（SBO）〜（SBO）〜（SBO）〜（3），以对宿主的风险和模态攻击量（4）进行研究（4在流行病学和临床研究中。斯科特博士已经组建了一个指导团队，以协助他实现这些目标。 MSCE医学博士James D. Lewis博士，宾夕法尼亚大学胃肠病学系医学和流行病学教授，将担任候选人的主要导师。刘易斯博士是一位世界知名的药物ePidemiology和胃肠道疾病流行病学专家。医学博士Gary D. Wu博士，医学教授兼胃肠病学副研究主任将担任顾问。外科副教授Najjia N. Mahmoud博士与Scott博士和Lewis博士合作进行了与粘附相关的研究，他将继续作为顾问提供宝贵的意见。生物统计学和流行病学系的Wensheng Guo博士将在纵向分析中分享他的专业知识。术后粘连是为了大量的发病率和死亡率是成年人SBO的主要原因。尽管缺氧似乎在动物模型中起作用，但目前对哪些与宿主相关的因素可能影响术后SBO的风险鲜为人知。 Scott博士的研究将检查与微血管疾病相关的合并医疗状况对使用健康改善网络（THIN）数据的术后SBO发生率的影响。因缺乏大量腹部手术人群的有效医疗数据而受到限制。拟议的研究将验证腹部手术和SBO的诊断代码，从而生成一个新的数据集（AIM 1）。然后，候选人将进行一项病例对照研究，以评估几种常见的医疗状况（例如高血压，高脂血症和糖尿病）之间的关联，并使用薄薄的腹腔内手术后的SBO风险（AIM 2）。最后，他将评估他汀类药物和ACE抑制剂的影响，这些抑制剂已知多效性抗纤维化作用对术后SBO的发生率（AIM 3）。这项研究将成为对危险因素修饰和药物使用的影响的未来预期评估，以防止与粘附相关的SBO。