World journal of clinical pediatrics最新文献

{"title":"Longitudinal extensive anti-AMPA-GluR3-related transverse myelitis and favorable therapeutic response: A case report and review of literature.","authors":"Maria Elena Cucuzza, Piero Pavone, Maria T Garozzo, Maria C Finocchiaro, Filippo Greco, Pierluigi Smilari, Alessandra Di Nora, Martino Ruggieri, Vita A Di Stefano","doi":"10.5409/wjcp.v15.i1.113155","DOIUrl":"10.5409/wjcp.v15.i1.113155","url":null,"abstract":"<p><strong>Background: </strong>Longitudinally extensive transverse myelitis (LETM) is defined as a spinal cord lesion that extends over three or more consecutive vertebral segments. It is a key manifestation of various inflammatory and demyelinating disorders of the central nervous system. We have described a rare case of a probable association between LETM and the presence of high serum and cerebrospinal fluid levels of metabotropic glutamate receptor 3 antibodies (mGluR3abs) in a 5-year-old girl. LETM is a neurological disorder characterized by a spinal cord lesion extending over three or more vertebral segments.</p><p><strong>Case summary: </strong>We report a case of a 5-year-old Caucasian girl affected by LETM, along with a review of the literature. The patient presented with lower back pain, varying degrees of bilateral sensory and motor deficits, and autonomic dysfunction. Magnetic resonance imaging showed hyperintense signals involving the spinal cord from C3 to the conus medullaris, suggesting a diagnosis of LETM. Laboratory analysis revealed high levels of mGluR3abs in both serum and cerebrospinal fluid. The patient responded favorably to treatment with high doses of intravenous methylprednisolone and immunoglobulin therapy, which has been shown to be particularly effective in children.</p><p><strong>Conclusion: </strong>The frequency of LETM associated with mGluR3abs is unknown; this report may contribute to expanding the understanding of it.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"113155"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517421","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":"Therapeutic interventions and pulmonary function in pediatric patients with post-infectious bronchiolitis obliterans.","authors":"Serena Chiellino","doi":"10.5409/wjcp.v15.i1.111021","DOIUrl":"10.5409/wjcp.v15.i1.111021","url":null,"abstract":"<p><p>Post-infectious bronchiolitis obliterans (PIBO) is a rare chronic obstructive pulmonary disease affecting children after a severe respiratory infection. The primary goal of this narrative review is to synthesize evidence on pulmonary function in children with PIBO, with a focus on spirometric indices, and to evaluate the efficacy of therapies reported in the literature. It also provides an overview of the disease's epidemiology, risk factors, clinical presentation and diagnostic methods. Studies reported various spirometric parameters including forced expiratory volume in one second, forced vital capacity, the ratio between these two parameters, and forced expiratory flow at 25%-75%. A narrative synthesis described therapies including bronchodilators, corticosteroids, macrolides, combination regimens, novel therapies and non-pharmacological interventions. Most studies were small, but data showed moderate to severe impairments in pulmonary function in pediatric PIBO, with mild heterogeneity. Corticosteroids and combined therapies offered short-term relief, but long-term benefits were limited by adverse effects. Pulmonary rehabilitation may preserve lung function and quality of life, although evidence remains scarce. Given the limited research on therapy and pulmonary outcomes, further studies are necessary to understand the long-term effects of treatments. This review underscores the urgent need for multicenter studies and evidence-based guidelines to improve care for children with PIBO.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111021"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517431","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":"Early inotropic support without fluid bolus <i>vs</i> standard resuscitation in pediatric septic shock: A randomized controlled trial.","authors":"Swasti Keshri, Anil K Goel, Ankit Kumar Garg, Varun Anand, Sanosh Kumar Rathia, Samreen Yusuf","doi":"10.5409/wjcp.v15.i1.109864","DOIUrl":"10.5409/wjcp.v15.i1.109864","url":null,"abstract":"<p><strong>Background: </strong>The current 2020 surviving sepsis guideline recommends fluid boluses of 10-20 mL/kg/bolus up to 40-60 mL/kg, but recent studies showed better outcomes when fluid boluses were restricted.