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Brossier DW, Goyer I, Morice C, Alsohime F, Mayberry HF, Porcheret F, Tume LN, Valla FV. How to follow the guidelines, when the appropriate fluid is missing? Eur J Pediatr 2024:10.1007/s00431-024-05514-6. [PMID: 38498239 DOI: 10.1007/s00431-024-05514-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/23/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024]
Abstract
Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. Recently paediatric societies have produced evidence-based practice guidelines that recommend the use of balanced isotonic fluid when prescribing IV-MFT in both acute and critical paediatric care. Unfortunately, the applicability of these guidelines could be called into question when a ready-to-use glucose-containing balanced isotonic fluid is not available. The main objective of this study was to describe the availability of glucose-containing balanced isotonic fluids in European and Middle Eastern paediatric acute and critical care settings. This work is an ancillary study of the survey dedicated to IV-MFT practices in the paediatric acute and critical care settings in Europe and Middle East, a cross-sectional electronic 27-item survey, emailed in April-May 2021 to paediatric critical care physicians across 34 European and Middle East countries. The survey was developed by an expert multi-professional panel within the European Society of Peadiatric and Neonatal Intensive Care (ESPNIC). Balanced isotonic fluid with glucose 5% was available for only 32/153 (21%) responders. Balanced isotonic fluid with glucose 5% was consistently available in the UK (90%) but not available in France, Greece, The Netherlands and Turkey. Conclusion: Ready-to-use isotonic balanced IV solutions containing glucose in sufficient amount exist but are inconsistently available throughout Europe. National and European Medication Safety Incentives should guarantee the availability of the most appropriate and safest IV-MFT solution for all children. What is Known: • Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. • Balanced isotonic fluid is recommended when prescribing IV-MFT in both acute and critical paediatric care. What is New: • Balanced isotonic fluid with glucose 5% is available for less than 25% of the prescribers in Europe and the Middle East. Availability of balanced isotonic fluid with glucose 5% varies from one country to another but can also be inconsistent within the same country. • Clinicians who have access to a ready-to-use balanced isotonic fluid with glucose 5% are more likely to consider its use than clinicians who do not have access to such an IV solution.
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Affiliation(s)
- David W Brossier
- CHU de Caen, Pediatric Intensive Care Unit, 14000, Caen, France.
- Medical School, Université Caen Normandie, 14000, Caen, France.
- Université de Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, 59000, Lille, France.
- CHU Sainte Justine Research Center, Montréal, Canada.
| | - Isabelle Goyer
- CHU de Caen, Department of Pharmacy, 14000, Caen, France
| | - Claire Morice
- Pediatric Intensive Care, University Hospital of Geneva, Geneva, Switzerland
| | - Fahad Alsohime
- Pediatric Intensive Care, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Huw F Mayberry
- Pediatric Intensive Care Unit, Alder Hey Childrens Hospital, Liverpool, UK
| | - Florence Porcheret
- Department of Pediatric Nephrology, CHU de Nantes, 44000, Nantes, France
| | - Lyvonne N Tume
- Pediatric Intensive Care Unit, Alder Hey Childrens Hospital, Liverpool, UK
- Faculty of Heath Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Frederic V Valla
- Faculty of Heath Social Care & Medicine, Edge Hill University, Ormskirk, UK
- Hospices Civils de Lyon, Pediatric Intensive Care, 69000, Lyon, France
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2
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Al-Eyadhy A, Almazyad M, Hasan G, AlKhudhayri N, AlSaeed AF, Habib M, Alhaboob AAN, AlAyed M, AlSehibani Y, Alsohime F, Alabdulhafid M, Temsah MH. Outcomes of Cardiopulmonary Resuscitation in the Pediatric Intensive Care of a Tertiary Center. J Pediatr Intensive Care 2023; 12:303-311. [PMID: 37970137 PMCID: PMC10631842 DOI: 10.1055/s-0041-1733855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/04/2021] [Indexed: 10/20/2022] Open
Abstract
Understanding the factors affecting survival and modifying the preventable factors may improve patient outcomes following cardiopulmonary resuscitation (CPR). The aim of this study was to assess the prevalence and outcomes of cardiac arrest and CPR events in a tertiary pediatric intensive care unit (PICU). Outcomes of interest were the return of spontaneous circulation (ROSC) lasting more than 20 minutes, survival for 24 hours post-CPR, and survival to hospital discharge. We analyzed data from the PICU CPR registry from January 1, 2011 to January 1, 2018. All patients who underwent at least 2 minutes of CPR in the PICU were included. CPR was administered in 65 PICU instances, with a prevalence of 1.85%. The mean patient age was 32.7 months. ROSC occurred in 38 (58.5%) patients, 30 (46.2%) achieved 24-hour survival, and 21 (32.3%) survived to hospital discharge. Younger age ( p < 0.018), respiratory cause ( p < 0.001), bradycardia ( p < 0.018), and short duration of CPR ( p < 0.001) were associated with better outcomes, while sodium bicarbonate, norepinephrine, and vasopressin were associated with worse outcome ( p < 0.009). The off-hour CPR had no impact on the outcome. The patients' cumulative predicted survival declined by an average of 8.7% for an additional 1 minute duration of CPR ( p = 0.001). The study concludes that the duration of CPR, therefore, remains one of the crucial factors determining CPR outcomes and needs to be considered in parallel with the guideline emphasis on CPR quality. The lower survival rate post-ROSC needs careful consideration during parental counseling. Better anticipation and prevention of CPR remain ongoing challenges.
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Affiliation(s)
- Ayman Al-Eyadhy
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Almazyad
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Gamal Hasan
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Pediatrics, Pediatric Critical Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | | | - Mohammed Habib
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali A. N. Alhaboob
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed AlAyed
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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3
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Brossier DW, Tume LN, Briant AR, Jotterand Chaparro C, Moullet C, Rooze S, Verbruggen SCAT, Marino LV, Alsohime F, Beldjilali S, Chiusolo F, Costa L, Didier C, Ilia S, Joram NL, Kneyber MCJ, Kühlwein E, Lopez J, López-Herce J, Mayberry HF, Mehmeti F, Mierzewska-Schmidt M, Miñambres Rodríguez M, Morice C, Pappachan JV, Porcheret F, Reis Boto L, Schlapbach LJ, Tekguc H, Tziouvas K, Parienti JJ, Goyer I, Valla FV. Correction: ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis. Intensive Care Med 2023; 49:1151-1153. [PMID: 37488304 PMCID: PMC10499677 DOI: 10.1007/s00134-023-07119-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Affiliation(s)
- David W. Brossier
- Pediatric Intensive Care, Medical School, Université Caen Normandie, CHU de Caen, Caen, France
| | - Lyvonne N. Tume
- Pediatric Intensive Care Unit Alder Hey Children’s Hospital, Faculty of Health, Social Care and Medicine, Edge Hill University, Liverpool, Ormskirk, UK
| | - Anais R. Briant
- Department of Biostatistics, CHU de Caen, 14000 Caen, France
| | - Corinne Jotterand Chaparro
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Bureau d’Echange des Savoirs pour des praTiques Exemplaires de Soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
| | - Clémence Moullet
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Shancy Rooze
- Pediatric Intensive Care, HUDERF, Brussels, Belgium
| | | | - Luise V. Marino
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Fahad Alsohime
- Pediatric Intensive Care, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sophie Beldjilali
- Pediatric Intensive Care, Assistance Publique Hopitaux de Marseille, Marseille, France
| | - Fabrizio Chiusolo
- Pediatric Intensive Care, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Leonardo Costa
- Pediatric Intensive Care, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Capucine Didier
- Pediatric Intensive Care, Hospices Civils de Lyon, Lyon, France
| | - Stavroula Ilia
- Pediatric Intensive Care, Medical School, University Hospital, University of Crete, Heraklion, Greece
| | | | - Martin C. J. Kneyber
- Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children’s Hospital, Critical Care, Anaesthesiology, Peri-Operative and Emergency Medicine (CAPE), University of Groningen, Groningen, the Netherlands
| | - Eva Kühlwein
- Department of Intensive Care and Neonatology, and Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Jorge Lopez
- Pediatric Intensive Care, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Jesus López-Herce
- Pediatric Intensive Care, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Huw F. Mayberry
- Pediatric Intensive Care, Alder Hey Childrens Hospital, Liverpool, UK
| | - Fortesa Mehmeti
- Pediatric Intensive Care, University Hospital of Geneva, Geneva, Switzerland
| | | | | | - Claire Morice
- Pediatric Intensive Care, University Hospital of Geneva, Geneva, Switzerland
| | - John V. Pappachan
- Pediatric Intensive Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Leonor Reis Boto
- Pediatric Intensive Care, Departament of Pediatrics, Faculdade de Medicina, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Universidade de Lisboa, Lisbon, Portugal
| | - Luregn J. Schlapbach
- Department of Intensive Care and Neonatology, and Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Hakan Tekguc
- Pediatric Intensive Care, Dr. Burhan Nalbantoglu State Hospital, Nicosia, North Cyprus Cyprus
| | | | - Jean-Jacques Parienti
- Department of Biostatistics, CHU de Caen, Université Caen Normandie, INSERM U1311 DYNAMICURE, 14000 Caen, France
| | | | - Frederic V. Valla
- Pediatric Intensive Care, Hospices Civils de Lyon, Lyon, France
- Service de Réanimation Pédiatrique, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69500 Bron, France
| | - the Metabolism Endocrinology and Nutrition section of the European Society of Pediatric and Neonatal Intensive Care (ESPNIC)
- Pediatric Intensive Care, Medical School, Université Caen Normandie, CHU de Caen, Caen, France
- Pediatric Intensive Care Unit Alder Hey Children’s Hospital, Faculty of Health, Social Care and Medicine, Edge Hill University, Liverpool, Ormskirk, UK
- Department of Biostatistics, CHU de Caen, 14000 Caen, France
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Bureau d’Echange des Savoirs pour des praTiques Exemplaires de Soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
- Pediatric Intensive Care, HUDERF, Brussels, Belgium
- Pediatric Intensive Care, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Pediatric Intensive Care, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care, Assistance Publique Hopitaux de Marseille, Marseille, France
- Pediatric Intensive Care, Bambino Gesù Children’s Hospital, Rome, Italy
- Pediatric Intensive Care, S. Orsola-Malpighi University Hospital, Bologna, Italy
- Pediatric Intensive Care, Hospices Civils de Lyon, Lyon, France
- Pediatric Intensive Care, Medical School, University Hospital, University of Crete, Heraklion, Greece
- Moi Teaching and Referral Hospital, Eldoret, Kenya
- Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children’s Hospital, Critical Care, Anaesthesiology, Peri-Operative and Emergency Medicine (CAPE), University of Groningen, Groningen, the Netherlands
- Department of Intensive Care and Neonatology, and Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Pediatric Intensive Care, Gregorio Marañón General University Hospital, Madrid, Spain
- Pediatric Intensive Care, Alder Hey Childrens Hospital, Liverpool, UK
- Pediatric Intensive Care, University Hospital of Geneva, Geneva, Switzerland
- Department of Paediatric Anaesthesiology and Intensive Therapy, Medical University of Warsaw, Warsaw, Poland
- Pediatric Intensive Care, Virgen de la Arrixaca Hospital, Murcia, Spain
- Pediatric Intensive Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Department of Pediatric Nephrology, CHU de Nantes, Nantes, France
- Pediatric Intensive Care, Departament of Pediatrics, Faculdade de Medicina, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Universidade de Lisboa, Lisbon, Portugal
- Department of Intensive Care and Neonatology, and Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
- Pediatric Intensive Care, Dr. Burhan Nalbantoglu State Hospital, Nicosia, North Cyprus Cyprus
- Pediatric Intensive Care, Aglaia Kyriakou Children’s Hospital, Athens, Greece
- Department of Biostatistics, CHU de Caen, Université Caen Normandie, INSERM U1311 DYNAMICURE, 14000 Caen, France
- Department of Pharmacy, CHU de Caen, Caen, France
- Service de Réanimation Pédiatrique, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69500 Bron, France
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4
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Monies D, Goljan E, Assoum M, Albreacan M, Binhumaid F, Subhani S, Boureggah A, Hashem M, Abdulwahab F, Abuyousef O, Temsah MH, Alsohime F, Kelaher J, Abouelhoda M, Meyer BF, Alkuraya FS. The clinical utility of rapid exome sequencing in a consanguineous population. Genome Med 2023; 15:44. [PMID: 37344829 DOI: 10.1186/s13073-023-01192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND The clinical utility of exome sequencing is now well documented. Rapid exome sequencing (RES) is more resource-intensive than regular exome sequencing and is typically employed in specialized clinical settings wherein urgent molecular diagnosis is thought to influence acute management. Studies on the clinical utility of RES have been largely limited to outbred populations. METHODS Here, we describe our experience with rapid exome sequencing (RES) in a highly consanguineous population. Clinical settings included intensive care units, prenatal cases approaching the legal cutoff for termination, and urgent transplant decisions. RESULTS A positive molecular finding (a pathogenic or likely pathogenic variant that explains the phenotype) was observed in 80 of 189 cases (42%), while 15 (8%) and 94 (50%) received ambiguous (variant of uncertain significance (VUS)) and negative results, respectively. The consanguineous nature of the study population gave us an opportunity to observe highly unusual and severe phenotypic expressions of previously reported genes. Clinical utility was observed in nearly all (79/80) cases with positive molecular findings and included management decisions, prognostication, and reproductive counseling. Reproductive counseling is a particularly important utility in this population where the overwhelming majority (86%) of identified variants are autosomal recessive, which are more actionable in this regard than the de novo variants typically reported by RES elsewhere. Indeed, our cost-effectiveness analysis shows compelling cost savings in the study population. CONCLUSIONS This work expands the diversity of environments in which RES has a demonstrable clinical utility.
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Affiliation(s)
- Dorota Monies
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ewa Goljan
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mirna Assoum
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Muna Albreacan
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Faisal Binhumaid
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Shazia Subhani
- Department of Computational Science, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdulmlik Boureggah
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mais Hashem
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, MBC-26, PO Box 3354, Riyadh, 11211, Saudi Arabia
| | - Firdous Abdulwahab
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, MBC-26, PO Box 3354, Riyadh, 11211, Saudi Arabia
| | - Omar Abuyousef
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, MBC-26, PO Box 3354, Riyadh, 11211, Saudi Arabia
| | - Mohamad H Temsah
- Department of Pediatrics, Pediatric Critical Care Unit, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Department of Pediatrics, Pediatric Critical Care Unit, King Khalid University Hospital and College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - James Kelaher
- General Corporate Consultancy Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohamed Abouelhoda
- Department of Computational Science, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
| | - Brian F Meyer
- Department of Clinical Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, MBC-26, PO Box 3354, Riyadh, 11211, Saudi Arabia.
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5
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Almazyad M, Aljofan F, Abouammoh NA, Muaygil R, Malki KH, Aljamaan F, Alturki A, Alayed T, Alshehri SS, Alrbiaan A, Alsatrawi M, Temsah HA, Alsohime F, Alhaboob AA, Alabdulhafid M, Jamal A, Alhasan K, Al-Eyadhy A, Temsah MH. Enhancing Expert Panel Discussions in Pediatric Palliative Care: Innovative Scenario Development and Summarization With ChatGPT-4. Cureus 2023; 15:e38249. [PMID: 37122982 PMCID: PMC10143975 DOI: 10.7759/cureus.38249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/02/2023] Open
Abstract
This study presents a novel approach to enhance expert panel discussions in a medical conference through the use of ChatGPT-4 (Generative Pre-trained Transformer version 4), a recently launched powerful artificial intelligence (AI) language model. We report on ChatGPT-4's ability to optimize and summarize the medical conference panel recommendations of the first Pan-Arab Pediatric Palliative Critical Care Hybrid Conference, held in Riyadh, Saudi Arabia. ChatGPT-4 was incorporated into the discussions in two sequential phases: first, scenarios were optimized by the AI model to stimulate in-depth conversations; second, the model identified, summarized, and contrasted key themes from the panel and audience discussions. The results suggest that ChatGPT-4 effectively facilitated complex do-not-resuscitate (DNR) conflict resolution by summarizing key themes such as effective communication, collaboration, patient and family-centered care, trust, and ethical considerations. The inclusion of ChatGPT-4 in pediatric palliative care panel discussions demonstrated potential benefits for enhancing critical thinking among medical professionals. Further research is warranted to validate and broaden these insights across various settings and cultures.
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Affiliation(s)
- Mohammed Almazyad
- Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, Riyadh, SAU
| | - Fahad Aljofan
- Pediatric Intensive Care Unit, Pediatric Department, King Faisal Specialist Hospital & Research Centre, Riyadh, SAU
| | - Noura A Abouammoh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Ruaim Muaygil
- Medical Education Department, College of Medicine, King Saud University, Riyadh, SAU
| | - Khalid H Malki
- Department of Otolaryngology, College of Medicine, King Saud University, Riyadh, SAU
| | - Fadi Aljamaan
- Critical Care Department, College of Medicine, King Saud University, Riyadh, SAU
| | - Abdullah Alturki
- Pediatric Intensive Care Unit, Pediatric Department, King Faisal Specialist Hospital & Research Centre, Riyadh, SAU
| | - Tareq Alayed
- Pediatric Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, SAU
| | - Saleh S Alshehri
- Pediatric Intensive Care Unit, King Saud Medical City, Riyadh, SAU
| | - Abdullah Alrbiaan
- Critical Care Department, King Faisal Specialist Hospital & Research Centre, Riyadh, SAU
| | - Mohammed Alsatrawi
- Pediatric Critical Care Medicine, King Saud University Medical City, Riyadh, SAU
| | - Hazar A Temsah
- Biomedical Engineering Department, Faculty of Electrical and Computer Engineering, Beirut Arab University, Beirut, LBN
| | - Fahad Alsohime
- Pediatric Critical Care Department, King Saud University, Riyadh, SAU
| | - Ali A Alhaboob
- Department of Pediatrics, King Saud University, Riyadh, SAU
| | - Majed Alabdulhafid
- Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, Riyadh, SAU
| | - Amr Jamal
- Department of Family and Community Medicine, King Saud University, Riyadh, SAU
| | - Khalid Alhasan
- Department of Pediatric Nephrology, King Saud University, Riyadh, SAU
| | - Ayman Al-Eyadhy
- Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, Riyadh, SAU
- Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, SAU
| | - Mohamad-Hani Temsah
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, SAU
- Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, Riyadh, SAU
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6
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Lévy R, Gothe F, Momenilandi M, Magg T, Materna M, Peters P, Raedler J, Philippot Q, Rack-Hoch AL, Langlais D, Bourgey M, Lanz AL, Ogishi M, Rosain J, Martin E, Latour S, Vladikine N, Distefano M, Khan T, Rapaport F, Schulz MS, Holzer U, Fasth A, Sogkas G, Speckmann C, Troilo A, Bigley V, Roppelt A, Dinur-Schejter Y, Toker O, Bronken Martinsen KH, Sherkat R, Somekh I, Somech R, Shouval DS, Kühl JS, Ip W, McDermott EM, Cliffe L, Ozen A, Baris S, Rangarajan HG, Jouanguy E, Puel A, Bustamante J, Alyanakian MA, Fusaro M, Wang Y, Kong XF, Cobat A, Boutboul D, Castelle M, Aguilar C, Hermine O, Cheminant M, Suarez F, Yildiran A, Bousfiha A, Al-Mousa H, Alsohime F, Cagdas D, Abraham RS, Knutsen AP, Fevang B, Bhattad S, Kiykim A, Erman B, Arikoglu T, Unal E, Kumar A, Geier CB, Baumann U, Neven B, Rohlfs M, Walz C, Abel L, Malissen B, Marr N, Klein C, Casanova JL, Hauck F, Béziat V. Human CARMIL2 deficiency underlies a broader immunological and clinical phenotype than CD28 deficiency. J Exp Med 2023; 220:e20220275. [PMID: 36515678 PMCID: PMC9754768 DOI: 10.1084/jem.20220275] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/17/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022] Open
Abstract
Patients with inherited CARMIL2 or CD28 deficiency have defective T cell CD28 signaling, but their immunological and clinical phenotypes remain largely unknown. We show that only one of three CARMIL2 isoforms is produced and functional across leukocyte subsets. Tested mutant CARMIL2 alleles from 89 patients and 52 families impair canonical NF-κB but not AP-1 and NFAT activation in T cells stimulated via CD28. Like CD28-deficient patients, CARMIL2-deficient patients display recalcitrant warts and low blood counts of CD4+ and CD8+ memory T cells and CD4+ TREGs. Unlike CD28-deficient patients, they have low counts of NK cells and memory B cells, and their antibody responses are weak. CARMIL2 deficiency is fully penetrant by the age of 10 yr and is characterized by numerous infections, EBV+ smooth muscle tumors, and mucocutaneous inflammation, including inflammatory bowel disease. Patients with somatic reversions of a mutant allele in CD4+ T cells have milder phenotypes. Our study suggests that CARMIL2 governs immunological pathways beyond CD28.
