Clinical Outcomes of Pediatric COVID-19 in a Tertiary Care Center in Bangkok, Thailand

The implementation of severe combined immunodeficiency (SCID) newborn screening has played a pivotal role in identifying these patients early in life as well as detecting various milder forms of T cell lymphopenia (TCL). In this study we reviewed the diagnostic and clinical outcomes, and interesting immunology findings of term infants referred to a tertiary care center with abnormal newborn SCID screens over a 6-year period. Key findings included a 33% incidence of non-SCID TCL including infants with novel variants in FOXN1, TBX1, MYSM1, POLD1, and CD3E; 57% positivity rate of newborn SCID screening among infants with DiGeorge syndrome; and earlier diagnosis and improved transplant outcomes for SCID in infants diagnosed after compared to before implementation of routine screening. Our study is unique in terms of the extensive laboratory workup of abnormal SCID screens including lymphocyte subsets, measurement of thymic output (TREC and CD4TE), and lymphocyte proliferation to mitogens in nearly all infants. These data allowed us to observe a stronger positive correlation of the absolute CD3 count with CD4RTE than with TREC copies, and a weak positive correlation between CD4RTE and TREC copies. Finally, we did not observe a correlation between risk of TCL and history of prenatal or perinatal complications or low birth weight. Our study demonstrated SCID newborn screening improves disease outcomes, particularly in typical SCID, and allows early detection and discovery of novel variants of certain TCL-associated genetic conditions.

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Deep Neck Space Infection: Clinical Outcomes of Patients Treated in a Tertiary Care Center

Hamidiye Medical Journal ◽

10.4274/hamidiyemedj.galenos.2021.30602 ◽

2021 ◽

Vol 2 (1) ◽

pp. 20-26

Author(s):

Kerem Sami Kaya ◽

İbrahim Yağcı ◽

Uğur Doğan ◽

Nurullah Seyhun ◽

Suat Turgut

Keyword(s):

Clinical Outcomes ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Space Infection ◽

Deep Neck Space Infection

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Risk Factors and Clinical Outcomes of Childhood Ischemic Stroke in a Single Korean Tertiary Care Center

Journal of Child Neurology ◽

10.1177/0883073811420297 ◽

2011 ◽

Vol 27 (4) ◽

pp. 485-491 ◽

Cited By ~ 13

Author(s):

Eun Hye Lee ◽

Mi-Sun Yum ◽

Tae-Sung Ko

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Clinical Outcomes ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center

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Abstract 240: Concomitant Use of Therapeutic Hypothermia with Mechanical Circulatory Support in Patients Post Cardiac Arrest in Cardiogenic Shock: A Single Center Experience

Circulation ◽

10.1161/circ.130.suppl_2.240 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Michael G Silverman ◽

Molly H O’Brien ◽

Kathleen R Avery ◽

Annmarie Chase ◽

Carol D Pierce ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiogenic Shock ◽

Clinical Outcomes ◽

Hospital Discharge ◽

Mechanical Circulatory Support ◽

Care Center ◽

Tertiary Care ◽

Circulatory Support ◽

Tertiary Care Center ◽

Baseline Characteristics

Background: The concurrent use of therapeutic hypothermia (TH) following cardiac arrest and mechanical circulatory support (MCS) for cardiogenic shock is becoming increasingly common. Little is known however, about the combined use of TH and MCS for patients after ROSC following a cardiac arrest who remain in cardiogenic shock. Therefore we describe the experience with concomitant use of TH and MCS from a large academic tertiary care center in Boston. Methods: Baseline characteristics and clinical outcomes at hospital discharge were reported for patients undergoing TH following cardiac arrest who also received MCS for cardiogenic shock. MCS included Intra-aortic balloon pump (IABP) two percutaneous ventricular assist devices (Impella, and TandemHeart), and extracorporeal membrane oxygenation (ECMO). Clinical outcomes included mortality as well as cerebral performance category (CPC) at hospital discharge. Results: There were a total of 14 patients who underwent concomitant TH and MCS following a cardiac arrest. Baseline characteristics and clinical outcomes are noted in the Figure. 9 patients underwent placement of IABP, 2 patients an Impella pump, 2 patients a TandemHeart, and 1 patient ECMO. All 14 cardiac arrests were due to cardiovascular etiologies; 9 of 14 had STEMI. 9 of 14 patients had an initial shockable rhythm. Mean age was 56 years (+/- 19), mean downtime was 35 minutes (+/- 24). All patients were vasopressor dependent. Bleeding events are noted in the table. 8 patients survived to hospital discharge, all with good neurologic outcome. These rates were comparable to the survival rates and neurologic outcomes among 82 patients who underwent TH post cardiac arrest (from cardiovascular etiologies) without concomitant MCS (Figure). Conclusion: Based on our experience from a large academic tertiary care center, concomitant use of TH and MCS is both safe and feasible with an encouraging rate of cardiac and neurologic recovery.

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