Advancing Clinical Science in Pediatric Gastroparesis

推进小儿胃轻瘫的临床科学

基本信息

批准号：
10851126
负责人：
Bruno Pedro Chumpitazi
金额：
$ 31.8万
依托单位：
BAYLOR COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
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/10851126
关键词：
Adolescence Adolescent Adult Affect Anxiety Assessment tool 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 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 Assessment 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 children&apos s depression inventory cohort common symptom comorbidity cost 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 trait

项目摘要

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.

儿童和成人胃轻瘫（GP）的特点是在缺乏胃排空的情况下胃排空延迟。机械性梗阻与显着的发病率和死亡率相关，但人们对其知之甚少。儿童全科医生的这一知识差距因儿童的发病率、患病率和自然史而加剧。功能性消化不良 (FD) 的症状和病理生理学有重叠，功能性消化不良是成人和儿童的常见疾病有限的数据表明儿童的临床症状和病理生理学之间存在显着差异。儿童与成人的 GP 和 FD 因此，有关成人 GP 和 FD 的数据不太可能提供洞察力和填补。这些问题（除其他外）强调了儿童全科医生和家庭医生的知识差距。因此，该更新应用程序的目标是建立在儿童全科医生和 FD 特定研究策略的基础上。并作为 NIDDK 胃轻瘫联盟 (GpCRC) 的一部分扩展我们之前的儿科登记工作（例如，招募登记人员、开发儿科生活质量和症状全科医生模块； PedSQL/Symptom GP 模块）最终确定影响所测疾病严重程度的因素根据生活质量和症状，我们的具体目标是：目标 1 – 通过现场测试完成 PedsQL/Symptom GP 模块的验证并开发一个儿科 FD 的类似模块使用定性测量，然后进行现场测试。目标 2 - 确定以下潜在因素对儿科全科医生疾病严重程度的作用和FD： 2a - 病理生理学：a) 内脏过敏（通过水负荷饱腹感测试）；b) 胃调节（通过胃内膳食分配）；c) 胃排空率（闪烁扫描）；炎症（肥大细胞和嗜酸性粒细胞）；e) 胃/近端肠道屏障功能（肠道通透性）。 2b - 心理困扰：与心理学家合作评估 a) 躯体化（儿童的躯体化） b) 抑郁（儿童抑郁量表）； c) 焦虑（状态特质焦虑量表）；残疾（功能性残疾量表）； e) 灾难化（疼痛灾难化量表）。 2c - 饮食不耐受：与营养师、患者和家长合作确定自我识别的食物 GP 和 FD 儿童的不耐受和饮食行为。目标 3 - 为了实现上述目标，通过纳入更多儿科中心（包括一些与成人 GpCRC 网站联系起来，以便开始探索从儿科护理过渡到成人护理的障碍。这种创新的多学科方法将有望开始填补有关方面的巨大知识空白儿童 GP 和 FD 目前的提案是为了响应 RFA-DK-20-504，实现以下目标：：以我们之前的成果为基础，吸收心理学家和营养师的专业知识，扩大招聘地点，以及研究儿科到成人护理的过渡。