Effectiveness and Complication Rate of Percutaneous Endoscopic Gastrostomy Placement in Pediatric Oncology Patients

Kidder, Molly,Phen, Claudia,Brown, Jerry,Kimsey, Kathryn,Oshrine, Benjamin,Ghazarian, Sharon,Mateus, Jazmine,Amankwah, Ernest,Wilsey, Michael The Korean Society of Pediatric Gastroenterology 2021 Pediatric gastroenterology, hepatology & nutrition Vol.24 No.6

Purpose: Malnutrition is a significant issue for pediatric patients with cancer. We sought to evaluate the effectiveness and complication rate of percutaneous endoscopic gastrostomy (PEG) placement in pediatric oncology patients. Methods: A retrospective chart review was performed on 49 pediatric oncology patients undergoing PEG placement at Johns Hopkins All Children's Hospital between 2000 and 2016. Demographic and clinical characteristics, complications, absolute neutrophil count at time of PEG placement and at time of complications, length of stay, and mortality were identified. Weight-for-age Z-scores were evaluated at time of- and six months post-PEG placement. Results: The overall mean weight-for-age Z-score improved by 0.73 (p<0.0001) from pre- (-1.11) to post- (-0.38) PEG placement. Improvement in Z-score was seen in patients who were malnourished at time of PEG placement (1.14, p<0.0001), but not in those who were not malnourished (0.32, p=0.197). Site infections were seen in 12 (24%), buried bumper syndrome in five (10%), and tube dislodgement in one (2%) patient. One patient (2%) with fever was treated for possible peritonitis. There were no cases of other major complications, including gastric perforation, gastrocolic fistula, clinically significant bleeding, or PEG-related death documented. Conclusion: Consistent with previous studies, our data suggests a relationship between site complications (superficial wound infection, buried bumper syndrome) and neutropenia. Additionally, PEG placement appears to be an effective modality for improving nutritional status in malnourished pediatric oncology patients. However, larger prospective studies with appropriate controls and adjustment for potential confounders are warranted to confirm these findings.

Down the Rabbit Hole-Considerations for Ingested Foreign Bodies

Brown, Jerry,Kidder, Molly,Fabbrini, Abigail,deVries, Jonathan,Robertson, Jason,Chandler, Nicole,Wilsey, Michael The Korean Society of Pediatric Gastroenterology 2019 Pediatric gastroenterology, hepatology & nutrition Vol.22 No.6

We report the case of a seven-year-old boy with an ingested foreign body, which was retained within the appendix for a known duration of ten months, ultimately requiring appendectomy. The ingested foreign body was incidentally discovered by abdominal x-ray at an emergency room visit for constipation. Despite four bowel cleanouts, subsequent x-rays showed persistence of the foreign body in the right lower quadrant. While the patient did not have signs or symptoms of acute appendicitis, laparoscopic appendectomy was performed due to the risk of this foreign body causing appendicitis in the future. A small metallic object was found within the appendix upon removal. This case highlights the unique challenge presented by foreign body ingestions in non-verbal or developmentally challenged children and the importance of further diagnostic workup when concerns arise for potential retained foreign bodies.

Controlled synthesis of mesoporous codoped titania nanoparticles and their photocatalytic activity

Mathis, John E.,Kidder, Michelle K.,Li, Yunchao,Zhang, Jinshui,Paranthaman, M.P. Techno-Press 2016 Advances in nano research Vol.4 No.3

The photocatalytic (PC) activity of anatase titania nanoparticles can be improved through codoping with transition metals and nitrogen. In addition, the PC activity can also be improved by creating monodisperse, mesoporous nanoparticles of titania. The question naturally arose as to whether combining these two characteristics would result in further improvement in the PC activity or not. Herein, we describe the synthesis and photocatalytic characteristics of codoped, monodisperse anatase titania. The transition metals tested in the polydisperse and the monodisperse forms were Mn, Co, Ni, and Cu. In each case, it was found that the monodisperse version had a higher PC activity compared to the corresponding polydisperse version.

