Fever is a prevalent clinical manifestation in pediatrics, representing a significant proportion of emergency department (ED) visits worldwide. While fever is often benign and self-limiting, it can also indicate life-threatening infections requiring immediate intervention, particularly in neonates and immunocompromised children. This comprehensive review delves into the intricate pathophysiology of fever, exploring its dual role as a protective immune mechanism and a potential physiological risk. It critically examines diagnostic challenges, evidence-based management strategies, and global disparities in fever treatment. Special emphasis is placed on parental perceptions, the overuse of antipyretics, and the emerging role of artificial intelligence in fever diagnosis. Future directions include refining diagnostic biomarkers, implementing digital health tools, and advancing antimicrobial stewardship to curb antibiotic resistance. By improving clinical decision-making and public awareness, this review aims to optimize the management of febrile children worldwide and enhance patient outcomes.
Background and Aim: Severe alcoholic hepatitis (SAH) is a serious condition with few treatments. By modifying the gut–liver axis, fecal microbiota transplantation (FMT) was proposed as a treatment for SAH. The purpose of this meta‐analysis was to evaluate the efficacy of FMT versus the standard of care (SOC) in improving SAH patient survival rates.Methods: A thorough search of electronic databases was conducted till September 2023. The survival rates of SAH patients undergoing FMT versus SOC were compared. Using Review Manager 5.4, odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.Results: The meta‐analysis consisted of six studies with a total of 371 patients with SAH. Patients who received FMT had significantly higher survival rates at 1 and 3 months compared to those who received SOC, with pooled OR of 2.91 (95% CI: 1.56–5.42, P = 0.0008) and 3.07 (95% CI: 1.81–5.20, P < 0.0001), respectively. However, the survival advantage disappeared after 6 months (OR: 2.96, 95% CI: 0.99–8.85, P = 0.05) and 1 year of follow‐up (OR: 1.81, 95% CI: 0.44–7.46, P = 0.41).Conclusion: This meta‐analysis highlights the potential of FMT to significantly improve short‐term survival rates in SAH patients. However, the survival benefit did not last 6–12 months. These findings call for additional research into the effectiveness of FMT over the long term, along with strategies for extending the survival benefit.
1 February 2025 in European Archives of Oto-Rhino-Laryngology
Colorectal cancer is the second leading cause of cancer-related deaths worldwide and the third most common type of cancer overall. Colorectal cancer can be avoided with regular screening and lifestyle modifications. This study aimed to identify the barriers to screening for colorectal cancer and to evaluate the public’s awareness and knowledge of the disease’s symptoms and risk factors. A cross-sectional study was conducted across nine countries from February 1, 2024, through April 3, 2024, targeting individuals aged 18 years and older. Data were collected using an online self-administered questionnaire in collaboration with national leaders and local team members in each country. Logistic regression analyses were employed to examine factors associated with participants’ knowledge, awareness, and screening barriers. Among the 13,030 participants, awareness of CRC symptoms was highest for “lump in the abdomen” (70%) and lowest for “back pain” (39%). The most recognized risk factor was “history of bowel disease” (71%), whereas the least recognized was “low fruit/vegetable intake” (33%). The primary barrier to screening was the belief in low personal risk due to the absence of symptoms (63%). Multivariate logistic regression identified working in the healthcare sector as the strongest predictor of high knowledge (aOR = 2.70, 95% CI: 2.50–2.94) relative to non-healthcare participants. Higher knowledge was also significantly associated with male sex, older age (25–49 years), and university-level education (all p < 0.001). Colorectal cancer usually goes unnoticed until it reaches an advanced stage, when treating it becomes far more difficult. These findings underscore an urgent need for targeted, culturally sensitive public health campaigns across the region to address knowledge gaps and mitigate barriers, particularly the prevalent misconception of asymptomatic low risk. These include avoiding risk factors, maintaining a healthy lifestyle, and participating in screening programs to detect disease early.
AI-driven triage presents a transformative opportunity to address persistent challenges in pediatric emergency care, from overcrowding and waiting times to human error and outcome disparities. This narrative review demonstrates that AI systems can achieve high accuracy in predicting critical outcomes, with pooled AUROCs of 0.87 for hospital admission, 0.93 for ICU admission, and 0.93 for mortality, significantly outperforming traditional triage scales, while observational studies report associations with improved efficiency, reduced triage errors, and enhanced resource allocation. However, publication bias favoring positive results affects the available evidence, and studies reporting no benefit or performance degradation exist. The promise of AI is tempered by significant challenges: performance varies across pediatric subgroups, the risks of perpetuating and amplifying bias remain inadequately addressed, and workflow integration and medico-legal liability require careful navigation. AI augments clinical judgment, guided by robust governance frameworks, fairness auditing, and human oversight for more equitable emergency care.