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Bjørklund G, Semenova Y, Hangan T, Pen JJ, Aaseth J, Peana M. Perspectives on Iron Deficiency as a Cause of Human Disease in Global Public Health. Curr Med Chem 2024; 31:1428-1440. [PMID: 38572614 DOI: 10.2174/0929867330666230324154606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/23/2022] [Accepted: 12/13/2022] [Indexed: 04/05/2024]
Abstract
Iron (Fe) is a necessary trace element in numerous pathways of human metabolism. Therefore, Fe deficiency is capable of causing multiple health problems. Apart from the well-known microcytic anemia, lack of Fe can cause severe psychomotor disorders in children, pregnant women, and adults in general. Iron deficiency is a global health issue, mainly caused by dietary deficiency but aggravated by inflammatory conditions. The challenges related to this deficiency need to be addressed on national and international levels. This review aims to summarize briefly the disease burden caused by Fe deficiency in the context of global public health and aspires to offer some hands-on guidelines.
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Affiliation(s)
- Geir Bjørklund
- Department of Research, Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway
| | - Yuliya Semenova
- Department of Surgery, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Tony Hangan
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Joeri J Pen
- Department of Nutrition, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Diabetes Clinic, Department of Internal Medicine, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jan Aaseth
- Research Department, Innlandet Hospital, Brumunddal, Norway
- Inland Norway University of Applied Sciences, Elverum, Norway
| | - Massimiliano Peana
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, Sassari, Italy
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Yu JY, Kim TH, Kim YJ, Kang HM, Yoo IH, Rhim JW, Lee SY, Jeong DC. Macrophage activation syndrome in neonatal lupus presenting with fever and rash. JOURNAL OF RHEUMATIC DISEASES 2024; 31:49-53. [PMID: 38130956 PMCID: PMC10730804 DOI: 10.4078/jrd.2023.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 01/01/2020] [Accepted: 01/01/2020] [Indexed: 12/23/2023]
Abstract
Neonatal lupus can occur in infants born to mother with autoimmune disorders through transplacental auto-antibodies. Clinical manifestations in neonatal lupus include cutaneous lesions and hematologic or hepatobiliary findings resembling those seen in systemic lupus erythematosus. In autoimmune state, macrophage activation syndrome (MAS) represent a critical and potentially fatal complication that can result in mortality if not immediately identified and managed with the appropriate care. Here we present a 33-day-old girl diagnosed with neonatal lupus and serious MAS. She was delivered by a primipara mother who did not exhibit any autoimmune symptoms. The patient visited the hospital due to fever and pancytopenia. Laboratory data were compatible with MAS, including pancytopenia, high level of ferritin, soluble interleukin-2, and decreased natural killer cell activity. In addition, autoimmune study showed positive results for anti-nuclear antibody (ANA), anti-Sjogren syndrome antigen A (SSA), and SSB, The autoimmune study for mother also showed positive results for ANA, anti-SSA, and SSB. The patient recovered after she received high dose steroid and supportive care. Our case indicates that neonatal lupus should be taken into consideration when fever, erythematous skin rash, and pancytopenia are observed in infants, even if their mothers have no prior history of autoimmune conditions.
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Affiliation(s)
- Ji Yoon Yu
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae Hwan Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ye Ji Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Mi Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - In Hyuk Yoo
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Woo Rhim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soo Young Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dae Chul Jeong
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Picca M, Carrozzo R, Milani GP, Corsello A, Macchi M, Buzzetti R, Marchisio P, Mameli C. Leading reasons for antibiotic prescriptions in pediatric respiratory infections: influence of fever in a primary care setting. Ital J Pediatr 2023; 49:131. [PMID: 37775784 PMCID: PMC10541709 DOI: 10.1186/s13052-023-01533-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Antibiotic overuse in children is a significant public health concern, as it can lead to the emergence and spread of antibiotic-resistant bacteria. Although respiratory infections account for most antibiotic prescriptions in children, many of these infections are viral and do not require antibiotics. In this study, we aimed to investigate the use of antibiotics in children with respiratory infections in a primary care setting and to explore the possible role of fever on antibiotic prescription. METHODS We conducted a prospective observational study that evaluated preschool children aged 0-5 years who were assessed by their primary care pediatricians for respiratory infectious diseases between October 2019 and March 2021. The study involved 69 public primary care pediatricians and a total of 678 pediatric episodes for respiratory infections. RESULTS Amoxicillin/clavulanate was the most frequently prescribed drug. Bronchitis accounted for most of inappropriate antibiotic prescriptions (73%). Furthermore, the presence of fever was associated with a ~ 300% increase in the likelihood of prescribing antibiotics for respiratory infections that do not typically require antibiotics. CONCLUSION Our findings emphasize the need for adherence to international guidelines and recommendations in the primary care of children to reduce unnecessary antibiotic use and prevent the development of antibiotic resistance. This study also underscores the potential relevance of new studies to evaluate antibiotic prescription attitudes in other clinical settings and geographical areas.
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Affiliation(s)
- Marina Picca
- Italian Primary Care Paediatrics Society (SICuPP), Lombardy, Italy
| | - Romeo Carrozzo
- Italian Primary Care Paediatrics Society (SICuPP), Lombardy, Italy
| | - Gregorio Paolo Milani
- Department of Health Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Corsello
- Department of Health Science and Community Health, University of Milan, Milan, Italy.
