World Journal of Pediatrics最新文献

{"title":"Anemia in Asian children: trends in the prevalence, etiology and analysis of geographic inequalities.","authors":"Nowaj Sharif, Ahmad Neyazi, Mahalaqua Nazli Khatib, Lalji Baldaniya, Suhas Ballal, V Kavita, Laxmidhar Maharana, Renu Arya, Ganesh Bushi, Muhammed Shabil, Rukshar Syed, Manika Gupta, Sunil Kumar, Sabah Ansar, Sanjit Sah, Diptismita Jena, Prakasini Satapathy","doi":"10.1007/s12519-025-00897-4","DOIUrl":"https://doi.org/10.1007/s12519-025-00897-4","url":null,"abstract":"<p><strong>Background: </strong>Pediatric anemia is a pervasive public health issue in Asia, significantly impairing children's growth, cognitive development, and future potential. This study evaluates trends, prevalence, and socio-economic disparities of pediatric anemia across Asia from 1990 to 2021, leveraging data from the Global Burden of Disease Study (GBD) 2021 study.</p><p><strong>Methods: </strong>Using estimated annual percentage change (EAPC) and Pearson's correlation coefficient, geographic variations and temporal trends were analysed alongside associations between prevalence, years lived with disability (YLDs), and Socio-demographic index (SDI).</p><p><strong>Results: </strong>The study reveals a modest overall decline in anemia prevalence by 11.9%, from 464.53 million cases in 1990 to 409.07 million in 2021. High-SDI regions such as East Asia achieved significant reductions (- 71.36%), with countries like Singapore, the Republic of Korea, Seychelles, Qatar, and the United Arab Emirates (UAE) showing substantial progress. In stark contrast, low-SDI countries, including Yemen (108.34%) and Afghanistan (130.28%), along with Cambodia, India, and Pakistan, experienced alarming increases. Dietary iron deficiency was the dominant cause, followed by hemoglobinopathies and neglected tropical diseases. Females, particularly adolescents, and children under five faced disproportionate burdens, with prevalence rates in low-SDI regions exceeding 47,000 per 100,000 compared to < 10,000 per 100,000 in high-SDI areas.</p><p><strong>Conclusions: </strong>These findings emphasize profound regional and socio-economic inequalities in anemia burden. Urgent, evidence-based interventions are imperative, focusing on enhancing nutrition, expanding healthcare access, and integrating sex-sensitive strategies to address this multifaceted issue. Strengthened policies and targeted actions are critical to mitigating the burden and fostering health equity, particularly in vulnerable low-SDI regions.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing toward a curative frontier: an updated narrative review on stem-cell therapy in pediatric type 1 diabetes.","authors":"Samia Sulaiman, Abdallah Alaarag, Nadin Rayyan, Yousof Tuffaha, Nada Al-Awamleh, Khalid Adel Al Dojan","doi":"10.1007/s12519-025-00908-4","DOIUrl":"https://doi.org/10.1007/s12519-025-00908-4","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes (T1D) is a chronic autoimmune disease primarily diagnosed in childhood, characterized by pancreatic β-cell destruction, severe insulin deficiency, and hyperglycemia. Current treatments, including insulin therapy and glucose-lowering medications, manage the condition but fall short of offering a cure. In this review we explore the potential of stem-cell therapy as a transformative and curative approach for T1D, focusing on its promise in regenerating β-cells and addressing challenges specific to the pediatric population.</p><p><strong>Data sources: </strong>A comprehensive review of the literature was conducted to evaluate stem-cell types: embryonic, perinatal, adult, induced pluripotent and cancer stem cells, and their role in T1D treatment. Particular emphasis was placed on methods for β-cell differentiation, advancements in autologous and allogeneic stem-cell transplantation and emerging strategies to overcome safety, efficacy, and economic barriers. Challenges such as immune rejection, tumorigenicity, and cost-effectiveness were analyzed, alongside novel solutions like immune-shielding and clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein-9 (Cas9) technology.</p><p><strong>Results: </strong>Stem-cell therapy presents a promising avenue for curing T1D, offering potential for β-cell regeneration and reduced dependence on exogenous insulin. However, challenges such as delayed β-cell functionality, immune responses, tumor risks, and high costs hinder widespread application.