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      저자 : Sharon Brown (검색결과 2 건)
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        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.

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        Using Shoreline Video Assessment for Coastal Planning and Restoration in the Context of Climate Change in Kien Giang, Vietnam

        Chu Van Cuong,Michael Russell,Sharon Brown,Peter Dart 한국해양과학기술원 2015 Ocean science journal Vol.50 No.2

        Kien Giang, bordering Cambodia in the Mekong River Delta, is one of the two most vulnerable provinces in the region to coastal erosion and flooding. Coastal protection can conflict with current land use and economic development activities. The conditions of the mangrove forest and mainland coastline of the Kien Giang province were assessed using the Shoreline Video Assessment Method (SVAM) backed up with information from satellite images. Half of the 206 km Kien Giang coastline has been eroded or is being eroded. Protective mangrove forests naturally occurred in 74% of the coastline but have been under threat from illegal cutting, erosion and coastal retreat. Accurate information on the state of the coastline and mangrove forest health provided invaluable data for developing a new coastal rehabilitation plan to guard against future sea level rise. In contrast to the current boundary management of land and natural resources, this plan divided the provincial coastline into 19 sections based on the landscape condition and exposure to erosion. Priority strategic actions for erosion management, mangrove restoration and sustainable livelihood development for local communities for each section of coast were developed based on an integrated cross sectoral approach and practical experience in the Conservation and Development of the Kien Giang Biosphere Reserve Project.

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