This application proposes a training program to develop Blair A. Jobe, MD into an independent clinician-scientist specializing in investigations of Barrett's esophagus and esophageal cancer. Dr. Jobe is a board certified General Surgeon with subspecialty training in laparoscopic and esophageal surgery. The mentored career development plan consists of a three-tiered approach: a didactic education resulting in a Masters in Clinical Investigation degree, a broad-based experiential learning program, and a mentored clinical research experience. The primary goal of this program will be for Dr. Jobe to achieve independence as a clinical investigator in all respects. Dr. Jobe is currently enrolled in the Human Investigations Program at Oregon Health and Science University (OHSU). This is a two year K30 (NIH) sponsored program for the purposes of developing patient-oriented research skills. Mentored research will be conducted under the direction of a mentorship committee composed of Dr. Cynthia Morris, Professor of Medical Informatics and Outcomes Research, OHSU, Dr. David Lieberman, Chief, Division of Gastroenterology, OHSU, and Dr. John Hunter, Chairman, Department of Surgery, OHSU. Dr. Jeffrey Peters from the University of Southern California will serve as an off-site mentor and committee member. The proposed research focuses on improving risk stratification for esophageal adenocarcinoma. The fact that most patients are unaware of the presence of Barrett's esophagus prior to cancer diagnosis and because a large proportion of these patients never develop heartburn or reflux, suggests that the current GERD symptom-based screening paradigm may be inadequate. We theorize that patients with extraesophageal reflux symptoms are at risk for unrecognized esophageal injury and thus Barrett's esophagus. We hypothesize that endoscopic screening of patients with extraesophageal reflux symptoms will reveal a significantly higher prevalence of Barrett's esophagus when compared to patients without symptoms of gastroesophageal reflux. The primary aim is to establish that patients with extraesophageal reflux symptoms who are referred to an otolaryngology clinic have a prevalence of Barrett's metaplasia equivalent to that of a population with GERD symptoms. A secondary aim is to establish that in-office unsedated small-caliber endoscopy is accurate and acceptable to patients when employed within a screening program for Barrett's esophagus.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DK066165-03
Application #
6987153
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Podskalny, Judith M,
Project Start
2004-02-01
Project End
2008-11-30
Budget Start
2005-12-01
Budget End
2006-11-30
Support Year
3
Fiscal Year
2006
Total Cost
$133,110
Indirect Cost
Name
Oregon Health and Science University
Department
Surgery
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Nason, Katie S; Murphy, Thomas; Schindler, Joshua et al. (2013) A cross-sectional analysis of the prevalence of Barrett esophagus in otolaryngology patients with laryngeal symptoms. J Clin Gastroenterol 47:762-8
Peery, Anne F; Hoppo, Toshitaka; Garman, Katherine S et al. (2012) Feasibility, safety, acceptability, and yield of office-based, screening transnasal esophagoscopy (with video). Gastrointest Endosc 75:945-953.e2
Enestvedt, C K; Hosack, L; Hoppo, T et al. (2012) Recombinant vascular endothelial growth factor165 gene therapy improves anastomotic healing in an animal model of ischemic esophagogastrostomy. Dis Esophagus 25:456-64
Nason, Katie S; Wichienkuer, Promporn Paula; Awais, Omar et al. (2011) Gastroesophageal reflux disease symptom severity, proton pump inhibitor use, and esophageal carcinogenesis. Arch Surg 146:851-8
Enestvedt, C K; Perry, K A; Kim, C et al. (2010) Trends in the management of esophageal carcinoma based on provider volume: treatment practices of 618 esophageal surgeons. Dis Esophagus 23:136-44
Witteman, Bart P L; Foxwell, Tyler J; Monsheimer, Sandy et al. (2009) Transoral endoscopic inner layer esophagectomy: management of high-grade dysplasia and superficial cancer with organ preservation. J Gastrointest Surg 13:2104-12
O'Rourke, R W; Metcalf, M D; White, A E et al. (2009) Depot-specific differences in inflammatory mediators and a role for NK cells and IFN-gamma in inflammation in human adipose tissue. Int J Obes (Lond) 33:978-90
Jobe, Blair A; O'Rourke, Robert W; McMahon, Barry P et al. (2008) Transoral endoscopic fundoplication in the treatment of gastroesophageal reflux disease: the anatomic and physiologic basis for reconstruction of the esophagogastric junction using a novel device. Ann Surg 248:69-76
Van Hove, Corey; Perry, Kyle A; Spight, Donn H et al. (2008) Predictors of technical skill acquisition among resident trainees in a laparoscopic skills education program. World J Surg 32:1917-21
Perry, Kyle A; Enestvedt, C Kristian; Lorenzo, Cedric S F et al. (2008) The integrity of esophagogastric junction anatomy in patients with isolated laryngopharyngeal reflux symptoms. J Gastrointest Surg 12:1880-7

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