</p><p><strong>Aim: </strong>To analyze the outcome of initial resuscitation of septic shock without giving fluid bolus and early initiation of inotropes.</p><p><strong>Methods: </strong>In this open label, randomized controlled clinical trial conducted at the Pediatric Emergency Medicine unit of a tertiary care hospital in central India, patients aged 1 month to 14 years who were hospitalized for septic shock were randomly allocated (1:1) to receive either inotropes (Group I) or fluid bolus as per surviving sepsis guideline (Group F). We analyzed the primary endpoint (either the resolution of shock or the patient's clinical status at 1 h from the initiation of resuscitation, whichever occurred first) by the intention-to-treat. Both the groups were compared in terms of reversal of shock, the mean time for reversal of shock, adverse effects including mortality at 48 h, and overall mortality.</p><p><strong>Results: </strong>Out of 119 patients with septic shock, 49 were included in the final analysis (24 patients in Group I and 25 patients in Group F. 16/49 (32.65%) patients had compensated shock, and 33/49 (67.35%) had hypotensive shock. During the initial resuscitation phase, shock resolved in all (100%) of the patients in Group I. In Group F only in 19/25 (76.00%) patients experienced resolution of shock. The mean time of resolution of shock was significantly shorter in Group I (83.98 + 42.02 min) compared with Group F (116.72 + 41.67 min, <i>P</i> = 0.015). Invasive mechanical ventilation was required in 34/49 (69.40%) and was comparable across the groups. In the comparator Group F, 16/25 (65.00%) of the patients had some features of fluid overload. There was no statistical difference in the initial vasoactive inotropic support score, the total duration of ventilation, total length of hospital stay, mortality at 48 h, and overall mortality across the two groups. In a subgroup analysis of patients with hypotensive shock, mortality at 48 h was significantly higher in patients of Group F (9/17, 52.94%) than in patients of Group I (3/16, 18.75%, <i>P</i> = 0.041). The overall mortality rate in the study subjects was 24/49 (49.00%), and it was positively correlated with the Pediatric Sequential Organ Failure Assessment- Lactate score and maximum vasoactive inotropic support scores.</p><p><strong>Conclusion: </strong>The use of fluid boluses in pediatric septic shock is dubious and contributes to fluid overload. The management of septic shock in children involves the use of adjuncts such as bedside ultrasound, early inotropes, and restricted and well-regulated fluid boluses.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"109864"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517440","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":"Efficacy and safety of semirigid ureterolithotripsy in pediatric urolithiasis: Retrospective analysis from a tertiary center.","authors":"Ulugbek Khudaybergenov, Azizbek Shomarufov, Olimjon Abdukarimov, Yalkin Nadjimitdinov","doi":"10.5409/wjcp.v15.i1.115147","DOIUrl":"10.5409/wjcp.v15.i1.115147","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ureterolithotripsy (EUL) is a minimally invasive and effective treatment for pediatric ureteral stones, offering high success rates while addressing anatomical challenges unique to children.</p><p><strong>Aim: </strong>To evaluate the success and safety of EUL in pediatric patients, focusing on lithotripsy technique, stone location, and patient-specific variables.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 250 children treated with EUL from 2015 to 2022. Laser and pneumatic lithotripsy techniques were compared in terms of stone-free rate (SFR), operative duration, and complication rates. Outcomes were also analyzed by stone location and patient age.</p><p><strong>Results: </strong>The overall SFR was 92.1%, with rates of 94% for distal, 89% for mid-ureteral, and 91% for proximal stones (<i>P</i> = 0.07). Laser lithotripsy showed a slightly higher success rate than pneumatic lithotripsy (<i>P</i> = 0.08) and slightly shorter operative times (<i>P</i> = 0.1). The mean procedure duration was 42.8 ± 16.3 minutes and was longer for proximal stones (<i>P</i> = 0.04). The overall complication rate was 12.4%, with the highest incidence among children aged 4-7 years (<i>P</i> = 0.02). Average hospital stay was 2.3 ± 0.5 days, with no significant intergroup differences.</p><p><strong>Conclusion: </strong>EUL is a safe and effective treatment for pediatric ureterolithiasis. Laser lithotripsy offers a slightly procedural time advantage, while younger patients are more prone to intraoperative challenges. These findings support EUL as a first-line treatment, with careful planning needed for younger children.