Urgent Updates | May 18

Fentanyl Deaths Have Spiked Among U.S. Children And Teens
In 2021, almost 70 000 US adults fatally overdosed on fentanyl. Little is known about the extent to which the fentanyl crisis has affected the pediatric population. More than 1,500 kids under the age of 20 died from fentanyl in 2021, four times as many as in 2018. The mortality rate from fentanyl soared more than 300 percent during that period, from 0.47 per 100,000 children to 1.92 per 100,000, she found. In 2021, 40 infants and 93 children 1 to 4 years of age died from fentanyl.
Full Access: Science news

Increased cardiovascular events in young patients with mental disorders: a nationwide cohort study
Mental disorders in young patients may have deleterious effects on the incidence of both Myocardial Infarction (MI) and Ischemic Stroke (IS) events. This is evident in mental disorders including depressive disorder, bipolar disorder, schizophrenia, insomnia, anxiety disorders, post-traumatic stress disorder, personality disorder, somatoform disorder, eating disorder, and substance use disorder. There were significant interactions between age and mental disorders and between sex and mental disorders for risks of MI and IS. Cardiovascular disease prevention efforts are needed to prevent MI and IS in young patients with mental disorders.
Full Access: European Journal of Preventative Cardiology

Xylazine — Medical and Public Health Imperatives
Increasing use of xylazine, most often in combination with other drugs such as fentanyl, is a rapidly growing threat to human health in the United States. The effects on the central nervous system include sedation, analgesia, and euphoria. People who use xylazine, however, may develop physiological dependence, have symptoms consistent with a xylazine-related substance use disorder, and have severe withdrawal symptoms (e.g., irritability, anxiety, and dysphoria) after abrupt discontinuation. Xylazine-withdrawal symptoms are not alleviated by the administration of opioids.
Full Access: NEJM

Are Children With Prolonged Fever At A Higher Risk For Serious Illness? A Prospective Observational Study
Children with fever ≥5 days and their risks for serious bacterial infection (SBI) were compared with children with fever <5 days, including diagnostic accuracy of non-specific symptoms, warning signs and C-reactive protein (CRP; mg/L). Incidence of SBI in children with fever ≥5 days was higher than in those with fever <5 days (8.4% vs 5.7%).
Full Access: BMJ