World journal of clinical pediatrics最新文献

{"title":"Cardiovascular involvement in multisystem inflammatory syndrome in children and midterm follow-up from a pediatric tertiary center in India.","authors":"Poovazhagi Varadarajan, Ritchie Sharon Solomon, Seenivasan Subramani, Ramesh Subramanian, Gomathy Srividya, Elilarasi Raghunathan","doi":"10.5409/wjcp.v14.i1.100453","DOIUrl":"10.5409/wjcp.v14.i1.100453","url":null,"abstract":"<p><strong>Background: </strong>In multisystem inflammatory syndrome in children (MIS-C) with coronavirus disease 2019, there was paucity of data from low-income and middle-income countries on cardiovascular involvement and its longitudinal outcomes. We planned to estimate the pattern of cardiovascular involvement among children with MIS-C and its mid-term outcomes.</p><p><strong>Aim: </strong>To determine association between cardiovascular abnormalities and clinical and laboratory parameters. To study the time-line for resolution of various abnormalities.</p><p><strong>Methods: </strong>In this prospective study done in a tertiary care hospital, 270 were recruited from June 2020 to January 2022. Baseline demographic data and clinical presentation were recorded. Laboratory parameters and echocardiography were done at admission. Follow-up was done at 2 weeks, 3 months, 6 months and 1 year after diagnosis. Descriptive statistics were used for parametric and non-parametric data. Risk factors were identified by multivariate regression analysis.</p><p><strong>Results: </strong>The 211 (78.2%) had cardiac involvement and 102 needed intensive care unit (ICU) admission. Cardiovascular abnormalities observed were shock 123 (45.6%), coronary dilatation 28 (10.4%), coronary aneurysm 77 (28.5%), left ventricular (LV) dysfunction 78 (29.3%), mitral regurgitation (MR) 77 (28.5%) and pericardial effusion 98 (36.3%). Coronary artery aneurysm/dilatation during follow-up at 2 weeks and 1 year were 25.7% and 0.9% respectively. Multivariate regression analysis revealed breathlessness [odds ratio (OR) = 3.91, 95%CI: 1.25-12.21, <i>P</i> = 0.019] and hi-flow nasal cannula (HFNC) support (OR = 8.5, 95%CI: 1.06-68.38, <i>P</i> = 0.044) as predictors of cardiovascular involvement. Higher mean age (OR = 1.16, 95%CI: 1.02-1.32, <i>P</i> = 0.026), breathlessness (OR = 4.99, 95%CI: 2.05-12.20, <i>P</i> < 0.001), gallop (OR = 4.45, 95%CI: 0.41-2.52, <i>P</i> = 0.016), MR (OR = 3.61, 95%CI: 1.53-8.53, <i>P</i> = 0.004) and invasive ventilation (OR = 4.01, 95%CI: 1.28-12.58, <i>P</i> = 0.017) were predictive of LV dysfunction. Altered sensorium (OR = 4.96, 95%CI: 2.23-11.02, <i>P</i> < 0.001), headache (OR = 6.61, 95%CI: 1.46-29.92, <i>P</i> = 0.014), HFNC (OR = 7.03, 95%CI: 2.04-24.29, <i>P</i> = 0.002), non-rebreathing mask usage (OR = 21.13, 95%CI: 9.00-49.61, <i>P</i> < 0.001) and invasive ventilation (OR = 5.64, 95%CI: 1.42-22.45, <i>P</i> = 0.014) were risk factors for shock. Anemia was a risk factor for coronary involvement (OR = 3.09, 95%CI: 1.79- 5.34, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Significant number of children with MIS-C had cardiovascular involvement contributing to higher ICU management. Although shock resolved quickly, resolution of ventricular function and coronary abnormalities were slower, and hence warrants a structured long-term follow-up protocol.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"100453"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-streptococcal acute glomerulonephritis in children: Association between proteinuria levels and renal outcomes.","authors":"Randula Ranawaka, Kavinda Dayasiri, Udara Sandakelum, Dulani Nelson, Manoji Gamage","doi":"10.5409/wjcp.v14.i1.100885","DOIUrl":"10.5409/wjcp.v14.i1.100885","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Post-streptococcal acute glomerular nephritis (PSAGN) is mostly a benign condition. The usual sequelae of PSAGN include hypertension, its complications, and acute kidney injury. Severe PSAGN is associated with significant long-term morbidity, and histological abnormalities such as crescentic glomerulonephritis are infrequently reported. PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the association between proteinuria levels and renal outcomes in children with PSAGN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective observational study was conducted at Lady Ridgeway Hospital (Colombo, Sri Lanka) over 15 months. Children with PSAGN were enrolled based on clinical and laboratory criteria. Persistent proteinuria ≥ 2+ for 2 weeks and serum creatinine &gt; 100 μmol/L warranted renal biopsy, assessed &lt;i&gt;via&lt;/i&gt; light microscopy and immunofluorescence. Normalization of complement 3 (C3) within 6 to 8 weeks was required for inclusion. Data on clinical features, urine protein levels, and renal function were collected from patient records, and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing. Ethical approval was obtained from the Ethical Review Committee, Lady Ridgeway Hospital for Children (Ref No: LRH/ERC/2021/60).