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"115147"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517447","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":"Interplay of childhood metabolic dysfunction-associated steatotic liver disease and obesity in the development of youth-onset type 2 diabetes.","authors":"Razieh Parizad, Juniali Hatwal, Ajit Singh Brar, Leila Alizadeh, Manjeet Kumar Goyal, Akash Batta, Bishav Mohan","doi":"10.5409/wjcp.v15.i1.111030","DOIUrl":"10.5409/wjcp.v15.i1.111030","url":null,"abstract":"<p><strong>Background: </strong>The global increase in childhood and adolescent obesity has significantly contributed to the rising prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) - a condition now recognized as a key metabolic complication in youth. MASLD significantly increases the risk of youth-onset type 2 diabetes (T2D), particularly among obese individuals. Its asymptomatic progression presents considerable challenges for timely diagnosis and intervention.</p><p><strong>Aim: </strong>To review epidemiology, pathophysiological mechanisms, and management strategies related to pediatric MASLD, exploring its interaction with obesity and youth-onset T2D.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar to identify peer-reviewed studies published between 2015 and 2025. Keywords included \"pediatric MASLD\", \"childhood obesity\", \"youth-onset type 2 diabetes\", \"hepatic insulin resistance\", and \"noninvasive biomarkers\". Articles were selected based on relevance, methodological quality, and focus on human pediatric populations.</p><p><strong>Results: </strong>MASLD affects approximately 13% of children globally and up to 47% of those with obesity, with the highest prevalence reported in urban areas of the United States, China, and India. In children and adolescents, excess adiposity is the leading contributor to hepatic steatosis and metabolic dysfunction, particularly when body mass exceeds standard growth benchmarks for age and sex. MASLD increases the risk of adolescent T2D by approximately 2.7-fold. Key pathophysiological mechanisms include hepatic insulin resistance, mitochondrial dysfunction, and chronic inflammation, driven by lipotoxic metabolites such as ceramides and pro-inflammatory cytokines. Lifestyle modifications - particularly low free-sugar diets and structured physical activity - have demonstrated moderate efficacy in reducing hepatic fat and improving metabolic outcomes. Pharmacologic interventions, including glucagon-like peptide-1 receptor agonists such as liraglutide and semaglutide, show potential for weight reduction and glycemic control, though their effects on hepatic histology remain under investigation.</p><p><strong>Conclusion: </strong>MASLD represents a critical metabolic threat in pediatric populations, strongly influenced by obesity and closely associated with increased risk of youth-onset T2D. Effective management requires early detection, multidisciplinary interventions, and equitable access to care. Future research should prioritize the validation of noninvasive diagnostic tools, development of targeted therapies, and reduction of socioeconomic and ethnic disparities in disease burden and treatment outcomes.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"111030"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517380","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 plasma D-dimer levels as diagnostic and prognostic marker in neonatal sepsis: An insightful support.","authors":"Alessandro Boscarelli","doi":"10.5409/wjcp.v15.i1.115780","DOIUrl":"10.5409/wjcp.v15.i1.115780","url":null,"abstract":"<p><p>Neonatal sepsis remains a serious health problem with significant morbidity and mortality. Clinical diagnosis at presentation is often challenging due to nonspecific signs and symptoms. Laboratory biomarkers, blood cultures, and other diagnostic/prognostic tools such as the hematological scoring system developed by Rodwell and the neonatal organ failure assessment are not considered reliable for routine clinical use. Basiouny <i>et al</i> conducted a two-center prospective case-control study investigating the diagnostic and prognostic utility of D-dimer and heparin-binding protein in neonatal sepsis. Despite several limitations of their study, the present research provides novel insight into the role of plasma D-dimer levels in the diagnosis and prognosis of neonatal sepsis. While future multicenter studies with larger patient populations are required, these findings suggest the utility of D-dimer inclusion into sepsis multi-marker diagnostic models for newborns in order to complement rather than replace existing tools.