The child with medical complexity

Abstract

Children with medical complexity represent a big challenge for the physicians, their families and the society as well. Although there is no clear definition of this type of patients, they are affected by a chronic, often very severe condition for their whole life. They also represent a huge cost for the health care system due to their needs of continuous assistance.In this review we summarized the definitions of child with medical complexity. Then we illustrated the strategies to treat and take care of these children in order to look at them not as a burden or a cost but as an opportunity to growth and improve as clinicians and to improve the society, to give them the best life they can live.We also wanted to give voice to the physicians, the parents and the children themselves to really show and understand what are their experiences and their feelings in dealing with their conditions. We concluded with the description of one example of children with medical complexity: prematurity. We discussed the progresses in their treatment so far in order to illustrate what is the future of pediatrics. Since it has been more and more acknowledged that every child with medical complexity is unique, the future of pediatric is to organize an individualized approach and to “see things with the eye of a child”.

One Year of the COVID-19 Pandemic in Galicia: A Global View of Age-Group Statistics during Three Waves

“…In relation to hospital admission rates (0.35%), ICU (0%) and mortality (0%), all values were far lower, significantly, than the population averages. These data do not differ too much from other experiences already published [ 26 , 27 , 28 , 29 ] and reinforce the initial plan that vaccination is not a priority in these groups [ 30 , 31 , 32 ].…”

Protective Action of L. salivarius SGL03 and Lactoferrin against COVID-19 Infections in Human Nasopharynx

“…The presence of lactoferrin itself and its anti-inflammatory properties perfectly harmonize with anti-viral activities. The important role of lactoferrin is to calm down the cytokine storm, which is the main cause of the rapid course of COVID-19 [ 45 , 46 , 47 , 48 , 49 , 50 , 57 , 79 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 ]. It can be also used to treat osteoporosis because it reduces osteolysis—the destruction of bone cells [ 134 ].…”

“…Currently, various therapies are used to treat COVID-19 that work on the immune system [ 124 , 125 ]. By activating the immune system, dietary supplements can be used as adjuvants with anti-bacterial and immunomodulating properties to inhibit the spread of the COVID-19 virus [ 126 ]. Active substances, which are components of many products include vitamins e.g., vitamin D, probiotics, lactoferrin and zinc, are now extensively clinically tested in patients with COVID-19 respiratory infection [ 127 , 128 , 129 , 130 ].…”

Potential Effects of Melatonin and Micronutrients on Mitochondrial Dysfunction during a Cytokine Storm Typical of Oxidative/Inflammatory Diseases

“…It has also been suggested that an adequate selenium intake may inhibit SARS-CoV-2 proteases, this being another beneficial effect of selenium in the prevention and treatment of COVID-19 disease [ 166 , 167 ]. Vitamins C, E, and magnesium have also proven to be useful as adjuvants in the therapy against COVID-19, due to their anti-inflammatory and antioxidant properties [ 168 , 169 , 170 , 171 , 172 ].…”