</p><p><strong>Conclusions: </strong>Advancements in personalized medicine, immune-shielding strategies, and cost reduction may pave the way for clinical success, especially in pediatric populations. Further research addressing these barriers is essential to establish stem-cell therapy as a viable and equitable treatment option.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps and challenges in the management of pediatric steatotic liver diseases: a narrative review.","authors":"Wathsala Hathagoda, Shaman Rajindrajith, Madunil Anuk Niriella","doi":"10.1007/s12519-025-00902-w","DOIUrl":"https://doi.org/10.1007/s12519-025-00902-w","url":null,"abstract":"<p><strong>Background: </strong>Given the rising prevalence of pediatric steatotic liver disease (SLD), it is imperative to identify and address common challenges in clinical practice. This article aims to examine key issues in managing pediatric SLD and attempts to propose evidence-based recommendations.</p><p><strong>Data sources: </strong>We reviewed published literature on steatotic liver diseases in children focusing on overweight and obesity, including original research, systematic reviews, meta-analyses, consensus statements, and position papers. Databases searched were PubMed/MEDLINE, Cochrane Library, Web of Science, and Scopus. Search terms included: \"non-alcoholic fatty liver disease\", \"NAFLD\", \"steatohepatitis\", \"NASH\", \"steatotic liver disease\", \"fatty liver\", \"children\", \"adolescents\", \"pediatric\", \"obesity\", and \"overweight\".</p><p><strong>Results: </strong>Critical issues include an over-reliance on liver biochemistry, which may fail to capture the broader spectrum of SLD [e.g., metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction associated with steatohepatitis (MASH)], and delays in recognizing metabolic comorbidities. Dietary and lifestyle recommendations are often generalized, overlooking individual patient needs, while psychological factors, such as stress and mental health, are frequently neglected despite their role in disease progression. Advanced fibrosis cases are under-referred, long-term risks like cirrhosis are underestimated, and insufficient follow-up, coupled with limited family involvement in education, further compromises care.</p><p><strong>Conclusions: </strong>Addressing these deficiencies through a multidisciplinary approach that incorporates early diagnosis, personalized treatment strategies, structured monitoring, and comprehensive family involvement is imperative for optimizing outcomes and mitigating the long-term impact of pediatric SLD.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and prognostic characteristics of bilateral Wilms tumor: a multi-center institutional retrospective cohort study experience from China.","authors":"Shen Yang, Jing-Hao Yan, Jin-Hu Wang, Hong Qin, Wei Yang, Kui-Ran Dong, Jun-Cheng Liu, Min Xu, Yi-Zhuo Zhang, Jian-Guo Zhang, Ye-Ming Wu, Qiang Zhao, Shan Wang, Jing-Fu Wang, Jian Chang, Rong-De Wu, Xiang-Ling He, Tao Li, Yan Su, Ju Gao, Hui Li, Xiao-Mei Yang, Xiao-Juan Wu, De-Guang Meng, Paul D Losty, Chan Hon Chui, Xiao-Feng Chang, Hong-Cheng Song, Huan-Min Wang","doi":"10.1007/s12519-025-00895-6","DOIUrl":"https://doi.org/10.1007/s12519-025-00895-6","url":null,"abstract":"<p><strong>Background: </strong>This multi-center analysis of data from China reviews the management and long-term outcomes of patients with bilateral Wilms tumors (BWT), and explores prognostic risk factors.</p><p><strong>Methods: </strong>We retrospectively analyzed a cohort of pediatric patients with synchronous BWT treated at 18 pediatric oncology centers in China between 2006 and 2023. The overall survival (OS) and event-free survival (EFS) rates were calculated using Kaplan-Meier methodology. Prognostic risk factors were determined using univariable and multivariable analysis.</p><p><strong>Results: </strong>A total of 167 patients with BWT and a median age at diagnosis of 13 months (range 0-78 months) were included in the study. Neoadjuvant chemotherapy was administered to 149 index cases; tumor biopsy was performed before initiating chemotherapy in 70 patients. One hundred and three children underwent bilateral nephron-sparing surgery (NSS) and two hundred fifty-two of the three hundred one kidneys underwent NSS. The four-year OS and EFS rates in the study cohort were 86.5% and 77.8%. After a median follow-up of 50 months, four patients developed renal failure requiring dialysis and a single patient received a kidney transplant 26 months postoperatively.