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Affiliation(s)
- Romain Lévy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- Pediatric Immunology-Hematology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Florian Gothe
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Mana Momenilandi
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Thomas Magg
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Marie Materna
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Philipp Peters
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Johannes Raedler
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Quentin Philippot
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Anita Lena Rack-Hoch
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - David Langlais
- Dept. of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Mathieu Bourgey
- Dept. of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Anna-Lisa Lanz
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Masato Ogishi
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Jérémie Rosain
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Emmanuel Martin
- Imagine Institute, University of Paris-Cité, Paris, France
- Laboratory of Lymphocyte Activation and Susceptibility to EBV infection, INSERM UMR 1163, Paris, France
| | - Sylvain Latour
- Imagine Institute, University of Paris-Cité, Paris, France
- Laboratory of Lymphocyte Activation and Susceptibility to EBV infection, INSERM UMR 1163, Paris, France
| | - Natasha Vladikine
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Marco Distefano
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | | | - Franck Rapaport
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Marian S. Schulz
- Dept. of Women and Child Health, Hospital for Children and Adolescents, Hospitals University of Leipzig, Leipzig, Germany
| | - Ursula Holzer
- Children’s Hospital, University of Tübingen, Tübingen, Germany
| | - Anders Fasth
- Dept. of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- The Queen Silvia Children’s Hospital, Gothenburg, Sweden
| | - Georgios Sogkas
- Dept. of Immunology and Rheumatology, Medical School Hannover, Hanover, Germany
| | - Carsten Speckmann
- Dept. of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology and Center for Chronic Immunodeficiency (CCI), Institute for Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Arianna Troilo
- Dept. of Rheumatology and CCI for Chronic Immunodeficiency, Division of Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Venetia Bigley
- Translational and Clinical Research Institute and NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Anna Roppelt
- Dept. of Immunology, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Yael Dinur-Schejter
- Dept. of Bone Marrow Transplantation, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Ori Toker
- Faculty of Medicine, Hebrew University of Jerusalem, The Allergy and Clinical Immunology Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | | | - Roya Sherkat
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ido Somekh
- Dept. of Pediatric Hematology/Oncology, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
| | - Raz Somech
- The Institute of Gastroenterology, Nutrition and Liver diseases, Schneider Children's Medical Center of Israel, Petah Tikva, Israel, and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dror S. Shouval
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; The Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Hospital, Petach-Tikva, Israel; Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Jörn-Sven Kühl
- Dept. of Women and Child Health, Hospital for Children and Adolescents, Hospitals University of Leipzig, Leipzig, Germany
| | - Winnie Ip
- Dept. of Immunology, Great Ormond Street Hospital, London, UK
| | | | - Lucy Cliffe
- Dept. of Pediatrics, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Ahmet Ozen
- Dept. of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey
| | - Safa Baris
- Dept. of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey
| | - Hemalatha G. Rangarajan
- Division of Hematology, Oncology and Bone Marrow Transplant, Dept. of Pediatrics, Nationwide Children’s Hospital, Columbus, OH
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
- Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, Paris, France
| | | | - Mathieu Fusaro
- Imagine Institute, University of Paris-Cité, Paris, France
- Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, Paris, France
| | - Yi Wang
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Xiao-Fei Kong
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Aurélie Cobat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - David Boutboul
- Dept. of Clinical Immunology, AP-HP, Saint-Louis Hospital, Paris, France
| | - Martin Castelle
- Imagine Institute, University of Paris-Cité, Paris, France
- Pediatric Immunology-Hematology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Claire Aguilar
- Necker Pasteur Center for Infectious Diseases and Tropical Medicine, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Olivier Hermine
- Imagine Institute, University of Paris-Cité, Paris, France
- Dept. of Clinical Hematology, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Morgane Cheminant
- Imagine Institute, University of Paris-Cité, Paris, France
- Dept. of Clinical Hematology, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Felipe Suarez
- Imagine Institute, University of Paris-Cité, Paris, France
- Dept. of Clinical Hematology, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Alisan Yildiran
- Dept. of Pediatric Immunology and Allergy, Ondokuz Mayis University Medical School, Samsun, Turkey
| | - Aziz Bousfiha
- Clinical Immunology, Inflammation and Auto-immunity Laboratory, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Casablanca, Morocco
| | - Hamoud Al-Mousa
- Translational Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Pediatric Intensive Care Unit, Dept. of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Immunology Research Laboratory, Dept. of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Deniz Cagdas
- Section of Pediatric Immunology, Hacettepe University, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - Roshini S. Abraham
- Dept. of Pathology and Laboratory Medicine, Nationwide Children’s Hospital, Columbus, OH
| | - Alan P. Knutsen
- Pediatric Allergy and Immunology, Cardinal Glennon Children’s Hospital, St. Louis, MO
| | - Borre Fevang
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
| | - Sagar Bhattad
- Dept. of Pediatrics, Aster CMI Hospital, Bangalore, India
| | - Ayca Kiykim
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Pediatric Immunology and Allergy, Istanbul, Turkey
| | - Baran Erman
- Institute of Child Health, Hacettepe University, Ankara, Turkey
- Can Sucak Research Laboratory for Translational Immunology, Hacettepe University, Ankara, Turkey
| | - Tugba Arikoglu
- Dept. of Pediatrics, Division of Pediatric Allergy and Immunology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ekrem Unal
- Division of Pediatric Hematology Oncology, Dept. of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Ashish Kumar
- Division of Bone Marrow Transplantation and Immune Deficiency, Dept. of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Christoph B. Geier
- Dept. of Rheumatology and CCI for Chronic Immunodeficiency, Division of Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ulrich Baumann
- Dept. of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany
| | - Bénédicte Neven
- Imagine Institute, University of Paris-Cité, Paris, France
- Pediatric Immunology-Hematology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Meino Rohlfs
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Christoph Walz
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Bernard Malissen
- Centre d’Immunologie de Marseille-Luminy, Aix-Marseille Université, INSERM, CNRS, Marseille, France
| | - Nico Marr
- Research Branch, Sidra Medicine, Doha, Qatar
| | - Christoph Klein
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
- Howard Hughes Medical Institute, New York, NY
- Dept. of Pediatrics, Necker Hospital for Sick Children, Paris, France
| | - Fabian Hauck
- Dept. of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Vivien Béziat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
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7
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Korol CB, Belkaya S, Alsohime F, Lorenzo L, Boisson-Dupuis S, Brancale J, Neehus AL, Vilarinho S, Zobaida A, Halwani R, Al-Muhsen S, Casanova JL, Jouanguy E. Fulminant Viral Hepatitis in Two Siblings with Inherited IL-10RB Deficiency. J Clin Immunol 2023; 43:406-420. [PMID: 36308662 PMCID: PMC9892130 DOI: 10.1007/s10875-022-01376-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/28/2022] [Indexed: 02/05/2023]
Abstract
Fulminant viral hepatitis (FVH) caused by hepatitis A virus (HAV) is a life-threatening disease that typically strikes otherwise healthy individuals. The only known genetic etiology of FVH is inherited IL-18BP deficiency, which unleashes IL-18-dependent lymphocyte cytotoxicity and IFN-γ production. We studied two siblings who died from a combination of early-onset inflammatory bowel disease (EOIBD) and FVH due to HAV. The sibling tested was homozygous for the W100G variant of IL10RB previously described in an unrelated patient with EOIBD. We show here that the out-of-frame IL10RB variants seen in other EOIBD patients disrupt cellular responses to IL-10, IL-22, IL-26, and IFN-λs in overexpression conditions and in homozygous cells. By contrast, the impact of in-frame disease-causing variants varies between cases. When overexpressed, the W100G variant impairs cellular responses to IL-10, but not to IL-22, IL-26, or IFN-λ1, whereas cells homozygous for W100G do not respond to IL-10, IL-22, IL-26, or IFN-λ1. As IL-10 is a potent antagonist of IFN-γ in phagocytes, these findings suggest that the molecular basis of FVH in patients with IL-18BP or IL-10RB deficiency may involve excessive IFN-γ activity during HAV infections of the liver. Inherited IL-10RB deficiency, and possibly inherited IL-10 and IL-10RA deficiencies, confer a predisposition to FVH, and patients with these deficiencies should be vaccinated against HAV and other liver-tropic viruses.
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Affiliation(s)
- Cecilia B Korol
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, Paris Cité University, Paris, France
| | - Serkan Belkaya
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Department of Molecular Biology and Genetics, Ihan Dogramaci Bilkent University, Ankara, Turkey
| | - Fahad Alsohime
- Immunology Research Laboratory, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Lazaro Lorenzo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, Paris Cité University, Paris, France
| | - Stéphanie Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, Paris Cité University, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Joseph Brancale
- Department of Internal Medicine, Section of Digestive Diseases, and Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Anna-Lena Neehus
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, Paris Cité University, Paris, France
| | - Silvia Vilarinho
- Department of Internal Medicine, Section of Digestive Diseases, and Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Alsum Zobaida
- Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Rabih Halwani
- Department of Clinical Sciences, College of Medicine, Sharjah Institute for Medical Research (SIMR), University of Sharjah, Sharjah, United Arab Emirates
| | - Saleh Al-Muhsen
- Immunology Research Laboratory, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, Paris Cité University, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Howard Hughes Medical Institute, New York City, NY, USA
- Department of Pediatrics, Necker Hospital for Sick Children, Paris, France
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.
- Imagine Institute, Paris Cité University, Paris, France.
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
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8
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Alsohime F, Temsah MH, Alotaibi RM, Alhalabi RM, AlEnezy S, Yousef AA, Alzaydi AM, Inany HS, Al-Eyadhy A, Almazyad M, Alharbi A, Alsoqati AA, Andijani A, Abu Ghazal M, El Masri K, Doussouki M, Butt RF, Alshehri S, Alsatrawi M, Macarambon J, Hasan GM, Alsultan A. Presentations and outcomes of familial hemophagocytic lymphohistiocytosis in the pediatric intensive care units (PICUs). Front Pediatr 2023; 11:1152409. [PMID: 37144147 PMCID: PMC10151775 DOI: 10.3389/fped.2023.1152409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/30/2023] [Indexed: 05/06/2023] Open
Abstract
Objectives We aimed to describe Familial Hemophagocytic Lymphohistiocytosis (F-HLH) patients' clinical features, intensive care courses, and outcomes. Methods Multi-center retrospective cohort study of pediatric patients diagnosed with F-HLH from 2015 to 2020 in five tertiary centers in Saudi Arabia. Patients were classified as F-HLH based on their genetic confirmation of known mutation or on their clinical criteria, which include a constellation of abnormalities, early disease onset, recurrent HLH in the absence of other causes, or a family history of HLH. Results Fifty-eight patients (28 male, 30 female), with a mean age of 21.0 ± 33.9 months, were included. The most common principal diagnosis was hematological or immune dysfunction (39.7%), followed by cardiovascular dysfunction in 13 (22.4%) patients. Fever was the most common clinical presentation in 27.6%, followed by convulsions (13.8%) and bleeding (13.8%). There were 20 patients (34.5%) who had splenomegaly, and more than 70% of patients had hyperferritinemia >500 mg/dl, hypertriglyceridemia >150 mg/dl and hemophagocytosis in bone marrow biopsy. Compared to deceased patients 18 (31%), survivors had significantly lower PT (p = 041), bilirubin level of <34.2 mmol/L (p = 0.042), higher serum triglyceride level (p = 0.036), and lesser bleeding within the initial 6 h of admission (p = 0.004). Risk factors for mortality included requirements of higher levels of hemodynamic (61.1% vs. 17.5%, p = 0.001) and respiratory (88.9% vs. 37.5%, p < 0.001) support, and positive fungal cultures (p = 0.046). Conclusions Familial HLH still represents a challenge in the pediatric critical care setting. Earlier diagnosis and prompt initiation of appropriate treatment could improve F-HLH survival.
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Affiliation(s)
- Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
- Prince Abdullah bin Khaled Coeliac Disease Research Chair, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Mohamad-Hani Temsah
| | - Rawan M. Alotaibi
- College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Reham M. Alhalabi
- College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sarah AlEnezy
- College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Aly Abdelrahman Yousef
- Division of Pediatric Critical Care, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Pediatrics, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Abdullah Mohammed Alzaydi
- Division of Pediatric Critical Care, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Hussam Sameer Inany
- Division of Pediatric Critical Care, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ayman Al-Eyadhy
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohammed Almazyad
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali Alharbi
- Pediatric Critical Care Division, Specialized Children Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulaziz Abdullah Alsoqati
- Pediatric Critical Care Division, Specialized Children Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdurahman Andijani
- Pediatric Critical Care Division, Specialized Children Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Abu Ghazal
- Pediatric Critical Care Division, Specialized Children Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Kamal El Masri
- Pediatric Intensive Care Unit, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Maher Doussouki
- Pediatric Hematology & Oncology Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Raheel Farooq Butt
- Pediatric Critical Care Division, King Saud Medical City, Riyadh, Saudi Arabia
| | - Saleh Alshehri
- Pediatric Critical Care Division, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohammed Alsatrawi
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Jaramia Macarambon
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Gamal M. Hasan
- Pediatric Department, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
- Pediatric Department, Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Abdulrahman Alsultan
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Oncology Center, King Saud University Medical City, Riyadh, Saudi Arabia
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9
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Brossier DW, Tume LN, Briant AR, Jotterand Chaparro C, Moullet C, Rooze S, Verbruggen SCAT, Marino LV, Alsohime F, Beldjilali S, Chiusolo F, Costa L, Didier C, Ilia S, Joram NL, Kneyber MCJ, Kühlwein E, Lopez J, López-Herce J, Mayberry HF, Mehmeti F, Mierzewska-Schmidt M, Miñambres Rodríguez M, Morice C, Pappachan JV, Porcheret F, Reis Boto L, Schlapbach LJ, Tekguc H, Tziouvas K, Parienti JJ, Goyer I, Valla FV. ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis. Intensive Care Med 2022; 48:1691-1708. [PMID: 36289081 PMCID: PMC9705511 DOI: 10.1007/s00134-022-06882-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/01/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE Intravenous maintenance fluid therapy (IV-MFT) prescribing in acute and critically ill children is very variable among pediatric health care professionals. In order to provide up to date IV-MFT guidelines, the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) undertook a systematic review to answer the following five main questions about IV-MFT: (i) the indications for use (ii) the role of isotonic fluid (iii) the role of balanced solutions (iv) IV fluid composition (calcium, magnesium, potassium, glucose and micronutrients) and v) and the optimal amount of fluid. METHODS A multidisciplinary expert group within ESPNIC conducted this systematic review using the Scottish Intercollegiate Guidelines Network (SIGN) grading method. Five databases were searched for studies that answered these questions, in acute and critically children (from 37 weeks gestational age to 18 years), published until November 2020. The quality of evidence and risk of bias were assessed, and meta-analyses were undertaken when appropriate. A series of recommendations was derived and voted on by the expert group to achieve consensus through two voting rounds. RESULTS 56 papers met the inclusion criteria, and 16 recommendations were produced. Outcome reporting was inconsistent among studies. Recommendations generated were based on a heterogeneous level of evidence, but consensus within the expert group was high. "Strong consensus" was reached for 11/16 (69%) and "consensus" for 5/16 (31%) of the recommendations. CONCLUSIONS Key recommendations are to use isotonic balanced solutions providing glucose to restrict IV-MFT infusion volumes in most hospitalized children and to regularly monitor plasma electrolyte levels, serum glucose and fluid balance.