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-four patients were recruited. There were 27 (61.4%) male patients and 17 (38.6%) female patients. Thirty-seven (84%) of them were above 5 years of age. Twenty (45%) patients had a history of skin sepsis, and eighteen (41%) had a history of throat infection. Among patients with proteinuria ≥ 2+, 53% had serum creatinine &gt; 100 µmol/L, while among those with proteinuria &lt; 2+, 7% had serum creatinine &gt; 100 µmol/L. The association of high-degree proteinuria with elevated serum creatinine was significant (&lt;i&gt;χ² =&lt;/i&gt; 7.8, &lt;i&gt;P&lt;/i&gt; = 0.005) in PSAGN. The odds ratio of the logistic regression model was 1.049 (95% confidence interval: 1.003-1.098), indicating a positive direction with statistically significant association (&lt;i&gt;P&lt;/i&gt; = 0.037). There was no significant association between proteinuria and the degree of hypertension or estimated creatinine clearance. Ten children underwent renal biopsy. Crescents (less than 50%) were demonstrated in five children, while three children had typical diffuse proliferative glomerulonephritis. One child had severe acute tubular necrosis, and another had crescentic glomerulonephritis (crescents &gt; 50%). The immunofluorescence studies revealed deposition of immunoglobulin G and C3 in all biopsy specimens.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;High-degree proteinuria was significantly associated with elevated serum creatinine (&gt; 100 μmol/L) in children with PSAGN. The majority of children with persistent proteinuria ≥ 2+ for more than 2 weeks and the highest recorded","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"100885"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, laboratory, and therapeutic differences between immunoglobulin E-mediated and non-immunoglobulin E-mediated cow's milk protein allergy in children.","authors":"Hasan M Isa, Marwa J Abdulnabi, Nawra S Naser, Fatema N Lahmda, Noor M AlAnsari, Zahra H Isa, Afaf M Mohamed","doi":"10.5409/wjcp.v14.i1.100386","DOIUrl":"10.5409/wjcp.v14.i1.100386","url":null,"abstract":"<p><strong>Background: </strong>Although breast milk is ideal for newborns, in some cases, it is replaced with cow's milk, which contains proteins that increase the risk of cow's milk protein allergy (CMPA).</p><p><strong>Aim: </strong>To evaluate CMPA prevalence in Bahrain and compare clinical characteristics of children with immunoglobulin E (IgE)- and non-IgE-mediated CMPA.</p><p><strong>Methods: </strong>This retrospective cohort study examined children with CMPA diagnosed at the pediatric gastroenterology outpatient clinic of the Salmaniya Medical Complex, Bahrain, between 2014 and 2022, and assessed CMPA prevalence. Clinical presentations, laboratory findings, dietary modifications, and outcomes were compared between children with IgE-mediated and non-IgE-mediated CMPA. Categorical variables were compared using Fisher's exact test or Pearson's <i>χ</i> ² test, whereas continuous variables were compared using Student's <i>t</i>-test or the Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>Of 8332 patients, 6022 (72.3%) adhered to their appointment. Of them, 618 (10.3%) were suggested of having CMPA and 595 (96.3%) were included; CMPA prevalence was 2%. Most patients were Bahraini (93.8%) and males (55.3%). Non-IgE-mediated type accounted for 77.3% cases and IgE-mediated type, 22.7%. IgE-mediated CMPA presented more in boys (<i>P</i> = 0.030), and later in life (5.1 months ± 4.5 months <i>vs</i> 4.2 months ± 4.2 months, <i>P</i> = 0.016, 95%CI: 0.08-1.73), had more associated diseases (<i>P</i> < 0.001); and presented with more cutaneous (<i>P</i> = 0.024) and respiratory (<i>P</i> = 0.003) manifestations, severe symptoms [rash/dry skin (<i>P</i> = 0.031), facial swelling/angioedema (<i>P</i> = 0.003), failure to thrive (<i>P</i> = 0.013), apparent life-threatening event (<i>P</i> < 0.001)], and positive physical findings (<i>P</i> = 0.002) than non-IgE-mediated CMPA. Most patients were exclusively fed cow milk formula (50.3%). The amino acid-based formula (AAF) was most prescribed (60.5%) with no difference between the two types (<i>P</i> = 0.173). Although breastfeeding was recommended to 49.6%, only 8.2% were exclusively breastfed. IgE-mediated CMPA was associated with a longer follow-up duration than non-IgE-mediated CMPA (17.3 months ± 14.0 months <i>vs</i> 13.5 months ± 13.4 months, <i>P</i> = 0.005, 95%CI: 1.1-6.3).