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"115780"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517443","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":"Could high serum C-reactive protein levels serve as a biomarker for children and adolescents diagnosed with generalized anxiety disorder?","authors":"Kübranur Ünal, Yasemin Taş Torun, Mehmet Emre Erol, Zeynep Kübra Kurt, Cansu Özbaş","doi":"10.5409/wjcp.v15.i1.115246","DOIUrl":"10.5409/wjcp.v15.i1.115246","url":null,"abstract":"<p><strong>Background: </strong>Generalized anxiety disorder (GAD) is a prevalent psychiatric condition in children and adolescents, frequently linked to difficulties in daily functioning and academic performance. Increasing evidence suggests that immune dysregulation and neuroinflammatory pathways contribute to its pathophysiology, yet studies examining circulating cytokines and related biomarkers in pediatric populations are still scarce.</p><p><strong>Aim: </strong>To investigate serum levels of C-reactive protein (CRP), tumor necrosis factor-like weak inducer of apoptosis, neopterin, interleukin-6, tumor necrosis factor-alpha, interferon-gamma, and zinc in drug-naïve children and adolescents with GAD, to gain insight into potential immune-related alterations.</p><p><strong>Methods: </strong>The observational case-control design was conducted, including 25 drug-naïve patients with 'pure' GAD and 30 healthy controls aged 8-18 years. Psychiatric diagnoses were confirmed by the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the Revised Child Anxiety and Depression Scale. Venous blood samples were analyzed using enzyme-linked immunosorbent assay, nephelometry, and electro-chemiluminescence assays. Group comparisons were performed using the Mann-Whitney <i>U</i> test and the <i>χ</i> ² test, and correlations were assessed using Spearman's correlation.</p><p><strong>Results: </strong>CRP levels were significantly higher in the GAD group than controls (median 1.7 mg/L <i>vs</i> 1.3 mg/L, <i>P</i> = 0.034, <i>r</i> = 0.32). No significant group differences were observed for tumor necrosis factor-alpha tumor necrosis factor-like weak inducer of apoptosis, interleukin-6, interferon-gamma, zinc, or neopterin. Time since symptom onset was positively correlated with total anxiety severity (<i>r</i> = 0.729, <i>P</i> = 0.001). Receiver operating characteristic analysis showed modest diagnostic value for CRP (area under the curve = 0.665, 95% confidence interval: 0.511-0.820).</p><p><strong>Conclusion: </strong>This study demonstrates a moderate elevation in CRP levels in drug-naïve patients with GAD. Although no change in other inflammatory markers was observed in our study, this may suggest a low-grade inflammatory response. The early detection of symptoms is still critical, and more longitudinal studies with larger samples are necessary further to elucidate the role of inflammation in childhood anxiety pathophysiology.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"115246"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517396","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":"Mucopolysaccharidosis type VI in the Russian registry: Further insights and considerations.","authors":"Sajid Malik","doi":"10.5409/wjcp.v15.i1.114152","DOIUrl":"10.5409/wjcp.v15.i1.114152","url":null,"abstract":"<p><p>This commentary evaluates the recent registry-based study of mucopolysaccharidosis type VI by Vechkasova <i>et al</i>, highlighting several methodological and reporting concerns that limit the interpretation of the findings. Although the establishment of a national registry is commendable and need of the time, the authors report an absence of correlations between clinical severity, age of onset, enzyme activity, and nucleotide variants without presenting any supporting statistical analyses or genotype-phenotype assessments. The dataset also appears affected by survivorship bias, and inconsistencies in reporting patient outcomes. Important clinical and genetic details, such as gender-stratified characteristics, variant zygosity and phasing, and American College of Medical Genetics and Genomics-based variant interpretation, are missing. Additionally, the use of inaccurate terminology and unclear prevalence calculations further complicates the interpretation. While the registry represents an important step toward understanding mucopolysaccharidosis type VI in Russia, improved methodological transparency, consistent terminology, and clearer data presentation are essential to strengthen the utility of these findings.