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Affiliation(s)
- David W Brossier
- Pediatric Intensive Care, Medical School, Université Caen Normandie, CHU de Caen, Caen, France
| | - Lyvonne N Tume
- Pediatric Intensive Care Unit Alder Hey Children's Hospital, Faculty of Health, Social Care and Medicine, Edge Hill University, Liverpool, Ormskirk, UK
| | - Anais R Briant
- Department of Biostatistics, CHU de Caen, 14000, Caen, France
| | - Corinne Jotterand Chaparro
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.,Bureau d'Echange des Savoirs pour des praTiques Exemplaires de Soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
| | - Clémence Moullet
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Shancy Rooze
- Pediatric Intensive Care, HUDERF, Brussels, Belgium
| | | | - Luise V Marino
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Fahad Alsohime
- Pediatric Intensive Care, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Sophie Beldjilali
- Pediatric Intensive Care, Assistance Publique Hopitaux de Marseille, Marseille, France
| | - Fabrizio Chiusolo
- Pediatric Intensive Care, Bambino Gesù Children's Hospital, Rome, Italy
| | - Leonardo Costa
- Pediatric Intensive Care, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Capucine Didier
- Pediatric Intensive Care, Hospices Civils de Lyon, Lyon, France
| | - Stavroula Ilia
- Pediatric Intensive Care, Medical School, University Hospital, University of Crete, Heraklion, Greece
| | | | - Martin C J Kneyber
- Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, Critical Care, Anaesthesiology, Peri-Operative and Emergency Medicine (CAPE), University of Groningen, Groningen, the Netherlands
| | - Eva Kühlwein
- Department of Intensive Care and Neonatology, and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Jorge Lopez
- Pediatric Intensive Care, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Jesus López-Herce
- Pediatric Intensive Care, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Huw F Mayberry
- Pediatric Intensive Care, Alder Hey Childrens Hospital, Liverpool, UK
| | - Fortesa Mehmeti
- Pediatric Intensive Care, University Hospital of Geneva, Geneva, Switzerland
| | | | | | - Claire Morice
- Pediatric Intensive Care, University Hospital of Geneva, Geneva, Switzerland
| | - John V Pappachan
- Pediatric Intensive Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Leonor Reis Boto
- Pediatric Intensive Care, Departament of Pediatrics, Faculdade de Medicina, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Universidade de Lisboa, Lisbon, Portugal
| | - Luregn J Schlapbach
- Department of Intensive Care and Neonatology, and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Hakan Tekguc
- Pediatric Intensive Care, Dr. Burhan Nalbantoglu State Hospital, Nicosia, North Cyprus, Cyprus
| | | | - Jean-Jacques Parienti
- Department of Biostatistics, CHU de Caen, Université Caen Normandie, INSERM U1311 DYNAMICURE, 14000, Caen, France
| | | | - Frederic V Valla
- Pediatric Intensive Care, Hospices Civils de Lyon, Lyon, France. .,Service de Réanimation Pédiatrique, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69500, Bron, France.
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10
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Ogishi M, Arias AA, Yang R, Han JE, Zhang P, Rinchai D, Halpern J, Mulwa J, Keating N, Chrabieh M, Lainé C, Seeleuthner Y, Ramírez-Alejo N, Nekooie-Marnany N, Guennoun A, Muller-Fleckenstein I, Fleckenstein B, Kilic SS, Minegishi Y, Ehl S, Kaiser-Labusch P, Kendir-Demirkol Y, Rozenberg F, Errami A, Zhang SY, Zhang Q, Bohlen J, Philippot Q, Puel A, Jouanguy E, Pourmoghaddas Z, Bakhtiar S, Willasch AM, Horneff G, Llanora G, Shek LP, Chai LY, Tay SH, Rahimi HH, Mahdaviani SA, Nepesov S, Bousfiha AA, Erdeniz EH, Karbuz A, Marr N, Navarrete C, Adeli M, Hammarstrom L, Abolhassani H, Parvaneh N, Al Muhsen S, Alosaimi MF, Alsohime F, Nourizadeh M, Moin M, Arnaout R, Alshareef S, El-Baghdadi J, Genel F, Sherkat R, Kiykim A, Yücel E, Keles S, Bustamante J, Abel L, Casanova JL, Boisson-Dupuis S. Impaired IL-23-dependent induction of IFN-γ underlies mycobacterial disease in patients with inherited TYK2 deficiency. J Exp Med 2022; 219:213456. [PMID: 36094518 PMCID: PMC9472563 DOI: 10.1084/jem.20220094] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 06/21/2022] [Accepted: 07/14/2022] [Indexed: 12/21/2022] Open
Abstract
Human cells homozygous for rare loss-of-expression (LOE) TYK2 alleles have impaired, but not abolished, cellular responses to IFN-α/β (underlying viral diseases in the patients) and to IL-12 and IL-23 (underlying mycobacterial diseases). Cells homozygous for the common P1104A TYK2 allele have selectively impaired responses to IL-23 (underlying isolated mycobacterial disease). We report three new forms of TYK2 deficiency in six patients from five families homozygous for rare TYK2 alleles (R864C, G996R, G634E, or G1010D) or compound heterozygous for P1104A and a rare allele (A928V). All these missense alleles encode detectable proteins. The R864C and G1010D alleles are hypomorphic and loss-of-function (LOF), respectively, across signaling pathways. By contrast, hypomorphic G996R, G634E, and A928V mutations selectively impair responses to IL-23, like P1104A. Impairment of the IL-23-dependent induction of IFN-γ is the only mechanism of mycobacterial disease common to patients with complete TYK2 deficiency with or without TYK2 expression, partial TYK2 deficiency across signaling pathways, or rare or common partial TYK2 deficiency specific for IL-23 signaling.
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Affiliation(s)
- Masato Ogishi
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Andrés Augusto Arias
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Primary Immunodeficiencies Group, University of Antioquia, Medellin, Colombia,School of Microbiology, University of Antioquia, Medellin, Colombia
| | - Rui Yang
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Ji Eun Han
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Peng Zhang
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Darawan Rinchai
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Joshua Halpern
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Jeanette Mulwa
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Narelle Keating
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Walter and Eliza Hall Institute of Medical Research, Department of Medical Biology, University of Melbourne, Melbourne, Australia
| | - Maya Chrabieh
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Candice Lainé
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Yoann Seeleuthner
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Noé Ramírez-Alejo
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Nioosha Nekooie-Marnany
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | | - Bernhard Fleckenstein
- Institute of Clinical and Molecular Virology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Sara S. Kilic
- Department of Pediatric Immunology and Rheumatology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - Yoshiyuki Minegishi
- Division of Molecular Medicine, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan
| | - Stephan Ehl
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Yasemin Kendir-Demirkol
- Department of Pediatric Genetics, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Flore Rozenberg
- Laboratory of Virology, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris, France
| | - Abderrahmane Errami
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Shen-Ying Zhang
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Qian Zhang
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Jonathan Bohlen
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Quentin Philippot
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Anne Puel
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Emmanuelle Jouanguy
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Zahra Pourmoghaddas
- Department of Pediatric Infectious Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Bakhtiar
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Child and Adolescent Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Andre M. Willasch
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Child and Adolescent Medicine, University Hospital Frankfurt, Frankfurt, Germany
| | - Gerd Horneff
- Center for Pediatric Rheumatology, Department of Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany,Medical Faculty, University of Cologne, Cologne, Germany
| | - Genevieve Llanora
- Division of Allergy and Immunology, Department of Paediatrics, Khoo Teck Puat - National University Children’s Medical Institute, National University Health System, Singapore
| | - Lynette P. Shek
- Division of Allergy and Immunology, Department of Paediatrics, Khoo Teck Puat - National University Children’s Medical Institute, National University Health System, Singapore,Department of Pediatrics, National University of Singapore, Singapore
| | - Louis Y.A. Chai
- Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore,Synthetic Biology for Clinical and Technological Innovation, Life Sciences Institute; Synthetic Biology Translational Research Program, National University of Singapore,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sen Hee Tay
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Division of Rheumatology, Department of Medicine, National University Hospital, Singapore
| | - Hamid H. Rahimi
- Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Alireza Mahdaviani
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Serdar Nepesov
- Department of Pediatric Allergy and Immunology, Istanbul Medipol University, Istanbul, Turkey
| | - Aziz A. Bousfiha
- Clinical Immunology Unit, Department of Pediatrics, King Hassan II University, Ibn-Rochd Hospital, Casablanca, Morocco
| | - Emine Hafize Erdeniz
- Division of Pediatric Infectious Diseases, Ondokuz Mayıs University, Samsun, Turkey
| | - Adem Karbuz
- Division of Pediatric Infectious Diseases, Okmeydani Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Carmen Navarrete
- Department of Immunology, Hospital de Niños Roberto del Río, Santiago de Chile, Chile
| | - Mehdi Adeli
- Division of Allergy and Immunology, Sidra Medicine/Hamad Medical Corp., Doha, Qatar
| | - Lennart Hammarstrom
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden,Beijing Genomics Institute, Shenzhen, China,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Abolhassani
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Parvaneh
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saleh Al Muhsen
- Immunology Research Laboratory, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed F. Alosaimi
- Immunology Research Laboratory, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Maryam Nourizadeh
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Moin
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Rand Arnaout
- Section of Allergy & Immunology, Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia,Al Faisal University, Riyadh, Saudi Arabia
| | - Saad Alshareef
- Section of Allergy & Immunology, Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | - Ferah Genel
- University of Health Sciences, Dr Behçet Uz Children’s Hospital, Division of Pediatric Immunology, Izmir, Turkey
| | - Roya Sherkat
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ayça Kiykim
- Pediatric Allergy and Immunology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Esra Yücel
- Division of Pediatric Allergy and Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sevgi Keles
- Division of Pediatric Allergy and Immunology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Jacinta Bustamante
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Center for the Study of Primary Immunodeficiencies, Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children, Paris, France
| | - Laurent Abel
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
| | - Jean-Laurent Casanova
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France,Howard Hughes Medical Institute, New York, NY,Deparment of Pediatrics, Necker Hospital for Sick Children, Paris, France
| | - Stéphanie Boisson-Dupuis
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY,Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, France,Paris Cité University, Imagine Institute, Paris, France
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11
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Al-Eyadhy A, Almazyad M, Hasan G, Almuhaideb Q, AbuDujain N, Alhaboob AAN, Alfawaz F, Alshenaifi S, Alfayez F, Aljebrin Y, Alsohime F, Alabdulhafid M, Temsah MH. The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience. J Infect Chemother 2022; 29:20-25. [PMID: 36103948 PMCID: PMC9464359 DOI: 10.1016/j.jiac.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
Objectives To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. Methods A retrospective chart review of children 0–14 years old admitted to PICU with a viral infection. Results Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). Conclusion Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations.
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Affiliation(s)
- Ayman Al-Eyadhy
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
| | - Mohammed Almazyad
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Gamal Hasan
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; Assiut Faculty of Medicine, Assiut University, Egypt; Pediatric Critical Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | | | - Ali A N Alhaboob
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Fahad Alfayez
- College of Medicine, King Saud University, Saudi Arabia
| | | | - Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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12
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Morice C, Alsohime F, Mayberry H, Tume LN, Brossier D, Valla FV. Intravenous maintenance fluid therapy practice in the pediatric acute and critical care settings: a European and Middle Eastern survey. Eur J Pediatr 2022; 181:3163-3172. [PMID: 35503578 DOI: 10.1007/s00431-022-04467-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/21/2022] [Accepted: 04/05/2022] [Indexed: 11/25/2022]
Abstract
The ideal fluid for intravenous maintenance fluid therapy (IV-MFT) in acutely and critically ill children is controversial, and evidence-based clinical practice guidelines are lacking and current prescribing practices remain unknown. We aimed to describe the current practices in prescribing IV-MFT in the context of acute and critically ill children with regard to the amount, tonicity, composition, use of balanced fluids, and prescribing strategies in various clinical contexts. A cross-sectional electronic 27-item survey was emailed in April-May 2021 to pediatric critical care physicians across European and Middle East countries. The survey instrument was developed by an expert multi-professional panel within the European Society of Pediatric and Neonatal Intensive Care (ESPNIC). A total of 154 respondents from 35 European and Middle East countries participated (response rate 64%). Respondents were physicians in charge of acute or critically ill children. All respondents indicated they routinely use a predefined formula to prescribe the amount of IV-MFT and considered fluid balance monitoring very important in the management of acute and critically ill children. The use of balanced solution was preferred if there were altered serum sodium and chloride levels or metabolic acidosis. Just under half (42%, 65/153) of respondents believed balanced solutions should always be used. Respondents considered the use of isotonic IV solutions as important for acute and critically ill children. In terms of the indication and the composition of IV-MFT prescribed, responses were heterogeneous among centers. Almost 70% (107/154) respondents believed there was a gap between current practice and what they considered ideal IV-MFT due to a lack of guidelines and inadequate training of healthcare professionals. Conclusions: Our study showed considerable variability in clinical prescribing practice of IV-MFT in acute pediatric settings across Europe and the Middle East. There is an urgent need to develop evidence-based guidelines for IV-MFT prescription in acute and critically ill children. What is Known: • The administration of maintenance intravenous fluid therapy is a standard of care for a lot of hospitalized children • Maintenance intravenous fluid therapy prescriptions are often based on Holliday and Segar's historical guidelines even if this practice has been associated with several complications. What is New: • This study provided information on the prescribing practice regarding fluid restriction, fluid tonicity, and balance. • This study showed considerable variability in clinical prescribing practice of intravenous maintenance fluid therapy across Europe and the Middle East.
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Affiliation(s)
- Claire Morice
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Critical Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Huw Mayberry
- Pediatric Intensive Care Unit, Alder Hey Children's Hospital, Liverpool, UK
| | - Lyvonne N Tume
- Pediatric Intensive Care Unit, Alder Hey Children's Hospital, Liverpool, UK.,School of Health & Society, University of Salford, Manchester, UK
| | - David Brossier
- Pediatric Intensive Care Unit, CHU de Caen, 14000, Caen, France. .,Medical School, Université Caen Normandie, 14000, Caen, France.
| | - Frederic V Valla
- School of Health & Society, University of Salford, Manchester, UK.,Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500, Lyon, France
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13
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Morice C, Alsohime F, Mayberry H, Tume LN, Brossier D, Valla FV. Correction to: Intravenous maintenance fluid therapy practice in the pediatric acute and critical care settings: a European and Middle Eastern survey. Eur J Pediatr 2022; 181:3173. [PMID: 35666315 DOI: 10.1007/s00431-022-04513-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Claire Morice
- Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Critical Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Huw Mayberry
- Pediatric Intensive Care Unit, Alder Hey Children's Hospital, Liverpool, UK
| | - Lyvonne N Tume
- Pediatric Intensive Care Unit, Alder Hey Children's Hospital, Liverpool, UK.,School of Health & Society, University of Salford, Manchester, UK
| | - David Brossier
- Pediatric Intensive Care Unit, CHU de Caen, 14000, Caen, France. .,Medical School, Université Caen Normandie, 14000, Caen, France.
| | - Frederic V Valla
- School of Health & Society, University of Salford, Manchester, UK.,Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69500, Lyon, France
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14
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Al-Muhsen S, Al-Numair NS, Saheb Sharif-Askari N, Basamh R, Alyounes B, Jabaan A, Saheb Sharif-Askari F, Alosaimi MF, Alsohime F, Halwani R, Al-Saud H. Favipiravir Effectiveness and Safety in Hospitalized Moderate-Severe COVID-19 Patients: Observational Prospective Multicenter Investigation in Saudi Arabia. Front Med (Lausanne) 2022; 9:826247. [PMID: 35308532 PMCID: PMC8931493 DOI: 10.3389/fmed.2022.826247] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/28/2022] [Indexed: 12/15/2022] Open
Abstract
Objectives There are limited data on the efficacy and safety of favipiravir antiviral in coronavirus disease 2019 (COVID-19), particularly in the more progressed disease phase. This study aims to evaluate the favipiravir effect on reducing the length of hospital stay and in-hospital mortality among moderate and severe hospitalized COVID-19 patients. Methods A prospective, multicenter observational study was conducted that included moderate and severe hospitalized adult COVID-19 patients in four major regions (Riyadh (Riyadh), Eastern (Dammam), Al-Qassem (Buraydah), and Macca (Jeddah) of Saudi Arabia. For the primary outcome of all-cause mortality, a Cox proportional hazard analysis was performed. While the association between favipiravir use and length of hospital stay was determined using adjusted generalized linear model. This study was approved by the Central Institutional Review Board in The Saudi Ministry of Health (MoH) with the approval number IRB # 20-85-M. Results This study included 598 moderate and severe COVID-19 patients, of whom 156 (26%) received favipiravir. Favipiravir treatment was associated with more extended hospital stays (14 vs. 10 median days, P = 0.034) and higher mortality rate (aHR 3.63; 95% CI 1.06–12.45) compared to no favipiravir regimen. Despite lack of effectiveness, favipiravir use was only associated with higher diarrhea adverse effects (12 vs. 5%, P = 0.002), but it did not affect the renal and liver profiles of patients. Conclusion Favipiravir was ineffective in reducing the length of hospital stay and in-hospital mortality in patients with moderate and severe COVID-19.
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Affiliation(s)
- Saleh Al-Muhsen
- Immunology Research Laboratory, Department of Pediatrics, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- *Correspondence: Saleh Al-Muhsen
| | - Nouf S. Al-Numair
- The Saudi Ministry of Health and Center of Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | - Roaa Basamh
- King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Banan Alyounes
- King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Amjad Jabaan
- King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | | | - Mohammed F. Alosaimi
- Immunology Research Laboratory, Department of Pediatrics, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Immunology Research Laboratory, Department of Pediatrics, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Rabih Halwani
- Immunology Research Laboratory, Department of Pediatrics, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Rabih Halwani
| | - Haya Al-Saud
- King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
- Hevolution Foundation, Riyadh, Saudi Arabia
- Haya Al-Saud
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15
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Al-Eyadhy A, Hasan G, Temsah MH, Alseneidi S, Alalwan M, Alali F, Alhaboob A, Alabdulhafid M, Alsohime F, Almaziad M, Somily AM. Initial Fluid Balance Associated Outcomes in Children With Severe Sepsis and Septic Shock. Pediatr Emerg Care 2022; 38:e1112-e1117. [PMID: 34469401 DOI: 10.1097/pec.0000000000002520] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Net fluid balance and its role in sepsis-related mortality is not clear; studies suggest that aggressive fluid resuscitation can help in treatment, whereas others consider it is associated with poor outcomes. This study aimed to clarify the possible association of initial 24 hours' fluid balance with poor outcomes in pediatric patients with sepsis. METHODS Retrospective data analysis included pediatric patients admitted with suspected or proven sepsis or septic shock to pediatric intensive care unit (PICU) of a tertiary care teaching hospital in Saudi Arabia. RESULTS The study included 47 patients; 13 (28%) died, and mortality rate was significant in children with neurologic failure (P < 0.02), mechanical ventilation within 24 hours of admission (P < 0.03), leukopenia (P < 0.02), abnormal international normalized ratio (P < 0.02), initial blood lactate levels higher than 5 mmol/L (P < 0.02), or positive fluid balance at 24 hours of admission to the PICU (P < 0.001). CONCLUSION Among children with sepsis and/or septic shock, there is significant association between mortality and initial high blood lactate levels and positive fluid balance at 24 hours from admission to the PICU.
