Objective: Children are particularly vulnerable to heat-related illnesses due to their unique physiological and behavioral characteristics. Understanding the epidemiology and clinical features of heat-related illnesses in children is crucial for guiding targeted preventive measures and management strategies. This descriptive study aims to investigate the characteristics of pediatric patients with heat-related illness who were transferred to emergency departments in Japan. Methods: This study was a secondary analysis of the Heatstroke Study, led by the Heatstroke and Hypothermia Surveillance Committee of the Japanese Association for Acute Medicine. This study included pediatric patients (<18 years) with heat-related illness transferred to emergency departments in the summer from 2017 to 2021. We summarized the circumstances of onset, clinical characteristics, and outcomes. Results: Of the 3,154 registered patients, 146 children were included. Of them, 60% were male, with a median age of 15 years (interquartile range, 13–16 years). The most cases occurred in August (47%), and most (80%) were associated with sports activities and with outdoor settings (70%). Cases with a body temperature above 40 °C were rare (3%). Most cases were admitted to hospitals (75% to the general ward and 16% to the intensive care unit), and patients admitted to intensive care unit had altered consciousness with increased serum creatinine. There were two cases of mortality, both of which were out-of-hospital cardiac arrest. Conclusion Most pediatric cases with heat-related illness were middle or high school students, occurred in August, and were related to outdoor sports activity. Patients admitted to hospitals suffered altered consciousness, dehydration, and acute kidney injury.

The immune-stromal cell interactions play a key role in health and diseases.In periodontitis,the most prevalent infectious disease in humans,immune cells accumulate in the oral mucosa and promote bone destruction by inducing receptor activator of nuclear factor-κB ligand(RANKL)expression in osteogenic cells such as osteoblasts and periodontal ligament cells.However,the detailed mechanism underlying immune-bone cell interactions in periodontitis is not fully understood.Here,we performed single-cell RNA-sequencing analysis on mouse periodontal lesions and showed that neutrophil-osteogenic cell crosstalk is involved in periodontitis-induced bone loss.The periodontal lesions displayed marked infiltration of neutrophils,and in silico analyses suggested that the neutrophils interacted with osteogenic cells through cytokine production.Among the cytokines expressed in the periodontal neutrophils,oncostatin M(OSM)potently induced RANKL expression in the primary osteoblasts,and deletion of the OSM receptor in osteogenic cells significantly ameliorated periodontitis-induced bone loss.Epigenomic data analyses identified the OSM-regulated RANKL enhancer region in osteogenic cells,and mice lacking this enhancer showed decreased periodontal bone loss while maintaining physiological bone metabolism.These findings shed light on the role of neutrophils in bone regulation during bacterial infection,highlighting the novel mechanism underlying osteoimmune crosstalk.

A case of abdominal aortic aneurysm associated with systemic lupus erythematosus (SLE) is described. SLE is rarely associated with aneurysm of great arteries. Histological investigation revealed marked infiltration of inflammatory cells in the aneurysmal aortic wall. Immunocytochemical analysis using anti-factor VIII-related antigen antibody showed a marked increase of the vasa vasorum with luminal narrowing due to intimal thickning. In this case the major etiology of aortic aneurysm is considered to be non-specific inflammation of the abdominal aorta, not arteriosclerosis.