</p><p><strong>Conclusions: </strong>Regarding prognostic factors, the results of the multifactor analysis indicate that distant metastasis and positive surgical margins have negative impacts on OS and distant metastasis had a negative effect on EFS. Distant metastasis and positive surgical margins affect the long-term prognosis of BWT. Video Abstract (MP4 19393 KB).</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted therapy for pediatric glioma: RAF(t)ing in the molecular era.","authors":"Zhi-Peng Shen, Zhong-Yuan Zhang, Nan Li, Liang Xu, Ye Chen","doi":"10.1007/s12519-025-00889-4","DOIUrl":"https://doi.org/10.1007/s12519-025-00889-4","url":null,"abstract":"<p><strong>Background: </strong>Pediatric gliomas are the most frequently occurring central nervous system tumors in children. While targeted therapies have been widely applied in the treatment of many adult cancers, their use in pediatric gliomas has lagged behind. However, recent advances in multiomics profiling of pediatric gliomas, coupled with the approval of inhibitors against Raf serine/threonine kinase (RAF), isocitrate dehydrogenase 1/2 (IDH1/2) and neurotrophic receptor tyrosine kinase (NTRK), have spurred significant progress in this field. In light of these developments, this review aims to provide a comprehensive overview of current advancements and the evolving landscape of targeted therapeutic strategies and approaches for pediatric gliomas.</p><p><strong>Data sources: </strong>Data analyzed in this study were obtained from the literature from PubMed, as well as other online databases and websites, including ClinicalTrials.gov and the Pediatric Neuro-Oncology Consortium.</p><p><strong>Results: </strong>Based on findings from multiomics profiling, significant insights have been gained into the genetic and molecular landscape of pediatric gliomas, enabling the identification of key mutations and potentially targetable lesions. These advancements provide rationales for the development of more precise treatment strategies and targeted therapies. Recent approvals of targeted therapies and ongoing clinical trials in pediatric gliomas are converging on the targeting of key signaling molecules and metabolic pathways.</p><p><strong>Conclusions: </strong>In the molecular era, targeted therapies offer new hope for more effective and personalized treatment options for pediatric glioma patients. By developing and tailoring treatments to target specific molecular and metabolic vulnerabilities, targeted therapies have the potential to improve the clinical management of pediatric gliomas, ultimately enhancing both the treatment experience and overall prognosis of these patients.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tofacitinib: a promising agent for the treatment of persistent rashes in juvenile dermatomyositis.","authors":"Zhao-Yu Chen, Tian-Nan Zhang, Ji Li, Zhen-Jie Zhang, Hong-Mei Song","doi":"10.1007/s12519-025-00901-x","DOIUrl":"https://doi.org/10.1007/s12519-025-00901-x","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the 2024 AHA guidelines for Kawasaki disease: practical insights for clinicians.","authors":"Tong Tong, Fang-Qi Gong","doi":"10.1007/s12519-025-00892-9","DOIUrl":"https://doi.org/10.1007/s12519-025-00892-9","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Qigong vs. routine physical exercise in school-aged children with attention-deficit hyperactivity disorder: a randomized controlled trial.","authors":"Yu Li, Yuan-Chen He, Yin Wang, Jing-Wei He, Meng-Yao Li, Wen-Qin Wang, Zhi-Heng Wu, Yun-Jia Xu, Wen-Nan He, Ya-Lan Dou, Duo-Lao Wang, Wei-Li Yan, Da-Qian Zhu","doi":"10.1007/s12519-025-00890-x","DOIUrl":"https://doi.org/10.1007/s12519-025-00890-x","url":null,"abstract":"<p><strong>Background: </strong>Increased understanding of the etiology of attention-deficit hyperactivity disorder (ADHD) emphasizes the importance of non-pharmaceutical treatments. This study compares the effects of Baduanjin exercise, a Qigong-based body therapy from traditional Chinese medicine (TCM), with routine physical exercise on school-aged children diagnosed with ADHD.