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Affiliation(s)
- Ayman Al-Eyadhy
- From the Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Mohamad-Hani Temsah
- From the Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | | | | | - Ali Alhaboob
- From the Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Majed Alabdulhafid
- From the Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Fahad Alsohime
- From the Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Almaziad
- From the Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ali Mohammed Somily
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Temsah MH, Aljamaan F, Alhaboob A, Almosned B, Alsebail R, Temsah R, Senjab A, Alarfaj A, Aljudi T, Jamal A, Habash A, Alsohime F, Almazyad M, Alabdulhafid M, Hasan G, Assiri RA, Alqahtani WMA, Alherbish A, Alhasan K, Al-Eyadhy A. Enhancing parental knowledge of childhood and adolescence safety: An interventional educational campaign. Medicine (Baltimore) 2022; 101:e28649. [PMID: 35060555 PMCID: PMC8772645 DOI: 10.1097/md.0000000000028649] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/03/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Safeguarding children and adolescents from unintentional injuries is a significant concern for parents and caregivers. With them staying more at home during the coronavirus disease 2019 pandemic, more educational tools and valid educational programs are warranted to improve parental knowledge and awareness about childhood and adolescences' safety. This study aims to explore the effectiveness of childhood and adolescence safety campaigns on parents' knowledge and attitude toward preventable injuries. METHODS This was a pre-post experimental study, in which the predesigned assessments were used as an evaluation tool before and after attending a childhood and adolescence safety campaign. The pre-post assessment question included questions to evaluate the socio-demographic status, followed by knowledge questions in line with the current childhood and adolescence safety campaign. The outcomes of interest were assessed before and after attending the campaign's stations. RESULTS Three hundred eight parents volunteered to participate in this study. Their knowledge score improved from 36.2 [standard deviation (SD) 17.7] to 79.3 (SD 15.6) after attending the Campaign (t value = 34.6, P < .001). Both, perceptions on the preventability of accidents and the parents' perceived usefulness of educational campaigns showed improvements, with (t value = 6.3, P < .001) and (t value = 3.097, P < .001), respectively. CONCLUSION The educational childhood and adolescence safety campaign for caregivers in Saudi Arabia resulted in a significant increase in the overall knowledge and attitudes toward childhood and adolescence's safety. As children and adolescents are currently staying at home more, additional educational tools and programs are warranted to promote safe practices among parents and caregivers.
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Affiliation(s)
- Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
- Prince Abdullah Ben Khalid Celiac Disease Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Critical care department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Badr Almosned
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Raghad Alsebail
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | | | | | - Talal Aljudi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
- Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Alia Habash
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Emergency Medicine Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohammed Almazyad
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Gamal Hasan
- Department of Pediatrics, Assiut University Children Hospital, Assiut University, Egypt
- Department of Pediatrics, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Raghad Asaad Assiri
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | | | - Adi Alherbish
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatrics Department, King Saud University Medical City, Riyadh, Saudi Arabia
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Jamal A, AlHokair A, Temsah MH, Alsohime F, Al-Eyadhy A, El-Mouzan M, Tharkar S. Evaluation of the use of electronic growth charts customized for race and national values. J Nat Sci Med 2022. [DOI: 10.4103/jnsm.jnsm_89_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alakeel A, Alsalman H, Alotaibi G, Somily H, Alsohime F. Propranolol-induced hyperkalemia in infantile hemangioma patients: How serious is it? J Family Med Prim Care 2022; 11:6944-6948. [PMID: 36993109 PMCID: PMC10041225 DOI: 10.4103/jfmpc.jfmpc_658_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 12/24/2022] Open
Abstract
Background Infantile hemangioma is the most frequent benign vascular tumor of infancy, which has a specific clinical history of early growth, followed by spontaneous remission. Since the fortuitous discovery of propranolol's efficacy in 2008, the management of infantile hemangioma has been quickly developing. Methods This study is a retrospective cohort study. Electronic search in the patient's registry of King Khalid University Hospital, Riyadh, Saudi Arabia, was performed using the keywords hemangioma, haemangioma, infantile hemangioma, and vascular tumors. The search revealed a total of 101 subjects for which 56 were included and 45 were excluded. Results A total of 56 patients with infantile hemangioma were evaluated in this study. The majority were females. The F: M ratio is 3.4:1. The highest percentage of the patients was delivered by the elective cesarian section, that is, 23 (41.1%), followed by spontaneous vaginal delivery, that is, 19 (33.9%). Full-term patients were 27 (48%), whereas the pre-term patients were 21 (37%). The total number of patients who developed hyperkalemia while on propranolol was 12 (31%). There was no statistically significant difference (P > 0.05) between patients who developed hyperkalemia and patients who did not develop hyperkalemia in terms of gender, gestational age, mode of delivery, size and location of hemangioma, or concomitant topical timolol use. Conclusion Hyperkalemia is benign and transient, although solid conclusive opinions cannot be drawn because of the small sample size and the retrospective nature of the study.
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Barry M, Temsah MH, Alhuzaimi A, Alamro N, Al-Eyadhy A, Aljamaan F, Saddik B, Alhaboob A, Alsohime F, Alhasan K, Alrabiaah A, Alaraj A, Halwani R, Jamal A, Alsubaie S, Al-Shahrani FS, Memish ZA, Al-Tawfiq JA. COVID-19 vaccine confidence and hesitancy among health care workers: A cross-sectional survey from a MERS-CoV experienced nation. PLoS One 2021; 16:e0244415. [PMID: 34843462 PMCID: PMC8629228 DOI: 10.1371/journal.pone.0244415] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 10/13/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives This study aimed to identify coronavirus disease 2019 (COVID-19) vaccine perception, acceptance, confidence, hesitancy, and barriers among health care workers (HCWs). Methods An online national cross-sectional pilot-validated questionnaire was self-administered by HCWs in Saudi Arabia, which is a nation with MERS-CoV experience. The main outcome variable was HCWs’ acceptance of COVID-19 vaccine candidates. The factors associated with vaccination acceptance were identified through a logistic regression analysis, and the level of anxiety was measured using a validated instrument to measure general anxiety levels. Results Out of the 1512 HCWs who completed the study questionnaire—of which 62.4% were women—70% were willing to receive COVID-19 vaccines. A logistic regression analysis revealed that male HCWs (ORa = 1.551, 95% CI: 1.122–2.144), HCWs who believe in vaccine safety (ORa = 2.151; 95% CI: 1.708–2.708), HCWs who believe that COVID vaccines are the most likely way to stop the pandemic (ORa = 1.539; 95% CI: 1.259–1.881), and HCWs who rely on the Centers for Disease Control and Prevention website for COVID 19 updates (ORa = 1.505, 95% CI: 1.125–2.013) were significantly associated with reporting a willingness to be vaccinated. However, HCWs who believed that the vaccines were rushed without evidence-informed testing were found to be 60% less inclined to accept COVID-19 vaccines (ORa = 0.394, 95% CI: 0.298–0.522). Conclusion Most HCWs are willing to receive COVID-19 vaccines once they are available; the satisfactoriness of COVID-19 vaccination among HCWs is crucial because health professionals’ knowledge and confidence toward vaccines are important determining factors for not only their own vaccine acceptance but also recommendation for such vaccines to their patients.
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Affiliation(s)
- Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
- * E-mail:
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alhuzaimi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Pediatric Cardiology, Cardiac Science Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nurah Alamro
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Critical Care Dept, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Basema Saddik
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ali Alhaboob
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulkarim Alrabiaah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alaraj
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
- Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Rabih Halwani
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sarah Alsubaie
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fatimah S. Al-Shahrani
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ziad A. Memish
- Director Research and Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Health Care, Dhahran, Saudi Arabia
- Infectious disease division, Department of Medicine, Indiana University School of Medicine, Indiana, United States of America
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
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20
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Al-Eyadhy A, Temsah MH, Hasan GM, Almazyad M, Alhaboob AA, Alabdulhafid M, Alsohime F, Alzahrani AS, Alammari AM, Abunohaiah FS, Alfawzan NF, Alghamdi SS. Causes, timing, and modes of death in a tertiary pediatric intensive care unit: Five years' experience. Saudi Med J 2021; 42:1186-1194. [PMID: 34732550 PMCID: PMC9149741 DOI: 10.15537/smj.2021.42.11.20210508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To identify the causes, modes, and timing of death in a tertiary pediatric intensive care unit (PICU). METHODS This is a retrospective data analysis of patients older than 48 hours and younger than 15 years who died in the PICU over a 5-year period from January 2012 until December 2016 at a tertiary hospital in Riyadh, Saudi Arabia. RESULTS There were 101 deaths out of 2295 admissions, representing average crude mortality rate of 4.4%. Sepsis was the most common cause of death in 31 patients (30.7%), followed by lower respiratory tract infections in 19 (18.8%), and cardiac diseases in 12 (11.9%). Failed cardiopulmonary resuscitation was the most common mode of death in 51 patients (50.5%), followed by withholding life-sustaining treatment in 43 (42.6%), and brain death in 7 (6.9%). Although more deaths occurred during after hours (n=70; 69.3%), there was no significant correlation between mode of death and working hours vs. after hours (p>0.05). Among the cohort, 63 patients (62.4%) had an infection-attributed mortality, of which 43 (68.3%) were bacterial, 14 (22.2%) were viral, and 10 (15.9%) were fungal. CONCLUSION Infections remain a significant cause of death in the PICU. Further improvement of prevention programs and early therapy of severe infections could lower pediatric mortality. This report highlights the need for enhancing palliative care programs. The low rate of brain death diagnoses warrants further investigation.
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Affiliation(s)
- Ayman Al-Eyadhy
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
- Address correspondence and reprint request to: Dr. Ayman A. Al-Eyadhy, Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0002-6051-9125
| | - Mohamad-Hani Temsah
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Gamal M. Hasan
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Mohammed Almazyad
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Ali A. Alhaboob
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Majed Alabdulhafid
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Fahad Alsohime
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Ahmed S. Alzahrani
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Abdullah M. Alammari
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Faisal S. Abunohaiah
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Nawaf F. Alfawzan
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Suhail S. Alghamdi
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
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Barry M, Temsah MH, Aljamaan F, Saddik B, Al-Eyadhy A, Alenezi S, Alamro N, Alhuzaimi AN, Alhaboob A, Alhasan K, Alsohime F, Alaraj A, Halwani R, Jamal A, Temsah O, Alzamil F, Somily A, Al-Tawfiq JA. COVID-19 vaccine uptake among healthcare workers in the fourth country to authorize BNT162b2 during the first month of rollout. Vaccine 2021; 39:5762-5768. [PMID: 34481700 PMCID: PMC8410227 DOI: 10.1016/j.vaccine.2021.08.083] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 08/15/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Kingdom of Saudi Arabia (KSA) was the fourth country in the world to authorize the BNT162b2 coronavirus disease 2019 (COVID-19) vaccine, which it rolled out on December 17, 2020 and first targeted at healthcare workers (HCWs). This study assesses vaccine uptake among this group during the first month of its availability. METHODS A national cross-sectional, pilot-validated, self-administered survey was conducted among HCWs in the KSA between December 27, 2020 and January 3, 2021. The survey included sociodemographic details, previous contact with COVID-19 patients, previous infection with COVID-19, receiving (or registering with the Ministry of Health website to receive) the COVID-19 vaccine, sources of HCWs' information on vaccines, awareness of emerging variants of concern, and anxiety level using the 7-item Generalized Anxiety Disorder assessment. A descriptive bivariate analysis and multivariate logistic binary regression analysis were performed. The primary evaluated outcome was vaccine uptake. RESULTS Of the 1058 participants who completed the survey, 704 (66.5%) were female, and 626 (59.2%) were nurses. Of all the respondents, 352 (33.27%) were enrolled to receive or had already received the vaccine, while 706 (66.73%) had not enrolled. In a bivariate analysis, not enrolling for vaccination was more likely in females than males (78.5% vs. 21.5%, P < 0.001), HCWs between the ages of 20 and 40 years than those >40 years (70.4% vs. 29.6%, P = 0.005), Saudi HCWs than expatriates (78% vs 22%, P < 0.001), and among HCWs who used social media as a source of information than those who did not (69.8% vs. 38.6%, P < 0.001). In a multivariate analysis, independent factors associated with uptake were being a Saudi national (aOR = 1.918, 95 %CI = 1.363-2.698, P < 0.001), working in an intensive care unit (aOR = 1.495, 95 %CI = 1.083-2.063, P = 0.014), and working at a university hospital (aOR = 1.867, 95 %CI = 1.380-2.525, P < 0.001). CONCLUSIONS A low level of vaccine uptake was observed especially in female HCWs, those younger than 40 years old, and those who used social media as their source of vaccine information. This survey provides important information for public health authorities in order to scale up vaccination campaigns targeting these HCWs to increase vaccine enrollment and uptake.
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Affiliation(s)
- Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Critical Care Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Basema Saddik
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates; Department of Family and Community Medicine, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ayman Al-Eyadhy
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Shuliweeh Alenezi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nurah Alamro
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah N Alhuzaimi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Division of Pediatric Cardiology, Department of Cardiac Sciences, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alaraj
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia; Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates; Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia; Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Omar Temsah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Fahad Alzamil
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Somily
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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22
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Temsah MH, Alkhattabi F, Aljamaan F, Alhasan K, Alherbish A, Philby M, Alsohime F, Alobaylan M, Alabdulkarim H, Almosned B, Gashgarey D, Felimban G, Alkathiri Z, Almaghrabi R, Jamal A, Barry M, Alhaider SA, Alsaywid B, Bashiri FA. Remote interviews for medical residency selection during the initial COVID-19 crisis: a national survey. BMC Med Educ 2021; 21:462. [PMID: 34461872 PMCID: PMC8405253 DOI: 10.1186/s12909-021-02890-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/17/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Medical training programs candidate's interview is an integral part of the residency matching process. During the coronavirus disease 2019 (COVID-19) pandemic, conducting these interviews was challenging due to infection prevention restrains (social distancing, namely) and travel restrictions. E-interviews were implemented by the Saudi Commission for Healthcare Specialties (SCFHS) since the matching cycle of March 2020 to hold the interviews in a safer virtual environment while maintaining the same matching quality and standards. AIM This study was conducted to assess the medical training residency program applicants' satisfaction, stress, and other perspectives for the (SCFHS) March 2020 Matching-cycle conducted through an urgently implemented E-interviews process. METHOD A cross-sectional, nationwide survey (Additional file 1) was sent to 4153 residency-nominated applicants to the (SCFHS) March 2020 cycle. RESULTS Among the 510 candidates who responded, 62.2% applied for medical specialties, 20.2% applied for surgical specialties, and 17.6% applied for critical care and emergency specialties. Most respondents (61.2%) never had previous experience with web-based video conferences. Most respondents (80.2%) used the Zoom application to conduct the current E-interviews, whereas only 15.9% used the FaceTime application. 63.3% of the respondents preferred E-interviews over in-person interviews, and 60.6% rated their experience as very good or excellent. 75.7% of the respondents agreed that all their residency program queries were adequately addressed during the E-interviews. At the same time, 52.2% of them agreed that E-interviews allowed them to represent themselves accurately. 28.2% felt no stress at all with their E-interviews experience, while 41.2% felt little stressed and only 8.2% felt highly stressed. The factors that were independently and inversely associated with applicants' level of stress with E-interviews experience were their ability to represent themselves during the interviews (p = 0.001), cost-savings (p < 0.001), their overall rating of the E-interviews quality (p = 0.007) and the speed of the internet connection (p < 0.006). CONCLUSION Videoconferencing was implemented on an urgent basis during the COVID-19 pandemic in the medical residency application process in Saudi Arabia. It was perceived as an adequate and promising tool to replace in-person interviews in the future. Applicants' satisfaction was mainly driven by good organization, cost-saving, and their ability to present themselves. Future studies to enhance this experience are warranted.
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Affiliation(s)
- Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
| | - Fadiah Alkhattabi
- Pediatric Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- Critical Care Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
| | - Adi Alherbish
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
| | - Mona Philby
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
| | - Mohamad Alobaylan
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
| | - Hayfa Alabdulkarim
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
| | - Badr Almosned
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
| | - Deema Gashgarey
- Pediatric Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ghadah Felimban
- Pediatric Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ziyad Alkathiri
- Pediatric Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Randa Almaghrabi
- Pediatric Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Amr Jamal
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
- Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, PO Box 2925, (Internal Code 34), Riyadh, 11461 Saudi Arabia
| | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sami A. Alhaider
- Saudi Commission For Healthcare Specialties, Riyadh, Saudi Arabia
| | - Basim Alsaywid
- Saudi Commission For Healthcare Specialties, Riyadh, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard,, Jeddah, 11461 Saudi Arabia
| | - Fahad A. Bashiri
- Pediatric Department, College of Medicine, King Saud University, PO BOX 2925, Riyadh, 11461 Saudi Arabia
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23
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Temsah MH, Alhboob A, Abouammoh N, Al-Eyadhy A, Aljamaan F, Alsohime F, Alabdulhafid M, Ashry A, Bukhari A, ElTahir O, Jamal A, Halwani R, Alhasan K, Alherbish A, Temsah R, Al-Tawfiq JA, Barry M. Pediatric Intensive Care Hybrid-Style Clinical Round During COVID-19 Pandemic: A Pilot Study. Front Pediatr 2021; 9:720203. [PMID: 34490169 PMCID: PMC8417365 DOI: 10.3389/fped.2021.720203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/21/2021] [Indexed: 01/14/2023] Open
Abstract
Objectives: With the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted the integration of Zoom meetings into clinical rounds. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients. Design: Mixed quantitative and qualitative deductive thematic content analysis of narrative responses. Setting: PICU, single tertiary-care academic center. Participants: Multidisciplinary PICU HCWs. Interventions: Integration of Zoom meeting into clinical daily PICU rounds. Measurements: For the quantitative part, we gathered the details of daily PICU hybrid rounds in terms of times, number of HCWs, and type of files shared through Zoom. For the qualitative part, open-ended questions were used. Main Results: The physical round took statistically significantly less time (34.68 ± 14.842 min) as compared with the Zoom round (72.45 ± 22.59 min), p < 0.001. The most shared component in the virtual round was chest X-rays (93.5%). Thirty-one HCWs participated in focus group discussions and were included in the analysis. Some of the HCWs' perceived advantages of the hybrid rounds were enabling multidisciplinary discussions, fewer round interruptions, and practicality of virtual discussions. The perceived challenges were the difficulty of the bedside nurse attending the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if video streaming was not utilized. Conclusions: Multidisciplinary hybrid virtual and physical clinical rounds in the PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round should be optimized to facilitate the virtual team-members' interactions and enhance the teaching experience.
