TRAUMA AND INJURY EXCELLENCE IN EDUCATION ON RESEARCH (TRALNEER) PROGRAM
Juan Carlos Puyana, Associate Professor
University Of Pittsburgh At Pittsburgh, Office Of Research, Pittsburgh, Pa 15213
Grant 5D43TW007560-05 from National Institute On Alcohol Abuse And Alcoholism
Keywords: American; Applications Grants; Caring; Chimp; Chimpanzee; Clinical Research; Clinical Study; Collaborations; Colombia; Country; Education; Educational aspects; Educational workshop; Faculty; Funding; Goals; Grant; Grant Proposals; Grants, Applications; Health; Human; Human, General; Infrastructure; Injury; Institutes; International; Investigators; Latin America; Leadership; Man (Taxonomy); Man, Modern; Master of Science; Mentorship; Methods; On-Line Systems; Online Systems; Pan; Pan Genus; Pan Species; Physicians; Population; Position; Positioning Attribute; Programs (PT); Programs [Publication Type]; Research; Research Infrastructure; Research Personnel; Research Resources; Research Training; Researchers; Resources; Sight; Societies; Structure; Training; Training Activity; Training Programs; Training Support; Trauma; Trauma Centers; Trauma Research; United States; Universities; Violence; Violence injury; Violent injury; Vision; Work; Workshop; conference; member; online computer; parent grant; programs; symposium; trauma centers; violent; violent behavior; web based
Project start date: 2006-04-01
Project end date: 2011-02-28
Budget start date: 1-MAR-2010
Budget end date: 28-FEB-2011
PFA/PA: PAR-04-083
5D43TW007560-05 (2010): $144666
Sponsored Links Excellgen http://Excellgen.com
Grants awarded to Juan Carlos Puyana
ENHANCING RESEARCH INFORMATICS CAPACITY FOR HEALTH INFORMATION IN COLOMBIA (ENRIC
Juan Carlos Puyana, Associate Professor
University Of Pittsburgh At Pittsburgh, Office Of Research, Pittsburgh, Pa 15213
Grant 5D43TW008443-02 from Fogarty International Center
Abstract: The current health profile of Colombia can be defined as a having a "triple" burden of disease characterized by an increasing incidence of chronic and degenerative diseases typical of developed countries, a prevalent number of infectious and parasitic disease such as malaria and tuberculosis and an inordinately high number of trauma-related injuries and deaths. Training a cadre of healthy professionals capable of offering medical informatics solutions to best study each and every one of these health afflictions will have a major impact on public health in Colombia. The ENRICH project "Enhancing Research and Informatics Capacity for Health Information in Colombia" will establish an international collaboration between the University Pittsburgh and the Javeriana University in Bogota with the goal of building the capacity of individuals in the field of health informatics with an emphasis on clinical research. We have established a partnership with the Department of Clinical Epidemiology and Biostatistics (DCEB) of the Javeriana University. Within this department, a center for medical informatics will be designated as the regional resource for advance in-country training and support center for the ENRICH program. The University of Pittsburgh will draw expertise to build a fully integrated program to educate a cadre of investigators in health informatics and advanced research methods relevant to the health needs of Colombia. The specific aims are 1) To provide formal training in medical informatics to at least 10 individuals from Colombia as part of a Certificate program in applied medical and health informatics at the University of Pittsburgh. 2) Advance in-country training by offering short term intensive training courses within Colombia consisting of workshops /seminars on clinical information systems, clinical terminologies, bioinformatics, data base management bio-surveillance and clinical research methodology and 3). To establish the infrastructure for the creation of a formal training program in medical informatics under the auspices of the DCEB at Javeriana University. Furthermore, we propose to build on our past activities trough our existing International Collaborative Trauma and Injury Research Training Program by offering the opportunity for rapid implementation of informatics solutions on a number of ongoing projects in trauma that could have an immediate impact on a major health public issue in Colombia. The status of Medical Informatics in Colombia is at stage in which a well trained cadre of experts in health informatics can make crucial and valuable contributions to the research necessary to improve Colombia´s health care while advancing the field of informatics. Ultimately, health professionals will have the opportunity to acquire skills in a variety of health information subjects, both in Pittsburgh and in Colombia. These individuals will play a major role in improving the quality, safety and efficiency of health car in Colombia and Latin America