</p><p><strong>Methods: </strong>In this two-arm, single-blind, randomized controlled trial, eligible school-aged children with ADHD were randomly assigned (1:1) to Baduanjin exercise or regular physical exercise using a permuted block randomization procedure. Both groups performed the designated exercise for at least 30 minutes a day and were monitored for exercise quality at least 5 days a week for 3 months. The primary outcome was a doctor-assessed hyperactivity/impulsivity score change, using the Swanson, Nolan, and Pelham rating scale (DSNAP_HYP) at the end of the third month since intervention initiation.</p><p><strong>Results: </strong>Between October 2020 and January 2023, 120 eligible children were randomly allocated to two exercise interventions. After 3 months, the DSNAP_HYP decreased by 3.67 ± 4.81 and 4.68 ± 4.44 of Baduanjin exercise and regular physical exercise, respectively, with no significant between-group difference [mean difference = 1.52; 95% confidence interval (CI) = - 0.08 to 3.13; P = 0.06]. No adverse events were reported during the whole study period.</p><p><strong>Conclusions: </strong>This study did not demonstrate the expected superiority of 3-month Baduanjin exercise in improving ADHD symptoms compared with routine physical exercise. However, the results suggest that both types of exercise may improve core symptom scores, providing preliminary evidence for Baduanjin as a potential supplementary intervention for children with ADHD.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining safety standards for animal-assisted therapy in pediatric oncology: a focus on neutropenic patients.","authors":"Gabrielle Grob, Maggie Rogers","doi":"10.1007/s12519-025-00887-6","DOIUrl":"10.1007/s12519-025-00887-6","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"213-215"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and disease burden of pediatric congenital anomalies of the kidney and urinary tract: a national cross-sectional study of hospitalized children in China.","authors":"Zhi-Han Hao, Ye-Ping Jiang, Hui Xu, Guo-Shuang Feng, Hui Wang, Xin Ni","doi":"10.1007/s12519-025-00891-w","DOIUrl":"10.1007/s12519-025-00891-w","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies of the kidney and urinary tract (CAKUT) are among the most prevalent congenital malformations in children and a common cause of chronic kidney disease. There is currently limited documentation of the clinical epidemiology and disease burden of hospitalized CAKUT patients globally. This study reports the clinic-epidemiological characteristics and disease burden of hospitalized CAKUT children in China, and offers critical data to inform the diagnosis, treatment, and prevention of CAKUT.</p><p><strong>Methods: </strong>From January 2016 to December 2022, hospitalized patients diagnosed with CAKUT were discharged from 33 provincial and municipal hospitals across China. Demographic and clinical data were collected for statistical analysis.</p><p><strong>Results: </strong>A total of 33,621 children aged 0-18 years were hospitalized with a CAKUT diagnosis, accounting for 0.46% of the total pediatric hospitalizations during the study period. There was a male-to-female ratio of 1.88:1. The CAKUT hospitalization rate demonstrated an increasing trend from 2016 to 2022 (P < 0.001). Regional hospitalization rates were significantly higher in Eastern and Central China compared to Western and Northeastern China (P < 0.001). Most patients were diagnosed with hydronephrosis, with a hospitalization ratio of 1.28% (n = 9359). 18.00% of patients were diagnosed with multiple CAKUT. The incidence of urinary tract infections (UTIs) increased as the number of combined CAKUT conditions rose.</p><p><strong>Conclusions: </strong>The most common CAKUT subtype is hydronephrosis. The disease spectrum of CAKUT was different in different age groups, which gradually evolved from hydronephrosis to duplex collection system and renal cystic disease. UTI, associated nonurinary congenital anomalies and low birth weight are the warning factors for CAKUT. The cost burden and fatality rate of CAKUT is low. Strengthening the management of CAKUT and appropriate intervention is expected to obtain a good prognosis and improve quality of life.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"306-321"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}