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：
8695341
负责人：
Frank Irving Scott
金额：
$ 15.51万
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/8695341
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 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 Microvascular Dysfunction Modeling Modification Morbid Obesity Morbidity - disease rate Mus Nicotine Observational Study 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 Frank I. Scott 博士的 K08 奖项申请，他将于 2011 年 7 月 1 日起担任宾夕法尼亚大学讲师。此 K08 将为候选人提供必要的支持，以在术后粘连相关并发症的流行病学研究领域取得成功。为了实现自己的目标，Scott博士提出了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进行观察性研究〜（2）开发新的研究工具，用于腹部手术和术后并发症的研究- 手术小肠梗阻 (SBO)~ (3) 对宿主相关危险因素和粘连相关 SBO 的调节因素进行研究~ 以及 (4) 在流行病学和临床研究方面发展独立的研究生涯。斯科特博士组建了一个指导团队来帮助他实现这些目标。宾夕法尼亚大学胃肠病学系医学和流行病学教授 James D. Lewis 博士（医学博士、理学硕士）将担任候选人的主要导师。 Lewis博士是世界著名的药物流行病学和胃肠道疾病流行病学专家。胃肠病学部医学教授兼研究副主任 Gary D. Wu 博士（医学博士）将担任顾问。外科副教授 Najjia N. Mahmoud 博士（医学博士）曾与 Scott 博士和 Lewis 博士合作开展粘连相关研究，他将继续作为顾问提供宝贵的意见。生物统计与流行病学系的郭文胜博士将分享他在纵向分析方面的专业知识。术后粘连是造成发病率和死亡率很高，是成人 SBO 的主要原因。尽管缺氧似乎在动物模型中发挥了作用，但目前尚不清楚哪些宿主相关因素可能会影响术后 SBO 的风险。 Scott 博士的研究将利用健康改善网络 (THIN) 的数据，探讨与微血管疾病相关的共病医疗状况对术后 SBO 发生率的影响。先前的研究工作因缺乏大量接受腹部手术的人群的有效医疗数据而受到限制。拟议的研究将验证 THIN 内腹部手术和 SBO 的诊断代码，从而为此类研究生成新的数据集 (AIM 1)。然后，候选人将进行病例对照研究，以评估几种常见疾病（例如高血压、高脂血症和糖尿病）与使用 THIN 进行腹内手术后发生 SBO 风险之间的关联 (AIM 2)。最后，他将评估他汀类药物和 ACE 抑制剂（已知具有多效性抗纤维化作用）对术后 SBO 发生率的影响 (AIM 3)。这项研究将为未来前瞻性评估危险因素改变和药物使用预防粘连相关 SBO 的效果奠定基础。