World Journal of Pediatrics最新文献

{"title":"Innovating pediatric epilepsy: transforming diagnosis and treatment with AI.","authors":"Giovanni Battista Dell'Isola, Antonella Fattorusso, Gianmichele Villano, Pietro Ferrara, Alberto Verrotti","doi":"10.1007/s12519-025-00904-8","DOIUrl":"10.1007/s12519-025-00904-8","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"333-337"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015184","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":"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":"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":"396-405"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","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":"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":"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":"352-360"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","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":"Performance of EMA algorithm, 2022 ACR/EULAR criteria, and EMA-ACR/EULAR algorithm in classifying pediatric ANCA-associated vasculitis: a national cohort study in China.","authors":"Zhe Lu, Li-Wen Tan, Hong Xu, Zheng-Kun Xia, Xiao-Yun Jiang, Xiao-Chuan Wu, Fang Wang, Xiao-Rong Liu, Cheng-Guang Zhao, Xiao-Zhong Li, Jian-Hua Mao, Xiao-Wen Wang, Wen-Yan Huang, Xiao-Shan Shao, Jian-Jiang Zhang, Shi-Pin Feng, Jun Yang, Qiu Li, Ai-Hua Zhang, Mo Wang","doi":"10.1007/s12519-025-00899-2","DOIUrl":"10.1007/s12519-025-00899-2","url":null,"abstract":"<p><strong>Background: </strong>Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a type of necrotizing vasculitis with poor prognosis, which is more severe in children. Classifying AAV patients may be helpful for diagnosis and management. However, present classification criteria for pediatric AAV are developed mainly based on adults, which have limitations in clinical practice. In this study, we introduced an updated algorithm based on the European Medicines Agency (EMA) algorithm in conjunction with the American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) criteria. This new approach aims to resolve the issue of duplicate classification present in the 2022 ACR/EULAR criteria and to refine the existing EMA algorithm.</p><p><strong>Methods: </strong>This study included 179 pediatric patients diagnosed with AAV across 17 centers in China. Patients were classified using the EMA algorithm, the ACR/EULAR criteria, and the EMA-ACR/EULAR algorithm. The Kappa value and Net Reclassification Index (NRI) were used to evaluate the classification performance of these criteria.</p><p><strong>Results: </strong>According to the EMA algorithm, 136 (76.0%) patients were classified with microscopic polyangiitis (MPA) and 14 (7.8%) with granulomatosis with polyangiitis (GPA), while 29 (16.2%) remained unclassifiable. According to the ACR/EULAR criteria, 145 (81.0%) patients were classified with MPA, 14 (7.8%) with GPA, 2 (1.1%) with eosinophilic granulomatosis with polyangiitis (EGPA), and 4 (2.2%) with both MPA and GPA, while 14 (7.8%) remained unclassifiable. The EMA-ACR/EULAR algorithm classified 124 patients (69.3%) as MPA, 26 (14.5%) as GPA, and 2 (1.1%) as EGPA, while 27 (15.1%) were unclassified. The Kappa values between the EMA algorithm and ACR/EULAR criteria for GPA and MPA were 0.225 [95% confidence interval (CI) 0.000-0.456, P = 0.003] and 0.357 (95% CI 0.196-0.518, P < 0.001). Compared to these two criteria, the EMA-ACR/EULAR algorithm demonstrated positive NRIs in the classification of both GPA (0.702, 95% CI 0.258-1.146, P = 0.002; 0.547 95% CI 0.150-0.944, P = 0.007) and MPA (0.425, 95% CI 0.209-0.642, P < 0.001; 0.519, 95% CI 0.305-0.733, P < 0.001).</p><p><strong>Conclusions: </strong>The EMA-ACR/EULAR algorithm addresses the limitations of the 1990 ACR criteria within the EMA framework and resolves the issue of duplicate classification in the 2022 ACR/EULAR criteria. However, further research is necessary to validate the superiority of the EMA-ACR/EULAR algorithm in the clinical classification of pediatric AAV patients.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"372-385"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"386-395"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","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":"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":"10.1007/s12519-025-00892-9","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"323-327"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","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":"Infant body composition in a randomised trial of a maternal nutritional supplement during preconception and pregnancy.","authors":"Jaz Lyons-Reid, José G B Derraik, Leigh C Ward, Timothy Kenealy, Benjamin B Albert, Jose M Ramos Nieves, Cathriona R Monnard, Mya Thway-Tint, Heidi Nield, Sheila J Barton, Sarah El-Heis, Elizabeth H Tham, Keith M Godfrey, Shiao-Yng Chan, Wayne S Cutfield","doi":"10.1007/s12519-025-00900-y","DOIUrl":"10.1007/s12519-025-00900-y","url":null,"abstract":"<p><strong>Background: </strong>In a multinational randomized controlled trial, we previously showed that maternal supplementation with myo-inositol, probiotics, and micronutrients was associated with reduced incidence of rapid infant weight gain and high body mass index (BMI) at two years among offspring. It was unclear whether these differences in weight gain and body mass were due to reduced adiposity. Therefore, we aimed to determine whether there were any differences in body composition.</p><p><strong>Methods: </strong>Body composition was measured using bioelectrical impedance spectroscopy at six weeks, six months, one year, and two years among offspring born to mothers who received a nutritional intervention (n = 268) or control (n = 264) supplement preconception and during pregnancy.</p><p><strong>Results: </strong>There were no group-level differences in body composition, except at two years, when fat-free mass was greater among control offspring [adjusted mean difference (aMD) 0.14 kg, 95% confidence interval (CI) 0.03, 0.25, P = 0.012]. However, there were no differences in mean percentage fat mass (%FM) at any time. In both groups, rapid weight gain [Δ weight > 0.67 standard deviation (SD) from birth to one year] was associated with greater %FM (aMD 2.0% at six months, 2.0% at one year, 1.4% at two years) compared with those who did not have rapid weight gain. Likewise, high BMI (≥ 95 percentile) at two years was associated with greater %FM (aMD 2.5%).</p><p><strong>Conclusions: </strong>A maternal nutritional intervention did not lead to differences in average offspring body composition in the first two years of life. However, fewer offspring from the supplemented group experienced rapid weight gain and high BMI, characterized by greater %FM.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"361-371"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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}

{"title":"Critical importance of accurate diagnosis in treatable neurometabolic disorders: insights from a large Chinese cohort with glucose transporter-1 deficiency syndrome.","authors":"Hui Xiong","doi":"10.1007/s12519-025-00885-8","DOIUrl":"10.1007/s12519-025-00885-8","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"211-212"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504639","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}