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- University of Milan, Via della Commenda 9, Milan, 20122, Italy.
| | - Marina Macchi
- Department of Health Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- University of Milan, Via della Commenda 9, Milan, 20122, Italy
| | - Chiara Mameli
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy
- Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Milan, Italy
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Wang H, Chang Y, Xin M, Hou T, Han L, Zhang R, Liu Z, Sun B, Gan L. Hypothermia or hyperthermia, which is associated with patient outcomes in critically ill children with sepsis? -A retrospective study. BMJ Open 2023; 13:e067716. [PMID: 37068899 PMCID: PMC10111912 DOI: 10.1136/bmjopen-2022-067716] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
OBJECTIVES In the early stage of sepsis, identifying high-risk paediatric patients with a poor prognosis and providing timely and adequate treatment are critical. This study aimed to evaluate the effect of average body temperature within 24 hours of admission on the short-term prognosis of paediatric patients with sepsis. DESIGN A retrospective cohort study. SETTING A single-centre, tertiary care hospital in China, containing patient data from 2010 to 2018. PARTICIPANTS 1144 patients with sepsis were included. INTERVENTION None. PRIMARY AND SECONDARY OUTCOME MEASURES The main outcome measure was in-hospital mortality, which was defined as death from any cause during hospitalisation. The secondary outcome was the length of hospital stay. RESULTS The LOWESS method showed a roughly 'U'-shaped relationship between body temperature on the first day and in-hospital mortality. Multivariate logistic regression showed that severe hypothermia (OR 14.72, 95% CI 4.84 to 44.75), mild hypothermia (OR 3.71, 95% CI 1.26 to 10.90), mild hyperthermia (OR 3.41, 95% CI 1.17 to 9.90) and severe hyperthermia (OR 5.15, 95% CI 1.84 to 14.43) were independent risk factors for in-hospital mortality. Compared with other variables, the Wald χ2 value of temperature on the first day minus the degree of freedom was the highest. CONCLUSIONS Whether hypothermic or hyperthermic, the more abnormal the temperature on the first day is, the higher the risk of in-hospital death in children with sepsis.
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Affiliation(s)
- Huabin Wang
- Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
- Postdoctoral Mobile Station, Shandong University of Traditional Chinese Medicine, Jinan, People's Republic of China
- Department of Neonatal Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Yanhua Chang
- Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Meiyun Xin
- Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
- Department of Pediatric Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Tongshu Hou
- The Second Medical College, Binzhou Medical University, Yantai, People's Republic of China
| | - Lei Han
- Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
- Department of Pediatric Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Ruipin Zhang
- Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
- Department of Pediatric Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Ziying Liu
- Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
- Department of Pediatric Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
| | - Bing Sun
- College of Integrated Traditional Chinese and Westen Medicine, Jining Medical University, Jining, People's Republic of China
| | - Lijun Gan
- Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, People's Republic of China
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Diaz Kane MM. "The Fever Is Still There!": Workup and Management of Prolonged Fever. Pediatr Ann 2023; 52:e124-e126. [PMID: 37036772 DOI: 10.3928/19382359-20230208-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Fever is one of the most common chief complaints that brings pediatric patients to seek medical care. Although fever is, in most cases, a physiologic response to a pathogen that has alerted the immune system, prolonged fever can be challenging to work up for the treating pediatrician. In addition to assessing causes of fever, pediatricians must also address the fears that many caregivers may have surrounding elevations in body temperature and provide education as to when fever becomes a concern. Fever can be classified by its duration as well as the presence or absence of associated symptoms. Fever without a source is defined as a fever that has been present for 1 week without a clear cause. Fever of unknown origin is a fever that has been present daily for 8 days or more without an apparent source. This article will walk through considerations for a clinician evaluating a pediatric patient with prolonged fever. [Pediatr Ann. 2023;52(4):e124-e126.].
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Pinto IM, Helito AC, Fonseca RLA, Gumiero FN, El-Mafarjeh E, Luglio M. Comparison Between Pediatric Patients With and Without Close Contact With COVID-19 in a Brazilian City During SARS-CoV-2 Pandemics. Clin Pediatr (Phila) 2022; 62:316-320. [PMID: 36189763 PMCID: PMC9527553 DOI: 10.1177/00099228221124662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To analyze clinical differences between a pediatric population with and without confirmed positive close contact for the new coronavirus, to establish the symptoms that define a population currently served in a children's emergency room for which polymerase chain reaction (PCR) collection for SARS-COV-2 is performed, and thus, make clinical and laboratory screening more reliable and applicable in medical routine. METHOD Cross-sectional study that characterized 128 children (0-17 years old) who collected PCR for SARS-COV-2 when seen in an emergency room at a private hospital between March and June 2020. Data were collected from the electronic medical record of the researched hospital. RESULTS Patients positive for close contact with COVID-19 had more diarrhea (P = .03) and less fever (P = .003) and coughing (P = .03). There was no statistically significant difference between the 2 groups on gender distribution, age, isolation of other etiologic agents, chest x-ray abnormalities, or the need for hospitalization. SARS-Cov-2 PCR showed a higher positivity among patients on the close contact positive group (P < .001). CONCLUSION As seen in previous research, positive SARS-CoV-2 tests are not required for the pediatric population to be diagnosed with the new coronavirus. Diarrhea should be included in those related to a high suspicion of potential SARS-CoV-2 infection, prompting nasopharyngeal PCR collection. However, fever and cough are unspecific symptoms for SARS-CoV-2 infection and should not be considered as warning signs for parents and, more importantly, for pediatricians to collect screening examinations.
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Affiliation(s)
- Isabela M.C. Pinto
- Hospital Sírio Libânes, São Paulo, Brazil,Isabela M.C. Pinto, Hospital Sírio Libânes, Rua Adma Jafet, 91, Casa Verde, Bela Vista, São Paulo 01308-050, Brazil.
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