</p><p><strong>Conclusion: </strong>This study revealed a high CMPA prevalence with clinical differences between both types that can influence treatment. AAF was most prescribed, while breastfeeding with dietary modification is rarely applied.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"100386"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and epigenetic alterations associated with gestational diabetes mellitus and adverse neonatal outcomes.","authors":"Amreen Shamsad, Tanu Gautam, Renu Singh, Monisha Banerjee","doi":"10.5409/wjcp.v14.i1.99231","DOIUrl":"10.5409/wjcp.v14.i1.99231","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) is a metabolic disorder, recognised during 24-28 weeks of pregnancy. GDM is linked with adverse newborn outcomes such as macrosomia, premature delivery, metabolic disorder, cardiovascular, and neurological disorders. Recent investigations have focused on the correlation of genetic factors such as β-cell function and insulin secretary genes (transcription factor 7 like 2, potassium voltage-gated channel subfamily q member 1, adiponectin <i>etc.</i>) on maternal metabolism during gestation leading to GDM. Epigenetic alterations like DNA methylation, histone modification, and miRNA expression can influence gene expression and play a dominant role in feto-maternal metabolic pathways. Interactions between genes and environment, resulting in differential gene expression patterns may lead to GDM. Researchers suggested that GDM women are more susceptible to insulin resistance, which alters intrauterine surroundings, resulting hyperglycemia and hyperinsulinemia. Epigenetic modifications in genes affecting neuroendocrine activities, and metabolism, increase the risk of obesity and type 2 diabetes in offspring. There is currently no treatment or effective preventive method for GDM, since the molecular processes of insulin resistance are not well understood. The present review was undertaken to understand the pathophysiology of GDM and its effects on adverse neonatal outcomes. In addition, the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"99231"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologics in the management of pediatric inflammatory bowel disease: When and what to choose.","authors":"Arghya Samanta, Anshu Srivastava","doi":"10.5409/wjcp.v14.i1.100938","DOIUrl":"10.5409/wjcp.v14.i1.100938","url":null,"abstract":"<p><p>Pediatric inflammatory bowel disease (PIBD) is a chronic inflammatory disorder of the gastrointestinal tract, with rising global incidence and prevalence. Over the past two decades, biologics have added to the therapeutic armamentarium and revolutionized the approach to treatment of inflammatory bowel disease. The available biologics include monoclonal antibodies which target inflammatory cytokines (anti-tumor necrosis factor alpha, anti-interleukin 12/23) or recruitment of leucocytes to the gastrointestinal tract (anti-alpha4beta7 integrin) and small molecules (Janus kinase inhibitors, sphingosine 1-phosphate-inhibitors) which modify the proinflammatory signaling. Considering their potential disease-modifying ability, recent pediatric guidelines from the West have advocated upfront use of biologics in appropriate clinical scenarios as a top-down approach rather than the conventional step-up approach. Although real-world studies are available regarding the clinical efficacy of biologics in PIBD, there is paucity of long-term outcome and safety data in children. Also, little information is available about the best approach in the newly industrialized - developing countries where PIBD is rising but at the same time, infections are prevalent and resources are limited. In this review, we summarize the efficacy and safety profile of biologics and small molecule drugs and discuss the challenges in the management of PIBD, especially in the developing world, and future directions.