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Affiliation(s)
- Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alhboob
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Noura Abouammoh
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Critical Care Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Ashry
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Bukhari
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Omer ElTahir
- Department of Medicine and Clinical Pharmacology, University of Medical Sciences and Technology (UMST), Khartoum, Sudan
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
- Evidence-Based Health Care and Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Khalid Alhasan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Adi Alherbish
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Reem Temsah
- College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia
| | - Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Mazin Barry
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
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24
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Shaiba LA, Alnamnakani MA, Temsah MH, Alamro N, Alsohime F, Alrabiaah A, Alanazi SN, Alhasan K, Alherbish A, Mobaireek KF, Bashiri FA, AlRuthia Y. Medical Faculty's and Students' Perceptions toward Pediatric Electronic OSCE during the COVID-19 Pandemic in Saudi Arabia. Healthcare (Basel) 2021; 9:950. [PMID: 34442087 PMCID: PMC8393546 DOI: 10.3390/healthcare9080950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The educational process in different medical schools has been negatively affected by the COVID-19 pandemic worldwide. As a part of the Saudi government's attempts to contain the spread of the virus, schools' and universities' educational activities and face-to-face lectures have been modified to virtual classrooms. The purpose of this study was to explore the perceptions of the faculty and the students of an electronic objective structured clinical examination (E-OSCE) activity that took place during the COVID-19 pandemic in the oldest medical school in Saudi Arabia. METHODS An e-OSCE style examination was designed for the final-year medical students by the pediatrics department, College of Medicine at King Saud University in Riyadh, Saudi Arabia. The examination was administered by Zoom™ video conferencing where both students and faculty participated through their laptop or desktop computers. In order to explore the students' and the faculty's perceptions about this experience, a newly designed 13-item online questionnaire was administered at the end of the e-OSCE. RESULTS Out of 136 participants (23 faculty and 112 students), 73 respondents (e.g., 54% response rate) filled out the questionnaire. Most of the respondents (69.8%) were very comfortable with this new virtual experience. Most participants (53.4%) preferred the e-OSCE compared to the classic face-to-face clinical OSCE during the pandemic. Regarding the e-OSCE assessment student tool, 46.6% reported that it is similar to the classic face-to-face OSCE; however, 38.4% felt it was worse. CONCLUSIONS The e-OSCE can be a very effective alternative to the classic face-to-face OSCE due to the current circumstances that still pose a significant risk of infection transmission. Future studies should examine different virtual strategies to ensure effective OSCE delivery from the perspective of both faculty and students.
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Affiliation(s)
- Lana A. Shaiba
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Neonatal Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Mahdi A. Alnamnakani
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- General Pediatric Unit, Department of Pediatrics, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
- Undergraduate Committee, Pediatric Department, King Saud University, Riyadh 11362, Saudi Arabia
| | - Nurah Alamro
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Department of Family and Community Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Abdulkarim Alrabiaah
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Pediatric Infectious Diseases Unit, Pediatric Department, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Shahad N. Alanazi
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
| | - Khalid Alhasan
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Pediatric Nephrology Unit, Pediatric Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Adi Alherbish
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Pediatric Nephrology Unit, Pediatric Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Khalid F. Mobaireek
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Pulmonary Medicine Unit, Pediatric Department, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Fahad A. Bashiri
- College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia; (L.A.S.); (M.A.A.); (N.A.); (F.A.); (A.A.); (S.N.A.); (K.A.); (A.A.); (K.F.M.); (F.A.B.)
- Pediatric Neurology Unit, Pediatric Department, College of Medicine, King Saud University Medical City, King Saud University, Riyadh 11362, Saudi Arabia
| | - Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
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25
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Almuzaini Y, Alsohime F, Subaie SA, Temsah MH, Alsofayan Y, Alamri F, Alahmari A, Alahdal H, Sonbol H, Almaghrabi R, Nahhas M, Khan A. Clinical profiles associated with SARS-CoV-2 infection and complications from coronavirus disease-2019 in children from a national registry in Saudi Arabia. Ann Thorac Med 2021; 16:280-286. [PMID: 34484444 PMCID: PMC8388572 DOI: 10.4103/atm.atm_709_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 02/21/2021] [Indexed: 12/13/2022] Open
Abstract
CONTEXT Exploring clinical characteristics of coronavirus disease-19 (COVID-19) in children may help in prevention and treatment guidelines. AIMS The aim of the to describe the spectrum of pediatric COVID-19 in Saudi Arabia. SETTINGS AND DESIGN A multicenter, retrospective, cross-sectional study involving pediatric COVID-19 patients across all Saudi regions. METHODS All patients aged between 2 months and 18 years with a confirmed diagnosis of COVID-19 were included. The primary end point was the hospitalization. STATISTICAL ANALYSIS USED Descriptive statistics were used to describe the baseline demographic data and clinical characteristics. Numerical data were explored using Kolmogorov-Smirnov test and Shapiro-Wilk test, while Chi-square or Fisher's exact test were used for categorical data. RESULTS Among the 654 pediatric COVID-19 patients, 4.7% (n = 31) were hospitalized, with one patient only needing pediatric intensive care admission. Sex, breastfeeding, birth status, and the patients' living environment showed no significant association with hospitalization. Most children (80.3%, n = 525) were symptomatic, with two symptoms that were significantly associated with admission, namely, vomiting (P = 0.007) and nausea (P = 0.026). History of admission within the last year was identified in 10.4% (n = 68) children but had no association with worse outcome. The median duration of hospitalization for the entire group was 5.5 days, with longest hospital stay for age group 7-12 years (median 6 days). CONCLUSIONS COVID-19 is usually a milder disease in children. Although having preexisting medical conditions was linked to a longer hospitalization, it was not associated with worse outcome. Continuous surveillance will allow additional characterization of the burden and outcomes of pediatric COVID-19-associated hospitalizations.
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Affiliation(s)
- Yasir Almuzaini
- Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Pediatric, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Sarah Al Subaie
- College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Pediatric, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mohamad Hani Temsah
- College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Pediatric, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Yousef Alsofayan
- Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Fahad Alamri
- Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Ahmed Alahmari
- Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - Hadil Alahdal
- Department of Biology, Faculty of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Hana Sonbol
- Department of Biology, Faculty of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Rana Almaghrabi
- Department of Pediatric, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mahmoud Nahhas
- School Health Affairs, Ministry of Health, Riyadh, Saudi Arabia
| | - Anas Khan
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Temsah MH, Abouammoh N, Ashry A, Al-Eyadhy A, Alhaboob A, Alsohime F, Almazyad M, Alabdulhafid M, Temsah R, Aljamaan F, Jamal A, Halwani R, Alhasan K, Al-Tawfiq JA, Barry M. Virtual Handover of Patients in the Pediatric Intensive Care Unit During the Covid-19 Crisis. J Multidiscip Healthc 2021; 14:1571-1581. [PMID: 34211276 PMCID: PMC8241813 DOI: 10.2147/jmdh.s310028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/28/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE A key measure to mitigate coronavirus disease 2019 (COVID-19) has been social distancing. Incorporating video-conferencing applications in the patient handover process between healthcare workers can enhance social distancing while maintaining handover elements. This study describes pediatric intensive care unit (PICU) physicians' experience using an online video-conferencing application for handover during the COVID-19 pandemic. DESIGN Qualitative content analysis. SETTING PICU at a university hospital in Riyadh, Saudi Arabia. SUBJECTS PICU Physicians. INTERVENTIONS Due to the pandemic, the hospital's PICU used Zoom® as a remote conferencing application instead of a face-to-face handover. Following institutional review board approval, data were collected over two weeks (1 Jul 2020 to 14 Jul 2020). MEASUREMENTS An online survey was conducted using open-ended questions to capture demographic data and the perceived efficacy of remote handovers. Thematic framework analysis process included open coding, creating categories, and abstraction. MAIN RESULTS All 37 PICU physicians who participated in the handover completed the survey. The participants comprised six attendings, nine specialists, and 22 residents. While 20 (54.1%) physicians reported attending 1-5 Zoom handovers by the time of the study, some (n. 6, 16.2%) had more than ten virtual handovers. They had variable previous teleconferencing experiences. Most physicians (78.4%) were comfortable conducting a remote handover. Most found that Situation-Background-Assessment-Recommendation handover elements were properly achieved through this remote handover process. The perceived advantages of online handover included fewer interruptions, time efficiency, and facilitation of social distancing. The perceived disadvantages were the paucity of nonverbal communication and teaching during virtual meetings. CONCLUSION Video-conferencing applications for online handovers could supplement traditional face-to-face intensive care unit patient handover during outbreaks of infectious diseases. The use of video streaming and more emphasis on teaching should be encouraged to optimize the users' experience.
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Affiliation(s)
- Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Noura Abouammoh
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Ashry
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Almazyad
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Reem Temsah
- College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Critical Care Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia
- Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Khalid Alhasan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mazin Barry
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
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Temsah MH, Abouammoh N, Al-Eyadhy A, AlRuthia Y, Hassounah M, Alsohime F, Alhaboob A, Almazyad M, Alabdulhafid M, Aljamaan F, Alhasan K, Jamal A. Predictors and Direct Cost Estimation of Long Stays in Pediatric Intensive Care Units in Saudi Arabia: A Mixed Methods Study. Risk Manag Healthc Policy 2021; 14:2625-2636. [PMID: 34188573 PMCID: PMC8235993 DOI: 10.2147/rmhp.s311100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background Several factors influence patients’ length of stay (LOS) in pediatric intensive care units (PICUs). This study explored the factors and cost associated with long LOS among pediatric patient population across various PICUs and pediatric surgical cardiac intensive care units (SCICUs). Methods This is a multi-center concurrent mixed-methods study that was conducted in different PICUs and SCICUs in Riyadh, Saudi Arabia. The units’ leaders were qualitatively interviewed to explore the potential factors contributing to long LOSs in PICUs and SCICUs, and deductive content analysis was used. Microcosting was utilized to estimate the inpatient costs for a sample of long-stay patients (LSPs) and the potential cost savings if those patients were transferred to step-down care units (SDUs) for those who stayed ≥60 days. Results Ten (90%) leaders of PICUs and SCICUs who were invited had participated. Changing the admission criteria, patient transfer to SDUs, family engagement in the decision-making process, and adopting a national do-not-resuscitate (DNR) policy were factors contributing to short LOSs. On the other hand, administrative constraints, staff avoidance of code status decisions, lack of palliative care resources, and complex patient characteristics were factors associated with long LOSs. The mean inpatient cost per patient was SAR 3.63 million (USD 0.97 million), and the total cost for the 48 patients was SAR 172.95 million (USD 46.12 million). Conclusion If the recommendation to transfer LSPs after a 60-day PICU stay to SDUs is taken, the estimated cost savings among this sample of patients alone can be as high as SAR 109.47 million (USD 29.19 million). Therefore, future studies should examine the factors contributing to long LOSs in PICUs and SCICUs as well as the effectiveness of different policies aimed at improving the resource allocation and management using more robust study designs and diverse patient population.
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Affiliation(s)
- Mohamad-Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Noura Abouammoh
- King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.,Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Marwah Hassounah
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Almazyad
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.,Department of Critical Care, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Amr Jamal
- King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.,Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
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Temsah MH, Barry M, Aljamaan F, Alhuzaimi A, Al-Eyadhy A, Saddik B, Alrabiaah A, Alsohime F, Alhaboob A, Alhasan K, Alaraj A, Halwani R, Alamro NM, Al-Shahrani FS, Jamal A, Alsubaie S, Memish ZA, Al-Tawfiq JA. Adenovirus and RNA-based COVID-19 vaccines' perceptions and acceptance among healthcare workers in Saudi Arabia: a national survey. BMJ Open 2021; 11:e048586. [PMID: 34155080 PMCID: PMC8219485 DOI: 10.1136/bmjopen-2020-048586] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/17/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the perception, confidence, hesitancy and acceptance rate of various COVID-19 vaccine types among healthcare workers (HCWs) in Saudi Arabia, a nation with Middle East respiratory syndrome coronavirus experience. DESIGN National cross-sectional, pilot-validated questionnaire. SETTING Online, self-administered questionnaire among HCWs. PARTICIPANTS A total of 2007 HCWs working in the Kingdom of Saudi Arabia participated; 1512 (75.3%) participants completed the survey and were included in the analysis. INTERVENTION Data were collected through an online survey sent to HCWs during 1-15 November 2020. The main outcome measure was HCW acceptance of COVID-19 candidate vaccines. The associated factors of vaccination acceptance were identified through a logistic regression analysis and via measurement of the level of anxiety, using the Generalised Anxiety Disorder 7 scale. RESULTS Among the 1512 HCWs who were included, 62.4% were women, 70.3% were between 21 and 40 years of age, and the majority (62.2%) were from tertiary hospitals. In addition, 59.5% reported knowing about at least one vaccine; 24.4% of the participants were sure about their willingness to receive the ChAdOx1 nCoV-19 vaccine, and 20.9% were willing to receive the RNA BNT162b2 vaccine. However, 18.3% reported that they would refuse to receive the Ad5-vectored vaccine, and 17.9% would refuse the Gam-COVID-Vac vaccine. Factors that influenced the differential readiness of HCWs included their perceptions of the vaccine's efficiency in preventing the infection (33%), their personal preferences (29%) and the vaccine's manufacturing country (28.6%). CONCLUSIONS Awareness by HCWs of the several COVID-19 candidate vaccines could improve their perceptions and acceptance of vaccination. Reliable sources on vaccine efficiency could improve vaccine uptake, so healthcare authorities should use reliable information to decrease vaccine hesitancy among frontline healthcare providers.
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Affiliation(s)
- Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mazin Barry
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Internal Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Critical Care Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Abdullah Alhuzaimi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Cardiac Science Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
- College of Medicine, University of Sharjah, Sharjah, UAE
| | - Abdulkarim Alrabiaah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali Alaraj
- Department of Medicine, Qassim University, Buraidah, Saudi Arabia
- Dr.Suliman Alhabib Medical Group, Riyadh, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
- College of Medicine, University of Sharjah, Sharjah, UAE
| | - Nurah Maziad Alamro
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fatimah S Al-Shahrani
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Internal Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
- Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Sarah Alsubaie
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ziad A Memish
- King Saud Medical City, Ministry of Health & Alfaisal University, Riyadh, Saudi Arabia
- Hubert Department of Global Health, Emory University Atlanta, Atlanta, Georgia, USA
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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29
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Temsah MH, Barry M, Aljamaan F, Alhuzaimi AN, Al-Eyadhy A, Saddik B, Alsohime F, Alhaboob A, Alhasan K, Alaraj A, Halwani R, Jamal A, Alamro N, Temsah R, Esmaeil S, Alenezi S, Alzamil F, Somily AM, Al-Tawfiq JA. SARS-CoV-2 B.1.1.7 UK Variant of Concern Lineage-Related Perceptions, COVID-19 Vaccine Acceptance and Travel Worry Among Healthcare Workers. Front Public Health 2021; 9:686958. [PMID: 34123997 PMCID: PMC8187763 DOI: 10.3389/fpubh.2021.686958] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/28/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Healthcare workers' (HCWs') travel-related anxiety needs to be assessed in light of the emergence of SARS-CoV-2 mutations. Methods: An online, cross-sectional questionnaire among HCWs between December 21, 2020 to January 7, 2021. The outcome variables were HCWs' knowledge and awareness of the SARS-CoV-2 B.1.1.7 lineage that was recently reported as the UK variant of concern, and its associated travel worry and Generalized Anxiety Disorder (GAD-7) score. Results: A total of 1,058 HCWs completed the survey; 66.5% were female, 59.0% were nurses. 9.0% indicated they had been previously diagnosed with COVID-19. Regarding the B.1.1.7 lineage, almost all (97.3%) were aware of its emergence, 73.8% were aware that it is more infectious, 78.0% thought it causes more severe disease, and only 50.0% knew that current COVID-19 vaccines are effective in preventing it. Despite this, 66.7% of HCWs were not registered to receive the vaccine. HCWs' most common source of information about the new variant was social media platforms (67.0%), and this subgroup was significantly more worried about traveling. Nurses were more worried than physicians (P = 0.001). Conclusions: Most HCWs were aware of the emergence of the SARS-CoV-2 B.1.1.7 variant and expressed substantial travel worries. Increased worry levels were found among HCWs who used social media as their main source of information, those with lower levels of COVID-19 vaccine uptake, and those with higher GAD-7 scores. The utilization of official social media platforms could improve accurate information dissemination among HCWs regarding the Pandemic's evolving mutations. Targeted vaccine campaigns are warranted to assure HCWs about the efficacy of COVID-19 vaccines toward SARS-CoV-2 variants.
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Affiliation(s)
- Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fadi Aljamaan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Critical Care Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah N. Alhuzaimi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Pediatric Cardiology, Department of Cardiac Sciences, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Basema Saddik
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Department of Community and Family Medicine, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alaraj
- Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
- Department of Medicine, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Amr Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
- Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Nurah Alamro
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Reem Temsah
- College of Pharmacy, Alfaisal University, Riyadh, Saudi Arabia
| | - Samia Esmaeil
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Shuliweeh Alenezi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alzamil
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali M. Somily
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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30
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Martin-Fernandez M, Bravo García-Morato M, Gruber C, Murias Loza S, Malik MNH, Alsohime F, Alakeel A, Valdez R, Buta S, Buda G, Marti MA, Larralde M, Boisson B, Feito Rodriguez M, Qiu X, Chrabieh M, Al Ayed M, Al Muhsen S, Desai JV, Ferre EMN, Rosenzweig SD, Amador-Borrero B, Bravo-Gallego LY, Olmer R, Merkert S, Bret M, Sood AK, Al-Rabiaah A, Temsah MH, Halwani R, Hernandez M, Pessler F, Casanova JL, Bustamante J, Lionakis MS, Bogunovic D. Systemic Type I IFN Inflammation in Human ISG15 Deficiency Leads to Necrotizing Skin Lesions. Cell Rep 2021; 31:107633. [PMID: 32402279 PMCID: PMC7331931 DOI: 10.1016/j.celrep.2020.107633] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/26/2020] [Accepted: 04/21/2020] [Indexed: 01/14/2023] Open
Abstract
Most monogenic disorders have a primary clinical presentation. Inherited ISG15 deficiency, however, has manifested with two distinct presentations to date: susceptibility to mycobacterial disease and intracranial calcifications from hypomorphic interferon-II (IFN-II) production and excessive IFN-I response, respectively. Accordingly, these patients were managed for their infectious and neurologic complications. Herein, we describe five new patients with six novel ISG15 mutations presenting with skin lesions who were managed for dermatologic disease. Cellularly, we denote striking specificity to the IFN-I response, which was previously assumed to be universal. In peripheral blood, myeloid cells display the most robust IFN-I signatures. In the affected skin, IFN-I signaling is observed in the keratinocytes of the epidermis, endothelia, and the monocytes and macrophages of the dermis. These findings define the specific cells causing circulating and dermatologic inflammation and expand the clinical spectrum of ISG15 deficiency to dermatologic presentations as a third phenotype co-dominant to the infectious and neurologic manifestations. Martin-Fernandez et al. report on five patients with inherited ISG15 deficiency, a recently discovered syndrome of type I IFN autoinflammation and mycobacterial susceptibility. This study defines an expanded clinical spectrum that now includes dermatologic disease and pinpoints the specific cell types driving inflammation.