Keywords: Bio-Informatics; Bioinformatics; Biometrics; Biometry; Biometry and Biostatistics; Biostatistics; Care, Health; Cessation of life; Chronic; Clinical; Clinical Research; Clinical Study; Collaborations; Colombia; Country; Data Base Management; Death; Degenerative Disorder; Developed Countries; Developed Nations; Educational workshop; Goals; Health; Health Care Professional; Health Informatics; Health Professional; Health profession; Healthcare; Healthcare professional; Healthcare worker; IT Systems; Incidence; Individual; Industrialized Countries; Industrialized Nations; Informatics; Information Systems; Information Technology Systems; Infrastructure; Injury; Instruction; International; Investigators; Latin America; Malaria; Medical; Medical Informatics; Methodology, Research; Paludism; Parasitic Diseases; Plasmodium Infections; Play; Programs (PT); Programs [Publication Type]; Public Health; Public Health Informatics; Research; Research Infrastructure; Research Methodology; Research Methods; Research Personnel; Research Resources; Research Training; Researchers; Resources; Role; Safety; Solutions; Staging; Systems, Data; Terminology; Training; Training Programs; Training Support; Trauma; Tuberculosis; Universities; Workshop; burden of disease; burden of illness; clinical epidemiology; consumer informatics; degenerative condition; degenerative disease; disease burden; disseminated TB; disseminated tuberculosis; improved; programs; public health medicine (field); skills; social role; statistics/biometry; tuberculous spondyloarthropathy; years of life lost to disability; years of life lost to disease
Project start date: 2009-09-25
Project end date: 2014-06-30
Budget start date: 1-JUL-2010
Budget end date: 30-JUN-2011
PFA/PA: RFA-TW-09-001
5D43TW008443-02 (2010): $240719
1D43TW008443-01 (2009): $249641
Metabolic-Inflammatory Systems In Irreversible Shock
Juan Carlos Puyana
University Of Pittsburgh At Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260
Grant 5R01HL076157-04 from National Heart, Lung, And Blood Institute IRG: ZHL1
Abstract: Current therapy for severe hemorrhagic trauma patients consists of hemorrhage control and volume expansion. Depending on the severity of the hemorrhage and the time lag between injury and hemostasis, some patients with hemorrhagic shock may enter into irreversible circulatory collapse, despite resuscitation. We now understand that circulatory shock, through rheological and ischemic processes, induces hemodynamic, metabolic, and hyper-acute inflammatory responses that interact in a complex fashion and may lead to the development of refractory hypotension and irreversible shock. We have demonstrated that "real-time" monitoring of pH, oxygenation, and capnometry in skeletal muscle and other organs correlates with the severity of the hemorrhagic insult. However, these measurements have not been correlated directly with the inflammatory process, nor is the contribution of acute inflammation to irreversible shock well understood. In parallel, we have developed and calibrated a mathematical model that describes the mediators of acute inflammation in hemorrhagic shock. Though informed by circulating mediators, this model expresses the physiological derangement experienced by individual organs in terms of a global, currently theoretical, tissue dysfunction equation. We hypothesize that the magnitude of tissue dysfunction associated with circulatory collapse is a reflection of a global energetic failure and ensuing acute inflammation, which we can measure and model mathematically. Irreversible shock may result from severe exsanguination of short duration, or a more subdued, continuous hemorrhage, and/or delayed or inadequate resuscitation. We propose a systematic series of experiments in mice and swine to delineate irreversible shock. These experiments will be integrated within the mathematical framework previously developed. We propose the following two Specific Aims 1) to characterize circulatory collapse in mice, and to augment a mathematical model of post-shock inflammation to include relevant neuroendocrine, cardiovascular and tissue metabolic elements; and 2) to validate the ability of several markers of tissue hypoperfusion to inform a mathematical model of post-shock inflammation in swine, and to provide specific outcome predictions. Within the scope of these Specific Aims, we will test the therapeutic efficacy of Ringer s Ethyl Pyruvate Solution (REPS), hypothesizing that the proven anti-inflammatory properties in moderate hemorrhagic shock will improve outcome in irreversible shock. These novel approaches to hemorrhagic shock may save lives on the battlefield by identifying high risk, high mortality victims and by aiding in assessing the severity or irreversibility of cell function in a multiple casualty scenario. On a more basic level, this research will advance the use of complex systems in biology. Our approach of mathematical modeling integrated with data in relevant animal models, and the associated data analysis, fitting, and statistics problems, will define new methodologies for systems biology research.
Keywords: inflammation, metabolism, shock, body fluid balance therapy, hemorrhagic shock, interleukin 10, interleukin 6, mathematical model, nitric oxide, nonhuman therapy evaluation, tumor necrosis factor alpha, laboratory mouse, swine
Project start date: 2004-04-01
Project end date: 2008-03-31
5R01HL076157-04 (2007): $358700
5R01HL076157-03 (2006): $356073
5R01HL076157-02 (2005): $362031
1R01HL076157-01 (2004): $372733