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"100938"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psycho-gastroenterological profile of an Italian population of children with disorders of gut-brain interaction: A case-control study.","authors":"Valentina Giorgio, Ilaria Venezia, Licia Pensabene, Elisa Blasi, Donato Rigante, Paolo Mariotti, Giuseppe Stella, Gaia Margiotta, Giovanna Quatrale, Giuseppe Marano, Marianna Mazza, Antonio Gasbarrini, Eleonora Gaetani","doi":"10.5409/wjcp.v14.i1.97543","DOIUrl":"10.5409/wjcp.v14.i1.97543","url":null,"abstract":"<p><strong>Background: </strong>Disorders of gut-brain interaction (DGBI) are common, but knowledge about their physiopathology is still poor, nor valid tools have been used to evaluate them in childhood.</p><p><strong>Aim: </strong>To develop a psycho-gastroenterological questionnaire (PGQ) to assess the psycho-gastroenterological profile and social characteristics of a pediatric population with and without DGBI.</p><p><strong>Methods: </strong>One hundred and nineteen Italian children (age 11-18) were included: 28 outpatient patients with DGBI (Rome IV criteria) and 91 healthy controls. They filled the PGQ, faces pain scale revised (FPS-R), Bristol stool chart, gastrointestinal symptoms rating scale, state-trait anxiety inventory, Toronto alexithymia scale 20, perceived self-efficacy in the management of negative emotions and expression of positive emotions (APEN-G, APEP-G), irritable bowel syndrome-quality of life questionnaire, school performances, tobacco use, early life events, degree of digitalization.</p><p><strong>Results: </strong>Compared to controls, patients had more medical examinations (35% of them went to the doctor more than five times), a higher school performance (23% <i>vs</i> 13%, <i>P</i> < 0.05), didn't use tobacco (never <i>vs</i> 16%, <i>P</i> < 0.05), had early life events (28% <i>vs</i> 1% <i>P</i> < 0.05) and a higher percentage of pain classified as 4 in the FPS-R during the examination (14% <i>vs</i> 7%, <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Pediatric outpatients with DGBI had a higher prevalence of early life events, a lower quality of life, more medical examinations rising health care costs, lower anxiety levels.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"97543"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of photon-counting computed tomography in pediatric cardiovascular imaging.","authors":"Arosh S Perera Molligoda Arachchige, Yash Verma","doi":"10.5409/wjcp.v14.i1.99288","DOIUrl":"10.5409/wjcp.v14.i1.99288","url":null,"abstract":"<p><p>Photon-counting computed tomography (PCCT) represents a significant advancement in pediatric cardiovascular imaging. Traditional CT systems employ energy-integrating detectors that convert X-ray photons into visible light, whereas PCCT utilizes photon-counting detectors that directly transform X-ray photons into electric signals. This direct conversion allows photon-counting detectors to sort photons into discrete energy levels, thereby enhancing image quality through superior noise reduction, improved spatial and contrast resolution, and reduced artifacts. In pediatric applications, PCCT offers substantial benefits, including lower radiation doses, which may help reduce the risk of malignancy in pediatric patients, with perhaps greater potential to benefit those with repeated exposure from a young age. Enhanced spatial resolution facilitates better visualization of small structures, vital for diagnosing congenital heart defects. Additionally, PCCT's spectral capabilities improve tissue characterization and enable the creation of virtual monoenergetic images, which enhance soft-tissue contrast and potentially reduce contrast media doses. Initial clinical results indicate that PCCT provides superior image quality and diagnostic accuracy compared to conventional CT, particularly in challenging pediatric cardiovascular cases. As PCCT technology matures, further research and standardized protocols will be essential to fully integrate it into pediatric imaging practices, ensuring optimized diagnostic outcomes and patient safety.