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"114152"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517402","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":"Proteomic biomarkers for early diagnosis and prognosis in pediatric sepsis.","authors":"Guldana Sabitova, Zhalaliddin Makhammajanov, Marina Khvan, Pavel Tarlykov, Vitaliy Sazonov","doi":"10.5409/wjcp.v15.i1.114054","DOIUrl":"10.5409/wjcp.v15.i1.114054","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of pediatric sepsis is difficult because of the lack of specific clinical signs and limitations of standard biomarkers. Proteomics is a promising approach because it can identify disease-specific protein signatures.</p><p><strong>Aim: </strong>To systematically evaluate the current literature on the application of proteomics in pediatric sepsis, review and evaluate the current evidence on proteomic biomarkers for diagnosing and predicting pediatric sepsis.</p><p><strong>Methods: </strong>This is a systematic review with a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-informed, structured search and transparent study-selection reporting. A structured literature search was conducted in PubMed, Scopus, and Web of Science up to January 2025. Studies involving pediatric patients (ages 0-18) with sepsis that used proteomic platforms and reported diagnostic or prognostic outcomes were included.</p><p><strong>Results: </strong>Four studies met the inclusion criteria. Identified biomarkers included interleukin-27, signal transducer and activator of transcription 3, haptoglobin, serum amyloid A 1/2, soluble CD25, and leucine-rich alpha-2-glycoprotein 1. Sensitivities ranged from 60% to 86%, and specificities ranged from 75% to 92%. Multi-marker panels demonstrated superior diagnostic performance compared to single markers. Biomarkers were detectable within 2-6 hours of symptom onset. The analytical methods used varied and included enzyme-linked immunosorbent assays, liquid chromatography-tandem mass spectrometry, and SOMAscan. Most studies were exploratory and lacked external validation; they also used small, heterogeneous cohorts.</p><p><strong>Conclusion: </strong>Proteomics shows promise for earlier and more precise diagnostics of pediatric sepsis, but clinical translation is limited by small, single-center cohorts; age-dependent variability without developmental reference ranges; scarce longitudinal profiling; and minimal external validation. The priority now is multicenter, age-stratified, longitudinal studies with real-world comparators.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"114054"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516750","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":"Assessing joint damage in juvenile idiopathic arthritis: Guide for prescribing physical exercise with the juvenile arthritis damage index.","authors":"Wlaldemir Roberto Dos Santos","doi":"10.5409/wjcp.v15.i1.113152","DOIUrl":"10.5409/wjcp.v15.i1.113152","url":null,"abstract":"<p><p>Juvenile idiopathic arthritis (JIA) is a chronic disease capable of causing significant structural and functional damage. The study by Kolkhidova <i>et al</i> demonstrated that baseline structural damage, assessed by the juvenile arthritis damage index (JADI), is a strong predictor of poor response to biological treatment. While promising, these findings require validation in larger and more diverse cohorts to enhance external applicability. In addition to reinforcing early pharmacological decision-making, these results highlight the importance of integrating a precise damage assessment into rehabilitation planning, as it can support individualized exercise prescriptions and targeted physiotherapy. JADI can identify patients with established lesions, such as contractures, who may benefit from personalized physical exercise and physiotherapy programs. A more explicit emphasis on how damage assessment guides functional planning can improve the clinical applicability of these findings. Early integration of rehabilitation alongside medication therapy can help not only restore function but also prevent further deterioration, improve adherence, and foster long-term self-management. Incorporating JADI assessment into clinical practice can optimize exercise prescription, improve mobility and strength, and ultimately enhance quality of life in patients with JIA.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"15 1","pages":"113152"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517370","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}