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Affiliation(s)
- Marta Martin-Fernandez
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Conor Gruber
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Muhammad Nasir Hayat Malik
- Hannover Medical School, 30625 Hannover, Germany; TWINCORE Centre for Experimental and Clinical Infection Research, 30625 Hannover, Germany; Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany; Faculty of Pharmacy, University of Lahore, Lahore, Pakistan
| | - Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alakeel
- King Saud University Medical City, College of Medicine, King Saud University, 12372 Riyadh, Saudi Arabia
| | - Rita Valdez
- Genetic Unit, Militar Hospital "Dr. Cosme Argerich," C1426BOR Buenos Aires, Argentina
| | - Sofija Buta
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Guadalupe Buda
- Department of Biological Chemistry, School of Natural and Exact Sciences, Buenos Aires University, C1428EGA Buenos Aires, Argentina; Institute of Biological Chemistry, School of Natural and Exact Sciences, IQUIBICEN, Buenos Aires University, CONICET, C1428EGA Buenos Aires, Argentina; Bitgenia, C1064AAT, Buenos Aires, Argentina
| | - Marcelo A Marti
- Department of Biological Chemistry, School of Natural and Exact Sciences, Buenos Aires University, C1428EGA Buenos Aires, Argentina; Institute of Biological Chemistry, School of Natural and Exact Sciences, IQUIBICEN, Buenos Aires University, CONICET, C1428EGA Buenos Aires, Argentina; Bitgenia, C1064AAT, Buenos Aires, Argentina
| | - Margarita Larralde
- Service of Pediatric Dermatology, Ramos Mejía Hospital, C1221ADC Buenos Aires, Argentina
| | - Bertrand Boisson
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U1163, 75015 Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA; Paris University, Imagine Institute, INSERM U1163, 75015 Paris, France
| | | | - Xueer Qiu
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maya Chrabieh
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U1163, 75015 Paris, France; Paris University, Imagine Institute, INSERM U1163, 75015 Paris, France
| | - Mohammed Al Ayed
- Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Saleh Al Muhsen
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jigar V Desai
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
| | - Elise M N Ferre
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
| | - Sergio D Rosenzweig
- Immunology Service, Department of Laboratory Medicine, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA
| | - Blanca Amador-Borrero
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | - Ruth Olmer
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), REBIRTH-Research Center for Translational and Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), 30625 Hannover, Germany
| | - Sylvia Merkert
- Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), REBIRTH-Research Center for Translational and Regenerative Medicine, Hannover Medical School, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research (DZL), 30625 Hannover, Germany
| | | | - Amika K Sood
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC 27599-7310, USA; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC 27517, USA
| | - Abdulkarim Al-Rabiaah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Michelle Hernandez
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC 27599-7310, USA; Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC 27517, USA
| | - Frank Pessler
- TWINCORE Centre for Experimental and Clinical Infection Research, 30625 Hannover, Germany; Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U1163, 75015 Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA; Paris University, Imagine Institute, INSERM U1163, 75015 Paris, France; Howard Hughes Medical Institute, New York, NY 10065, USA; Pediatric Hematology and Immunology Unit, AP-HP, Necker Hospital for Sick Children, 75015 Paris, France
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, U1163, 75015 Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA; Paris University, Imagine Institute, INSERM U1163, 75015 Paris, France; Center for the Study of Primary Immunodeficiencies, AP-HP, Necker Hospital for Sick Children, 75015 Paris, France
| | - Michail S Lionakis
- Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20814, USA
| | - Dusan Bogunovic
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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Alsohime F, Temsah MH, Al-Eyadhy A, Ghulman S, Mosleh H, Alsohime O. Technical Aspects of Intensive Care Unit Management: A Single-Center Experience at a Tertiary Academic Hospital. J Multidiscip Healthc 2021; 14:869-875. [PMID: 33907413 PMCID: PMC8068504 DOI: 10.2147/jmdh.s294905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/26/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Special technical issues associated with the function and maintenance of medical devices arise in intensive care units (ICUs). This study explored the level of comfort of ICU staff in dealing with selected equipment, the factors that are associated with the staff’s ease of adaptation to new technologies, and the role of technical support staff. Patients and Methods This is a single-center cross-sectional questionnaire-based survey that was conducted in February 2018 and targeted nurses working in the ICUs of King Saud University Medical City in Riyadh, Saudi Arabia. Results Among the 297 nurses who completed the survey, almost all of the respondents (99.3%) were aware of the ICU equipment preventive maintenance program. Most of the nurses had received training on how to use infusion pumps (96.2%), cardiac monitoring systems (78.0%), and cardiac defibrillation devices (73.9%). Sixty nurses (20.2%) indicated that at least one super user was available for at least one device. About half of the staff reported one device whose user manual was available. Most nurses reported having no resources regarding updates on medical devices. Conclusion Our findings revealed an alarming need to address technical issues related to medical devices used in the ICU and to design a framework for the safe operation of medical devices based on international practices. It is necessary to empower the role of the super user and medical device clinical educator as well as to optimize communication between the national regulatory body of medical devices and healthcare providers, especially those working in acute care areas.
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Affiliation(s)
- Fahad Alsohime
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia.,Clinical Skills & Simulation Center, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia.,Prince Abdullah Ben Khalid Celiac Disease Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sanaa Ghulman
- Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Haytam Mosleh
- Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Omar Alsohime
- Prince Abdullah Ben Khalid Celiac Disease Research Chair, King Saud University, Riyadh, Saudi Arabia.,Regulation and Registration Support Department, Medical Devices Sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
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Temsah MH, Al-Eyadhy A, Alsohime F, Nassar SM, AlHoshan TN, Alebdi HA, Almojel F, AlBattah MA, Narayan O, Alhaboob A, Hasan GM, Abujamea A. Unintentional exposure and incidental findings during conventional chest radiography in the pediatric intensive care unit. Medicine (Baltimore) 2021; 100:e24760. [PMID: 33655939 PMCID: PMC7939184 DOI: 10.1097/md.0000000000024760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/25/2021] [Indexed: 01/04/2023] Open
Abstract
Radiation overexposure is common in chest X-ray (CXRs) of pediatric patients. However, overexposure may reveal incidental findings that can help to guide patient management or warrant quality improvement.To assess the prevalence of overexposure in CXRs in pediatric intensive care unit (PICU); and identify the incidental findings within overexposed areas, we conducted a retrospective cohort study of children who were admitted to PICU. Two independent evaluators reviewed patient's charts and digital CXRs according to the American College of Radiology standards; to evaluate overexposure of the anatomical parameters and incidental findings.A total of 400 CXRs of 85 patients were reviewed. The mean number of CXRs per patient was 4.7. Almost all (99.75%) CXRs met the criteria for overexposure, with the most common being upper abdomen (99.2%), upper limbs (97%) and neck (95.7%). In addition, 43% of these X-rays were cropped by the radiology technician to appear within the requested perimeter. There was a significant association between field cropping and overexposure (t-test: t = 9.8, P < .001). Incidental findings were seen in 41.5% of the radiographs; with the most common being gaseous abdominal distension (73.1%), low-positioned nasogastric tube (24.6%), and constipation (10.3%).Anatomical overexposure in routine CXRs remains high and raises a concern in PICU practice. Appropriate collimation of the X-ray beam, rather than electronically cropping the image, is highly recommended to minimize hiding incidental findings in the cropped-out areas. Redefining the anatomic boundaries of CXR in critically ill infants and children may need further studies and consideration. Quality improvement initiatives to minimize radiation overexposure in PICU are recommended, especially in younger children and those with more severe illness upon PICU admission.
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Affiliation(s)
- Mohamad-Hani Temsah
- College of Medicine, King Saud University
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City
- Prince Abdullah Ben Khalid Celiac Disease Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- College of Medicine, King Saud University
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City
| | - Fahad Alsohime
- College of Medicine, King Saud University
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City
| | | | | | | | | | | | | | - Ali Alhaboob
- College of Medicine, King Saud University
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City
| | - Gamal Mohamad Hasan
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdullah Abujamea
- College of Medicine, King Saud University
- Radiology Department, King Saud University Medical City, Riyadh, Saudi Arabia
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Batais MA, Temsah MH, AlGhofili H, AlRuwayshid N, Alsohime F, Almigbal TH, Al-Rabiaah A, Al-Eyadhy AA, Mujammami MH, Halwani R, Jamal AA, Somily AM. The coronavirus disease of 2019 pandemic-associated stress among medical students in middle east respiratory syndrome-CoV endemic area: An observational study. Medicine (Baltimore) 2021; 100:e23690. [PMID: 33545936 PMCID: PMC7837988 DOI: 10.1097/md.0000000000023690] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/15/2020] [Indexed: 01/18/2023] Open
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic significantly affected different life aspects, including healthcare communities and academic institutes. We aimed to assess the level of stress and risk factors among medical students and interns during the COVID-19 pandemic in the setting of the middle east respiratory syndrome -CoV endemic area.A questionnaire-based cross-sectional study was conducted on a randomly selected sample of medical students and interns. The questionnaire was anonymously self-administered to indicate perceive hygienic practice change, importance of viral prevention domestic hygiene, perceive adequacy of received information, perceived agreement to facilitators to alleviate covid stress, self-reported stress level, and generalized anxiety disorder score.A total of 322 returned the questionnaire (69.7% response rate). Participants had good knowledge regarding severe acute respiratory syndrome -CoV2 in multiple aspects, with an average score of 13.8 out of 14. Two-thirds (62.4%) of the students experienced mild anxiety, (23.9%) had moderate anxiety, (6.8%) had clinically high anxiety level, and another (6.8%) had a clinically very high anxiety level. The stress level, as reported by the respondents (on a 1-10 scale), showed a correlation with the Generalized Anxiety Disorder scale. We observed an increased level of social avoidance and hygienic practice facilitated by availability of hand sanitizers. Majority of the students receive information regarding COVID-19 from reliable and official resourcesMost students reported mild to moderate levels of anxiety, and was associated with enhancement of their universal precaution measures. The availability of alcohol-based hand sanitizers and the off-campus study were great relievers. The importance of reliable pandemic resources in educating students during pandemics is emphasized. Furthermore, this study indicate the importance of students' support services to address mental health and students' wellbeing in the era of pandemics.
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Affiliation(s)
- Mohammed A. Batais
- College of Medicine, King Saud University, PO Box 242069
- Department of Family and Community Medicine
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, PO Box 242069
- Pediatric Department, College of Medicine
- Prince Abdullah Bin Khaled Coeliac Disease Chair, Faculty of Medicine
| | | | | | - Fahad Alsohime
- College of Medicine, King Saud University, PO Box 242069
- Pediatric Department, College of Medicine
| | - Turky H. Almigbal
- College of Medicine, King Saud University, PO Box 242069
- Department of Family and Community Medicine
| | - Abdulkarim Al-Rabiaah
- College of Medicine, King Saud University, PO Box 242069
- Pediatric Department, College of Medicine
| | - Ayman A. Al-Eyadhy
- College of Medicine, King Saud University, PO Box 242069
- Pediatric Department, College of Medicine
| | - Muhammad Hussain Mujammami
- College of Medicine, King Saud University, PO Box 242069
- Endocrinology and Metabolism Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rabih Halwani
- Sharjah Institute for Medical Research (SIMR), Department of Clinical Sciences, College of Medicine, University of Sharjah, PO. Box 27272, Sharjah, United Arab Emirates
| | - Amr A. Jamal
- College of Medicine, King Saud University, PO Box 242069
- Department of Family and Community Medicine
- Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University
| | - Ali Mohammed Somily
- College of Medicine, King Saud University, PO Box 242069
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
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Alsohime F, Alkhalaf H, Almuzini H, Alyahya M, Allhidan R, Assiry G, AlSalman M, Alshuaibi W, Temsah MH, Alakeel A, Aleyadhy A. Pediatric resident's perception of night float system compared to 24 hours system, a prospective study. BMC Med Educ 2021; 21:23. [PMID: 33407360 PMCID: PMC7789422 DOI: 10.1186/s12909-020-02474-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The study aims to evaluate the perceptions of pediatric residents under the night float (NF) on-call system and its impact on well-being, education, and patient safety compared with the traditional 24-h on-call system. METHODS The study is prospective in nature and conducted on two pediatric resident training centers who apply the NF on-call system as a pilot project. Senior residents (PGY-3 and PGY-4) enrolled in the two training centers were invited to participate before and 6 months after the implementation of the change in the on-call system. A self-administered online questionnaire was distributed. Responses were rated using a five-point Likert-type scale (1 = strongly disagree; 5 = strongly agree). The items covered three main domains, namely, residents' well-being, ability to deliver healthcare, and medical education experience. Pre- and post-intervention scores were presented as means and compared by t-test for paired samples. RESULTS A total of 42 residents participated in the survey (female = 24; 57.1%). All participants were senior residents; 25 (59.6%) were third-year residents (PGY-3), whereas 17 (40.4%) were fourth-year residents (PGY-4). The participants reported that many aspects of the three domains were improved with the introduction of the NF system. The system was perceived to exert less adverse health effect on the residents (mean: 2.37 ± 1.01) compared with the 24-h on-call system (mean: 4.19 ± 0.60; P < 0.001). In addition, the NF system was perceived to lead to less exposure to personal harm and result in less negative impact on quality of care, better work efficiency, reduced potential for medical errors, more successful teaching, and less disruptions to other rotations compared with the 24 h on-call system (P < 0.001). CONCLUSION The perception of senior residents toward the 24-h on-call system pertains to negative impacts on well-being, education, and patient safety compared with on-call systems with restrictive duty hours, such as the NF system, which is perceived to be less harmful, to exert positive impacts on the quality of delivered healthcare services, and more useful from pedagogic aspect.
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Affiliation(s)
- Fahad Alsohime
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia.
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Hamad Alkhalaf
- General Pediatrics and Complex Care, King Abdullah Specialized Children's Hospital, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hissah Almuzini
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
| | - Malak Alyahya
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
| | - Reema Allhidan
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
| | - Ghadeer Assiry
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
| | - Munirah AlSalman
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
| | - Walaa Alshuaibi
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
- Department of Pediatrics, Medical Generics Division, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Abdullah Alakeel
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
| | - Ayman Aleyadhy
- College of Medicine, King Saud University, P.O. 231418, Riyadh, Riyadh, 11321, Saudi Arabia
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
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Bashiri FA, Temsah MH, Hundallah K, Alsohime F, AlRuthia Y. 2020 Update to Spinal Muscular Atrophy Management in Saudi Arabia. Front Pediatr 2021; 9:684134. [PMID: 34136444 PMCID: PMC8200403 DOI: 10.3389/fped.2021.684134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/29/2021] [Indexed: 11/17/2022] Open
Abstract
Novel therapeutic strategies have shown some promise in treating spinal muscular atrophy (SMA). However, the outcomes and acceptance of these new strategies are yet to be explored. We aimed to investigate physicians' opinions and perceptions toward management strategies of SMA across Saudi Arabia. This is a cross-sectional survey using a self-administered, structured questionnaire sent to physicians who care for SMA patients during the Saudi Pediatric Neurology Society annual conference. A total of 72 clinicians of different neurological subspecialties were included. 48.6% prescribed nusinersen to their patients, with 39% of them having patients started on nusinersen. Though, 8.3% prescribed onasemnogene abeparvovec for 1-3 patients, while none of their patients started on the treatment. 64.3% stated that the only treatment available for SMA in their settings is supportive care. Around 69.4% described having a moderate to high knowledge on SMA gene therapy, and 79.2% would recommend it. 48.6% confirmed they would prescribe gene therapy at the age of 6 months, and 78.3% would prescribe it for type-I SMA. Pediatric neurologists are receptive to novel and innovative therapies for SMA in Saudi Arabia. However, the high treatment acquisition cost, strict regulations, logistical issues, and budget constraints delay their adoption and implementation.
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Affiliation(s)
- Fahad A Bashiri
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Pediatric Neurology, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Khalid Hundallah
- Division of Neurology, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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AlRuthia Y, Almuaythir GS, H Alrasheed H, Alsharif WR, Temsah MH, Alsohime F, Sales I, Alwhaibi M, Bashiri FA. Proxy-Reported Quality of Life and Access to Nusinersen Among Patients with Spinal Muscular Atrophy in Saudi Arabia. Patient Prefer Adherence 2021; 15:729-739. [PMID: 33880016 PMCID: PMC8053517 DOI: 10.2147/ppa.s305849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/19/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The recent approval of innovative therapies for spinal muscular atrophy (SMA), such as nusinersen, has brought hope to patients and their families. OBJECTIVE The aims of this study were to compare the characteristics and HRQoL of SMA patients treated with nusinersen and those treated with the standard of care. METHODS This was a cross-sectional, interviewer-administered telephone questionnaire, which used a purposive sampling of SMA patients through a social support network. EuroQol five-dimensions-3-level (EQ-5D-3L) and the visual analog scale (VAS) have been used to assess the HRQoL. Different descriptive and inferential tests have been performed to compare the characteristics, EQ-5D responses, and mean scores of EQ-VAS between patients on nusinersen and the standard of care. RESULTS Eleven out of 36 SMA patients (30.55%) have been treated with nusinersen. Patients with type I SMA represented 54% of those treated with nusinersen (P=0.012). Only 12.5% of SMA patients living in the Mecca region are treated with nusinersen in comparison to 50% of patients living in the Riyadh region (P=0.029). No difference was noticed in the proxy-responses for the five domains of the EQ-5D or the mean VAS scores for patients on nusinersen and the standard of care despite controlling for the SMA type and the ability to breathe independently (β= 1.39, 95% CI= - 5.15-7.93, P=0.667). However, the mean VAS score for patients who are unable to breathe independently was significantly lower than their counterparts who are able to breathe independently even after controlling for the SMA type and nusinersen treatment (β= -31.61, 95% CI= - 51.59 - -11.63, P=0.003). CONCLUSION The results of this study highlight the uncertainty about the impact of nusinersen on SMA patients' HRQoL. Therefore, the impact of nusinersen on HRQoL should be examined using more robust study designs.