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"99288"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal glucosuria in children.","authors":"Meral Torun Bayram, Salih Kavukcu","doi":"10.5409/wjcp.v14.i1.91622","DOIUrl":"10.5409/wjcp.v14.i1.91622","url":null,"abstract":"<p><p>The kidneys play a critical role in maintaining glucose homeostasis. Under normal renal tubular function, most of the glucose filtered from the glomeruli is reabsorbed in the proximal tubules, leaving only trace amounts in the urine. Glycosuria can occur as a symptom of generalized proximal tubular dysfunction or when the reabsorption threshold is exceeded or the glucose threshold is reduced, as seen in familial renal glycosuria (FRG). FRG is characterized by persistent glycosuria despite normal blood glucose levels and tubular function and is primarily associated with mutations in the <i>sodium/glucose cotransporter 5A2</i> gene, which encodes the sodium-glucose cotransporter (SGLT) 2. Inhibiting SGLTs has been proposed as a novel treatment strategy for diabetes, and since FRG is often considered an asymptomatic and benign condition, it has inspired preclinical and clinical studies using SGLT2 inhibitors in type 2 diabetes. However, patients with FRG may exhibit clinical features such as lower body weight or height, altered systemic blood pressure, diaper dermatitis, aminoaciduria, decreased serum uric acid levels, and hypercalciuria. Further research is needed to fully understand the pathophysiology, molecular genetics, and clinical manifestations of renal glucosuria.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"91622"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selenoprotein P1 as a biomarker of insulin resistance in pediatric obesity: Insights and implications.","authors":"Chun-Han Cheng, Wen-Rui Hao, Tzu-Hurng Cheng","doi":"10.5409/wjcp.v14.i1.99652","DOIUrl":"10.5409/wjcp.v14.i1.99652","url":null,"abstract":"<p><p>This editorial discusses the findings of Elbarky <i>et al</i> on the role of selenoprotein P1 (SEPP1) in pediatric obesity and insulin resistance. Their study uncovered significantly lower SEPP1 Levels in children who were obese compared with healthy peers, demonstrating a negative correlation between SEPP1 levels and measures of adiposity and insulin resistance. These findings suggest that SEPP1 is a biomarker useful in the early identification of insulin resistance in pediatric populations. This editorial emphasizes the clinical implications of the study and calls for further research to validate and explore the role of SEPP1 in metabolic health.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"99652"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital anomalies of coronary artery misdiagnosed as coronary dilatations in Kawasaki disease: A clinical predicament.","authors":"Rakesh Kumar Pilania, Pallavi L Nadig, Suprit Basu, Reva Tyagi, Abarna Thangaraj, Ridhima Aggarwal, Munish Arora, Arun Sharma, Surjit Singh, Manphool Singhal","doi":"10.5409/wjcp.v14.i1.99177","DOIUrl":"10.5409/wjcp.v14.i1.99177","url":null,"abstract":"<p><strong>Background: </strong>2D-echocardiography (2DE) has been the primary imaging modality in children with Kawasaki disease (KD) to assess coronary arteries.</p><p><strong>Aim: </strong>To report the presence and implications of incidental congenital coronary artery anomalies that had been misinterpreted as coronary artery abnormalities (CAAs) on 2DE.</p><p><strong>Methods: </strong>Records of children diagnosed with KD, who underwent computed tomography coronary angiography (CTCA) at our center between 2013-2023 were reviewed. We identified 3 children with congenital coronary artery anomalies in this cohort on CTCA. Findings of CTCA and 2DE were compared in these 3 children.</p><p><strong>Results: </strong>Of the 241 patients with KD who underwent CTCA, 3 (1.24%) had congenital coronary artery anomalies on CTCA detected incidentally. In all 3 patients, baseline 2DE had identified CAAs. CTCA was then performed for detailed evaluation as per our unit protocol. One (11-year-boy) amongst the 3 patients had complete KD, while the other two (3.3-year-boy; 4-month-girl) had incomplete KD. CTCA revealed separate origins of left anterior descending artery and left circumflex from left sinus [misinterpreted as dilated left main coronary artery (LCA) on 2DE], single coronary artery (interpreted as dilated LCA on 2DE) and dilated right coronary artery on 2DE in case of anomalous origin of LCA from the main pulmonary artery. The latter one was subsequently operated upon.</p><p><strong>Conclusion: </strong>CTCA is essential for detailed assessment of coronary arteries in children with KD especially in cases where there is suspicion of congenital coronary artery anomalies. Relying solely on 2DE may not be sufficient in such cases, and findings from CTCA can significantly impact therapeutic decision-making.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 1","pages":"99177"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}