Down the Rabbit Hole-Considerations for Ingested Foreign Bodies

Jerry Brown,Molly Kidder,Abigail Fabbrini,Jonathan deVries,Jason Robertson,Nicole Chandler,Michael Wilsey 대한소아소화기영양학회 2019 Pediatric gastroenterology, hepatology & nutrition Vol.22 No.6

We report the case of a seven-year-old boy with an ingested foreign body, which was retained within the appendix for a known duration of ten months, ultimately requiring appendectomy. The ingested foreign body was incidentally discovered by abdominal x-ray at an emergency room visit for constipation. Despite four bowel cleanouts, subsequent x-rays showed persistence of the foreign body in the right lower quadrant. While the patient did not have signs or symptoms of acute appendicitis, laparoscopic appendectomy was performed due to the risk of this foreign body causing appendicitis in the future. A small metallic object was found within the appendix upon removal. This case highlights the unique challenge presented by foreign body ingestions in non-verbal or developmentally challenged children and the importance of further diagnostic workup when concerns arise for potential retained foreign bodies.

IGRINS SPECTROSCOPY OF CLASS I SOURCES: IRAS 03445+3242 AND IRAS 04239+2436

Lee, Seokho,Lee, Jeong-Eun,Park, Sunkyung,Lee, Jae-Joon,Kidder, Benjamin,Mace, Gregory N.,Jaffe, Daniel T. American Astronomical Society 2016 The Astrophysical journal Vol.826 No.2

<P>We have detected molecular and atomic line emission from the hot and warm disks of two Class I sources, IRAS 03445+3242 and IRAS 04239+2436, using the high-resolution Immersion GRating INfrared Spectrograph (IGRINS). CO overtone band transitions and near-IR lines of Na I and Ca I, all in emission, trace the hot inner disk, while CO rovibrational absorption spectra of the first overtone transition trace the warm gas within the inner few AU of the disk. The emission-line profiles for both sources show evidence for Keplerian disks. A thin Keplerian disk with power-law temperature and column density profiles with a projected rotational velocity of similar to 60-75 km s(-1) and a gas temperature of similar to 3500 K at the innermost annulus can reproduce the CO overtone band emission. Na I and Ca I emission lines also arise from this disk, but they show complicated line features possibly affected by photospheric absorption lines. Multi-epoch observations show asymmetric variations of the line profiles on one-year (CO overtone bandhead and atomic lines for IRAS 03445+3242) or on one-day (atomic lines for IRAS 04239+2436) timescales, implying non-axisymmetric features in disks. The narrow CO rovibrational absorption spectra (v = 0 -> 2) indicate that both warm (>150 K) and cold (similar to 20-30 K) CO gas are present along the line of sight to the inner disk. This study demonstrates the power of IGRINS as a tool for studies of the sub-AU-scale hot and AU-scale warm protoplanetary disks with its simultaneous coverage of the full H and K bands with high spectral resolution (R = 45,000) allowing many aspects of the sources to be investigated at once.</P>

Characterizing TW Hydra

Sokal, Kimberly R.,Deen, Casey P.,Mace, Gregory N.,Lee, Jae-Joon,Oh, Heeyoung,Kim, Hwihyun,Kidder, Benjamin T.,Jaffe, Daniel T. American Astronomical Society 2018 The Astrophysical journal Vol.853 No.2

<P>At 60 pc, TW Hydra (TW Hya) is the closest example of a star with a gas-rich protoplanetary disk, though TW Hya may be relatively old (3-15 Myr). As such, TW Hya is especially appealing for testing our understanding of the interplay between stellar and disk evolution. We present a high-resolution near-infrared spectrum of TW Hya obtained with the Immersion GRating INfrared Spectrometer (IGRINS) to re-evaluate the stellar parameters of TW Hya. We compare these data to synthetic spectra of magnetic stars produced by MoogStokes, and use sensitive spectral line profiles to probe the effective temperature, surface gravity, and magnetic field. A model with T-eff = 3800 K, log g = 4.2, and B = 3.0 kG best fits the near-infrared spectrum of TW Hya. These results correspond to a spectral type of M0.5 and an age of 8 Myr, which is well past the median life of gaseous disks.</P>