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Affiliation(s)
- Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Yazed AlRuthia Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaTel +996 114677483Fax +966 114677480 Email
| | - Ghadah S Almuaythir
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Hala H Alrasheed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Wejdan R Alsharif
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ibrahim Sales
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Monira Alwhaibi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Fahad A Bashiri
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Neurology, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
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Soliman M, AlGhamdi M, Shadid A, Alsaif F, Alkuwaiz L, Alaql M, Khdary M, Basfar A, Alsohime F, Aldhahri S, Neel K. Perception of first-year medical students of virtual video demonstration of the objective structured clinical examination at king saud university medical college in Saudi Arabia during the COVID-19 pandemic. J Nat Sci Med 2021. [DOI: 10.4103/jnsm.jnsm_175_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alsohime F, Assiry G, AlSalman M, Alabdulkareem W, Almuzini H, Alyahya M, Allhidan R, Al-Eyadhy A, Temsah MH, Al Sarkhy AA. Barriers to the delivery of enteral nutrition in pediatric intensive care units: A national survey. Int J Pediatr Adolesc Med 2020; 8:186-190. [PMID: 34350333 PMCID: PMC8319679 DOI: 10.1016/j.ijpam.2020.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/24/2020] [Accepted: 12/09/2020] [Indexed: 11/24/2022]
Abstract
Background and Aim According to previously reported studies in the literature, a significant number of patients do not receive enteral nutrition in pediatric intensive care unit (PICU) because of avoidable barriers. Optimal nutrition is a fundamental goal in PICU. This study aims to identify the barriers of enteral nutrition in PICU. Setting and Design A cross-sectional study of the results of a 25-item questionnaire-based survey distributed during the Annual International Critical Care Conference by the Saudi Critical Care Society. Methods and material A 7-point Likert-type scale was used to rank the participants’ responses, and the relative importance index (RII) approach was used to analyze the relative contribution of each indicator to its main theme. The factor and parallel analysis methods were used to assess the factorial and unidimensionality of the enteral feeding barriers scale. Results A total of 223 PICU healthcare workers from various intensive care settings responded to the survey. The top-three perceived barriers for commencing enteral feeding were due to the patient being hemodynamically unstable (M = 3.6 and SD = 1.70), delays and difficulties in obtaining small bowel access in patients not tolerating other types of enteral nutrition (M = 3.4 and SD = 1.52), or severe fluid restriction, particularly in postoperative cardiac surgery (M = 3.3 and SD = 1.59). The top perceived overall barriers to enteral feeding were the dietician-related issues (M = 3.3, SD = 1.32), barriers related to enteral feeding delivery (M = 3.16 and SD = 1.13), and medical practice-related (M = 3 and SD = 1.10) issues. The lowest reported overall barriers were the resource-related obstacles (M = 2.7 and SD = 1.26). Conclusion Being hemodynamically unstable and other dietician-related reasons were the top overall barriers in commencing enteral feeding.
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Affiliation(s)
- Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ghadeer Assiry
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Wejdan Alabdulkareem
- Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hissah Almuzini
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Malak Alyahya
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Reema Allhidan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ahmed A Al Sarkhy
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Gastroenterology Unit, Pediatric Department, King Khalid University Medical City, King Saud University, Riyadh, Saudi Arabia.,Prince Abdullah Bin Khalid Celiac Disease Research Chair, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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39
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Alsohime F, Temsah MH, Al-Nemri AM, Somily AM, Al-Subaie S. COVID-19 infection prevalence in pediatric population: Etiology, clinical presentation, and outcome. J Infect Public Health 2020; 13:1791-1796. [PMID: 33127335 PMCID: PMC7574780 DOI: 10.1016/j.jiph.2020.10.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 10/01/2020] [Accepted: 10/08/2020] [Indexed: 12/28/2022] Open
Abstract
Novel COVID-19 infections caused major morbidity and mortality globally in the adult age group. Likewise, SARS-COV-2 infections in children are highly risky in the selected patient population. We performed a focused literature search of published reports from December 1, 2019, till August 20, 2020. The aim was to explore the etiology, clinical presentations, and outcome of pediatric COVID-19 patients. Viral respiratory infections are associated with high societal costs for children. In addition, children with asymptomatic SARS-COV-2 infections can be a source of COVID-19 spread to parents and caregivers. The major reported risk factors for pediatric COVID-19 cases were close contact with a SARS-COV-2 positive family member, a history of travel, and/or living in endemic areas. Children with COVID-19 who required ICU care had various comorbidities, such as malignancy. As the pandemic evolved, multiple cases of multisystem inflammatory syndrome in children and adolescents temporarily related to covid-19 (MIS-C) were reported. A unique population is neonates born to COVID-19 affected mothers, as there is an urgent need to optimize their management and outcome during this rapidly evolving pandemic. The early identification of SARS-COV-2 infection in infants and children has important direct management effects in these children and public health implications because of the effects on disease transmission control measures.
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Affiliation(s)
- Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatric, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatric, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman M Al-Nemri
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatric, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali M Somily
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pathology and Laboratory Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sarah Al-Subaie
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatric, King Saud University Medical City, Riyadh, Saudi Arabia.
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40
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Temsah MH, Al-Eyadhy A, Alsohime F, Alhasan KA, Bashiri FA, Salleeh HB, Hasan GM, Alhaboob A, Al-Sabei N, Al-Wehaibi A, Temsah O, Somily AM, Al-Zamil F. Effect of lumbar puncture educational video on parental knowledge and self-reported intended practice. Int J Pediatr Adolesc Med 2020; 8:112-116. [PMID: 34084883 PMCID: PMC8144859 DOI: 10.1016/j.ijpam.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/20/2020] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Abstract
Background Lumbar puncture (LP) remains an essential diagnostic procedure for neurological and infectious diseases. However, it remains a source of anxiety to patients and families. This research aimed to assess the impact of a newly developed educational simplified video about LP, in the parents’ native language, that is tailored to their social background and beliefs and to assess whether it can facilitate their consent for the procedure. Methods This prospective, interventional study was conducted at the outpatient pediatric clinics at a teaching hospital. The conventional arm used verbal explanation about LP. The second method utilized a standardized video, having the same information as the conventional arm, with streaming of graphic depictions. Parents’ knowledge and perceived LP risks were measured before and after the intervention. Results Two hundred and one parents were enrolled, with no significant differences in the socio-demographic and baseline characteristics. Both verbal and video-based counseling were found to provide a statistically significant increase in knowledge scores, and a Wilcoxon signed-rank test showed that knowledge gains for both groups were statistically significant (Verbal Explanation: W = 2693, n = 83, P < .001 and Video: W = 5538, n = 117, P < .001). However, the conventional verbal counseling resulted in more consistent gain of knowledge (SD = 14.5) as compared to the video group (SD = 18.94). The video group reported higher perceived risk (Mean 8.2, SD 3.59) than the verbal explanation group (Mean 7.12, SD 2.51). The less educated parents perceived LP procedure to be of significantly higher risk after watching the video (P < .001). It was found that 73.6% of persons with perceived intention to refuse LP changed their opinion after either of the counseling interventions, with significant opinion difference pre- and post-counseling intervention (P value .002). Conclusions Video education in parents’ native language about LP is as effective as conventional verbal education for informed consent, with the additional advantage of reproducibility and more illustrations to give parents better insight. However, this video should be followed by direct interaction with parents to ensure their full understanding and address any further concerns.
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Affiliation(s)
- Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ayman Al-Eyadhy
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Khalid A Alhasan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Pediatric Nephrology, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad A Bashiri
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Pediatric Neurology, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hashim Bin Salleeh
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Emergency Medicine, Department of Emergency Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Gamal M Hasan
- Pediatric Department, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ali Alhaboob
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Intensive Care Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Narjes Al-Sabei
- Division of General Pediatrics, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | - Omar Temsah
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ali M Somily
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Pathology and Laboratory Medicine College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad Al-Zamil
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Infectious Disease Unit, Pediatric Department, King Saud University Medical City, Riyadh, Saudi Arabia
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41
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Zhang Q, Bastard P, Liu Z, Le Pen J, Moncada-Velez M, Chen J, Ogishi M, Sabli IKD, Hodeib S, Korol C, Rosain J, Bilguvar K, Ye J, Bolze A, Bigio B, Yang R, Arias AA, Zhou Q, Zhang Y, Onodi F, Korniotis S, Karpf L, Philippot Q, Chbihi M, Bonnet-Madin L, Dorgham K, Smith N, Schneider WM, Razooky BS, Hoffmann HH, Michailidis E, Moens L, Han JE, Lorenzo L, Bizien L, Meade P, Neehus AL, Ugurbil AC, Corneau A, Kerner G, Zhang P, Rapaport F, Seeleuthner Y, Manry J, Masson C, Schmitt Y, Schlüter A, Le Voyer T, Khan T, Li J, Fellay J, Roussel L, Shahrooei M, Alosaimi MF, Mansouri D, Al-Saud H, Al-Mulla F, Almourfi F, Al-Muhsen SZ, Alsohime F, Al Turki S, Hasanato R, van de Beek D, Biondi A, Bettini LR, D'Angio' M, Bonfanti P, Imberti L, Sottini A, Paghera S, Quiros-Roldan E, Rossi C, Oler AJ, Tompkins MF, Alba C, Vandernoot I, Goffard JC, Smits G, Migeotte I, Haerynck F, Soler-Palacin P, Martin-Nalda A, Colobran R, Morange PE, Keles S, Çölkesen F, Ozcelik T, Yasar KK, Senoglu S, Karabela ŞN, Rodríguez-Gallego C, Novelli G, Hraiech S, Tandjaoui-Lambiotte Y, Duval X, Laouénan C, Snow AL, Dalgard CL, Milner JD, Vinh DC, Mogensen TH, Marr N, Spaan AN, Boisson B, Boisson-Dupuis S, Bustamante J, Puel A, Ciancanelli MJ, Meyts I, Maniatis T, Soumelis V, Amara A, Nussenzweig M, García-Sastre A, Krammer F, Pujol A, Duffy D, Lifton RP, Zhang SY, Gorochov G, Béziat V, Jouanguy E, Sancho-Shimizu V, Rice CM, Abel L, Notarangelo LD, Cobat A, Su HC, Casanova JL. Inborn errors of type I IFN immunity in patients with life-threatening COVID-19. Science 2020; 370:eabd4570. [PMID: 32972995 PMCID: PMC7857407 DOI: 10.1126/science.abd4570] [Citation(s) in RCA: 1458] [Impact Index Per Article: 364.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/16/2020] [Indexed: 12/15/2022]
Abstract
Clinical outcome upon infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ranges from silent infection to lethal coronavirus disease 2019 (COVID-19). We have found an enrichment in rare variants predicted to be loss-of-function (LOF) at the 13 human loci known to govern Toll-like receptor 3 (TLR3)- and interferon regulatory factor 7 (IRF7)-dependent type I interferon (IFN) immunity to influenza virus in 659 patients with life-threatening COVID-19 pneumonia relative to 534 subjects with asymptomatic or benign infection. By testing these and other rare variants at these 13 loci, we experimentally defined LOF variants underlying autosomal-recessive or autosomal-dominant deficiencies in 23 patients (3.5%) 17 to 77 years of age. We show that human fibroblasts with mutations affecting this circuit are vulnerable to SARS-CoV-2. Inborn errors of TLR3- and IRF7-dependent type I IFN immunity can underlie life-threatening COVID-19 pneumonia in patients with no prior severe infection.
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Affiliation(s)
- Qian Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Zhiyong Liu
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Jérémie Le Pen
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Marcela Moncada-Velez
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Jie Chen
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Masato Ogishi
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Ira K D Sabli
- Department of Paediatric Infectious Diseases & Virology, Imperial College London, London, UK
| | - Stephanie Hodeib
- Department of Paediatric Infectious Diseases & Virology, Imperial College London, London, UK
| | - Cecilia Korol
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
| | - Jérémie Rosain
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Kaya Bilguvar
- Yale Center for Genome Analysis and Department of Genetics, Yale School of Medicine, New Haven, CT, USA
| | - Junqiang Ye
- Zukerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | | | - Benedetta Bigio
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Rui Yang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Andrés Augusto Arias
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Primary Immunodeficiencies Group, University of Antioquia UdeA, Medellin, Colombia
- School of Microbiology, University of Antioquia UdeA, Medellin, Colombia
| | - Qinhua Zhou
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Yu Zhang
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, NIAID, NIH, Bethesda, MD, USA
- NIAID Clinical Genomics Program, NIH, Bethesda, MD, USA
| | - Fanny Onodi
- Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, Paris, France
| | - Sarantis Korniotis
- Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, Paris, France
| | - Léa Karpf
- Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, Paris, France
| | - Quentin Philippot
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Marwa Chbihi
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Lucie Bonnet-Madin
- Laboratory of Genomes & Cell Biology of Disease, INSERM U944, CNRS UMR 7212, Université de Paris, Institut de Recherche Saint-Louis, Hôpital Saint-Louis, Paris, France
| | - Karim Dorgham
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses-Paris (CIMI PARIS), Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Pitié-Salpêtrière, Paris, France
| | - Nikaïa Smith
- Translational Immunology Lab, Institut Pasteur, Paris, France
| | - William M Schneider
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Brandon S Razooky
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Hans-Heinrich Hoffmann
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Eleftherios Michailidis
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Leen Moens
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, Department of Pediatrics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Ji Eun Han
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Lazaro Lorenzo
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Lucy Bizien
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Philip Meade
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anna-Lena Neehus
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Aileen Camille Ugurbil
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Aurélien Corneau
- Sorbonne Université, UMS037, PASS, Plateforme de Cytométrie de la Pitié-Salpêtrière CyPS, Paris, France
| | - Gaspard Kerner
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Peng Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Franck Rapaport
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Yoann Seeleuthner
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Jeremy Manry
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Cecile Masson
- Bioinformatics Platform, Structure Fédérative de Recherche Necker, INSERM UMR1163, Université de Paris, Imagine Institute, Paris, France
| | - Yohann Schmitt
- Bioinformatics Platform, Structure Fédérative de Recherche Necker, INSERM UMR1163, Université de Paris, Imagine Institute, Paris, France
| | - Agatha Schlüter
- Neurometabolic Diseases Laboratory, IDIBELL-Hospital Duran i Reynals, CIBERER U759, and Catalan Institution of Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Tom Le Voyer
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Taushif Khan
- Department of Immunology, Research Branch, Sidra Medicine, Doha, Qatar
| | - Juan Li
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Jacques Fellay
- School of Life sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Swiss Institue of Bioinformatics, Lausanne, Switzerland
| | - Lucie Roussel
- Infectious Disease Susceptibility Program, Research Institute, McGill University Health Centre, Montréal, Québec, Canada
| | - Mohammad Shahrooei
- Specialized Immunology Laboratory of Dr. Shahrooei, Sina Medical Complex, Ahvaz, Iran
- Department of Microbiology and Immunology, Clinical and Diagnostic Immunology, KU Leuven, Leuven, Belgium
| | - Mohammed F Alosaimi
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Davood Mansouri
- Department of Clinical Immunology and Infectious Diseases, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of, Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti, University of Medical Sciences, Tehran, Iran
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti, Iran
| | - Haya Al-Saud
- National Center of Genomics Technology, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Fahd Al-Mulla
- Dasman Diabetes Institute, Department of Genetics and Bioinformatics, Kuwait
| | - Feras Almourfi
- National Center of Genomics Technology, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Saleh Zaid Al-Muhsen
- Immunology Research Laboratory, Department of Pediatrics, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saeed Al Turki
- Translational Pathology, Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Misery of National Guard Health Affairs, Riyadh, Saudi Arabia
- Cancer & Blood Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Rana Hasanato
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Diederik van de Beek
- Amsterdam UMC, Department of Neurology, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Andrea Biondi
- Pediatric Departement and Centro Tettamanti-European Reference Network PaedCan, EuroBloodNet, MetabERN-University of Milano-Bicocca-Fondazione MBBM-Ospedale, San Gerardo, Monza, Italy
| | - Laura Rachele Bettini
- Pediatric Departement and Centro Tettamanti-European Reference Network PaedCan, EuroBloodNet, MetabERN-University of Milano-Bicocca-Fondazione MBBM-Ospedale, San Gerardo, Monza, Italy
| | - Mariella D'Angio'
- Pediatric Departement and Centro Tettamanti-European Reference Network PaedCan, EuroBloodNet, MetabERN-University of Milano-Bicocca-Fondazione MBBM-Ospedale, San Gerardo, Monza, Italy
| | - Paolo Bonfanti
- Department of Infectious Diseases, San Gerardo Hospital-University of Milano-Bicocca, Monza, Italy
| | - Luisa Imberti
- CREA Laboratory, Diagnostic Laboratory, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandra Sottini
- CREA Laboratory, Diagnostic Laboratory, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Simone Paghera
- CREA Laboratory, Diagnostic Laboratory, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Eugenia Quiros-Roldan
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali di Brescia, Brescia, Italy
| | - Camillo Rossi
- Chief Medical Officer, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Andrew J Oler
- Bioinformatics and Computational Biosciences Branch, Office of Cyber Infrastructure and Computational Biology, NIAID, NIH, Bethesda, MD, USA
| | - Miranda F Tompkins
- PRIMER, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Camille Alba
- PRIMER, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Isabelle Vandernoot
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Christophe Goffard
- Department of Internal Medicine, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Guillaume Smits
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Migeotte
- Fonds de la Recherche Scientifique (FNRS) and Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Filomeen Haerynck
- Department of Paediatric Immunology and Pulmonology, Centre for Primary Immunodeficiency Ghent (CPIG), PID Research Lab, Jeffrey Modell Diagnosis and Research Centre, Ghent University Hospital, Ghent, Belgium
| | - Pere Soler-Palacin
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Andrea Martin-Nalda
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Roger Colobran
- Immunology Division, Genetics Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Vall d'Hebron Barcelona Hospital Campus, UAB, Barcelona, Catalonia, Spain
| | | | - Sevgi Keles
- Necmettin Erbakan University, Meram Medical Faculty, Division of Pediatric Allergy and Immunology, Konya, Turkey
| | - Fatma Çölkesen
- Department of Infectious Diseases and Clinical Microbiology, Konya Training and Research Hospital, Konya, Turkey
| | - Tayfun Ozcelik
- Department of Molecular Biology and Genetics, Bilkent University, Bilkent-Ankara, Turkey
| | - Kadriye Kart Yasar
- Departments of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sevtap Senoglu
- Departments of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Şemsi Nur Karabela
- Departments of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Carlos Rodríguez-Gallego
- Department of Immunology, Hospital Universitario de G.C. Dr. Negrín, Canarian Health System, Las Palmas de Gran Canaria, Spain
- University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Giuseppe Novelli
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome, Italy
| | | | - Yacine Tandjaoui-Lambiotte
- Avicenne Hospital Intensive Care Unit, APHP, Bobigny, INSERM U1272 Hypoxia & Lung, Paris, France
- PH Réanimation CHU Avicenne, Bobigny, INSERM U1272 Hypoxie & Poumon, Paris, France
| | - Xavier Duval
- Université de Paris, IAME UMR-S 1137, INSERM, Paris, France
- Inserm CIC 1425, Paris, France
| | - Cédric Laouénan
- Université de Paris, IAME UMR-S 1137, INSERM, Paris, France
- Inserm CIC 1425, Paris, France
- AP-HP, Département Epidémiologie Biostatistiques et Recherche Clinique, Hôpital Bichat, Paris, France
| | - Andrew L Snow
- Department of Pharmacology & Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Clifton L Dalgard
- PRIMER, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Department of Anatomy, Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Joshua D Milner
- Division of Pediatric Allergy, Immunology and Rheumatology, Columbia University, New York, USA
| | - Donald C Vinh
- Infectious Disease Susceptibility Program, Research Institute, McGill University Health Centre, Montréal, Québec, Canada
| | - Trine H Mogensen
- Department of Infectious Diseases, Aarhus University Hospital, Skejby, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Nico Marr
- Department of Immunology, Research Branch, Sidra Medicine, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - András N Spaan
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Department of Medical Microbiology, Utrecht UMC, Utrecht, Netherlands
| | - Bertrand Boisson
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Stéphanie Boisson-Dupuis
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Jacinta Bustamante
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Paris, France
| | - Anne Puel
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Michael J Ciancanelli
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Turnstone Biologics, New York, NY, USA
| | - Isabelle Meyts
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, Department of Pediatrics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Tom Maniatis
- Zukerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- New York Genome Center, New York, NY, USA
| | - Vassili Soumelis
- Université de Paris, Institut de Recherche Saint-Louis, INSERM U976, Hôpital Saint-Louis, Paris, France
- AP-HP, Hôpital Saint-Louis, Laboratoire d'Immunologie, Paris, France
| | - Ali Amara
- Laboratory of Genomes & Cell Biology of Disease, INSERM U944, CNRS UMR 7212, Université de Paris, Institut de Recherche Saint-Louis, Hôpital Saint-Louis, Paris, France
| | - Michel Nussenzweig
- Laboratory of Molecular Immunology, Rockefeller University, New York, NY, USA
- Howard Hughes Medical Institute, New York, NY, USA
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aurora Pujol
- Neurometabolic Diseases Laboratory, IDIBELL-Hospital Duran i Reynals, CIBERER U759, and Catalan Institution of Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Darragh Duffy
- Translational Immunology Lab, Institut Pasteur, Paris, France
| | - Richard P Lifton
- Laboratory of Genetics and Genomics, The Rockefeller University, New York, NY, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
- Yale Center for Genome Analysis, Yale School of Medicine, New Haven, CT, USA
| | - Shen-Ying Zhang
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Guy Gorochov
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses-Paris (CIMI PARIS), Assistance Publique-Hôpitaux de Paris (AP-HP) Hôpital Pitié-Salpêtrière, Paris, France
| | - Vivien Béziat
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Emmanuelle Jouanguy
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Vanessa Sancho-Shimizu
- Department of Paediatric Infectious Diseases & Virology, Imperial College London, London, UK
| | - Charles M Rice
- Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA
| | - Laurent Abel
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Luigi D Notarangelo
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, NIAID, NIH, Bethesda, MD, USA
- NIAID Clinical Genomics Program, NIH, Bethesda, MD, USA
| | - Aurélie Cobat
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Helen C Su
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, NIAID, NIH, Bethesda, MD, USA
- NIAID Clinical Genomics Program, NIH, Bethesda, MD, USA
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- Howard Hughes Medical Institute, New York, NY, USA
- Pediatric Hematology and Immunology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
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Al-Rabiaah A, Temsah MH, Al-Eyadhy AA, Hasan GM, Al-Zamil F, Al-Subaie S, Alsohime F, Jamal A, Alhaboob A, Al-Saadi B, Somily AM. Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) associated stress among medical students at a university teaching hospital in Saudi Arabia. J Infect Public Health 2020; 13:687-691. [PMID: 32001194 PMCID: PMC7102651 DOI: 10.1016/j.jiph.2020.01.005] [Citation(s) in RCA: 211] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 11/09/2019] [Accepted: 01/02/2020] [Indexed: 12/16/2022] Open
Abstract
Background and objectives Middle East Respiratory Syndrome Corona Virus (MERS-CoV) outbreak in 2014 was associated with high public anxiety in the affected countries. Media speculations may have increased this psychological distress. The healthcare community was the most distressed because they were at the highest risk of infection. This study is the first to explore MERS-CoV epidemic impact on medical students’ perception and determinants of their psychological distress during this outbreak. Methods We randomly selected and surveyed 200 students from the College of Medicine at King Saud University, Riyadh, Saudi Arabia. A predesigned questionnaire was answered by participants, and the collected data were statistically analyzed. Results One hundred and seventy-four (87%) responded. Female students had a significantly higher mean stress level than males (P < 0.001). Participants had a mean GAD score of 2.7 ± 3.1 and a median of 2. Perceived sufficiency of information score was the highest mean and median (17.4 ± 4.2 and 18 respectively). College and hospital announcements were the most common source of information (25.4%). One hundred and thirty-four (77%) reported minimal anxiety, thirty-two (18.4%) reported mild anxiety, 8 (4.6%) reported moderate anxiety, and none of them reported severe anxiety (score >14). The stress level (as reported on 1–10 scale) shows significant correlation with Generalized Anxiety Disorder (GAD-7) score. We found in this study that significant predictors in our model, in terms of more significant to the least, were: an increased self-report on hygienic habits, self-reported social avoidance, the generalized anxiety score and finally being female gander while other variables including numbers of resources access, agreeing with public fear and knowledge score on MERS-CoV all were found to be non-significant. However, the number of accessed resources, as per students, has borderline significant correlation with higher self-reported anxiety from MERS-CoV. Conclusions Medical students’ psychological needs during the MERS-CoV outbreak should be addressed appropriately. Our results highlight the need to establish psychological support programs for medical students during an infectious disease outbreak.
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Affiliation(s)
- Abdulkarim Al-Rabiaah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia; Prince Abdullah Bin Khaled Coeliac Disease Chair, Faculty of Medicine, King Saud University, Saudi Arabia
| | - Ayman A Al-Eyadhy
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Gamal M Hasan
- Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia; Assiut University Children Hospital, Assiut Faculty of Medicine, Assiut University, Egypt
| | - Fahad Al-Zamil
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sarah Al-Subaie
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Amr Jamal
- Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Evidence-Based Healthcare and Knowledge translation Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alhaboob
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Basma Al-Saadi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Mohammed Somily
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia.
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43
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Abstract
Hypertensive crisis is a deadly complication that should be avoided at all costs, let alone when it is associated with a rare disease, such as polyarteritis nodosa. We present a case of a child who initially came to our hospital with a prolonged high-grade fever responding to antipyretics. Upon follow up, the patient went into a hypertensive crisis, which led to the admission to the Pediatric Intensive Care Unit (PICU). The hypertension was difficult to control until the culprit was revealed. Polyarteritis nodosa was then diagnosed by angiography, which revealed tight stenosis of the right renal artery. Prompt treatment was initiated, and the patient's blood pressure normalized. Our case highlights the importance of detecting such diseases, since it may be easily missed as it usually presents with nonspecific symptoms. Hypertension in children shouldn't be taken lightly and should be investigated promptly. We hope our case report sheds enough light on this issue for other clinicians and researches to identify and prevent later on.
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Affiliation(s)
- Fahad Alsohime
- Pediatric Intensive Care Unit, King Khalid University Hospital, Riyadh, SAU
| | - Talal AlHoshan
- Pediatric Intensive Care Unit, King Khalid University Hospital, Riyadh, SAU
| | - Faisal Almojel
- Pediatric Intensive Care Unit, King Khalid University Hospital, Riyadh, SAU
| | - Nader A Rezeni
- Pediatric Intensive Care Unit, King Khalid Unversity Hospital, Riyadh, SAU
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44
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Alsohime F, Martin-Fernandez M, Temsah MH, Alabdulhafid M, Le Voyer T, Alghamdi M, Qiu X, Alotaibi N, Alkahtani A, Buta S, Jouanguy E, Al-Eyadhy A, Gruber C, Hasan GM, Bashiri FA, Halwani R, Hassan HH, Al-Muhsen S, Alkhamis N, Alsum Z, Casanova JL, Bustamante J, Bogunovic D, Alangari AA. JAK Inhibitor Therapy in a Child with Inherited USP18 Deficiency. N Engl J Med 2020; 382:256-265. [PMID: 31940699 PMCID: PMC7155173 DOI: 10.1056/nejmoa1905633] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Deficiency of ubiquitin-specific peptidase 18 (USP18) is a severe type I interferonopathy. USP18 down-regulates type I interferon signaling by blocking the access of Janus-associated kinase 1 (JAK1) to the type I interferon receptor. The absence of USP18 results in unmitigated interferon-mediated inflammation and is lethal during the perinatal period. We describe a neonate who presented with hydrocephalus, necrotizing cellulitis, systemic inflammation, and respiratory failure. Exome sequencing identified a homozygous mutation at an essential splice site on USP18. The encoded protein was expressed but devoid of negative regulatory ability. Treatment with ruxolitinib was followed by a prompt and sustained recovery. (Funded by King Saud University and others.).
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Affiliation(s)
- Fahad Alsohime
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Marta Martin-Fernandez
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Mohamad-Hani Temsah
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Majed Alabdulhafid
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Tom Le Voyer
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Malak Alghamdi
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Xueer Qiu
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Najla Alotaibi
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Areej Alkahtani
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Sofija Buta
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Emmanuelle Jouanguy
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Ayman Al-Eyadhy
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Conor Gruber
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Gamal M Hasan
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Fahad A Bashiri
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Rabih Halwani
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Hamdy H Hassan
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Saleh Al-Muhsen
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Nouf Alkhamis
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Zobaida Alsum
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Jean-Laurent Casanova
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Jacinta Bustamante
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Dusan Bogunovic
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
| | - Abdullah A Alangari
- From the Department of Pediatrics (F.A., M.-H.T., M. Alabdulhafid, M. Alghamdi, N. Alotaibi, A.A., A.A.-E., G.M.H., F.A.B., S.A.-M., N. Alkhamis, Z.A., A.A.A.) and the Immunology Research Laboratory, Department of Pediatrics (R.H., S.A.-M.), College of Medicine, King Saud University, the Department of Pediatrics, College of Medicine, Imam Mohammed bin Saud University (A.A.), and the Department of Radiology and Medical Imaging, King Saud University Medical City (H.H.H.) - all in Riyadh, Saudi Arabia; the Departments of Microbiology and Pediatrics and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai (M.M.-F., X.Q., S.B., C.G., D.B.), St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, the Rockefeller University (E.J., J.-L.C., J.B.), and Howard Hughes Medical Institute (J.-L.C.) - all in New York; Paris Descartes University, Imagine Institute, and the Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM Unité 1163 (T.L.V., E.J., J.-L.C., J.B.), and the Pediatric Hematology and Immunology Unit (J.-L.C.) and the Center for the Study of Primary Immunodeficiencies (J.B.), Assistance Publique-Hôpitaux de Paris, Necker Hospital for Sick Children - all in Paris; the Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt (G.M.H.); and Sharjah Institute for Medical Research, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates (R.H.)
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Alsohime F, Temsah MH, Al-Jelaify M, Bafaqih H, El Masri K, Abusibah A, Al-Eyadhy A, Hasan G, Alhaboob A, Alabdulhafid M, Almazyad M, Alghamdi A, Bashiri F. Nusinersen in spinal muscular atrophy: Respiratory outcomes at tertiary care centers. J Nat Sci Med 2020. [DOI: 10.4103/jnsm.jnsm_68_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alsubaie S, Hani Temsah M, Al-Eyadhy AA, Gossady I, Hasan GM, Al-Rabiaah A, Jamal AA, Alhaboob AA, Alsohime F, Somily AM. Middle East Respiratory Syndrome Coronavirus epidemic impact on healthcare workers' risk perceptions, work and personal lives. J Infect Dev Ctries 2019; 13:920-926. [PMID: 32084023 DOI: 10.3855/jidc.11753] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/03/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Middle East respiratory syndrome coronavirus (MERS-CoV) continues to cause frequent outbreaks in hospitals in Saudi Arabia. Since healthcare workers (HCWs) have a higher risk of acquiring and spreading MERS-CoV, we aimed to evaluate the perceived risk and anxiety level of HCWs in Saudi Arabia regarding MERS. METHODOLOGY An anonymous, self-administered questionnaire was sent online to HCWs at King Khalid University Hospital in Saudi Arabia. The total knowledge and anxiety scores were calculated. Logistic regression analyses were used to identify predictors of high anxiety scores. RESULTS Of 591 (70%) HCWs that responded, 284 (55%), 164 (32%), and 68 (13.2%) were physicians, nurses, and technicians, respectively. Physicians obtained a lower median knowledge score (6/9) compared to other professions (7/9). The mean anxiety score was similar for physicians and other HCWs (3/5); however, non-physicians expressed higher levels of anxiety toward the risk of transmitting MERS-CoV to their families, with an anxiety score of 4/5. The ability of the virus to cause severe disease or death was the most frequently reported reason for worry by physicians (89.7%) and non-physicians (87.2%). Overall, 80% of physicians and 90% of non-physicians reported improvement in adherence to hand hygiene and standard precautions while in hospital (p = 0.002). Concern over transmitting MERS-CoV to family members was the most predictive factor for anxiety among non-physician HCWs. CONCLUSION A significant proportion of HCWs expressed anxiety about the risk of acquiring MERS-CoV infection. Healthcare institutions need to develop an integrated psychological response for HCWs to the occupational and psychological challenge of MERS-CoV outbreaks.
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Affiliation(s)
- Sarah Alsubaie
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | | | | | - Ibrahim Gossady
- Departments of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.
| | - Gamal M Hasan
- Pediatric Department, Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia.
| | | | - Amr A Jamal
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Ali An Alhaboob
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Fahad Alsohime
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Ali M Somily
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Alsohime F, Temsah MH, Al-Eyadhy A, Bashiri FA, Househ M, Jamal A, Hasan G, Alhaboob AA, Alabdulhafid M, Amer YS. Satisfaction and perceived usefulness with newly-implemented Electronic Health Records System among pediatricians at a university hospital. Comput Methods Programs Biomed 2019; 169:51-57. [PMID: 30638591 DOI: 10.1016/j.cmpb.2018.12.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/19/2018] [Accepted: 12/24/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Apposite implementation of Electronic Health Records (EHR) is anchoring standards of care in healthcare settings by reducing long-run operational costs, improving healthcare quality, and enhancing patient safety. OBJECTIVE This study aims to explore factors that might influence Pediatricians' satisfaction with an implemented EHR system and its perceived usefulness at a tertiary-care teaching hospital, Riyadh, Saudi Arabia. METHODS A cross-sectional survey distributed to all physicians working in the pediatric department of King Saud University Medical City (KSUMC) in the period from June to November 2015, two months after the launch of the EHR system, internally branded as electronic system for integrated health information (eSiHi). Bivariate and multivariate regression were analyzed to examine factors associated with physicians' satisfaction. RESULTS Of the 112 physicians who completed the survey, 97 (86.6%) attended training courses before the implementation of new EHR. On average, the participants rated the perceived usefulness of the new system at 6.4/10 for patient care and physicians' satisfaction levels were 5.2/10. The top indicator of EHR usefulness was the system's ability to reduce errors and improve the quality of care [mean 3.31, SD 0.9, RII 82.8%]; the lowest-ranking indicator was the physicians' perceived familiarity with functions and benefits [mean 2.68, SD 0.7, RII 67%]. The top indicator of satisfaction with the EHR system was enhanced "individual performance" [mean 3.04, SD 1, RII 60.9%]; the lowest-ranking perceived indicator was the limited availability of workplace computers [mean 1.91, SD 1.2, RII 38.2%]. CONCLUSIONS Limited data regarding EHR implementation and end-users satisfaction in the Middle East region necessitates further work on factors affecting levels of satisfaction with the EHR system among different health institutes. Lack of information technology (IT) support, hardware, and time-consuming data entry process are challenging barriers for proper utilization of EHR for pediatric health care services.
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Affiliation(s)
- Fahad Alsohime
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia; Prince Abdullah Ben Khaled Celiac Disease Research Chair, King Saud University, Riyadh, Saudi Arabia.
| | - Ayman Al-Eyadhy
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fahad A Bashiri
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Division of Neurology, Department of Pediatrics, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mowafa Househ
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Amr Jamal
- Family and Community Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Gamal Hasan
- Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia; Pediatric Department, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ali A Alhaboob
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Yasser S Amer
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Clinical Practice Guidelines Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia; Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia
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Alsohime F, Assiri RA, Al-Shahrani F, Bakeet H, Elhazmi M, Somily AM. Premature labor and neonatal sepsis caused by Actinomyces neuii. J Infect Public Health 2018; 12:282-284. [PMID: 29706318 DOI: 10.1016/j.jiph.2018.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/28/2018] [Accepted: 04/08/2018] [Indexed: 10/17/2022] Open
Abstract
Actinomycosis is a rare infection in patients younger than 10years of age. It mainly affects the cervicofacial region, but many other sites of infection have been recognized. About 70% of infections are due to either Actinomyces israelii or Actinomyces gerencseriae. Actinomyces neuii was first described in 1985 in two patients with post cataract endophthalmitis, A. neuii represents 17% of clinical Actinomyces isolates. Several reports indicated a well-known association between Actinomyces infections and Intrauterine devices (IUD). We are reporting a case of neonatal sepsis due to A. neuii as a first case reported from Saudi Arabia. It was thought to be the cause of the premature labor and neonatal sepsis. The prevalence of Actinomyces infection is likely underestimated and additional premature labors and abortions could have been caused by Actinomyces infections that were never detected. More studies are needed to confirm the association of maternal Actinomyces infections with preterm labor.
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Affiliation(s)
- Fahad Alsohime
- Department of Pediatric, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Rasha A Assiri
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Fatimah Al-Shahrani
- Department of Medicine, Division of Infectious Diseases, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hind Bakeet
- Department of Pediatric, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Malak Elhazmi
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali M Somily
- Department of Pediatric, College of Medicine, King Saud University and King Saud University Medical City, Riyadh, Saudi Arabia.
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Alsohime F, Harrington K, Vobecky S, Tremblay J, Toledano B. Single-center experience with pediatric patients on ECMO who received recombinant factor VIIa for refractory bleeding. Qatar Med J 2017. [PMCID: PMC5474637 DOI: 10.5339/qmj.2017.swacelso.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Fahad Alsohime
- 1Department of PICU, Sainte-Justine Hospital, Montreal, QC, Canada
- 2College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Karen Harrington
- 1Department of PICU, Sainte-Justine Hospital, Montreal, QC, Canada
| | - Suzanne Vobecky
- 1Department of PICU, Sainte-Justine Hospital, Montreal, QC, Canada
| | - Julie Tremblay
- 1Department of PICU, Sainte-Justine Hospital, Montreal, QC, Canada
| | - Baruch Toledano
- 1Department of PICU, Sainte-Justine Hospital, Montreal, QC, Canada
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Alsohime F. Experience With Levosimendan as an Alternative to Catecholamines in Children. Chest 2015. [DOI: 10.1378/chest.2220367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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